The latest psychotherapist to practice on these shores

With a new teaching position in Marmara University’s Psychiatry Department, Dr. Axel Würz relocated to Istanbul last month after living in London for nine years. Settling into his new apartment this week on the Asian side of Istanbul in Uskudar, he talked with the Hürriyet Daily News & Economic Review in the Istanbul neighborhood’s bustling fish market.

When a Turkish colleague presented an opportunity to work in Turkey, Würz made the move with little hesitation. "He said Turkey is never boring," Würz said, agreeing with the view after frequent visits in recent years. "This means that when I sit somewhere waiting for the bus or dolmuş there is lots of human activity in every sense." In London and his native Germany, he had missed this type of pulse.

"Here you can do a bit of people watching and bit of work at the same time," he said. Without a trace of sarcasm or complaint, Würz said he had noticed that many Turkish people find it difficult to wait in line. "There is a certain urgency people have of ’If I don’t get it now, I might not ever get it,’" he said.

An expert in cognitive behavioral therapy, his expertise ranges from family, adolescent and addiction therapy to clinical hypnosis and post traumatic stress disorder. A member of the Royal College of Psychiatrists and the British Society of Clinical Hypnosis, the trined neurologist also has a few languages in his repertoire: English, Spanish, Turkish and some French.

The aim of behavioral therapy is to enable the patient to take control of his own health. "When we experience pain or emotional distress we often feel out of control," he said. Cognitive behavioral therapy tries to provide the patient with some empowerment through a collaborative approach. "Rumor has it that in Turkey that doesn’t happen easily," he said. "People expect to sit before the doctor at the big desk." Perhaps changing this view is a matter of people simply waiting for opportunities to interact on more equal footing, Würz said.

Würz has worked extensively with people who experience post-traumatic stress disorder and anxiety disorder. "Emotional disorders contribute to physical symptoms that are expressions of trauma and anxiety." He said his background might benefit people in Turkey who have anxiety resulting from traffic accidents and earthquakes. Earning a degree Ğ with distinction Ğ in Clinical and Applied Hypnosis from University College London, he said hypnosis has the most success in helping control both acute and chronic pain, allowing the patient to take control of the pain.

Working with police in London after the 2005 train bombings, he recalled that some officers had viewed the bombing as a personal failure. Patients suffering from trauma need to complete the story of what happened by recreating the scene, he said. One off-duty police woman in the metro at the time was finally able to enter the London underground after 20 therapy sessions with Würz. "Usually when people understand the source of avoidance behaviors, the anxiety no longer dominates."

Inhibitions rooted in tradition
While visiting a colleague in the Anatolian city of Zile, Würz met a fellow cognitive behavioral therapist who told him that the locals seeking therapy were almost all women. "There could be a greater reluctance in some parts of Turkey where the traditional understanding of masculinity might prevent some men from seeking therapy at all," Würz said. But he had seen male patients in London from strict Muslim populations such as Somalia and Afghanistan overcome their reluctance to seek therapy. When a Muslim man from Somalia asked a question about sexuality that he had never brought himself to ask, Würz noticed that the man was able to address other issues that had once encumbered him.

While sitting in on a lively lecture on sexuality for first-year medical students at Marmara University, Würz noticed the students’ lack of exposure to information. "It was apparent that acceptance of differences in sexual orientation had not been part of the students’ basic education."

London’s general acceptance of multiculturalism is quite different from Turkey’s, he said. "It’s still challenging but the acceptance of differences is widespread." Not having enough resources might contribute to Turkish people’s notion that they are not fully established and thus still under attack by outsiders, he added.

Being German often creates a familiarity when he meets Turks, sometimes one he welcomes, sometimes not. With generations of workers and immigrants relocating from Turkey to Germany in the last 60 years, many Turks he meets know someone who lives there. On the other hand, he finds it difficult to relate to some positive reactions. "It’s scary that some people have respect for Germany [regarding the Nazi policy of murdering Jews]".

National traumas
On a trip to the east of Turkey on a postal train, he visited Diyarbakir, Mardin and Van with a Kurdish friend. Next he hopes to rent a car to reach places that are difficult to access by bus or train such as the Black Sea region as well as neighboring Azerbaijan and Turkmenistan.

He said he had been interested for some time in nations with a high incidence of trauma or large populations that have experienced trauma. Würz has seen that victims of genocide and torture have a diminished capacity to create opportunities for themselves. "That also might be affecting parts of Turkey," he said. For people with post traumatic stress (PST), the brain is reduced in size.

"People can recover and recover their memory functions but memory and attention are reduced. There is also a tendency with PST that shows the fewer resources the sufferer had before, the less they are able to recover," Würz said. "This is relevant in a region that has already been deprivedÉ The challenge for Turkey is that out of its huge population, how many will have opportunities to develop their full potential."


Respect for champions

As an amateur photographer, Würz made traditional Turkish oil wrestlers the subject of a photography book he published online last year, "The Art of Turkish Oil Wrestling". In this collection of his photographic work from 2004 to 2007, he documents large and small tournaments, including the granddaddy, the Kırkpınar Festival near Edirne. Today this festival attracts some 1,500 wrestlers from all over Turkey to compete in the three-day Oil Wrestling (Yağlı Güreş) tournament.

On the Web site featuring his book, he writes: "Wrestlers greet their opponents and the spectators in a ritualistic way, involving striding across the field and greeting their opponent in a traditional way. This expresses respect for each other, the spectators and God."

The top competitors, Baş Pehlivan, make up a elite circle but nonetheless must struggle to make a living, Würz said. "When you see them in their wrestling outfits, they are transported to other lives." To see photos from the book: www. artofwestling.net.

Dr. Würz is available for office consultations:
messageaxel@googlemail.com