Meaning Making , Forgiveness , and Gratitude : Nurturing a Healthy , Peaceful , and Prosperous Haiti 1

We have witnessed the growth and resilience of the Haitian people since 2010 and the devastating earthquake, in over fourteen humanitarian missions. In addition, MeaningfulWorld’s global presence, which aims to raise consciousness and nurture resilience and sustainability among local and global communities in Haiti, has highlighted perspectives from vulnerable and marginalized groups including children, women, and traumatized refugees. The results of this work has addressed the ultimate question in resolving emotional and psychological scars and promoting meaning, healing, hope, reconciliation, and trust: what lessons have we learned from our traumatic past? For MeaningfulWorld ambassadors, the only healthy and permanent means of resolution for past traumas is through integration of emotional intelligence (EQ), spiritual connections, love, meaning-making, forgiveness, and empathy, and nurturing gratitude as a basic foundation. This paper will describe the value of cultivating gratitude as a foundation and utilizing forgiveness and meaning-making through post trauma growth, building resilience, and emotional intelligence. Although historically Haiti has shown resilience, while the lessons learned are not only unclear, it is fragmented, misguided, and focused on fear derived from mass spread of horizontal violence, where the majority of the Haitian population pull one another down, and call it the ‘Haitian disease.’

POSITIVE PSYCHOLOGY ACROSS CULTURES AND NATIONS sion was in August of 2019. Gratitude to all our volunteers, especially the 2019 team: Dr. Ani Kalayjian, Justina Medina, Psy.D., Lorraine Simmons, B.F.A., B.S., and Art Jaffe. We also extend special gratitude to Father Wismick and the Symposium International du Centre de Spiritualité et de Santé Mentale (CESSA) organizing committee for their volunteer spirit.

What is Gratitude?
The word gratitude is derived from the Latin word gratus, which means grace, graciousness, or gratefulness (depending on the context) (Merriam-Webster, 2019). In some ways, gratitude encompasses all these meanings. Gratitude is a deep appreciation for what an individual receives, in-kind, an attitude, or material. With gratitude, people have a chance to express their appreciation to what they have, what they feel, and what they intend and to acknowledge the goodness in their lives. In the process, people usually recognize that the source that goodness lies at least partially outside themselves. As a result, gratitude also helps people connect to something larger than themselves as individuals -whether to other people, nature, or a higher power. Instead of feeling grateful to someone, we feel grateful for them and for God or the Spirit working through them. We begin to feel grateful for everyone and everything in our lives and this feeling uplifts us and energizes us. We then help uplift others and embrace others, knowing that we are, in fact, not alone but in this journey together.

Gratitude is Beyond Thank You
The great open secret of gratitude is that it is not dependent on external circumstances. It is like a channel that we can switch to at any moment, no matter what is going on around us, despite stressors, trauma, and disasters. Gratitude helps us connect to our basic right to be here like the breath does. It is a stance of the soul, reinforcing the positive aspects of life.
"Gratitude is the kernel that can flower into everything we need to know."

Importance of Gratitude in our Lives
By being more grateful for what we do have, we can increase our happiness by 25% according to the University of California Psychology Professor Dr. Emmons (Emmons, 2007).
With gratitude, we can cope more effectively with everyday stress. We will have increased resilience in the face of trauma-induced stress. With gratitude, we recover more quickly from illness and benefit from greater health and well-being.
MeaningfulWorld Humanitarian Relief Missions utilize the three-prong approach to reinforce the practice of gratitude: 1) healing & education; 2) research, publications & dissemination through media & print; 3) policy revisions, changing old regulations and integrating our environment. Maintaining a harmonious balance between these three is essential to address multiple challenges of individuals and collective challenges facing Haiti. Seven Strategies for Practicing Gratitude 1. SMART Goals. Although setting goals are emphasized in our educational system, setting goals in our lives outside of formal schools is not often practiced. Goal setting is essential for evaluation, follow-through, and motivation for change. We at MeaningfulWorld recommend setting SMART Goals: Specific, Measurable, Attainable, Realistic, and Timely. Setting goals helps us step into a journey towards deeper satisfaction and happiness, but the satisfaction does not just come at the end when we attain our goal. Our brains produce dopamine (the feel-good hormone released in the pre-frontal cortex of the brain) when a goal is achieved; therefore, we feel good accomplishing our dreams, set forth by our goals. Basic survival mode, meaning obtaining food and sex, are basics of this process, but as humans, we are more complex and aspire for more. We also feel the euphoria of achieving goals such as; high social status, cultivating friendships, bonding with a mate, and witnessing the achievements of our children. This euphoria at achieving a goal is short-lived because the dopamine release comes in a burst rather than a slow release. The process of celebrating only when goals are complete can be frustrating because it is short-lived. When we take time to recognize and be grateful as we are making small steps of progress and while we are moving toward our goals, then the dopamine will be released more often, and the euphoria and satisfaction of the journey will be recognized as fulfilling. Holding an attitude of gratitude for our progress and achievements is essential for a satisfying life.

Disarm Yourself Within:
• Let go of Anger.
• Let go of Negativity.
• Let go of Greed.
• Let go of Envy.
• Let go of Rage.

Morning pages.
Each morning upon waking, discharge by writing anything and everything that comes to your mind. This writing does not have to make sense and does not have to be read by anyone else but you. Think of it like going to the bathroom in the morning -a discharge of waste and toxins from your physical body is essential for your health. Morning pages are a discharge of dreams and unconscious thoughts that need to be discharged to clear your mind.

Gratitude List for Each Morning.
We start each moment with gratitude and therefore making a list. As we awaken in the morning, we open our eyes and we affirm: How wonderful, I can see, thank you for my eyesight. Then we begin hearing our neighbors, Mother Nature and its winds and birds chirping out the window, or the sound of traffic, and we affirm: How wonderful, I can hear, thank you for my hearing. Then we start moving our legs and arms, stretching and shaking off sleep while trying to get out of bed, and we affirm: How wonderful, I can move my body, my limbs are working fine. Then we smell the aroma of coffee and eggs and the toast from the neighbors or the fragrance of flowers, the fresh-cut grass, and we affirm: How wonderful, I can smell. We then take a deep breath and affirm: How wonderful, I can breathe, breath is central to my health and well-being. Then I hold my child, or my pet, or touch my plants and feel the richness of Mother Earth between my fingers and I affirm: How wonderful, I can touch and POSITIVE PSYCHOLOGY ACROSS CULTURES AND NATIONS feel, hold and embrace. Thus, we have generated a list of six areas that we are grateful for in a short 15 minutes of awakening.

7-Step Integrative Healing Model.
The earthquake in Haiti served as a grave reminder that a disaster can come without warning and therefore, our mitigation and preparation must always be ready in order to strengthen our response. Our organization's 7-Step Healing Model is a tool through which traumatic experiences are assessed, identified, explored, described, processed and reintegrated (Kalayjian, Diakonova-Curtis, 2019). The model builds from the integration of multiple theories including psychodynamic (Freud, 1910), interpersonal (Sullivan, 1953), existential and humanistic (Frankl, 1962;Kalayjian, Diakonova-Curtis, 2019), Electromagnetic Field Balancing (Dubro, Lapierre, 2002), adult learning theories, Flower Remedies (FesFlowers.com), mindfulness, and meditation.
The seven steps of the Integrative Healing Model include: (1) assessing levels of distress, disagreement or conflict; (2) encouraging expression of feelings; (3) providing empathy and validation; (4) encouraging discovery and expression of meaning; (5) providing information; (6) nurturing Mother Earth; and (7) learning deep breathing, movement-centered healing, mindfulness, and meditation, integrative practice called 'Soul-Surfing.' The model aims to aid the individual in meaningmaking and forgiveness following trauma. One of the central components in healing from a disaster is the ability to find meaning in a traumatic event and to cultivate a sense of purpose in one's life (Frankl, 1962;Kalayjian, Eugene, 2010). Meaningmaking has been linked to better adjustment following stressful life events and lower severity of post-traumatic symptoms (Collie, Long, 2005;Skaggs, Baron, 2006;.

Circle of Gratitude and Love.
At the close of all MeaningfulWorld gatherings, we practice a "Circle of Gratitude and Love." We come together with hands embraced, the left one placed on the heart of the person to our left, we close our eyes, breathe deeply and connect to one another in the circle. After connecting with the others in our group, we continue to breathe deeply as we imagine our love and gratitude being sent out to others in the world. We express our gratitude for something or someone in the moment. We also imagine that we are all connected and that we can send love and receive love any time we need to be embraced by the healing and love which we feel while standing in the circle. 7. Gratitude meditation at bedtime. Each night we invite you to have a ritual for quieting the mind, turning electronic devices off, and turning on our inner gratitude compass. Reviewing our day and our actions mindfully, looking at areas of lessons learned.

Impact of Gratitude on Transforming Trauma
Trauma, whether human-made or natural disaster can impact us both physically and emotionally. When healing from trauma, there are many factors to consider. The initial needs to be addressed are the physical needs of the individual and then people can come together to address the community needs. The individual needs to be addressed are stabilization from injury, food, water, and shelter. After these needs are met, then the emotional healing can begin. The state of mind of an individual will impact the quality of the healing and how quickly the healing will take place. We start with the gratitude of the moment because we are not ready to see the full meaning or lessons learned from the trauma but we must start with the little flicker of gratitude that comes at the moment for it to blossom and grow. The gratitude is necessary because without it, we risk holding onto the trauma as we do not have a replacement for the trauma. When we do not acknowledge gratitude, we risk allowing the negative effects of the trauma to continue to grow and fester. Without gratitude, we risk not allowing our trauma to heal completely.
We, at MeaningfulWorld, focus on transforming five kinds of trauma: 1) individual trauma experienced by an individual; 2) collective trauma, people within a group experience the same trauma, such as COVID-19; 3) vicarious/secondary, trauma experienced when listening to other's trauma story or from watching a visual representation of a trauma (watching the television); 4) generational, trauma which is experienced by people from another generation and the effects of it are passed on through the family through our DNA; 5) horizontal violence: internalizing the aggression of the perpetrator, and therefore, putting one another down. Preferring the oppressor's kind will cause us making negative statements about ourselves and one's kind. We, therefore, are being and acting envious or jealous of our own kind, our family, neighbors, and friends .

"Don't be a crab in the bucket; be a true Haitian and lift one another up."
Dr.

Forgiveness Transforms Trauma
Those who are still under the influence of trauma are unable to forgive, nor could they see the benefits of gratitude. We recommend that first, one exercises catharsis, and discharge their negative traumatic past, in order to achieve peace in the present moment. Forgiveness can enable people to move beyond trauma. Due to the deep pain, anger, hatred, grudges, and revenge that are often the result of trauma, whether it is human-induced or the result of natural disasters.
Research on forgiveness in fifteen countries showed a positive relationship between forgiveness, meaning-making, and a decrease of trauma-related symptoms . Additional research revealed that meaning-making combined with forgiveness alleviates and decreases symptoms of trauma (Toussaint, .
Forgiveness is a choice, and it is a practice. Forgiveness is a shift in perception to see beyond the reactive judgments of the ego. Our perceptions and attitudes are a choice, nurtured with our free will.
"If we could see the secret history of our enemies, we would find there enough suffering to disarm all hostility".

Henry W. Longfellow
Forgiveness is shifting from the automatic ego reaction of hurting back, to a mindful response; considering that the other is a human, perhaps not mindful.

Anger and Violence Dramatically Alter Our Health
When we hold on to negative emotions, they begin to become lodged in our bodies and cause us illness and pain. For example, anger, violence, revenge, and social distress has a negative impact on our neurological, skeletal, immune, lung, brain, skin, gastro-intestinal tracks, heart and respiratory, adrenal system, as well as other challenges. Think about when you are stressed and start to hold your shoulders in a tense way and they become sore or perhaps you are thinking about a situation or problem and you develop a headache, these are examples of how stress affects the body. These begin as minor aches and pains, but the longer negative emotions are not expressed, the more destruction they will do to our body. In the Meaningful World practice of the 7-Step Integrative Healing Model, we practice Soul-Surfing exercises which utilizes movement, positive affirmations, color consciousness, and breath work to release tensions and release negative energy that can lead to illness .

Symptoms of Unforgiving Spirit
After nurturing gratitude, we need to start learning about the benefits of forgiveness and the disadvantages of an unforgiving spirit. Anxiety, anger, hatred, compulsion, hurt, fear, resentment, inflexible, violence -horizontal violence, and depression are signs of an unforgiving spirit . The absence of forgiveness leads us to feel out of control with our emotions and feel like we are being used or taken advantage of. While the benefits of forgiveness are listed below, one needs to be mindful that forgiveness is a process, and it is an ongoing practice, not a one-time act.
Benefits of Forgiving: -frees us from the chains of hatred and anger; -opens us to love; -yields one's grip on misery; -improves our character; -broadens our point of view and gives you a see-through vision; -cleanses our soul from resentment and fear; -helps us rely on compassion and caring; -helps us develop gratefulness; -clears our consciousness; -helps us develop wholeness, passion and commitment; -helps our self-transcendence; -helps us accept our fate, not argue with it.

Myths about Forgiveness:
-if I forgive, I will forget; -if I forgive, you will do it again; -if I forgive, the enemy will be set free; -if I forgive, I will hurt those who died; -if I forgive, there will be no justice; -if I forgive, I will no longer be a victim; -I need the anger to survive; -I must wait for the enemy to acknowledge and ask for forgiveness first; -only survivors themselves can forgive, offspring should not forgive; -only God/Allah can forgive, not humans (Kalayjian, Paloutzian, 2010). Our motto is: When one helps another, both become stronger. Seven Steps of Forgiving: 1. Select a grievance against someone, or yourself, and review it in complete detail.
2. Hold in your mind the image of whatever is to be forgiven and say: "I release you from the grip of my sadness, anger, disapproval, or condemnation." 3. Imagine for a while what your life will be like without this grievance that has haunted you.
4. Make amends with someone who has hurt you, tell a friend about your self-forgiveness. 5. Ask for spiritual (God, humanity, nature) guidance to overcome fear or resistance at any step. 6. Have patience; forgiveness is a healing process not a destination. 7. Repeat steps 1 through 6 as often as needed, for life.

The 7 Step Integrative Healing Model
At the basis for all programming is the 7-Step Integrative Healing Model, through which various aspects of traumatic exposure are assessed, identified, explored, processed, integrated, and released with a positive meaning discovered. The model was developed based on the idea that any trauma can cause physical, emotional, and spiritual symptoms leading to a variety of illnesses, including posttraumatic stress disorder, major depression, generalized anxiety disorder, phobic disorders, somatic disorders, addictions, and aggression turned inward and outward, as well as physical illnesses, such as back pain, gastrointestinal diseases, cardiovascular diseases, etc. On a spiritual level, traumas cause spiritual vacuums and loss or disillusionment of faith. The list of psychological symptoms includes nightmares, night terrors, flashbacks, regression, loss of or increase in appetite, loss of hope, loss of status, and helplessness. A trauma may not only affect the survivors themselves, but also the families over several generations (Kupelian et al., 1998), as well as immediate family members living and interacting with the traumatized person.

7-Step Integrative Healing Model for transforming trauma into resilience and meaning:
1. Assess Levels of Distress. Participants are brought together at a meeting place and given the questionnaires described above to assess their levels of trauma, forgiveness, and meaning at the outset.
2. Encourage Expression of Feelings. One at a time, each member of the group is encouraged to express his or her feelings in the "here and now," in relation to POSITIVE PSYCHOLOGY ACROSS CULTURES AND NATIONS the trauma, paying close attention to the following feelings commonly associated with post-traumatic stress: fear, uncertainty of the future, flashbacks, avoidance behaviors, anger at the perpetrator(s), sleep disturbances and nightmares, somatic symptoms, substance abuse, and domestic abuse.
3. Provide Empathy and Validation. The members of the group validate each survivor's feelings by using statements such as "It makes sense to me…." and share information about how other survivors from around the world have coped. Intentional therapeutic touch, such as holding a survivor's hand, is also used. In this step it is emphasized that the survivor's feelings of grief, fear, and anger, as well as the joy of surviving, are all-natural responses to the disaster and need to be expressed. When trauma ruptures an individual's connection with a group, an intolerable sense of isolation and helplessness may ensue. Providing validation and empathy in a group setting addresses these effects by reestablishing the mutual exchange between the individual and the group, and the individual and the universe. Forgiveness is introduced as a mechanism for creating inner peace in spite of unjust acts committed against the individual and in spite of ongoing denial of injustices. It is reinforced that when someone angers us, they control us. When we feel controlled, we feel helpless. Therefore, participants are encouraged to find ways to release and transform their anger and sublimate it or use it in a therapeutic way.
4. Promote Discovery and Expression of Meaning. Survivors are asked, "What lessons, meaning, or positive associations did you discover as a result of this traumatic experience?" This question is based on Frankl's (1962) logotherapeutic principles, which stipulate that a positive meaning can be discovered in the worst catastrophe, as well as on the Buddhist assertion that it takes darkness to appreciate and reconnect with light. Again, each member of the group is invited to focus on the strengths and meanings that naturally arise from any disaster situation. Some of the positive lessons learned and expressed by survivors from around the world are: that interpersonal relationships are more important than material goods, it is important to release the resentments, working through anger and practicing forgiveness is healthy, it is possible to take charge of one's own life, and that it is important for nations to come together for the purpose of peace. Once forgiveness is practiced regularly, one feels freer to move into this phase of searching for a meaning and is more likely to recognize the positive growth that can occur after a hardship.
5. Supply, Seek and Gather Information. Practical tools and information are given on how to gradually return to one's daily routine by using the systematic desensitization process. The importance of preparation in advance of disasters is taught and elaboration is provided on specific ways to prepare. Handouts are given to teachers and prospective group leaders on how to conduct disaster evacuation drills and create safe and accessible exits from buildings, homes, factories, and other potential disaster sites. Booklets are distributed to parents and teachers on how to understand and respond to their children's nightmares, fears, and disruptive behaviors after wars. In addition, assessment tools are given to mental-health professionals. Handouts are provided on grief as well as on how to take care of oneself as a caregiver and prevent secondary traumatization.
6. Eco-Centered Processing. Practical tools are shared to connect with Mother Earth. Discussion and exercises are conducted around environmental connections.
Ways to care for one's environment are shared, starting with one's environment and expanding to the larger globe.
7. Soul-Surfing Exercises with Deep Breaths. Breath is used as a natural medicine and a healing tool. Since no one can have full control over nature, others, or what happens outside of one's self, survivors are assisted in learning how to control the way that they respond to traumas. A demonstration is provided of exercises that bring a sense of harmony to the mind, body, and spirit by focused and guided attention, imagery, and suggestion. It is important to note that breathing exercises may be uniquely adapted to the beliefs or customs of the people being helped. This is the experiential section of the model. Survivors are given instructions on how to dissipate fear, uncertainty, and resentments from mind-body-and spirit. In addition, survivors are instructed on how to move toward self-empowerment as well as to engender gratitude, compassion, faith, strength, and forgiveness in response to disasters, mass trauma, and denial of the trauma. Forgiveness meditation exercises are conducted. Forgiving oneself as a first step is introduced. We end with meditation, and then our signature Heart-to-Heart-Circle of Love and Gratitude.

Meaning Making and Meaning Centered Therapy
Meaning-centered therapy, also called logotherapy, was pioneered by Viktor Frankl (1962), who is perhaps best known for his book Man's Search for Meaning. According to Frankl, we can find a positive meaning in the most difficult and traumatic situations. Frankl differentiates the global meaning vs. individual meaning of the day or the specific moment. Meaning-making is creating a silver lining, our ability to make sense of the nonsense. By meaning-making, we create a way to accept the situation we are in and keep going in the face of adversity. Meaningmaking helps us learn to become more creative, to cope with our life predicaments, to improve our life, maximize our potential, find happiness and success.

Conclusion and recommendations
In this paper, we presented three important concepts that are integral and assist in our healing process, and transform trauma into meaning through gratitude, meaning-making, and forgiveness. We also presented seven (7) strategies for practicing and nurturing gratitude. International research reinforces the value of each of the following variables: gratitude, forgiveness and meaning-making for healing, transformation, and happiness.
Although most organized religions emphasize the importance of forgiveness and living a life of gratitude, the practice of being spiritual is lagging. While the importance of these variables is reinforced through scripture, a clear direction as to how to practice them is missing. To reinforce, emotional catharsis and gratitude are essential for living a harmonious life full of gratitude and meaning.

"You give but little when you
Give of your possessions. It is when you give of your heart That you truly give." Kahlil Gibran (Lebanese poet)