Staff Spotlight: Chhori Laxmi Maharjan

Chhori Laxmi Maharjan, Head of Ankur Counseling & Training Center

Dr. Chhori Laxmi Maharjan is the Head of NYF’s Ankur Counseling & Training Center. She cherishes daily opportunities to witness emotional healing in the children receiving therapy from her and her team.

“I get to know my client’s needs,” she says. “This is a chance to prepare them for any risks and achievements, as well as to help them address their most prominent issues, such as anxieties, worries, and hopelessness. I can be the safe container for them with a loving, compassionate heart.”

“Nisha”

One young patient, “Nisha*,” came to Chhori’s office when her guardians noticed she was struggling in school and finding it difficult to get along in social settings. Nisha described intense feelings of inner conflict, trust issues, loneliness, and poor self-esteem. As Chhori listened, however, it became clear that Nisha’s personality was joyful, hopeful, and creative. But traumatic experiences in her early life had made Nisha very guarded and distrustful of these traits.

“She mentioned her dream to become a successful person in the future,” Chhori remembers. This dream became a guiding light in Nisha’s healing journey.

Meeting once a week, Chhori and Nisha began coaxing her natural positivity out of hiding. They used a child-centered technique called sandplay therapy.

In the beginning, Nisha’s work revealed themes of deep hopelessness, with only small sparks of joy and playfulness emerging. But as she grew more comfortable, and in coordination with her guardians and teachers, she became kinder and more compassionate towards herself. Her perspective on herself began to shift, and she realized that she possessed the power to change. Gradually, Nisha became more hopeful about the future. She choose to invest more effort in her schoolwork and to open her heart to friends, family, and classmates.

Today, Nisha is still working with Chhori in therapy. But she is doing so with a solid foundation of her own self-worth and making tremendous progress. Chhori feels deeply grateful for the opportunity to help each of her patients explore and overcome the challenges standing between themselves and a joyful future.

*Confidentiality is critical in a therapeutic setting. “Nisha’s” story is a blend of several of Chhori’s past patients, with details changed to protect privacy.

Chhori’s Background

Dr. Chhori Laxmi Maharjan grew up in Kathmandu, in a traditional Newari family. Her father was a carpenter. Her mother managed the household, raising five children.

“My mother truly believes that education is the key to wisdom and freedom,” Chhori says. Her mother made every effort to ensure that all five children had access to this precious opportunity. Chhori took her education very seriously as a result. “I remember wanting to make my mother’s dream come true while I was young.”

One day, as Chhori was about to graduate high school, she came across an Introduction to Psychology book on her uncle’s bookshelf. The material was fascinating to Chhori, who was a thoughtful, emotionally attuned, service-oriented person by nature. “I decided to earn a higher degree to become the one who listens with an empathetic heart,” she says.

Meeting NYF

After receiving her bachelor’s degree in clinical psychology, Dr. Chhori Laxmi Maharjan began working for an organization serving adults and children living with HIV/AIDS. Mental health services are extremely important for individuals living with chronic health conditions, especially those which are life-threatening and highly stigmatized.

She quickly realized that the children and youth in her care were the most vulnerable to developing severe psychosocial issues. “Children need to have the opportunity to process traumatic experiences in a manner consistent with their cognitive and emotional development,” Chhori wrote in her PhD dissertation in 2019. But unfortunately, “clinical psychology and therapeutic interventions are in their infancy in Nepal.”

“Deep in my heart, I felt that I needed to work for children.” In mid-2006, Chhori intersected with NYF leadership, including Som Paneru and Olga Murray. Our organization was searching for a counselor specifically for children and youth, ideally one who specialized in sandplay therapy. “Without a second thought, I applied and joined NYF in October 2006.”

Ankur Counseling Center

Chhori helped to open Ankur Counseling Center right away, in 2006. “Ankur” is Sanskrit for “flower bud,” “sapling,” or “sprout.” Ankur became Nepal’s very first counseling center for children.

The first children to receive care here were the kids living J House and K House, the precursors to Olgapuri Children’s Village, as well as young survivors of the exploitative childhood bondage practice called kamlari. But Ankur’s mission quickly expanded to include beneficiaries of many other NYF programs, with remarkable results.

In 2014, with support from mentors, partners, and friends met through NYF, Chhori took a several-year hiatus from Ankur Counseling Center to travel to San Francisco to pursue her PhD in Psychology from the California Institute of Integral Studies. She earned her doctorate in 2019. Her dissertation focused on sandplay therapy as a child-focused technique in Nepal’s childcare homes, including case studies from NYF’s work. She paid special attention to the success of sandplay therapy (which was developed originally in the West) on the outcomes for children within an Eastern cultural context.

Fresh PhD in hand, Chhori returned to Ankur Counseling Center. She was more determined than ever to continue offering mental health resources to Nepal’s children.

Childhood Trauma

Childhood trauma is severely disruptive to healthy development. Impacts can last a lifetime, long after a child has been removed to safety. Some common symptoms of those with unprocessed childhood trauma include poor self-care, self-harm, interpersonal struggles and difficulty with authority, trouble expressing emotions (both extreme reactivity and numbing), and more.

Trauma impacts the part of the brain called the “orbitofrontal cortex,” Dr. Chhori Laxmi Maharjan explains in her dissertation. The orbitofrontal cortex oversees complex decision-making, managing the balance between our emotions and analytical thinking. Disruption to its normal development results in learning and behavior problems, and even developmental delays and physical illnesses.

These disruptions include traumas like extreme poverty; homelessness; neglect and/or abuse; a parent’s mental illness or chronic or terminal illness; abandonment or death of parents; natural disasters (like the 2015 earthquake) or wars (like the Nepali Civil War from 1996-2006); displacement; bullying or stigma—and many more.

To “rescue” a child from childhood trauma, the first step is to do everything possible to interrupt that traumatic situation, providing a safe, stable environment with safe, stable adult caregivers. Helping these children to cultivate as many healthy relationships as possible is a crucial protective measure for emotional and mental well-being.

But this is only the beginning, as it does not undo the harm already sustained by the growing brain.

In order to set healthy brain development back on course, it is crucial to also provide these children with the care, support, tools, and space necessary to grapple with these complex, frightening experiences.

The tremendous success of all of NYF’s programming is due to our team’s keen understanding of the importance of mental health care for childhood trauma survivors. Chhori is a leader in ensuring all of NYF’s physical interventions are strengthened, supported, and sustained by robust mental and emotional care as well.

Sandplay Therapy

Ankur Counseling Center uses many different therapeutic approaches, but sandplay therapy is Chhori’s specialty.

For both adults and children, a common symptom of traumatic stress is an intense struggle to articulate the experience in a way that is organized and linear while also sufficiently capturing the complex layers of distress behind the narrative. This is because part of what makes an experience traumatic is its scale, scope, and impact on so many pieces of an individual’s life. The brain’s inability to untangle and sort this tremendous snarl is itself a major facet of the trauma. This is especially true for children, whose brains are still developing their baseline understanding of the world.

Sandplay therapy bypasses the factual story of the trauma entirely. It instead capitalizes on a child’s natural ways of learning: imagination, creativity, and pretend play. In much the same way healthy children will explore their worlds in miniature by playing house, acting out stories with their toys, or making up elaborate playground games (taking advantage of the options to swap roles, add dramatic surprises, adjust the rules, go back to change the ending, and more), a child grappling with trauma can use play to safely navigate the major sources of distress within their traumatic histories.

How Sandplay Therapy Works

In Chhori’s counseling room, a child is presented with trays of sand and many shelves of miniatures representing all parts of life and fantasy: figures of men, women, children, and babies; superheroes and villains; houses, castles, schools; gods and goddesses; trees, dump trucks, rubber duckies, dinosaurs, frying pans, puppies, and more. The child is invited to gather as many items as he or she wishes, and to create a world within the sand tray.

Chhori watches patiently as the child creates the world, careful not to interrupt the process. Some worlds—often in the beginning of a child’s journey—are highly disorganized, overwhelmed with figures in chaotic relation to one another. Other worlds are quite sparce, with figures appearing far away from one another. Still other worlds reveal consistent themes, like villains lurking in the shadows, families being reunited, or community roles.

When the tray is complete, Chhori asks the child if their creation has a title, or if they’d like to walk her through the world they’ve created. Certain figures clearly have more significance to the child than others—perhaps a specific problem the figure has encountered. Letting the child lead as much as possible, Chhori lets the tray become the subject, with the child explaining about the characters, their relationships to one another, their desires, and their struggles. Discussions emerge naturally from this process, allowing the child to gently explore challenging themes from a safe distance, and as the expert in control of their own created world.

The results are transformative, as children gradually peel through the layers in this safe, affirming environment, gently processing their trauma piece by piece.

And, wonderfully, sandplay therapy is a useful technique for children from virtually any cultural background. It’s especially crucial in a country like Nepal, where children come from many different subcultures.

A Day in the Life

Dr. Chhori Laxmi Maharjan has a very full daily schedule, touching on every NYF program in one way or another.

“Usually, my day starts with providing one-on-one counseling sessions,” she says. Chhori has an average of four individual sessions per day, each lasting 30-50 minutes. Most of her patients are children and youth, including Olgapuri Children’s Village kids, NYF Scholarship recipients, and children referred from other children’s homes or nonprofits working with families in Kathmandu Valley.

Twice a month, she also leads 90-minute group therapy sessions.

After each counseling session, Chhori makes careful session notes to document each patient’s progress. Occasionally, if necessary, she meets with parents or guardians.

Chhori also provides clinical supervision sessions with the rest of the Ankur team (currently six counselors, each with a master’s degree) and mental health professionals from other organizations.

Afternoons are for larger projects. Some days, Chhori leads trainings and workshops for mental health professionals, teachers, parents and guardians, social workers, and other people who work with children and youth.

Innovative Trainings & Workshops

Some of these trainings are for NYF’s teams, while others are specifically for organizations with missions that complement ours. For example, Chhori recently led a several-day workshop for staff members at a Kathmandu Valley women’s shelter which had been struggling with behavior problems from some of the children receiving services there. The training focused on trauma-informed discipline: methods of effectively addressing problematic behaviors in ways that recognize and honor the chaotic, frightening, and painful circumstances these children were responding to. Professionals who received this training responded with glowing appreciation. They have already seen remarkable improvement in their interactions with the children in their care.

Other trainings are part of larger NYF programs. Women in our Olgapuri Vocational School Industrial Tailoring program receive empowerment and goal-setting workshops as part of their curriculum. These students frequently report that these workshops were their favorite part of the training!

And, of course, Peer Counseling training is a major facet of the Caste Equality Project (CEP). Chhori is leading this program, working closely with CEP Coordinator Lalit Gahatraj to ensure our 30 Saptari District peer counselors are supported and empowered in their mission to begin building their community members’ self-confidence, overcoming generational trauma, and daring to seize opportunities to participate fully in Nepali society.

Community Mental Health Program

Mental health problems are very common across Nepal. But unfortunately, awareness of mental health concepts are still very low, even in urban areas. During the height of the COVID-19 pandemic, rates of mental health crisis spiked. At the same time, Ankur Counseling Center’s reach extended further than ever before.

During NYF’s rapid pivot to lockdown-safe programming, Chhori’s team was the first to introduce remote services. And soon, Ankur Counseling Center had expanded their offerings to include services to local women experiencing domestic violence, support for front-line healthcare workers, and training for other organizations serving women and children.

The COVID lockdowns showed local governments and other changemakers how important mental health care is. In mid-2023, the government of Lalitpur Metropolitan City (the area of Kathmandu Valley where NYF’s offices are) invited Ankur Counseling Center to launch a Community Mental Health Program. Chhori has been leading this important work ever since. So far, she has introduced monthly “Mental Health Desk” activities in local schools, organized World Mental Health Day celebrations, and provided mental health awareness training for students, teachers, healthcare workers, social workers, and traditional healers.

What’s Next?

Dr. Chhori Laxmi Maharjan is involved with many Kathmandu-based organizations focused on mental health. She’s passionate about applying the world’s best understanding of psychology to a Nepali cultural context.

Most psychological care techniques today were developed in Western cultures, which in many ways are very different from Nepal’s society! As a result, some care techniques which are very effective for an American mindset or worldview are not culturally appropriate for Nepali patients. However, Chhori understands the scientific basis for these techniques. She and her network of Nepali psychology experts are deeply interested in studying which of these approaches may have promise in a Nepali context, with a few culturally minded tweaks.

Meanwhile, she says, “Personally, I feel NYF is my second home. My values match with NYF’s values.” Our organization gives her a sense of belonging and of a meaningful life. And because NYF is structured with trust in our on-the-ground experts, Chhori has plenty of opportunities to stretch her expertise as far as she is able.

“Working more than 15 years with children and youth, I have learned that suffering can be reduced or prevented by cultivating compassion,” Chhori says. “I can see the hardships in the community—and opportunities for community transformation.”

NYF is deeply proud of Dr. Chhori Laxmi Maharjan and the work she is doing to advance mental health care in Nepal—especially for children and survivors of trauma.

You are not alone. If you or someone you know is experiencing a mental health crisis or thoughts of suicide, get help right away. You can contact your physician, go to your local ER, or call the suicide prevention hotline in your country. For the United States, you may call or text the Suicide Prevention and Crisis Hotline at 988. You can also message the Crisis Text Line by texting “HOME” to 741741 or visiting https://www.crisistextline.org/. Both programs provide free, confidential support 24/7.