20 Chapters
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Chapter Eight: Working with Family

Alayarian, Aida Karnac Books ePub

One of the common issues that we face working with children and young people is that adults tell us that they don't want the child to talk about what happened in the past and if they do we should tell them not to. Many parents, and some foster carers for unaccompanied children, indeed sometimes the child's contact person from social services, desperately want the child or the young person to change their behaviour, not to think about past and get on with life—because they care. However, as therapists we must remember that they, the carers, and we know less than the child about the traumatic events that they have endured.

When children are having difficulties, establishing links with their home can be crucial; however, working with the parents of traumatised children of refugees is not always easy. They may find it hard to acknowledge that their child may have a problem, especially of a psychological nature. Parents may be eager for their children to forget the past, look to the future and do well at school. They may really want to believe that the horrific experiences the family has gone through have not affected their children, so they convince themselves that the children are OK and are reluctant to accept evidence to the contrary.

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CHAPTER FOUR: Literature and post traumatic stress disorder

Alayarian, Aida Karnac Books ePub

Introduction

Trauma plays a significant role in the psychogenesis of violence (e.g., Johnson, Cohen, Brown, Smailes, & Bernstein, 1999). A normal awareness of the relationship between internal and external reality is not universal, but rather a developmental achievement (Fonagy & Target, 1996, 1997). If they are exposed to or suffer multiple traumas during their lives, people, in general, will have some psychological difficulties, and for those who have actually experienced trauma, these difficulties hinder the process of adaptation to, and integration in, a different environment. There is a need to think about this and search for appropriate help for efficient integration. Another issue that this study will consider is: what is it in the personality of traumatized people that makes some resilient to their traumatic experiences, but leaves others vulnerable to psychological collapse (i.e., development of PTSD)? As it is not something that lies in the objective external event, what is it about the personality that enables, or disables, resilience?

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Chapter Two: Traumatic Experiences of Children of Refugees

Alayarian, Aida Karnac Books ePub

It is not uncommon for children of refugees to experience the violent death of one or both parents. Some witness the massacre or casualties of friends and close relatives and members in their communities. They go through the experience of forced separation and displacement. Some suffer extreme poverty, starvation, physical injuries, and disabilities, as well as sexual, physical, and emotional abuse. Often children are exposed to direct combat; they may be kidnapped, arrested, imprisoned, tortured, sexually abused or forced to participate in violent acts. Some children are born or conceived in prison as a result of their mothers’ involvement in opposition parties or human rights activities. In our clinical work we have the evidence from children's narratives of young children being raped or massacred and of other children being made to witness these horrific events.

In some cases, specifically in African countries, children are forced to join the army and become child soldiers to participate actively in armed conflicts. They are often given extremely dangerous tasks, for instance: mine detection, spying, messengering, or taking valuables from corpses in conflicted and military areas.

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CHAPTER SEVEN: A non-clinical encounter

Alayarian, Aida Karnac Books ePub

Boris

Here, I write about a meeting with a person whom I shall call Boris, who had been in power in the running of an African country. I mainly focus on the aftermath of trauma in his unhealthy dissociative manner. He and much of his family had suffered tremendous trauma prior to him coming into power. This is not a clinical vignette; it is an observation based on a discussion with this man. I would like to emphasize that at the time, I was not fully aware of the negative effect this man had on me. I was clearly disassociating from the unpleasant experience I was having and the anger and frustration that I felt. I listened to his entire narrative, much as a therapist or supervisor would, looking for those features in which I could be guided by psychoanalytic concepts. I could see that his portrayal of humanity was false and that he was aware of this.

I will give a few brief factual presentations that I encountered with him. I use the sense of self here as an existential function that is connected to object relations, which depends on the socio-cultural circumstances, and the central aspects of the loss of a socio-cultural environment. I also use the term psychic space, but it is less experiential or existential, being based instead on one’s identity and ability to have a sense of the self, rather as the psychic structure is correlated with sense of self, but in a different conceptual framework. I use both terms, equating a coherent psychic space as a structure of the mind with having a sense of self, and use the terms interchangeably.

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CHAPTER THREE: Psychological trauma

Alayarian, Aida Karnac Books ePub

Introduction

The focus of this chapter is to look at the meaning of trauma and to expand a possible classification of traumatic events that have an impact on individual functioning. I start with a description of trauma to offer a general understanding of the term, before looking at possible causes, various kinds of trauma, its dynamics, its mechanisms, and the diverse areas of functioning that trauma potentially has an impact on. The chapter also looks at the consequences of trauma and the relevance of these in resilience, with a brief discussion about post traumatic stress disorder (PTSD). Emphasis throughout is given to the fact that people have subjective reactions to objective events and no two persons will experience or respond to a stressor of the same traumatic occurrence in the same way.

What is trauma?

In the Oxford English Dictionary trauma is defined as:

1.  A deeply distressing experience;

2. Med. Physical injury;

3. Emotional shock following a stressful event.

Traumatize: cause (someone) to experience lasting shock as a result of a disturbing experience or injury.

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