31 Chapters
Medium 9781855758766

CHAPTER ONE: Introduction to literature review

Alayarian, Aida Karnac Books ePub

The literature review is intended as a means of examining the psychoanalytic and psychological literature on resilience, as well as other related key concepts in psychoanalysis, with the aim of drawing out a possible theoretical response to the research question. This part lays the foundations for the discussions on trauma, resilience, and dissociation in the following three chapters. It starts with a brief discussion of two enduring pieces of psychological research into resilience, and goes on to assert the importance of certain psychoanalytical conceptualizations in working with people who have endured trauma. The significance of unconscious processes and states in driving human behaviour is a central tenet emphasized here and throughout this study. Specific attention is given to object relations theory as a way of understanding how internal and external realities are structured in the mind, as well as intrapsychic relationships. In this context, a perception of “psychic space”, the “sense of self” and its relation to the external world, and the distinction between secure and insecure attachment in early development are discussed. The self (true and false) and disruption of the self in relation to trauma, vulnerability, retraumatization, and resilience as major tenets of an individual’s personal characteristics are discussed. Some key defence mechanisms identified as specifically used by traumatized patients, and which are central to the hypothesis of resilience, are described, including dissociation. Dissociation is emphasized throughout this study as intrinsically linked with the concept of an inner psychic space or lack of it, relevant to having a “listening other”, as therapeutic tools for the development or regaining of the sense of self which have been lost as the result of the trauma the patient has endured.

See All Chapters
Medium 9781782201939

Chapter One: Overview

Alayarian, Aida Karnac Books ePub

Examining theoretical approaches to working with children of refugees and unaccompanied minors, I will map several useful psychoanalytic concepts for working interculturally with children therapeutically. The discussion aims to present several key concepts that underpin the development of effective psychotherapeutic treatment: an understanding of the self and others in the context of mourning; prior experience and capacity of resilience, dissociation (healthy and unhealthy), and repression (Freud, 1915d); the concept of the True and the False Self (Winnicott, 1965a), dissociation, and the development of resilience (Alayarian, 2011).

In this chapter and throughout the book, clinical vignettes and case studies are presented and discussed. These invigorate and stir the diversity of the experiences of unaccompanied minors and children of refugees while also demonstrating the impact of appropriate therapeutic intervention. They further explore a resilience-focused approach to working with children of refugees or unaccompanied minors.

See All Chapters
Medium 9781855754614

CHAPTER SIX: Loss of network support piled on trauma: thinking more broadly about the context of refugees

Karnac Books ePub

Tirril Harris

It is understandable that the endurance of trauma is always the first issue to feature in any discussion of the refugee experience. I But other aspects are equally important in their impact upon refugee well-being. As Burnett and Thompson (2005) have argued, the experience of exile involves such substantial change that any intervention should be at a more holistic level rather than the simple focus on trauma, and that one of the priorities should be to recognize the importance of rebuilding the social world.

However, they are realistic about the enormity of the task, even for those who have fled with other family members, pinpointing the difficulty of forming a new network without the usual security provided by an established set of close ties on which to build. In this chapter I shall explore ideas concerning the fulfilment of this task, building on my experience both at the Refugee Therapy Centre and with participants in social psychiatry research projects with which I have been involved (Brown &Harris, 1978; Brown, Andrews, Harris, Adler, &Bridge, 1988; Harris, Brown, &Robinson, 1999; see also Brown, Adler, &Bifulco, 1986; Brown, Bifulco, Veiel, &Andrews, 1990). I shall start by looking at the theories and evidence concerning the manner in which different aspects of “social support” promote both physical and mental health, then consider what I have learnt about other aspects of the support networks developed in other cultures from talking with clients, and finally address the ways in which expectations of UK therapists and counsellors need to be adapted because of these other aspects.

See All Chapters
Medium 9781855754614

CHAPTER FOUR: The therapeutic needs of those fleeing persecution and violence, now and in the future

Karnac Books ePub

Lennox K. Thomas

Introduction

The maxim of “a stitch in time saves nine” needs to be borne in mind when thinking about and planning therapeutic T work with refugees. For all the experiences of persecution and torture in their country and the estrangement in their place of refuge, some sense has to be made of the experiences. Greater planning needs to take place in order to ensure better mental health services for refugees and asylum seekers. This is not just important at the point of arrival but for the future, particularly for children and young people. Many professionals could be helpful in that process, among them general medical practitioners as the first line of contact, then schools, and psychotherapists. Therapists are more likely to attend to people who are experiencing psychological and emotional problems, but there are others involved in hospitalization, religious counselling, or other assistance who might also need to be able to understand the cultural context of the psychological presentation. In that regard, the planning of services might require the input of social and medical anthropologists, whose understanding of culture and symptomatology will be helpful. Because being a refugee is not a normal part of life and is therefore something that most people will be unlikely to experience, some asylum seekers will need help with the process of resettlement. While for some the move from one country culture, and language might be relatively unproblematic and taken on as one of life's challenges, others might want help for a variety of reasons. For many, there may be needs as a result of the trauma they experienced, as well as a call for legal support with their asylum claim. Not everyone who is referred for therapy will need it at that time, or at any other time for that matter.

See All Chapters
Medium 9781782201939

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.

See All Chapters

See All Chapters