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Chapter Three: Anxiety, Depression, Post-Traumatic Stress, and Dissociation

Alayarian, Aida Karnac Books ePub

In this chapter I focus on anxiety, depression, and post-traumatic stress.

Anxiety

Anxiety is a warning signal that may present in the form of overwhelming emotions and feelings which give rise to a sense of unmanageable helplessness. In it, the threat may be perceived as arising from either external or internal sources and be the conscious response to a variety of powerful fantasies in the unconscious mind.

Anxiety's physical symptoms include butterflies in the stomach, a pounding heart, unpleasant sensations or a persistent sense of unease. Anxiety is certainly not just a product of irrational fears. If we look at the cases of anxiety in people that have encountered traumatic events, it is clear to see that their anxiety is often justified and in many cases it is existential. Some of the existential causes of anxiety in refugee and asylum seekers include: being in a new culture, struggling with a new language, not knowing what to do, not knowing the Home Office decision about immigration matters. Some of these are enough to make anyone anxious—in fact I would be more concerned if patients in such circumstances did not present anxiety. This type of anxiety is a normal reaction to a pressured and abnormal situation. Although individual fears may appear irrational, it is easy to see that the base of that fear is perfectly normal, rational, and to be expected.

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APPENDIX I: Maps of 1915 Armenian genocide

Aida Alayarian Karnac Books ePub
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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 FIVE: Resilience

Alayarian, Aida Karnac Books ePub

Introduction

Resilience is central to this study and touched upon in the previous chapters as a means of illustrating why any two people can have different responses to potentially the same traumatic occurrences. The Oxford English Dictionary’s (2001) definition of resilient is: “adj. 1. able to recoil or spring back into shape after bending, stretching or being compressed. 2. able to recover quickly after difficult conditions”.

The word resilience comes from the Latin resalire (to jump up again), and has passed into psychological idiom systematically since the 1960s. I define resilient as the ability to experience severe trauma or neglect without a collapse of psychological functioning or evidence of post traumatic stress disorder. This does not imply psychological well-being or positive mental health, which assumes an acceptable environment, but it is a reasonably effective psychological functioning with a protected inner space.

In this chapter, after a generalized definition, I look at the work of Werner and Garmezy, mentioned in Chapter One. From this, my understanding of the term resilience is offered with a list of the factors typically found in resilient people, expanding on some of the psychoanalytic concepts that can be viewed as the equivalent to resilience. These are then applied to two vignettes, illustrating one individual who demonstrates resilience and another who lacks resilience.

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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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