Working with Shame and Trauma

Not only does the literature attest to the high levels of trauma among displaced populations, research in the past decade has increasingly revealed the hidden yet pervasive role that shame may play in posttraumatic symptomatology. As defined by Wilson and colleagues, “in the posttraumatic self, shame develops from traumatic experiences that render the victim fearful, powerless, helpless, and unable to act congruently with moral values” (Wilson et al., 2006, p. 127). In the context of forced migration in particular, both trauma and shame are ubiquitous, pervasive, and contagious.

Working with PTSD in the Asylum Procedure

Europe is living through a refugee crisis of historic proportions, with subsequent evolving responses having now become one of the continent’s defining challenges of the early twenty-first century (Médécins Sans Frontières, 2016; UNHCR, .The sea route to Europe: The Mediterranean passage in the age of refugees, United Nations High Commissioner for Refugees, Geneva, 2015).

Conclusion

The number of refugees across the globe is growing dramatically—a trend predicted to continue due to a global increase in social and political instability as well as socioeconomic conflicts. In places where violence is seen as a necessary factor in achieving peace, ongoing armed conflict, and displacement will likely contribute to continued psychological impairment and suffering among those affected (Morina et al., .Frontiers in Psychiatry 9:433, 2018). Indeed, research overwhelmingly attests to the alarmingly high rates of PTSD among this population (Schouler-Ocak, M., Laban, C. J., Bäärnhielm, S., Kastrup, M. C., Dein, S., & Wintrob, R. (2019). Transcultural psychiatry: Refugee, asylum seeker and immigrant patients over the globe. In A. Javad & K. Fountoulakis (Eds.), Advances in Psychiatry (pp. 637–655). Cham: Springer.).

Beyond PTSD

PTSD as a disorder was first introduced as a diagnosis by the American Psychiatric Association (American Psychiatric Association (APA), Diagnostic and statistical manual of mental disorders 1980) in the DSM III in 1980, with interest in it booming to such an extent thereafter that it was referred to in mass media as “the disorder of the 1990s” (Marsella et al., Ethnocultural aspects of posttraumatic stress disorder: Issues, research, and clinical applications, 1996).

Collective Aspirations

Europe has faced an unprecedented influx of asylum seekers– with over one and a half million sea arrivals reported since 2015 by the United Nations High Commissioner for Refugees (UNHCR). As the “reception crisis” continues unabated, Greece remains one of the first ports of sanctuary. According to recent statistics provided for March 2018 by the UNHCR, over 50,000 asylum seekers and refugees currently remain in Greece following this mass flow.

Trauma and Migration

Over the past two decades, there has been an increasing interest in the question of trauma among refugee populations. This body of research has largely focused on the immediate psychological aftermaths of armed conflicts in light of the well-described associations between these psychiatric disorders, displacement, and generalized forms of violence (Morina et al., Morina et al., .Frontiers in Psychiatry 9:433, 2018). In general, the literature attests to the greater mental health difficulties among refugees compared to general populations within host communities.

Correction to: Trauma and Resilience Among Displaced Populations

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Working with Cultural Mediators

While Western mental health professionals are working to provide assistance to displaced populations around the world, it is important to take a step back and consider the unique contexts in which this work is done (Nicolas et al., .International Journal of Culture and Mental Health 8:34–45, 2015).

Prevalence of PTSD Among Displaced Populations—Three Case Studies

As explored in chapter two, displaced populations face a myriad of traumatic events, throughout the migration process. It comes as no surprise than, that two landmark, systematic meta-reviews found prevalence rates among refugee populations of 40% (Turrini et al., .International Journal of Mental Health Systems 11:51, 2017) and 30.6% (Steel et al., .JAMA 302:537–549, 2009) respectively.

Introduction

This chaper aims to offer an introduction to trauma and resilience among displaced communities in humanitarian contexts across the globe. Key themes being introduced include the various definitions of trauma, the importance of the sociocultural environment on the ways in which trauma manifests, factors influencing individual and group resilience, and a consideration of the impact of political and economic factors on the mental health of displaced and forced migrant populations.