Neutralizing the Effects of War: Psychosocial Support for TRC Public

Hearing Participants

Torture treatment

centers help survivors heal. The Center for

Victims of Torture

was started in 1985.

Center for Victims of Torture

Provides a multidisciplinary approach Provides a multidisciplinary approach to treatment and services:to treatment and services:

Rehabilitative treatment Rehabilitative treatment TrainingTraining ResearchResearch Public policyPublic policy

Center for Victims of Torture, June 1999

According to Amnesty International, more than 100 countries worldwide systematically practice torture against their own civilian populations.

Amnesty International Report 2007 © Center for Victims of Torture

Region of Origin, CVT clients1985-2004

15%

3%4%1%

6%

71%

Africa

Asia

Middle East

Europe

North America

South America

Center for Victims of Torture

What is happening to What is happening to your parishioners who your parishioners who

have survived civil have survived civil war?war?

Emotional or physical reactions

are NORMAL.

Center for Victims of Torture

Check on yourself throughout this training:

Severe, repeated, and/or prolonged exposure

to violent events of war Center for Victims of Torture

Refugee stages:The Triple Trauma Paradigm

Pre-flight Flight Resettlement

Adapted by the Center for Victims of Torture

l Life threatening l Unpredictablel Out of the person’s controll Stress is extreme

Center for Victims of Torture

Elements of TraumaElements of Trauma

Normal Reactions to StressNormal Reactions to Stress

FightFight

FlightFlight

FreezeFreeze

Signs and SymptomsSigns and Symptoms

ScarsScars Musculoskeletal and Musculoskeletal and

foot painfoot pain Loss of limbLoss of limb Hearing lossHearing loss Dental painDental pain Visual problemsVisual problems HeadachesHeadaches Organic impairment Organic impairment

(TBI, nutritional)(TBI, nutritional)

Center for Victims of TortureCenter for Victims of Torture

Signs and SymptomsSigns and Symptoms Chest painChest pain Heart beats very fastHeart beats very fast Stomach aches or nauseaStomach aches or nausea Shaking or tremblingShaking or trembling Hands or feet coldHands or feet cold Hot or burning feelingHot or burning feeling Sweating at nightSweating at night Feeling dizzy, faint Feeling dizzy, faint

or weakor weak

© © Center for Victims of TortureCenter for Victims of Torture

Signs and SymptomsSigns and Symptoms

Substance useSubstance use Learning difficultiesLearning difficulties Sexual dysfunctionSexual dysfunction Depression Depression PTSD, other anxiety disordersPTSD, other anxiety disorders

DepressionDepression Feeling sad or angry a lotFeeling sad or angry a lot Trouble thinkingTrouble thinking Feeling worthlessFeeling worthless No hopeNo hope Feeling guilty a lotFeeling guilty a lot Appetite problemsAppetite problems Sleeping problemsSleeping problems Wishing for deathWishing for death

Posttraumatic Stress Posttraumatic Stress DisorderDisorder

Symptoms fall in three main Symptoms fall in three main categories: categories: – Re-experiencingRe-experiencing– Avoidance/NumbingAvoidance/Numbing– Hyper-arousalHyper-arousal

Triggers for PTSDTriggers for PTSD

Certain words, sights, sounds, or Certain words, sights, sounds, or smells may trigger response.smells may trigger response.

Person may not seem “present”.Person may not seem “present”.

Effects on FamiliesEffects on Families

Loss of cultural and social supportsLoss of cultural and social supports Parent-child role reversal Parent-child role reversal Conflict: marital, intergenerational, Conflict: marital, intergenerational,

ethnic/tribal/clan (broken bonds)ethnic/tribal/clan (broken bonds)

© © Center for Victims of TortureCenter for Victims of Torture

Effects on the Community Effects on the Community and Cultureand Culture

FearFear Distrust Distrust Blame Blame ApathyApathy Isolation Isolation StrifeStrife HelplessnessHelplessness

© © Center for Victims of TortureCenter for Victims of Torture

Effects of War on FaithEffects of War on Faith

Strengthening one’s faithStrengthening one’s faith Questioning a supreme beingQuestioning a supreme being Loss of faithLoss of faith

Why can’t we just forget about it Why can’t we just forget about it and go on with our lives?and go on with our lives?

.

Center for Victims of TortureHow can faith leaders help?

Torture, War Trauma and Terrorism affect FIVE basic human needs.

è The need to feel safe

è The need to trust

è The need to feel of value (self worth)

è The need to feel close to others

è The need to feel some control over our lives

Center for Victims of Torture

Clergy with parishioners from Clergy with parishioners from countries in conflict can:countries in conflict can:

+Work to develop trust +Work to develop trust

with members of with members of congregation.congregation.

+Recognize symptoms +Recognize symptoms

““out of control”.out of control”.

++Assure confidentiality.Assure confidentiality.

+ + Find opportunities that Find opportunities that give responsibility.give responsibility.

+ Give choices.+ Give choices.

+ Use community + Use community resources.resources.

+ Offer opportunities to + Offer opportunities to have fun.have fun.

+ Be aware of secondary + Be aware of secondary traumatization.traumatization.

Dealing with DisclosureDealing with Disclosure

As traumatized refugees form As traumatized refugees form trustingtrusting relationships, they may relationships, they may shareshare pain, losses and suffering. pain, losses and suffering. The disclosure represents an The disclosure represents an opportunitopportunity for them y for them to beto be

heard and believedheard and believed..

Dealing with Disclosure of TraumaDealing with Disclosure of TraumaAdopted from the “Guide to Working with Youth people who are Refugees”Adopted from the “Guide to Working with Youth people who are Refugees”

Victorian foundation for Survivors or Torture, Australia Victorian foundation for Survivors or Torture, Australia

When intense emotions are When intense emotions are expressed, you act as a buffer expressed, you act as a buffer against a parishioner being against a parishioner being overwhelmed. overwhelmed.

Disclosure can alternate between Disclosure can alternate between numbing and denial. numbing and denial.

Stay close to his way of coping and Stay close to his way of coping and not challenge it.not challenge it.

You can not assume what is the most You can not assume what is the most traumatic event for a person.traumatic event for a person.

Center for Victims of Torture

Dealing with Disclosure of TraumaDealing with Disclosure of Trauma Adopted from the “Guide to Working with Youth people who are Refugees”Adopted from the “Guide to Working with Youth people who are Refugees”

Victorian foundation for Survivors or Torture, Australia Victorian foundation for Survivors or Torture, Australia

Acknowledgement of the traumatic Acknowledgement of the traumatic experience and feelings is foremost.experience and feelings is foremost.

Closing the discussion when traumatic Closing the discussion when traumatic material has been expressed requires material has been expressed requires sensitivity.sensitivity.– Emphasize that the response is understandable Emphasize that the response is understandable

(i.e., normalize).(i.e., normalize).– Acknowledge her bravery in talking about difficult Acknowledge her bravery in talking about difficult

experiences and feelings.experiences and feelings.– Suggest that he will again feel sad, angry or Suggest that he will again feel sad, angry or

worried .worried .– Suggest that when this happens she shares those Suggest that when this happens she shares those

feelings and thoughts with someone.feelings and thoughts with someone. Center for Victims of Torture

Dealing with AngerDealing with Anger

Understand the cause of anger.Understand the cause of anger.Allow her space and time toAllow her space and time to

express herself further.express herself further.Suggest expressing the violationSuggest expressing the violation

appropriately (making a appropriately (making a complaint,complaint,

writing an editor).writing an editor).Use an intermediary, if conflict is Use an intermediary, if conflict is withwith

you.you.

Messages for survivors:Messages for survivors:

Welcome; I’m glad you are safe and here in Welcome; I’m glad you are safe and here in our community.our community.

You will have much to contribute.You will have much to contribute. I know you have gone through many bad I know you have gone through many bad

experiences.experiences. Most war survivors are still feeling the Most war survivors are still feeling the

effects of these experiences. This is effects of these experiences. This is normal.normal.

I know you were not always a refugee. You I know you were not always a refugee. You have lost much.have lost much.

Spiritual LeadersBe informed. Who has the resources?

How can you access these?

Communicate and make connections. Take a strengths-based and problem-

solving approach to challenges. Center for Victims of Torture

CommunityCommunity LeadersLeaders

Raise awareness.Raise awareness. Be an advocate for Be an advocate for

individuals.individuals. Be an advocate forBe an advocate for

change in systems.change in systems.

Community building and interventions need to focus in all possible ways on enlarging the

sense of community.

Source: Based on work by Mirjana Bijelic, CVT, 1999

Refer, as indicatedRefer, as indicated

Psychotherapy: individual/family/groupPsychotherapy: individual/family/group PharmacotherapyPharmacotherapy Primary medical and dental carePrimary medical and dental care Corrective medical treatmentCorrective medical treatment Physiotherapy, bodywork, etc.Physiotherapy, bodywork, etc. Traditional healing methodsTraditional healing methods Social servicesSocial services Community projects, programsCommunity projects, programs

REFERRAL RESOURCESREFERRAL RESOURCES

Make a list!Make a list! Keep it current.Keep it current. Use it often.Use it often. Accompaniment - take people to Accompaniment - take people to

the resources.the resources.

The Journey of Healing - what would it look like in your:

Family? Community? Place of worship? Self?