What we heard at the trauma workshop
For many who have been through war and other major disruptions, talking about the problem can make it worse: it can be 'triggering', as they say, and open old wounds. There are better ways to deal with trauma, and they start with human connection.
As part of the shift toward bringing mental health issues into the mainstream, there has been an opening up of conversation about trauma and the role it plays in everyday life. For many newcomers, especially refugees fleeing war and other upheavals, trauma is more than a topic worth talking about. It's the subject of a daily, even moment-by-moment struggle.
This summer, the Union of Medical Care and Relief Organizations Canada hosted a trauma response workshop at the Islamic Centre of Canada. (For folks in the GTA, that's the mosque you see on the side of the QEW as you drive past Mississauga).
I went with a trio of friends, one of whom works for Not Just Tourists and helped organize the event. The other two - thanks to the civil conflicts in Syria and Burma - were approaching the day's lessons with more than just a clinical curiosity.
The main speakers were a pair of psychiatrists, Dr. Samer Aldanshashi, who focused on emotional upheaval in Syrian refugees, and Dr. Clare Pain, a U of T professor who often sees patients in Ethiopia, and whose topic was on the need for cultural sensitivity in addressing and treating trauma.
The most surprising and eye-opening insights came from Dr. Pane (apt name...?), who spoke firmly about the limitations of traditional talk therapy. It was definitely a revelation, at least for a psychoanalytic amateur such as myself.
What follows are her words, more or less.
The limits of talk therapy
Often when we talk about therapy for mental or emotional issues, we assume that means talk therapy. Since the time of Sigmund Freud, we consider that the main and most important type of treatment.
Talk therapy has helped countless number of people find the peace and stability they need to lead functional and rewarding lives. On the other hand, it can make the traumatized person feel invaded and uncomfortable, especially if the therapist is otherwise a stranger.
A better approach
We need to start with a beter understanding of post-traumatic stress. PTS (let's leave out the word 'disorder', for now) is often seen as a condition that might last a lifetime.
This understanding of PTS has the sad effect of encouraging us to avoid the person with symptoms of trauma, because we fear we can do nothing to help, or that we may even do or say the wrong thing, and make the situation worse. That fear and stigma can deepen the isolation of the person affected.
In fact, trauma is often quite an understandable reaction to a harmful situation. And like most reactions, it is not a life sentence, but a reactive state that can be overcome with time.
One characteristic of people who have suffered deeply is a tendency protect themselves by staying emotionally flat. When former refugees from the civil conflict in Serbia were shown pictures of kittens and other comforting images, they barely reacted. It was too much of a risk to enjoy such things, only to have their hopes dashed.
The response was quite the opposite when they were exposed to disturbing pictures. This time, their physiological reactions went off the charts. Years after the war had ended, they were still in flight or flight mode.
They had lost the middle range of emotional response, the daily accumulation of small pleasures - looking forward to a meal, or a meeting with a friend.
A big part of PTS - both a cause and effect of it - is disconnection. The social fabric is torn, and people look to themselves to survive. To keep their emotions from being repeatedly damaged, they protect themselves by going numb to the world.
The cure is to restore that connection. For boys and young men, for example, that could involve sports. Building trust with the other players and the coach is a great way to help a person feel like a valued and contributing part of a group.
The connection can come from drama, or art, or any kind of activity that involves self-expression and finding meaning and connection with others.
To underline her point, Dr. Pane showed a picture of a woman celebrating after a church service in South Africa. Her eyes closed, arms in the air, surrounded by other churchgoers: a vision of ecstasy.
Most people in the township where the picture was taken cannot afford clinical treatment. But is talk therapy really what they need? The image suggests otherwise, that they have found their treatment and it is a powerful one.
Whether you're a social worker, a therapist, a sponsor, a family member or a friend of someone who has been through a particularly tough time in life, consider this approach. Reach out and invite them back into the fold.
A little engagement and empathy may be exactly the sort of healing they need: it may be what you need as well.