Thoughts on trauma therapy in a post-conflict society
The text below is a compilation of David Becker’s introduction article in “A contextual approach to fear, trauma and loss” – published by Vive Žene, Center for Therapy and Rehabilitation in Tuzla.
David Becker was the long term supervisor and consultant for Vive Žene. David Becker is psychologist and PhD, based in Germany, with a specialization in the field of psychosocial work in relation to trauma, human rights, conflict and war.
Question of individual and social dimension in post-war trauma
Dealing with trauma in the context of manmade disaster is not only a problem of definitions. If it is true, that trauma is part of the social process, so is the discourse about trauma. We thus can describe a series of potential difficulties we have to deal with, when confronting trauma in a given society.
In the transition to democracy politicians tend to think it is time for the victims to shut up. They fear they might hinder the process of reconciliation. The political relevance of a victim has no longer a necessary correspondence to the individual needs of the victim.
There is a social and an individual dimension to trauma. One can overemphasize one or another. During a fight for decomocracy and change, one can still hope for everything to change. But afterwards when the change comes, democracy is not as fantastic as imagined and it does not heal the wounds one has suffered: the dead are still dead, what was lost will not come back. Political change doesn’t heal the individual wounds and it confirms that the past is the past, and that is also something sad.
The social and political ignorane with which many health institutions, therapist, doctors and social workers pretend they can help victims of social and political disaster is quite frightening. “Psychologizing” social realities only deepens the level of alienation in the individual and deepens the traumatic destruction of the individual. Help on an individual level can be very useful if it is done, recognizing the limits inherent to this process.
In the context of war, persecution and post-conflict society we always have the persons directly involved in the ongoing power struggles, and those that seem to be just bystanders. But in fact, no dictatorship could happen if bystanders exist. Mostly bystanders are scared. They have suffered the conflict situation in a position of passivity and anxiety, waiting for those in power to do something. Many of them have suffered. They have hoped to stay out of the conflict. So often ther position is to try to be apolitical, or to just make the whole problem go away.They opt for silence, and thus often, against their own interest, perpetuate the underlying conflicts. Victims run the risk of self-perpetuating their destruction either by denying the social character of their suffering or by ‘over-politicizing’ it.
Lifelong victimhood means lifelong victimization. Individually and socially the situation of victimhood is very difficult. They cannot forget, but somehow they also must continue with their lives. They must look for the political aspect of their suffering but they also have to take care of their individual needs.
Who defines who is a “victim”? Trauma work is supposed to help victims. But who defines who they are? Is it enough if I consider myself as a victim? Should doctors, or psychologists, or judges or politicians define who the victims are? Does it help a society if we enter into a kind of competition about who suffered most?
Adjusting international trauma work to the local context
Trauma work is usually associated to emergency interventions within the framework of humanitarian aid (internationally) and health care (locally), although it has a long-term perspective and might well be better associated to community development.
To understand, for example, in a village in which all the houses were destroyed and people were killed, that reconstruction of the houses, trauma work, reinitiating educational activities, and so on, should all be part on one integral communal project, seems to be common sense. Unfortunately, international help agencies do not have this kind of common sense and tend to carry out one project beside the other, actually avoiding joint ventures and trans-disciplinary projects.
Local groups often deal for years with an unquestioned imported trauma concept that does neither reflect their needs, nor their actual work. Very often people do not dare to say what they are doing, and accept concepts, without critically asking if they really need them. The basic rule here is that the poorer a group or a country is, the bigger the specific need, less people dare to say their own opinion.
Local groups are often confronted with the fact that their work is taken serious and financed immediately after their the disaster has occured. At this moment they themselves lack still knowledge and expertise. When they later have gained expertise and are doing good work that is dealing with the long-term implications of trauma, then a part of the victims doesn’t want to listen anymore. Aid agencies pull out, local politicians seem to think victim’s problems are marginal and not important for the society. Good institutions find themselves in the dilemma that when they are finally doing good work, they begin to have financial problems and a political structure that starts ignoring them.