Refugee Trauma and Dissociation: Reintegrating Lost Parts of the Being
Clinical Master Class Evening held on 30 May 2016
“Come in to my parlour” said the spider to the fly: Complex trauma and betrayal
Refugees and asylum seekers experience betrayal trauma at a ‘meta level’. Subjected to persecution and danger often at the hands of a government that is meant to protect them, trauma is compounded by ongoing danger and often years (or decades), of no safe haven or permanent resettlement. Child refugees and asylum seekers are not only exposed to the same trauma as their parents but also witness parents who are rendered powerless and struggling with their own trauma. They may also be separated from family members. Dissociation is a frontline defence against overwhelming emotional or physical responses to trauma. Intrusive thoughts, images, sensations and emotional flooding are frequently one of the long-term legacies for trauma survivors. Relational issues underpin much of the inner and external conflicts common with survivors of trauma, compounded by dissociative defences. Paradoxically, it is within the context of relationship that the opportunity to heal presents. Rapidly shifting and complex client transference, coupled with the therapist’s countertransference can quickly find the client and therapist partnering in the ‘dance of the triangle’. This can lead to serious rupture of the therapeutic relationship boundary crossings and therapeutic impasse. Based on principles elucidated in her book co-authored with Dr Colin Ross, Trauma Model Therapy: A Treatment Approach For Trauma, Dissociation and Complex Comorbidity, (2009), Naomi outlined four core trauma dynamics. She explored how holding these at the forefront of consciousness, mindful attunement to self, the client’s inner processes and supported by trauma-informed strategies, client and therapist can partner in steps to stay off the triangle.
Making connections: Working our way around the dissociative landscape in psychotherapy with refugees
Staying in the present is impossible when traumatic memory presents as current reality; The dilemma for the psyche is whether or not to split. It seems that this “decision” is first made peritraumatically for many people and this sets them on a particular trajectory where dissociation becomes a default response.
It is possible in therapy, once client and therapist have established safety and a common language, to track the process of dissociation. Thus approach can be therapeutic in itself.
Deb Gould presented the case of a refugee client whose triggers for dissociation were only vaguely (to the observer anyway) connected to the aetiological traumatic event. She described some of the detective work involved in tracking dissociation in a young refugee man from Egypt.
These events are recorded by Psychevisual and are available for viewing on the internet at a later date for a fee. Please see the Psychevisual website www.psychevisual.com.