Kloetzer, Laure

2019-4-30, Womersley, Gail, Kloetzer, Laure

Malgré la prévalence élevée d’état de stress post-traumatique, ou SSPT (Syndrome de Stress Post-Traumatique) diagnostiqué chez les réfugiés, d’importantes critiques ont été soulevées quant à sa pertinence comme construction diagnostique, notamment au plan interculturel. En outre, la collaboration entre les professionnels en santé mentale et les réfugiés se heurte fréquemment aux barrières linguistiques et culturelles, ce qui accroît les risques d’incompréhension. Le médiateur culturel joue dans cet espace un rôle clef de mise en dialogue des conceptions et interprétations variées de la souffrance et du trouble mental entre les réfugiés et les professionnels de santé. Afin d’explorer la diversité des perspectives des réfugiés, des professionnels de santé et des médiateurs culturels sur le traumatisme, nous présentons les analyses issues d’un travail de recherche de douze mois auprès d’ONG travaillant à Athènes, en Grèce, avec des réfugiés victimes de torture. Nos analyses se centrent sur la manière dont les réfugiés victimes de torture vivent et qualifient leur traumatisme ; la construction des représentations, des pratiques et des normes concernant les troubles mentaux dans l’interaction avec les professionnels de santé ; et la façon dont divers acteurs se représentent, comprennent et utilisent une construction diagnostique telle que le SSPT. Notre recherche souligne la nécessité d’une compréhension plus nuancée et contextualisée du traumatisme, comme étant influencée de façon déterminante par des systèmes culturels et des contextes sociaux, économiques et historiques plus vastes.

2018-7-30, Womersley, Gail, Kloetzer, Laure, Van den Bergh, Rafael, Venables, Emilie, Severy, Nathalie, Gkionakis, Nikos, Popontopoulou, Christina, Kokkiniotis, Manolis, Zamatto, Federica

Abstract Introduction: The dual trauma of being a victim of torture as well as a refugee is related to a myriad of losses, human rights violations and other dimensions of suffering linked to torture experienced pre-migration, as well as different forms of violence experienced during and after migration. Method: To present three case studies to explore culturally-informed perspectives on trauma among victims of torture and track trajectories of psychosocial rehabilitation in relation to environmental factors. The case studies are part of a larger qualitative study of asylum seekers and refugees in a center for victims of torture in Athens, managed by Médecins Sans Frontières and Babel in collaboration with Greek Council for Refugees, which follows beneficiaries, their care providers and community representatives and leaders. Results: Key themes emerging include the substantial psychological impact of current material realities of migrant victims of torture as they adapt to their new environment and engage in rehabilitation. Delayed asylum trials, poor living conditions and unemployment have a substantial impact on posttraumatic symptoms that in turn influence psychosocial rehabilitation. Personal, social, and cultural resources emerged as having a mediating effect. Discussion: The results highlight the significant impact of the political, legal, and sociocultural environment on psychosocial rehabilitation. Practical implications for interventions are to ensure holistic, interdisciplinary, and culturally sensitive care which includes a focus on environmental factors affecting resilience; and with a dynamic focus on the totality of the individual over isolated pathologies.

2017, Womersley, Gail, Kloetzer, Laure, Goguikian Ratcliff, Betty

Events that took place before migration have an influence on the mental health of asylum seekers and refugees. But research findings show that the majority of stress factors are directly related to post-migration living conditions and restrictions. Prolonged legal insecurity, the obligation to move from one center to another, and isolation among other factors contribute to the deterioration of refugees’ mental health. Implications reach far beyond the individual: it is a question of social and economic significance for Switzerland as well.

2018-10-4, Womersley, Gail, Kloetzer, Laure

Résumé Aux expériences traumatisantes multiples vécus tout au long du parcours migratoire, font écho des expériences d'exclusion ainsi que les difficultés et incertitudes liées aux trajectoires administratives – tous ces facteurs générant des effets désubjectivisants. Pour les victimes de torture en particulier, le trauma est extrême. Afin d’explorer des processus de resubjectivation, nous avons mené une étude longitudinale à Athènes, dans un centre pour demandeurs d’asile victimes de torture. Quelles activités et quelles ressources ces personnes en situation d’exil mobilisent-elles pour résister de manière créative aux processus de déshumanisation ? Les analyses dialogiques mettent en évidence le potentiel transformatif des « ressources créatives » mobilisées pour réinjecter de la vie et du lien là où prévaut le mortifère et la déliaison. Mots clés : traumatisme, resubjectivation, demandeurs d’asile, torture Pathways of “resubjectification” among victims of torture seeking asylum Résumé The multiple traumas experienced by migrants throughout the migratory journey echo experiences of exclusion as well as the difficulties and uncertainties related to administrative procedures in the host country - all of which risk “desubjectifying” the individual. For victims of torture in particular, the trauma is extreme. In order to explore processes of “resubjectification,” we conducted a longitudinal study in Athens, in a centre for victims of torture seeking asylum. What activities and resources do these individuals in exile mobilize creatively to resist processes of dehumanization? A dialogical analysis highlights the transformative potential of creative resources for the individual as a source of life and creativity. Key words: trauma, resubjectification, asylum seekers, torture

2018-6-19, Womersley, Gail, Kloetzer, Laure

The psychological impact of atrocities endured by refugee populations is clear, with the literature reporting significantly high prevalence rates of post-traumatic stress disorder (PTSD). Given the numerous criticisms surrounding the use of PTSD, we argue that cultural-historical psychology allows for a unique perspective in which to examine trauma among this population. Notably, we aim to bring a critical regard towards ‘psychiatrisation,’ arguing instead for a non-reductionist ontological vision of human nature and development as being rooted in cultural-historical context as well as material social practices. The results of a yearlong intervention in a center for refugee victims of torture in Athens is presented, which included 3 months of participant observation and 125 interviews with health professionals, refugee community leaders and individual victims of torture. A qualitative case study is presented to emphasise the social, cultural, and historical location of trauma. The paper highlights the need to focus on the current material ecologies of refugees entering Europe – their developmental activities in interaction with their environment.

2018-7-31, Womersley, Gail, Kloetzer, Laure

The need for culturally relevant treatment interventions for refugees focusing on post-migration factors is clearly of no small concern. To (i) explore culturally informed perspectives on trauma from an individual, qualitative perspective and (ii) track the trajectory of post-traumatic responses in relation to processes of social integration, we present the results of 12 months of research among asylum seekers and refugees in an NGO-run centre for victims of torture in Athens, Greece. This included an in-depth follow-up of 10 victims of torture, as well as interviews with 36 health professionals, seven cultural mediators and 21 refugee community leaders. A case study from the research project is presented to illustrate the substantial psychological impact of current material realities of refugee victims of torture as they adapt to their new environment. An interpersonal-social model is presented which examines various post-migration ‘feedback loops’ influencing post-traumatic symptomatology.

2018-4-9, Womersley, Gail, Kloetzer, Laure

In April 2016, Armin,1 an asylum seeker in a village of Switzerland, set himself alight in the public square of the town, one of a few cases reported across Europe. He performed the act following a denied request for asylum and was saved by bystanders. We present the results of two qualitative interviews conducted with Armin, his translator and his roommate following the incident. The act is theorized through the lens of a dialogical analysis focusing on the concept of social recognition. The notion of trauma is considered as a key mediating mechanism, theorized as creating ruptures in time, memory, language, and social connections to an Other. We conclude this communicative act to represent both “being-toward-death” and a relational striving toward life; a “destruction as the cause of coming into being.”