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    Raconter le traumatisme : perspectives croisées dans le champ de l'asile
    Les représentations collectives du traumatisme des exilés constituent un cadre narratif qui donne forme au traitement et à la manière dont l’individu peut transmettre sa détresse dans un contexte socialement compréhensible et avec des moyens acceptables. Cela souligne alors la nécessité d'explorer des perspectives diverses et croisées, en interrogeant la manière dont le récit de traumatisme prennent effet dans des environnements historiques, culturels, sociaux, économiques, politiques, et dont les espaces collectifs sont agis, signifies, transformes par les acteurs individuels. Le récit est considéré ici comme un outil relationnel dans la vie sociale quotidienne et dans les systèmes institutionnels, un voie de résistance et de création. Pour ce faire, nous présentons quelques résultats d'une étude longitudinale à Athènes, dans un centre pour demandeurs d’asile victimes de torture. L’enquête conduite sur le récit de traumatisme selon trois plans : l'examen des processus par lesquels l’expérience de traumatisme passe au langage ; l'étude de leurs modes de circulation ; et l'analyse des processus de légitimation du récit et des formes de réception qui en résultent.
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    Accès libre
    «En Afrique, aller voir le psychologue, je n’ai jamais entendu ça»: interprétations croisées du psycho-traumatisme entre médiateurs culturels, professionnels de santé et réfugiés victimes de torture à Athènes
    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.
  • Publication
    Accès libre
    Voies de « resubjectivation » chez les demandeurs d’asile victimes de torture
    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
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    Accès libre
    ‘This is not paranoia, this is real life’: psychosocial interventions for refugee victims of torture in Athens
    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.
  • Publication
    Accès libre
    “My mind is not like before”: Psychosocial rehabilitation of victims of torture in Athens
    (2018-7-30) ; ;
    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.
  • Publication
    Accès libre
    Using Cultural-Historical Theory to Explore Trauma among Refugee Populations in Europe
    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.
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    Accès libre
    Being through doing: the self-immolation of an asylum seeker in Switzerland
    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.”
  • Publication
    Métadonnées seulement
    Using cultural-historical theory to explore trauma among refugee populations in Europe
    Europe is living through a refugee crisis of historic proportions which has now become one of the continent’s defining challenges of the early 21st century. Not least among the difficulties are the public health challenges of the multiple traumas faced by this population which constitute severe threats to human, social, cultural, and community development. The psychological impact of atrocities endured by refugees and asylum seekers populations is clear, with the literature reporting significantly high prevalence rates of post-traumatic stress disorder (PTSD) among this population (de Arellano & Danielson, 2008; Kirmayer, Kienzler, Afana, & Pedersen, 2010; Lambert & Alhassoon, 2015; Schweitzer, R., Melville, Steel, & Lacherez, 2006; Steel et al., 2009; Sturm, Baubet, & Moro, 2010; Van Ommeren et al., 2001; Weine, Kuc, Eldin, Razzano, & Pavkovic, 2001). However, there have been significant concerns raised in the literature over the relevance and cross-cultural validity of PTSD as a diagnostic construct (P. Bracken, 2002; P. J. Bracken, 2001; Fisher, 2014; Hinton & Lewis‐Fernández, 2011; Janoff-Bulman, 1985; Kirmayer et al., 2010; Marsella, 2010; Staeuble, 2004; Summerfield, 2001; Tummala-Narra, 2007; Wasco, 2003; Young, 1995). As noted by Roth and Lee (Roth & Lee, 2007), the analytic challenges raised by Vygotsky regarding the “atomistic and functional modes of analysis … [that] treated psychic processes in isolation” (p.1, as cited by Roth and Lee, 2007) remain unresolved. Indeed, one of the principal contributions of the Vygotsky-Luria project is the establishment of a "new psychology" – a ‘decolonized’ way of understanding human thought and activity which takes into consideration the inseparable unity of mind, brain and culture in concrete socio-historical settings (Toomela, 2014). Therefore, consistent with major Vygotskian principles of interactive individual–societal development via the creation of meaning in everyday activities (Daiute & Lucić, 2010), this paper presents the results of a qualitative investigation into experiences of trauma among refugees and asylum seekers. The study incorporates various units of analyses including historicity and context as well as social and material environments in an attempt to go beyond an ‘atomistic’ or individualised framing of psychological difficulties – a particularly relevant consideration for understanding trauma among refugees and asylum seekers in light of the multiple and arguably ongoing environmental stressors with which they are faced as they negotiate material ecologies which both enable and constrain their human activity. It thus offers a subjective analysis of trauma among migrants which takes into account historicity, context, and various levels of analytic scale from within a socio-cultural and historical perspective. Outside of a standardised clinical understanding of trauma, there is a plethora of research indicating that sociocultural and linguistic heritage influences what experiences are interpreted as ‘traumatic,’ the manifestations and expressions of post-traumatic symptomatology, the interpretation of symptoms, narratives of distress as well as culturally-informed healing models (Janoff-Bulman, 1985; Kirmayer et al., 2010; Kleinman & Good, 2004; Luno, Beck, & Louwerse, 2013; Marsella, 2010). As a diagnostic construct developed for use in Western contexts, PTSD has been criticized for ignoring significant variability among symptoms evident in different cultural settings across the world (Hinton & Lewis‐Fernández, 2011; Steel et al., 2009). One example of this variability which continues to attract considerable debate is the prevalence of psychosomatic symptoms found among some cultures and not others (Eagle, 2014). Further criticism is based on the fact that one cannot always link post-traumatic symptoms directly and uncritically to a single event in the life of an individual – a pre-requisite of a PTSD diagnosis by its very definition. Moreover, scholars globally have argued that the location of trauma at the level of the individual in the form of a PTSD diagnosis neglects the broader socio-political and cultural context within which it occurs (Marsella, 2010; Summerfield, 2001; Young, 1995). Such a reductionist discourse potentially individualizes and medicalizes an issue by focusing attention on therapeutic outcomes rather than a political response to the structural issues that led to trauma (Pratt, Johnston, & Banta, 2015). The medicalisation of trauma on an individual level through a psychiatric diagnosis, linked to fixed ‘traumatic’ events in the past, risks rendering us blind to other ongoing aspects of interpersonal, political and social violence on a more global scale, including significant post migration factors which may be deemed equally traumatic by refugees, including current social, political and economic realities and lived daily experiences in host countries (Maier & Straub, 2011; D. Silove, Steel, McGorry, & Mohan, 1998; Derrick Silove, Steel, & Watters, 2000). These criticisms of PTSD therefore highlight the need for a more nuanced, contextualised and ‘decolonized’ understanding of trauma as being significantly determined by larger cultural systems and historic contexts (Carlson, 2005; Dauite, In Press; Kirmayer et al., 2010; Marsella, 2010; Marsella, Friedman, & Spain, 1996; Mattar, 2011; Rousseau, Drapeau, & Corin, 1997; Tummala-Narra, 2007; Wilson, Wilson, & Drozdek, 2004; T. Zittoun, 2014; T. Zittoun, & Sato In press). We will present the results of a 2 month research intervention with NGOs addressing the refugee crisis in Athens, Greece - which included both participant observation and qualitative, in-depth interviews among staff and beneficiaries. Based on principles of ‘action research’ (Reason & Torbert, 2001), the methodology was designed both with regards to the collection of data for research as well as for its potential for transformative action for participants. As such, the design allowed for collaboration with team members of the involved NGOs, local refugee communities and individual beneficiaries, including those diagnosed with PTSD, in order to forge a more direct link between intellectual knowledge and moment-to-moment personal and social action (Reason, 2006; Reason & Torbert, 2001) as well as for an analysis of institutional frameworks. This methodology was similarly inspired by the call of Loizos (Loizos, 2002) for us to invite participants to ‘tell stories’ about themselves at their own speed… [allowing] the suffering persons to represent their ‘illness’ to themselves, perceiving the illness within their own ideas, according to their culture’ (p. 227). Individual participants interviewed were all victims of torture in their respective countries of origin who subsequently sought psychological and medical attention from NGO clinics in Athens, Greece. The 20 refugee community leaders were interviewed in order to broaden our exploration into the multiple traumas to which refugee communities are exposed, and some subjective understandings of ‘PTSD’ as a diagnosis among this population (Schick et al., 2016). By interviewing both individuals as well as community leaders, we attempt to gain a deeper understanding of life trajectories, dynamic processes, interactions and the continual development and change in psychological symptoms; an exploration which equally incorporates a focus on the ever-changing cultural and social systems which determine the various forms of individual subjective experience of psychological difficulties (Ratcliff & Rossi, 2015) The results of these interviews will be presented and open to the audience for discussion. They have been analysed through the lens of activity theory, recently defined by O’Connor as ‘a family of approaches to understanding human mental functioning and action that focuses on how culture, history and social interactions shape individual consciousness’ (p. 1). He examines the various levels in which to make sense of human mental functioning, notably phylogeny (the history of the species), the cultural history of the social group, ontogenesis (the personal history of the individual), and micro-genesis (a microhistory of specific events in the life of the individual, including traumatic events). He draws on Vygotskian theory to illustrate that before a process has landed on a psychological plane, it has to arrive on the social plane. Thus, in examining trauma among refugees, the focus is on ever-changing cultural and social systems which are in continual interaction with the various forms of an individual subjective experience of mental illness. Furthermore, the individuals interviewed are seen as being deeply embedded in complex and dynamic activity systems in which resources are exchanged - wherein individuals are both capable of negotiating and influencing this system as well as being influenced themselves by the system. We will also explore the dynamics of multiple tensions and internal conflicts faced by these individuals in this particular developmental phase of their life trajectories. As such, this presentation aims to draw on a socio-cultural framework which focuses on the intersubjective, mediational space between the individual and culture-society-interaction (O'Connor, 2015); going beyond reductionist labels such as ‘refugee’ or ‘PTSD’ in order to try account for the experience of humans in time and in particular social and cultural environments (T. Zittoun, 2012). Such an approach presupposes human beings inhabit shared forms of life, and utilize semiotic resources (meaning-making and signifying) with reference to social structures and institutions. Meaning is continually negotiated within the social sphere and ‘cultural products, like language and other symbolic systems, mediate thought and place their stamp on our representations of reality’ (Bruner, 1991) (p. 3). This perspective therefore involves a focus on the thread of language and related underlying semiotic systems (T. Zittoun, 2014). It likewise includes a recognition that all languages are composed of different social languages (Bakhtin, 1981; Gee, 2014). Within this framework, we aim to explore, together with the audience, how an individual’s experience of trauma necessarily is influenced by and reflected through language and culture – with culture being considered both as a set of practices physically executed in a tangible and observable sense by the group, as well as integral to belief systems lying internally within individual members (Brewin, Dalgleish, & Joseph, 1996; Drozdek & Wilson, 2007; Sturm, Baubet, & Moro, 2007; Sturm et al., 2010). Such a constructivist approach acknowledges that current concepts of mental health, notably a diagnosis of PTSD, are to some extent socially constructed objects produced within a specific historical period (Ratcliff & Rossi, 2015). The perception of trauma then is mediated through collective memory and the inter-generationally transmitted historic experiences, myths or stories from the past shaping worldviews (Drozdek & Wilson, 2007). Here, elements of temporality will be considered, as well as the continual interaction of the person with their environment in a given social and historical context. The results demonstrate that not only do reactions to trauma differ according to cultural norms, but the very making sense of what is or what is not traumatic may similarly be informed by socio-cultural context (Dauite, In Press; T. Zittoun, 2014; T. Zittoun, & Sato In press). This critical approach goes beyond a reductionist focus on ‘cultural differences’ wherein ‘culture’ is perceived a reified, crystallised concept and viewed as a potential barrier to be overcome in a process of psychiatric classification (Watters, 2001). We thus draw on a Vygotskian view noted by Dauite and Lucic (2010) wherein “ ‘culture’ is not presumed to exist in values or beliefs of ethnicity, gender, or other categories but in the creation of meaning through symbolic thought in situations on the ground. As the primary location of development, social interaction, according to this theory, is not only an influence but the basis for human processes of knowing” (p. 616). The results aim to highlight the heterogeneous, fluid and dynamic nature of individual subjectivities and the multitude of socio-culturally determined discourses which may be drawn upon to make sense of life experiences (Gee, 2014; Squire, 2008), bringing ‘profoundly into question not only the universality of knowledge from one domain to another, but the universal translatability of knowledge from one culture to another (Bruner, 1991)(p. 2). In engaging in such an exploration together with the audience, we aim to contribute to practices of ISCAR by enriching understandings of ‘historical trauma’ (Gone, 2013) or collective, cultural, and identity-related trauma among refugee and asylum seeking populations, with an emphasis on the social location of human subjects and a recognition that trauma responses may carry a sense of group burden and collective suffering beyond symptomatic individuals (Eagle, 2014; T. Zittoun, 2014). Learning about the impact of dislocation, trauma and loss, of political persecution and human malevolence, and social systems involving abuse, neglect, and ethnic and cultural rejection is crucial to understanding the social and historical perspectives of trauma (Wilson et al., 2004).
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    A qualitative and dynamic exploration of multiple vital uses of ICTs among refugees
    Mobile communities have long been known in the social sciences as early adopters and innovative users of information and communication technologies (ICTs) (Broadbent, 2012; Benitez, 2006; Horst, 2006; Ros et al., 2007), allowing them to maintain transnational ties within and beyond family networks and stay connected to the cultural and political life of multiple countries. Specifically, ICTs have played various new, critical roles in the “migration crisis”: as stated by the convenors, “Internet, GPS and social media become important migratory resources for populations on the move.” We propose a qualitative, dynamic exploration of ICTS among precarious migrants. We highlight how they function as symbolic, cultural and material resources (Bruner, 1991) drawn upon by ‘online,’ ‘connected’ migrants to negotiate bureaucratic uncertainty, share important practical information, navigate local situations and maintain a sense of social identity. Thus, we explore the myriad and complex adaptive uses and responses to the dynamic changes and challenges in institutional and social systems which define modern migration (Ratcliff & Rossi, 2015), and how these uses evolve over time. We argue that ICTs open a methodological window into a better understanding of the trajectories, activities, networks and experiences of precarious migrants. Our main data is drawn from the first phase of an 18-month long research intervention in a centre for Victims of Torture in Athens, Greece, which included 60 qualitative interviews with humanitarian actors, individual migrants followed over time and refugee community leaders. This is complemented with examples from an educational project conducted within Za’atari camp, Jordan. References Benítez J.L. (2006). Transnational dimensions of the digital divide among Salvadoran immigrants in the Washington DC metropolitan area. Global Networks 6 (2): 181-199. Broadbent, S. (2012). Approaches to personal communication. Digital anthropology, 127-145. Bruner, J. (1991). The narrative construction of reality. Critical inquiry, 18(1), 1-21. Horst H. 2006. The Blessings and Burdens of Communication: Cell Phones in Jamaican Transnational Social Fields. Global Networks 6 (2): 143-159. Ratcliff, B. G., & Rossi, I. (2015). Santé mentale et sociétés plurielles. Alterstice-Revue Internationale de la Recherche Interculturelle, 4(2), 3-12. Ros A, Gonzalez E, Marin A, and Sow P. 2007. Migration and information flows: A new lens for the study of contemporary international migration. Barcelona: Internet Interdisciplinary Institute.
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