Womersley, Gail

2020-1-7, Womersley, Gail

Greece represents a unique context in which to explore the imagination-(im)mobility nexus: both a transit country and final destination for refugees. This article explores the imagination of refugee victims of torture in Athens as they weave together images of the past, present and future to confer meaning to their current situation and imagine new possible futures. In the context of a growing interest in emotions and temporalities linked to migration, the aim of this paper is thus to explore the complex interplay between the imagination of migrants and the trauma from the theoretical standpoint of sociocultural psychology. The paradoxes are multiple: (i) Migration is inherently imaginative, in the sense that the actualisation of migration begins with individuals imagining their destination; (ii) however, trauma related to forced migration experiences in particular may impede imagination. To further add to the complexity: it may be imagination itself which acts as an essential component to healing from trauma. The article explores forced migrants’ mobility choices and individual migration trajectories to provide insight into how the emotionality of subjective experiences, as well as the sociocultural context, are fundamentally involved in people’s plans to migrate and the development of their ever-changing imagination of a better future elsewhere. The results similarly illustrate imagination as being significantly shaped by the collective imaginings of entire communities.

2019, Womersley, Gail

Shame profoundly colours the experiences of the thousands of refugees entering Europe. Not only does the literature attest to the high levels of trauma among this population, research in the past decade has increasingly revealed the hidden yet pervasive role that shame may play in posttraumatic symptomatology. Shame may emerge as a result of the many forms of torture, sexual violence and other atrocities experienced in the country of origin, yet is equally exacerbated by degrading and humiliating asylum procedures, having to accept a new and often devalued social identity of being an asylum seeker, and the embarrassment of not meeting culturally-informed expectations to financially support the family back home. Shame is a complex process affecting core dimensions of the self, identity, ego processes, and personality—and is thus inextricably shaped by culture. It has a detrimental impact on health-seeking behaviour, yet its masked manifestations remain often unnoticed by practitioners. This is a critical consideration for clinicians and researchers working with refugee populations, where the relation is typically marked by power differentials across a matrix of identities informing not only the shame of the refugee but of the clinicians or researchers themselves. As both a researcher and clinical psychologist working with refugee populations, I explore the myriad dimensions of shame within this context based on personal reflections of my time “in the field” as well as the burgeoning literature on this topic. Key implications for techniques and methods which may be drawn upon by both researchers and clinicians are discussed.

2018-7-2, Womersley, Gail

Shame profoundly colours the experiences of the thousands of refugees entering Europe. Not only does the literature attest to the high levels of trauma among this population, research in the past decade has increasingly revealed the hidden yet pervasive role that shame may play in posttraumatic symptomatology. Shame may emerge as a result of the many forms of torture, sexual violence and other atrocities experienced in the country of origin, yet is equally exacerbated by degrading and humiliating asylum procedures, having to accept a new and often devalued social identity of being an asylum seeker, and the embarrassment of not meeting culturally-informed expectations to financially support the family back home. Shame is a complex process affecting core dimensions of the self, identity, ego processes, and personality – and is thus inextricably shaped by culture. It has a detrimental impact on health-seeking behavior, yet its masked manifestations often remain unnoticed by practitioners. This is a critical consideration for clinicians and researchers working with refugee populations, where the relation is typically marked by power differentials across a matrix of identities informing not only the shame of the refugee but of the clinicians or researchers themselves. As both a researcher and clinical psychologist working with refugee populations, I explore the myriad dimensions of shame within this context based on personal reflections of my time “in the field” as well as the burgeoning literature on this topic. Understanding shame as a health resource for refugee populations will be discussed.

2018-3-3, Womersley, Gail

Background: The mental health impact of atrocities endured by refugees and asylum seekers is clear, with significantly high prevalence rates of post-traumatic stress disorder (PTSD) being reported among this population. Torture has emerged as a particular triggering factor. However, there have been significant concerns raised in the literature over the relevance and cross-cultural validity of this psychiatric diagnosis for refugee populations Method: In order to explore culturally informed representations and perspectives on trauma among refugee victims of torture, we present the results of 12 months of research among asylum seekers and refugees in a center for victims of torture in Athens. This research includes 125 in-depth, qualitative interviews with beneficiaries (refugee victims of torture), health professionals, cultural mediators/interpreters, and leaders from refugee associations and communities across Athens. The results are illustrated using case studies. Results: The majority of refugee victims of torture appear to contest the medicalised notion of « PTSD » with which they had been diagnosed. When referring to their subjective experiences of trauma, they draw upon a variety of diverse cultural representations of suffering (« explanatory models ») and idioms of distress to explain their subjective experiences of trauma. Conclusion: The research findings highlight the need for psychosocial interventions to incorporate a more culturally contextualised understanding of trauma.

2019-11-27, Womersley, Gail, Kloetzer, Laure

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.

2018-10-26, Womersley, Gail

Asylum seekers entering into Europe are often obliged to tell their story to multiple actors (often with a focus on the ‘trauma narrative’) in order to be legally recognized as refugees. Lacking alternative evidence, many attempt to prove their ‘well-founded fear’ and the violence to which they have been exposed through a diagnosis of post-traumatic stress disorder (PTSD). However, the literature highlights the risk of PTSD becoming a ‘pre-requisite’ for validating the experiences of asylum seekers, reifying and reducing these experiences to a diagnosis in order to render accounts believable. To categorize an asylum seeker with PTSD is therefore ‘an act of meaning making,’ entrenched in the habits and discursive practices of medical and legal institutions with very concrete social, material and legal consequences. To explore this, we present the results of a yearlong research projects among asylum seekers diagnosed with PTSD as well as their treating health professionals (including doctors, psychologists and psychiatrists) in a center for victims of torture in Athens, Greece. We analyze the use of the category of PTSD by various actors, notably as factor influencing the decision-making process and the exercise of discretion during the refugee status determination process. The analysis reveals the multiple contradictions in how the various actors involved (including lawyers, bureaucrats, health professionals and the asylum seekers themselves) use this diagnostic construct. We highlight the substantial differences in understanding the diagnosis reflecting existing power imbalances, the way in which narratives of trauma may be purposefully ‘rehearsed’ for the tribunal, and the tensions surrounding the sharing of the trauma narrative within this activity-system.

2018-6-19, Womersley, Gail

The dual trauma inherent in being both a victim of torture as well a refugee is related to a myriad of losses, human rights violations and other dimensions of suffering. Furthermore, a plethora of research has demonstrated the psychological impact of discrimination and racism experienced by migrants upon arrival to the host country (Akhtar, 1999; Hollander et al., 2016; Kartal & Kiropoulos, 2016). Such research highlights how “racial trauma” (Tummala-Nara, 2007) can have a profound impact on an individual’s sense of self, identity formation, and relationships with others. However, focusing too heavily on trauma risks pathologizing individuals, thereby ignoring wider socio-ecological contexts and denying aspects of resilience. This paper explores resilience as it is experienced by refugees in the context of a relational community (Eades, 2013). Resilience here is considered essentially as a social and environmental attribute (Lusk & Baray, 2017), the capacity of a person’s “informal and formal social networks to facilitate positive development under stress” (Ungar, 2013, p.1). In order to explore trauma and resilience among refugee victims of torture, we present the results of 12 months of research among refugees in a centre for victims of torture in Athens. This research includes 125 in-depth, qualitative interviews with victims of torture, health professionals, cultural mediators/interpreters, and leaders from refugee communities. Case studies illustrate the substantial psychological impact of current material realities of refugee victims of torture as they adapt to their new environment and confront discrimination, and the variety of resources they draw upon to build resilience. Using a socio-ecological framework (Sleijpen, Mooren, Kleber, & Boeije, 2017), we explore the strategies used by this population in order to discuss additional insights of an interpersonal and communal perspective for the growing field of research regarding resilience after traumatic experiences.

2019-7-31, Womersley, Gail, Arikut-Treece, Yesim

Yezidism arguably remains one of the most oppressed religions in Iraq, with the population historically confronted by many attempts at genocide. These atrocities haveleft many survivors displaced and affected by trauma, yet little research has been conducted on experiences of trauma among this population. In the context of an internal evaluation of the Free Yezidi Foundation’s mental health intervention in the Kurdistan Region of Iraq, 200 Yezidi women were screened at the beginning and end of a six-month mental health intervention using the World Health Organization (WHO)-5 well-being scale and the Harvard Trauma Questionnaire (HTQ). Qualitative data were obtained from sixteen focus group discussions (FGDs) among service users ofthe project as well as six in-depth qualitative interviews conducted with members of the project team. The results of the WHO-5 indicate a 74% increase in self-reported well-being among service users who completed the programme. According to the results of the HTQ, the baseline prevalence rate of posttraumatic stress disorderwas 81.25%,which decreased to 45% upon completion of the programme. A qualitative analysis of interviews and FGDs highlighted that a significant impact on mental health were collective, multiple losses and separations (including family members who sought refuge abroad), the fact that not all Yezidi held in captivity have returned, fear of ongoing attacks and daily stressors related to poor living conditions. The results highlight the substantial impact of the political, legal and sociocultural environment on both the prevalence of trauma as well as processes of psychosocial rehabilitation. The implications for interventions include utilising socioecological frameworks for research and practice, engaging in advocacy and establishing agendas for mental health practice and psychosocial support that emphasises individual and collective self-determination

2018-7-3, Womersley, Gail

The mental health impact of atrocities endured by refugees and asylum seekers is clear, with significantly high prevalence rates of post-traumatic stress disorder (PTSD) being reported among this population. Torture has emerged as a particular triggering factor. However, there have been significant concerns raised in the literature over the relevance and cross-cultural validity of this psychiatric diagnosis for refugee populations. 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 trauma manifests. In order to explore culturally informed representations and perspectives on trauma among refugee victims of torture, we present the results of 12 months of research among asylum seekers and refugees in a center for victims of torture in Athens. This research includes 125 in-depth, qualitative interviews with beneficiaries (refugee victims of torture), health professionals, cultural mediators/interpreters, and leaders from refugee associations and communities across Athens. The results are illustrated using case studies. The majority of refugee victims of torture appear to contest the medicalised notion of « PTSD » with which they had been diagnosed. When referring to their subjective experiences of trauma, they draw upon a variety of diverse cultural representations of suffering (« explanatory models ») and idioms of distress to explain their subjective experiences of trauma. The research findings highlight the need for psychosocial interventions to incorporate a more culturally contextualised understanding of trauma.

2018-6-15, Womersley, Gail