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  • Publication
    Métadonnées seulement
    (Un)imagination and (im)mobility: Exploring the past and constructing possible futures among refugee victims of torture in Greece
    (2020-1-7)
    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.
  • Publication
    Accès libre
    A sociocultural exploration of trauma among refugee victims of torture
    (Neuchâtel, 2020)
    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. The mental health impact of atrocities endured by refugee populations (1) is clear, with the literature reporting significantly high prevalence rates of post-traumatic stress disorder (P.T.S.D.) among this population. However, there have been significant concerns raised over the relevance and cross-cultural validity of P.T.S.D. as a diagnostic construct. Furthermore, we cannot ignore the impact of the current economic, political, and sociocultural reality facing refugees on their mental health. We need to locate trauma experiences within sociocultural context. The thesis aims to do so by addressing the following questions: • Which narratives of trauma circulate among the diverse actors working with refugees within various legal and medical activity systems? How is the diagnostic construct of P.T.S.D. used as a tool within these activity systems? • How do the individual trajectories of individual refugees, diagnosed with P.T.S.D., unfold over time within this sociocultural context? • How is trauma understood and made sense of by individual refugees? How is a diagnosis of P.T.S.D. accepted and understood (or not) by asylum seekers and refugees from culturally diverse populations? The research is centred on a yearlong follow-up of 10 beneficiaries of the M.S.F. Victims of Torture (V.O.T.) Project in Athens and their partner organization, Babel. An average of five open-ended interviews were conducted with these individual participants. Further data was also gained through complementary sources in order to locate these individual narratives within a socio-cultural context. This included 43 semi-structured interviews with “key informants” - professionals working with this population (doctors, psychologists, psychiatrists, social workers etc.), 21 semi-structured interviews with community leaders of various refugee communities across Athens, and four months of participant observation in the project The results, presented in the form of eight publications, highlight: i) the way in which a P.T.S.D. diagnosis is being used strategically as a cultural tool by various actors within medical and legal activity systems put in place to address the large influx of refugees arriving in Europe ii) the substantial impact of the current (sociocultural, legal, economic, and political) environment on refugee trauma trajectories iii) the culturally diverse narratives of trauma informing refugee mental health, which may compete, contradict, or conform to the narrative of trauma inherent to a diagnosis of P.T.S.D. iv)the multitude of ways in which refugees may exert a power to act as active agents,despite obvious power imbalances characterizing the medical and legal systems within which they manoeuvre. (1)Throughout the thesis, the term “refugee” as defined by the Geneva Convention of 1951 is used to include both refugees legally recognised in a host country as well as asylum-seekers. Résumé: La migration est devenue l’un des sujets majeurs pour le continent européen en ce début de XXIe siècle. Les besoins en accompagnement psychologique des populations de réfugiés sont reconnus, la littérature faisant notamment état d’un taux de prévalence significativement élevé du syndrome de stress post-traumatique (SSPT) au sein de cette population. Toutefois, la pertinence et la validité interculturelle du SSPT en tant que construction diagnostique fait l’objet de critiques et d’interrogations. En outre, nous ne pouvons figer les besoins de réfugiés à leur situation pré-migratoire et ignorer l'impact des réalités économiques, politiques et socioculturelles auxquelles ils sont confrontés tout au long de leur parcours migratoire, au sein des pays d’accueil et de destination, sur leur santé mentale. Nous devons situer les expériences traumatisantes dans leur contexte socioculturel. La présente thèse vise à le faire en abordant les questions ci-après : • Quels récits du traumatisme circulent parmi les divers acteurs travaillant avec les réfugiés dans le cadre des systèmes d'accompagnement et de prise en charge juridiques, sociaux et médicaux ? • Comment la construction diagnostique du SSPT est-elle utilisée comme outil par et au sein de ces systèmes ? • Comment les trajectoires individuelles de chaque réfugié diagnostiqué avec un SSPT se déroulent-elles dans le temps dans leur contexte socioculturel ? • Comment le traumatisme est-il perçu par chaque réfugié ? • Comment un diagnostic de SSPT est-il accepté et compris (ou non) par les réfugiés issus de populations culturellement diverses ? Cette recherche est centrée sur un suivi d’une durée d’un an de dix bénéficiaires pris en charge au sein du projet de Médecins sans Frontières pour les Victimes de Torture à Athènes et par une organisation partenaire, Babel. En moyenne, cinq entretiens ouverts et individuels ont été menés avec chaque participant. Des sources complémentaires ont également été consultées, afin de situer ces récits individuels dans leur contexte socioculturel. Ces dernières comprennent 43 entretiens semi-structurés avec des « informateurs clés » - des professionnels travaillant avec cette population (médecins, psychologues, psychiatres, travailleurs sociaux, etc.), 21 entretiens semi-structurés avec des responsables de diverses communautés de réfugiés à Athènes, et quatre mois d'observation des participants au projet. Les résultats, présentés sous forme de huit publications, mettent en évidence : v) la manière dont un diagnostic de SSPT est utilisé stratégiquement comme outil culturel par divers acteurs au sein des systèmes d’accompagnement et de prise en charge sociale, médicale et juridique ; vi) l'impact considérable de leur environnement actuel (socioculturel, juridique, économique et politique) sur les trajectoires de traumatisme des réfugiés ; vii)les récits culturellement divers du traumatisme informant la santé mentale des réfugiés, parfois en concurrence, contradiction ou conformité avec le récit du traumatisme tel que porté par un diagnostic de SSPT ; viii)les multiples manières dont les réfugiés peuvent exercer leur pouvoir d'action,malgré les déséquilibres de pouvoir évidents caractérisant les systèmes d’accompagnement et de prise en charge sociaux, médicaux et juridiques au sein desquels ils évoluent.
  • Publication
    Métadonnées seulement
    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.
  • Publication
    Métadonnées seulement
    Collective trauma among displaced populations in Northern Iraq: A case study evaluating the therapeutic interventions of the Free Yezidi Foundation
    (2019-7-31) ;
    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
  • Publication
    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
    Métadonnées seulement
    A Sociocultural Exploration of Shame and Trauma Among Refugee Victims of Torture
    (Cham: Springer, 2019)
    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.
  • Publication
    Métadonnées seulement
    “Crying makes your story more believable”: The use of PTSD by asylum seekers and health professionals within the asylum process
    (2018-10-26)
    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.
  • 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
  • Publication
    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.