In war, the saying “a picture is worth a thousand words” applies all too well. Images of bullet-riddled houses, children injured by landmines, and mass graves are striking and disturbing to view. Still, they are only glimpses into the reality of those whose daily lives are dominated by violent conflict.
The resulting damage goes far beyond the physical: these images are but markers of trauma etched deeply in the memories of victims and survivors.
After Vietnam, the term Post Traumatic Stress Disorder (PTSD) entered into our vocabularies. PTSD is centered on the individual both in its definition and approaches to trauma treatment. Yet violent conflict affects not only the individual, but also whole societal structures: communities, families, villages and cities, as well as their cultural, social and economic institutions.
How can communities deal with trauma on such a vast scale? So far, community approaches to coping with trauma have received little attention, but an emerging field has been questioning psychological approaches that examine trauma only at an individual level.
IDRC’s Peace, Conflict and Development program (PCD) has been supporting these efforts in the hope of building a critical mass of research on community-oriented understandings of trauma and the consequences of violent conflict. PCD-funded research highlights how local approaches to trauma healing tend to be more holistic by taking into consideration social, communal, as well as individual concerns — in other words, a psychosocial framework.
We have to think beyond the individual consequences of violence to include how social and political contexts influence individuals and communities. What needs to be “treated” is therefore the multitude of individual, political, social and cultural responses to a traumatic situation and its aftermath. Such an approach has direct synergy with development and peacebuilding work.
Youth and Conflict in the West Bank
One example of PCD-supported research in this area is a multiphase project on Palestinian Adolescents Coping with Trauma (PACT), led by Birzeit University and Queen’s University. In the West Bank, where adolescents make up 49% of the population, prolonged conflict and political violence, lack of security, disruption of normal social structures, and familial stress have all had negative impacts on adolescent social and emotional development.
The first phase of the Palestinian Adolescents Coping with Trauma (PACT) project began in 2002. It focused on field research that assessed youth exposure to trauma, their symptoms of psychological distress, coping mechanisms, socio-economic status, available social support, as well as adolescent views on violence and their hopes for the future. In the second phase, the researchers applied these findings in a pilot community intervention model addressing social suffering in non-biomedical ways.
By engaging communities in understanding and dealing with their problems, particularly among youth populations, existing social support networks and social cohesion were strengthened and communal resources and assets were pooled. The PACT research team partnered with Community-based Rehabilitation (CBR) workers in the West Bank, and these CBR workers are now working with youth and their families in four West Bank locales to address psycho-social health.
The resulting intervention model for psycho-social support in Palestinian communities has a dual strategy: it contains both a development model designed by Birzeit with Queen’s University and international support; and a community-based “bottom-up” intervention model strengthening internal community support in a society suffering from violent military occupation and severe economic stagnation. The third phase of the project will continue to build upon these efforts and to transfer the model into more widespread and mainstream CBR practices.
Understanding the Trauma of Female Refugees in Africa
Another example of research aiming to influence trauma service delivery in developing countries was a sub-project of the Violence in Transition Project (VTP 2), led by the Centre for the Study of Violence and Reconciliation, this time focusing on adult female refugees from the Great Lakes region who settled in South Africa.
This research provides a stark example that a cookie-cutter approach to dealing with trauma is simply not enough. For example, women who are victims of rape and forced marriages, or again have suffered the loss of a child during the conflict, are not only traumatized by these events, but also suffer the burden of social expectations regarding virginity and motherhood.
The research documents women who were forced to marry men who have raped them, and others were targeted because their husbands came from another ethnic group. Also, because women often do not have the same rights to land, widows may lose their land and become more impoverished, all the while having more difficulty caring for their children.
It is clear that these women’s experience of conflict is strongly shaped by social expectations, gender roles, discrimination and poverty. However, it is important to recognize that these women should not be viewed purely as victims: they not only demonstrate significant resilience, but also access informal support networks within their communities. It is therefore not surprising that the research concludes that there is a need for a holistic intervention that goes far beyond the usual PTSD counseling model.
Former Child Soldiers in Colombia
This is a new PCD initiative in partnership with Universidad de los Andes. To date, public policies in Colombia, well-known for its protracted civil war, have focused more on the physical and economic protection of the victims – the more “visible” damages from conflict. This project will instead focus on the psychosocial trauma experienced by young people who have left the armed conflict, as well as their families and communities. Based on the studies findings, the researchers will propose and implement a sustainable model intervention to address psychosocial trauma at the community level.
Psychosocial Practitioners Collaborating Globally
Based on earlier research support, PCD is launching a new global project with INCORE (International Conflict Research) on the psychosocial dimensions of trauma. It will consolidate the theory and best practices of these alternative perspectives and challenge the dominant medical approach to trauma and the industry that surrounds it.
In the spring of 2008, social science researchers, mental health practitioners, psychologists and physicians from Africa, Europe, Latin America, North America, Middle East and South Asia will gather for a roundtable in New Delhi to develop a core text on psychosocial approaches to trauma. In the longer term, this project will facilitate the creation of a network that would privilege Southern-based, alternative approaches to trauma in the hopes of mainstreaming thinking on trauma – which remains Northern-driven and dominated by individualistic approaches.
Peace, Conflict and Development is proud to support research that explores the intricate stories behind the pictures, and more importantly, empower communities to cope with conflict positively. The applied research that it supports on trauma healing means more context-relevant, community-based interventions. PCD’s programming is also building on those regional projects to develop global collaborations and learning on trauma healing.
