Adonis Diaries

Posts Tagged ‘Post-traumatic-Stress Disorder (PTSD).

The Invisible Trauma of War-Affected Children

Millions of children struggle with the physical and psychological traumas of war

18 million children are being raised in the chaos of war. In the past ten years, as a result of armed conflict, over 2 million children have been killed, 6 million have been disabled, 20 million are homeless, and more than 1 million have become separated from their caregivers.

In 1996, Graça Machel, former wife of Nelson Mandela, released a UN report entitled “The Impact of War on Children,” bringing international attention to the subject among policy makers and academics.

The 10 recommendations made in the report have become guiding principles to aid war-affected children.

Advancements have been made by the international community to address issues of security, displacement, and human rights monitoring, but less support has come to the psychosocial and educational needs of war-affected children.

Robert T. Muller, Ph.D. published on April 27, 2013 :

— Reposted from the online magazine, “The Trauma & Mental Health Report

War vets speak of the images, sounds and smells that continue to haunt them. Many speak of nightmares, flashbacks and periods of crippling grief.

“When elephants fight, it is the grass that suffers” – African proverb

So too, children children living in violent, terrorized environments experience such horrors as destruction of their homes, and the death of parents, siblings, neighbours and friends.

Many live in circumstances where they make critical survival decisions to hide under deceased remains of others, to kill or be killed, and often live through situations where they believe they will die.

Recent years have seen celebrity and political activists join in the discussion. Following his own recovery from severe post traumatic stress disorder (PTSD), Canadian Lieutenant-General Roméo Dallaire, released two books “Shake Hands with the Devil” and “They Fight Like Soldiers, They Die Like Children,” detailing the horrors he witnessed in Rwanda and his mission to stop the use of child soldiers.

Hollywood films have included Hotel Rwanda, Blood Diamond, and Machine Gun Preacher.

Despite media attention, response has been limited. Immediate measures for increased protection and security are necessary and being actively pursued, but the more regenerative responses like those of child-focused psychosocial and trauma rehabilitation are not being appropriately supported or implemented despite the demand and need for these interventions among affected communities.

Following the genocide in Rwanda, in psychological interviews, more than 60% of children claimed that they didn’t care if they ever grew up.

While the global community struggles to value and prioritize global mental health care, millions of war-affected children around the world are left in the wake of traumatic experiences with little to no support.

Children between the ages of 12-18, having had more years exposed to violent conflict, struggle to recover from years of compounding traumas.

Interviews within refugee camps reveal pervasive feelings of depression, anxiety, hopelessness, grief, resentment, anger, and fear among war-affected children.

Graça Machel reports, “The physical, sexual and emotional violence to which they [children] are exposed shatters their world. War undermines the very foundations of children’s lives, destroying their homes, splintering their communities and breaking down their trust in adults.”

Without the support of the international community, most of these children will carry these heavy emotional burdens into adulthood.

Humanitarian aid generally focuses on the concrete, what we can see, measure, build: Food, medicine, bricks, and mortar. Psychological trauma is invisible.

To address the mental health needs of war-affected children as they relate to future peace building goals, international interventions are being established with a focus on the complex interplay between children’s psychological and social development.

These “psychosocial” interventions support not just the emotional healing and development of compassion and empathy, but recognize the important dynamics between children and the social environment in which they form attachments, acquire a sense of belonging, and learn codes of pro-social behaviour.

For more information on psycho-social and trauma rehabilitation for war-affected children check out the non-profit organization, The Freedom to Thrive Foundation, devoted to providing these resources within refugee camps and at the community level in an evidence-based, culturally-sensitive, and community-informed manner.

— Contributing Writer: Adriana Wilson, The Trauma & Mental Health Report

Note 1: Over one million Syrian kids live in abject refugee camps in Lebanon, Jordan and Turkey and many more have been displaced. As is the practice in Israel with Palestinian kids, kids in Syria are frequently used as human shields in this war ravaged country.

Note 2: Visit this site for therapy of traumatized Syrian kids http://sabinechoucair.blogspot.com/2013/08/social-therapy-with-syrian-refugees.html

Read more Is there effective treatment for traumatized kids?

What are the Brain’s Survival Skills? And Fear beyond the Amygdala

Can scientists use the brain’s inherent survival mechanisms to develop better stroke treatment?

Strokes are a major cause of death and disability worldwide, with 150,000 people affected in the UK every year.

Most strokes happen when a blood vessel that supplies blood to the brain is blocked due to blood clots or fat deposits. Once blood is cut off from an area of the brain, brain cells are starved for oxygen and nutrients and start to die within minutes.

A new study in Nature Medicine, scientists at the University of Oxford reveal a novel way in which the brain protects itself in response to stroke.

Ranya Bechara posted on Feb. 27, 2013 “Stroke Vs Brain: Harnessing the Brain’s Survival Skills”

Current treatments for stroke are focussed on breaking up the clots, improving blood flow to the affected area, and ultimately reducing the brain damage caused by the stroke. However, the so called ‘clot-busters’ are only effective if given within one to two hours of the stroke.

Other ways of protecting the brain against stroke damage are in high demand.

In this study, the research team from Oxford University (in collaboration with other researchers from Greece, Germany, and Canada, and the UK) decided to try a new approach. They investigated a phenomenon that has been known for years: some brain cells have an inherent defence mechanism that allows them to survive when deprived of oxygen.

These cells are located in the part of the brain responsible for forming memories: a pretty sea-horse shaped structure called the hippocampus.

The scientists analysed the proteins produced by these cells and found that the key to their survival is a protein called hamartin. This protein is released by the cells in response to oxygen deprivation, and when its production was supressed, the cells became more vulnerable to the effects of stroke.

Photo credit: http://www.vascularinfo.co.uk

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Original article is available here

Fear beyond the Amygdala
Ranya Bechara posted on Feb. 6, 2013

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For decades now, scientists have thought that fear could not be experienced without the amygdala. This almond-shaped structure located deep in the brain (pictured on the left).
The amygdala has been shown to play an important role in fear-related behaviours, emotions, and memories, and patients with damage to the amygdala on both sides of the brain were thought to be incapable of feeling afraid.
However, a recent study in Nature Neuroscience reports that these ‘fearless’ patients do experience fear if made to inhale carbon dioxide- a procedure that induces feelings of suffocation and panic.
The patients reported being quite surprised at their own fear, and that it was a novel experience for them!
Scientists behind the study have suggested that the way the brain processes fear information depends on the type of stimulus.
The results of this study could have important implications for people who suffer from anxiety disorders such as panic attacks and post-traumatic stress disorder (PTSD).
More details can be found here

Any Problems for Social Change in Lebanon? Can humanitarian organizations make a difference?

 And this standardizing of Post-traumatic-Stress Disorder (PTSD

And this stupid  dissemination of erroreous propaganda of “cultures of death,” and the claim of this natural “Lebanese way” of normalizing violence and loss.

I stumbled on an interesting post published by Lamia Moghnieh on The Jadaliyya blog, and titled “Humanitarian and Humane Subjects in Lebanon: The Problem of Social Change”.

I will undertake vigorous editing to make the post readable to the general public, the way I comprehend it, before commenting.

[A Lebanese Red Cross Worker in a Bombed Ambulance in 2006; Image by Ali Hashisho for Reuters]
[A Lebanese Red Cross Worker in a Bombed Ambulance in 2006; Image by Ali Hashisho for Reuters]

The ubiquitous presence of humanitarian organizations in Lebanon since the 2006 war has created a variety of well-paid jobs. 

NGOs have opened up new careers and hopes of  producing new forms of Lebanese tendencies (Moghnieh wrote “subjectivities”).

There are two categories of humanitarian workers

1. Volunteers and workers who contribute from an ethical sentiment of traumatic shock when faced with dehumanizing violence, and this category  has been met with resistance in Lebanon, at least within certain social classes and communities

2. And  those whose activism regulates violations of human rights.This category has been acting with strong subjective mentality, whose critical way of belonging to the Lebanese State might be eroding the possibilities for a real and sustainable mobilization for social change in the country.

The history of humanitarian intervention in Lebanon is tightly linked to a strand of Lebanese history: that of conflict and violence

European governments repeatedly used humanitarianism as a pretext for their own political and military agenda in the nineteenth century, from the Greek war of independence in 1820 to the erupted conflicts and fighting in Mount Lebanon in 1860. The French intervention in Lebanon in 1860 was justified as a humanitarian rescue of a victimized “Christian minority” suffering under “Ottoman Muslim” rule.

Lebanon civil war  that lasted 17 years, and Israel occupation of one-third of Lebanon in 1982, did not necessarily attract multiple forms of international humanitarian interventions: Wars in Lebanon contributed in standardizing Post-traumatic-Stress Disorder (PTSD).

This psychiatric disorder was added to the diagnostic Statistical Manual (DSM) by the American Psychiatric Association in 1980, and disseminated worldwide as trauma resulting from suffering in violent-related situations. The incorporation of psychological trauma in humanitarian intervention programs received priority in 1990. The programs included treatments of PTSD, trauma diagnosis, and other forms of western-validated psychological programs, and placed trauma at the center of humanitarian emergency aid in sites of conflict and war.

This standardized proliferation of humanitarian psychological interventions has been widely articulated and visible in Lebanon during and after the 2006 war. These interventions attempt to produce and influence new forms of psychological concerns with particular and global symptoms of suffering from, and for dealing with violence and loss.

The incorporation of trauma-related interventions in humanitarian emergency aid is one of the many changes that impacted humanitarianism in the post-Cold War era. The identity and principles of humanitarianism have been dramatically reshaped after the fall of the Soviet Union and the outbreak of civil wars in eastern European countries.

These conflict areas opened new domains for humanitarian sovereignty and intervention. Humanitarianism turned from a neutral form of aid to an inevitably politicized intervention in emergencies, a witness of human rights violations and an entrepreneurial industry accountable to Western States, private donors, and corporations.

This new face of humanitarianism has brought forth new challenges, critiques, and dilemmas in the field.

Neutrality in action, a long-standing humanitarian principle acknowledged by most internationally acclaimed organizations like the Red Cross, has been revoked by humanitarian experts themselves among others.

Humanitarian organizations began conflating emergency aid intervention with development and military intervention, while their humanitarian workers were perceived more as politically interested actors than as rescuing heroes.

These new challenges and critiques are manifested in Lebanon, especially since the 2006 war: International and local non-governmental organizations (NGO), as well as State social service institutions , began implementing different post-conflict and relief-outreach programs mainly in South Lebanon and the southern suburbs of Beirut.

During the 33-day war in July 2006 by Israel on Lebanon, humanitarian organizations focused on providing emergency first aid to displaced populations, including a “psychological first aid” (PFA) program that attempts to “de-traumatize” both local and international humanitarian staff and affected communities.

By prioritizing “trauma” as a first aid issue, PFA served as an “on the spot” psychological relief for displaced populations during war. Other forms of psychological interventions included psychiatric referrals, art therapy and psychosocial interventions that were implemented more chaotically during the war.

After the cease-fire, the interest of humanitarian organizations shifted to more standardized and formalized forms of psychosocial rehabilitation for affected communities and vulnerable populations, especially children. The psychosocial rehabilitation programs included different types of developmental projects in villages, which ranged from dialogue with community members to building libraries, and community – programs that served as psychological prevention for future wars and catastrophes and physical reconstruction of affected areas. These programs helped propagate and introduce globally psychiatry as a legitimate way of suffering and of making sense of violence, loss and death.

One example of how some local Lebanese communities resisted and refused to subscribe by this traumatized subjectivity can be seen in the failure of humanitarian organizations in providing proper psychological interventions for Lebanese Moslem Shi‘a sect, the Lebanese community most affected by the 2006 war.

In a public speech delivered during ‘Ashura’ in December 2009, Hizballah’s Secretary General Sayyid Hassan Nasrallah discussed the role of “global organizations studying the psychological effect of the war in South Lebanon” and their failures in detecting signs of trauma among Lebanese Shi‘a. For Nasrallah “this absence of trauma is a special and unique phenomenon in history.”His speech can be seen to express a form of counter-humanitarian discourse , and he challenged universally legitimate forms of suffering that dismiss the political, historical, and cultural contexts of violence and loss.

The epistemic implications behind these programs, the insistence on a victimized, individualistic, and traumatized form of suffering, did not seem to fit with a historical and contemporary discourse of resistance to Israeli occupation and preemptive wars, nor with religio-political worldviews of suffering that circulate in these communities.

This “absence of trauma” is not new in Lebanon. In 1983, Mansell Pattison, an American psychiatrist from the University of Cincinnati, was invited by the Lebanese Ministry of Health to study the impact of the civil war on the nation’s mental health. In a research report published in 1984, Pattison wrote:

I fully expected to find a war-devastating population, with obvious evidence of war trauma. Much to my surprise, this was not the case. The Lebanese population, both Christian and Moslem, were relieved, cheerful, energetic, enthusiastic, basically rebuilding their country. It was like a country of buzzing worker bees. I did not find obvious cases of psychic trauma, and only with difficulty did I unearth indication of indirect effects of war on psychological well-being”

Despite the obvious “essentialism” behind Pattison’s explanations for the absence of trauma in Lebanon, war-affected Lebanese communities seem to ironically engage with these kinds of representations as a way of defying a global form of traumatized subjectivity.

This “absence of trauma” has been sometimes dangerously translated and explained by statements like “cultures of death,” which claim a natural “Lebanese way” of normalizing violence and loss.

But a closer look at the particular modes of violence in everyday life in Lebanon will reveal a much more complex form of suffering and pain that Lebanese communities deal with and recover from collectively. The epistemic resistance to trauma and humanitarian psychological interventions should be read in terms of a resistance to global forms of suffering that abstract death and violence from its historical and political context .

Secondly, humanitarian organizations in Lebanon have created a political economy of human rights and civility that dominates the everyday anatomy in political behaviors and ways of being “Lebanese,” from the proper ways of driving, smoking, standing in line, hiking, and enjoying nature, to  speaking about violence, religion, women, racism and remembering the civil war.

The increased humanitarian involvement in Lebanon helped fund, create and standardize local NGOs and opened new job opportunities for Lebanese youth. This rise of the NGO market also produced a micro political economy of human rights that influences Lebanese politics and the social fabric.

However, in the long-term, it eventually contributes to political stagnation because of the type of Lebanese activism and activists it is producing.

Moreover, during the 2006 war, humanitarian organizations focused heavily on training local staff and community leaders in different forms of humanitarian skills and principles that varied from community-based development, identification and treatment of trauma, programs that aim to prevent the detrimental psychosocial consequences of future conflicts and wars, communication skills, empowerment, community building, identifying human right violations, and others.

These “humanitarian skills” introduced a specific form of activism and humanitarian subjectivity for both local staff and the targeted community members who practiced, performed and learned the value of humanitarian subjectivity.

While it intersected in some ways with the politics of particular local Lebanese communities,humanitarian policies and programs have contributed to the “commodification ” of violence and “incivility” in Lebanon, thus producing a political economy of human rights. While these forms of interventions make corruption and suffering audible and visible, they produce specific forms of subjectivity, the Lebanese activist, the humanitarian and the NGO worker, that may lead to negative consequences in failed States of sovereignty like Lebanon.

These forms of subjectivity can rarely be sustainable since they depend heavily on global connections and many times lack an inter-subjective locality in Lebanon. The documentary Remnants of a War [http://www.remnantsfilm.com ] produced and filmed by Jawad Metni about South Lebanese de-mining workers, is one example of these temporary humanitarian “subjectivities” that cannot possibly be sustained and made permanent by a failed State.

The Lebanese humanitarian subject therefore became inscribed to global and universal forms of humanity, someone who is familiar and aware of multiple causes and takes stands with and against different global and local issues. This micro political humanitarian sovereignty created a special form of belonging to the State, whose already failed and corrupted institutions became the target of critiques, scrutiny and human rights violations.

The Lebanese activist critique the State from the outside, gesturing and recording the already established failures of the State. By globally gesturing at the State and not to the State, the Lebanese humanitarian subject becomes an outside actor incapable of producing meaningful and sustainable social change.

Here lies the paradox of humanitarianism and Lebanese activist who keeps the failed State at check by performing human rights, a temporary form of global critical citizenship and connectivity to the State, while herself being incapable of building a permanent connection and belonging to the institution of which she is critical.” End of article.

 Time to digest this profound perspective.

Note: Israel peppered south Lebanon with 4 million cluster bombs a day before the UN resolution for cease-fire.  Israel objective was to prevent the people to return to their hometown and land…


adonis49

adonis49

adonis49

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