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Working with young survivors of refugee trauma & torture [2012]

What have refugee young people experienced?

Young people who arrive in Australia as refugees or are from refugee-like situations have often had little choice in their migration. Rather it has been forced as a consequence of war or their persecution as members of particular ethnic, religious or social group. Most refugee young people will have been subjected to or have witnessed horrifying and traumatic events.  

These may include:

  • War, bombing or shelling
  • Destruction of homes and schools
  • Violent death or injury of family or friends
  • Separation from family members
  • Sudden disappearances of family members or friends
  • Physical injury and limited medical attention
  • Deprivation of food, safe water and other resources essential for survival
  • Fear of discovery or arrest
  • Arrest, detention or torture
  • Forced conscription into armies or militias
  • Rape or sexual assault
  • Denial of opportunities for play.

All will have experienced some degree of loss of home, place, culture, as well the profound losses of parents, siblings, friends and significant others through death or separation.

What is the impact of resettlement?

On arrival in the new country young people are faced with learning a new language, adapting to a new set of cultural norms, and orienting themselves to many new systems such as the health and schooling system.  

Many experiences in the new country can create new or ongoing traumas for the young people such as:

  • Ongoing danger in country of origin
  • New unfamiliar environments
  • Fear about the future and not coping
  • Continuing separation from family
  • Isolation and a sense of not belonging
  • Devaluing of the person in new culture
  • Injustice
  • Exposure to ignorance and lack of understanding
  • Racial prejudice
  • New humiliations
  • Australian Immigration Detention centres
  • Asylum seeking process/visa processing.

What is the impact of this experience?

The impact of the above experiences can be broken into four broad areas of trauma reaction:

1. Anxiety

  • Intrusive and recurrent distressing recollections of the traumatic event such as recurrent memories, images, nightmares of trauma and flashbacks
  • Impairment in ability to think, concentrate and remember
  • Conditioned fear response to reminders, places, things and people's behaviours leading to avoiding fearful situations, restriction of imaginative play and emotional withdrawal
  • Generalised fear not directly related to trauma such as fear of strangers, fear of being alone and fear of dark places
  • Hyper-vigilance or watchfulness
  • Reacting with startle to sudden changes in environment such as noise
  • Capacity to manage tension and frustration may be reduced leading to reduced control over impulsive behaviour
  • Emotional numbing leading to denial, detachment, reduced interest in activities and people
  • Re-enactments of traumatic events in play
  • Psychosomatic complaints such as headaches, panic attacks, nausea, diarrhoea/constipation, dry mouth
  • Regressive behaviour such as bed-wetting or thumb sucking after having given up those behaviours.

2. Loss of relationships

Grief

  • Numbness, denial
  • Pining, yearning
  • Preoccupation with lost person
  • Emptiness, apathy, despair
  • Anger

Attachment behaviour in relationships altered

  • Increased dependency, clinging behaviour
  • Fierce self-sufficiency
  • Compulsive care-giving
  • Guardedness, suspiciousness.

Depression

  • Pessimism
  • Loss of interest
  • Sleep disturbance including difficulties falling or staying asleep, oversleeping and dreams with loss-related content
  • Appetite disturbance including overeating or low appetite
  • Difficulties with concentration and memory
  • Self-degradation
  • Self-blame
  • Hopelessness
  • Suicidal thoughts and plans.

3. Shattered core assumptions about human existence

  • Loss of meaning and purpose
  • Damaged capacity to trust and intense sense of betrayal
  • Previous expectations and dreams of future changed and need to build new outlook
  • Adolescents may be more alert to issue of human accountability
  • Heightened sensitivity to injustice
  • Impact on moral concepts. Behaviour is either overly regulated by considerations of what is good or bad or alternatively without consideration of good or bad
  • Loss of faith in adult's ability to protect
  • Loss of continuity of the self or impact on developing self-concept.

4. Shame and Guilt

  • Preoccupation with feelings of having failed to do something more to avert violence
  • Use of fantasy to exact revenge and repair damage done during traumatic event
  • Self-destructive behaviour
  • Avoidance of others due to shame
  • Inhibited experience of pleasure
  • Self-blame expressed as self-derogatory
  • Altered sense of self as being, feeling "dirty" or "bad".

How can I assist refugee young people?

When working with a young person who has experienced refugee trauma it is easy to feel overwhelmed. Often we see the many things that could be done to support the young person but find it hard to come to terms with what "I", the worker, can actually achieve for the young person. It is important to remember that "recovery" from trauma is the journey of the young person. We must remember that we will only travel on part of that journey with the young person and they will continue on. For this reason, it is important that case-management and partnership development be central to our work with the young person as this will assist the young person to develop a new network of support in Australia.

Having identified that we have a contribution to make, we then need to identify what skills we will use and what strategies will assist. The following list of strategies relate to the four areas of trauma reaction listed above. Four broad recovery goals are identified and example strategies given. The goals can be used as questions to assist you to reflect on your previous work with a young person and to assist you to plan for the future. Eg. "How have I assisted the young person to restore safety in their life?" and in the future "What could I be doing to assist the young person to restore safety?"

1. Restore safety and enhance control and reduce the disabling effects of fear and anxiety

  • Provide access to basic needs eg. health, welfare, education, accommodation
  • Identify causes of anxiety and accommodate the effects of anxiety
  • Provide services that are safe and consistent
  • Provide information about the trauma reaction
  • Introduce relaxation exercises.

2. Restore attachment and connections to other people who can offer emotional support and care, and overcoming grief and loss

  • Foster a trusting continuing connection with an available caring adult
  • Group participation to reduce social isolation
  • Promote belonging by overcoming settlement problems
  • Link to supportive groups and agencies
  • Provide opportunities for social/ political action which may be valued and restore a sense of purpose.

3. To restore meaning and purpose to life

  • Group programs to promote communication, reduce isolation and enhance self esteem
  • Offer opportunities for integration of past, present and future through art, story telling and drama
  • Create opportunities to facilitate a view of the future
  • Explore concepts of self, other and the community
  • Validate the trauma and difficulties experienced
  • Validate the cultural differences in values
  • Provide human rights education and political background to violence.

4. To restore dignity and value, which includes reducing excessive shame and guilt

  • Facilitate expression of guilt and shame
  • Reflect that it is normal for them to wish they could have done more to prevent others from being harmed
  • Allow the telling and retelling of events and stories
  • Assist with developing ways to reduce guilt
  • Provide space for discussion about the political and social environment contribution to the development of shame
  • Community acknowledgement of human rights violations and the need for redress.

Resources

  • Issues for young refugees Youth Action fact sheet.

  • If you would like to explore these issues in more depth contact STARTTS Training Officer on (02) 9794 1900. STARTTS can provide tailored workshops.

  • CYHS, STARTTS, RHS & BCC. Beyond Survival, 2003 Victorian Foundation for Survivors of Torture. Rebuilding Shattered Lives, 1998

  • Victorian Foundation for Survivors of Torture Inc. Schools In for Refugees, 2004