III Engaging with involuntary dislocation

Chapter 10

Involuntary dislocation adversities

Contents

‘Refugee traumaa problematic concept 252

Phases of involuntary dislocation 253

The sequential, constructed process of the adversity impact 256

Meaning Attribution Processes 258

• (a) Personal factors 259
• (b) Relational factors 259

Family 260

Community/socialfactors 261

• (c) Gender, race, age, ethnicity, class, disability, poverty’ 262
• (d) Power position 263
• (e) Predictability, anticipated duration and lasting effects 263
• (f) Set systems of meaning 264
• (g) Current conditions, circumstances, and relationships 264
• (h) Future prospects and hope 265
• (i) A host of socio-political, cultural, legal factors 265

Epistemological punctuation; mark and sign 265

Figure 10.1 Constructed (prolonged) response to adversity 268

The range of impacts from adversity: the Adversity Grid 268

• (a) Negative responses to adversity 269
• (i) Psychiatric disorders (PD) 269
• (ii) Distressful psychological reactions (DPR) 271
• (Hi) Ordinary human suffering (OHS) 271
• (b) Unchanged responses to adversity 272
• (c) Positive responses to adversity 275

Further considerations about the Adversity Grid 280

Adversity Grid administration and applications 282

References 285

‘Refugee trauma’: a problematic concept

The very term ‘refugee trauma’ suggests the simple causality of the problematic Stimulus-Response (S-R) formula. This term is based on the two assumptions that (a) there is a distinctive set of adverse conditions that all refugees are exposed to, and (b) these adversities result in a typical type of ‘trauma’ that refugees experience. Obviously, not all refugees are exposed to the same set of adversities, and, more importantly, it cannot be assumed that all refugees would experience these realities in the same way, even if they were to be exposed to the identical adversities. Despite the fact that these observations are self-evident, the conviction about the validity of the ‘refugee trauma’ persists (e.g. Boehnlein & Kinzie, 1995; George, 2010; Mollica, 2001; Nickerson et al., 2015; Papadopoulos, 1998, 2001a, 2002a, 2002b, 2007).

The idea of ‘refugee trauma' is confused and confusing because it entails a comparable tautological fallacy to what was identified in the previous chapter, i.e. refugees are ‘traumatised’ because they are exposed to a ‘(refugee) trauma' (referring, incorrectly, to a set of adverse events and experiences), and the set of events is considered ‘traumatic’ because refugees developed a ‘trauma’ by being exposed to it. Another fallacy is that because the typical events and circumstances that refugees tend to be exposed to are indeed detrimental, inhuman, damaging, criminal, and negative in some respect, inevitably they will also have, exclusively, a ‘traumatising’ effect on those who are exposed to them. Finally, there is another lack of differentiation, between distress and disorder (Horwitz, 2007). Even if a person exposed to certain types of adversities experiences various forms of distress, suffering, disorientation, etc., why are these considered to be ‘traumatic’? Especially if trauma is understood to be of the PTSD type, which refers to a psychiatric disorder, an actual form of pathological dysfunctionality. In effect, such lack of differentiation amounts to pathologisation of human suffering.

In order to avoid such unclarities, we need to develop a more precise discernment of these processes as well as select appropriate language to address them. Accordingly, it is imperative to differentiate the complexities involved by being reminded of the five constitutive elements of this process (as discussed in Chapter 1), i.e. (a) events, (b) experiences of events, (c) impact of the experience, (d) response to the impact, and (e) communication of all of the above. This means that we need to appreciate these elements as being actual successive stages of the process from dislocation to relocation: not as abstract chronological landmarks, but as phases hill of new experiences which substantially reshape a person. This reshaping affects not only one’s psychological or mental functioning but also the entire person, including, inter alia, alterations in one's outlook to life and human nature, in one’s sense of self and identity, and in many aspects of how one conceptualises key events and experiences. Accordingly, the term ‘refugee trauma' cannot possibly convey the multiplicity of such changes.

In order to fully appreciate the role of these five stages, we need to relate them to two other sets of phases that affect people during the involuntary dislocation process. The first refers to the impact of the actual chain of events, and the second to the epistemic processing of the relevant events and experiences.

Phases of involuntary dislocation

Traditionally, the relevant literature has identified three main stages of the refugee and migration process: pre-flight, flight and post-flight or variations of this, e.g. ‘pre-migration, migration, postmigration’ (Bhugra & Jones, 2001), ‘predisplacement and postdisplacement' (Porter & Haslam, 2005), ‘pre-migration, transit, post-migration’ (Scwheitzer et al., 2007), ‘pre-migration or departure, transit or intermediate stage, and resettlement stage’ (Pine & Drachman. 2005). In addition, other classifications have been used, such as Agier’s three stages: ‘stage of destruction’, ‘confinement’, ‘moment of action’ (Agier, 2008); Stein’s nine stages: ‘perception of a threat; decision to flee; the period of extreme danger and flight; reaching safety; camp behavior; repatriation, settlement or resettlement; the early and late stages of resettlement; adjustment and acculturation’ (Stein, 1981); and Hynes’ slight modification of Stein's eight stages: ‘The Period of Threat, The Decision to Flee, In Flight, Reaching Safety and a Place of Asylum, Refugee Camp Experience, Reception Into a Host Country, Resettlement, PostResettlement' (Hynes, 2003).

Most individuals feel that their lives were divided sharply by their dislocation, in terms of the before and after their big ordeal. This is not untrue. However, the question is: what are the actual sequences of events and their impact on people that produced this radical split between the before and the after? Over the years, I have come to identify four main phases: Anticipation, Devastating Events, Survival, and Adjustment (Papadopoulos, 2001a, 2001b, 2002a, 2010a).

To begin with, the predominant perception in society is that the most ‘traumatic’ experiences are those that are associated with the events that caused the actual dislocation in the first place. Still today, the events that lead up to the dislocation tend to be privileged, even among professionals, as being the main cause of ‘refugee trauma’. For example, Heide, Mooren, and Kleber (2016) argue that ‘many refugees, almost by definition, . . . [suffer from complex trauma], having left their country of origin because of persecution, war, or organised violence’. Without a doubt, these are events of a severely distressing nature, but limiting our focus only to these ones prevents us from appreciating the complexity of the entire dislocation process.

By identifying the phase of Anticipation, attention is directed towards examining what happens before people abandon their homes. In most situations, people know or sense that there is an impending danger, and they are faced with not only the fear of what is going to happen to them, their loved ones, their property etc., but also the enormous pressures to make critical, life-and-death decisions as to how to act. At the same time, they are also being plagued by most painful unknowns, unable to answer agonising questions: will they be able to return or not? is it better for all of them to leave together or for some of them to remain behind and protect their properties? which direction is safer? etc. The pressure on them is enormous because they are not unaware that their decisions are likely to affect not only their own survival but also the future of their families for generations to come.

Connecting these phases with the two involuntary dislocation moments that were identified in Chapter 2 (i.e. the dislodgement from the experience of ‘feeling at home’ within one’s home spaces and the subsequent actual physical movement away from these spaces), we appreciate that the phase of Anticipation often consists of two sub-phases: the first refers to the time when they are still not certain whether their home spaces continue to be experienced as safe and home-like as before and the second includes all their reactions to accepting the reality of their initial dislodgement. Therefore, it is during this phase that they sense the momentous impact of the life-changing shift that the first moment produces.

The phase of Devastating Events encompasses everything that happens when some of the fears that had arisen during the Anticipation phase become a reality, i.e. when the acts of violence explode and when brutalisation and destruction demolish the previous order of things. Coming after the Anticipation, this phase includes all the calamitous and catastrophic actions that make it impossible for people not to abandon their homes. It is during this phase that the most serious and perilous threats to life occur, e.g. killing, rape, torture, destraction of property.

Four interrelated observations need to be made about this phase.

• (a) This is the phase that includes actions with a direct and most detrimental impact on people; possibly the most tangible events and circumstances that can be clearly identified, documented, and consequently characterised and condemned as criminal, as violations of human rights, as inhuman.
• (b) This is the phase that is usually referred to as ‘the trauma’ or the phase of the ‘traumatic events’.
• (c) As a result of the two preceding observations, it is the narrative which accounts for the events and experiences of this particular phase that is usually understood as conveying not only the ‘trauma story’, but also the very essence of the affected person's plight. This means that when workers want to facilitate fleeing people to articulate their unique narrative, it is mainly the story that narrates the incidents of this phase that they are attempting to piece together. As a result, the affected person’s narrative of this phase acquires the status of the ‘personal story’ which serves as the accepted ‘identity card’ of that particular person, becoming the currency for all interactions with most services that offer assistance. These interactions are not limited to those between that individual and the services she or he interacts with, but also include communications among the referring network itself, i.e. when one service refers the identified individual to another service. Unavoidably, this specific narrative that becomes the unique marker of that particular individual is a co-construction between the person and the services and organisations that she or he interacts with.
• (d) In reality, not all involuntarily dislocated persons experience such a phase. A lot of them, sensing the impending danger, flee before they are exposed to any forms of actual violence. This poses enormous problems for such individuals because they are unable to make use of the accepted currency of such communications with their helpers. Moreover, intentionally or unintentionally, a ranking order seems to emerge (among both beneficiaries and helpers) as to who has the most severe ‘trauma story’, creating a seemingly logical linking between the degree of severity of the devastating events, the degree of damage inflicted on the affected persons, and the amount of assistance they will require. As discussed in the first chapter, this apparently logical equation is deeply flawed, mainly because it ignores the complexity of the way events are experienced.

The phase of Survival is characterised by the termination of the previous phase. Now people are safe and have survived all the destructiveness of the Devastating Events. Although during this phase people are indeed free from physical attacks and no longer experience serious threat to their lives, this can nevertheless also be a most unsettling period in its own right due to experiencing their lives as being turned upside down and full of uncertainties. Having been compelled to reluctantly abandon their home spaces, and having endured the ferocity of the Devastating Events, people often languish in limbo during this phase. Typically, this phase covers the time when people are under protection in some safe location, such as temporary refugee camps, where they are not masters of their own destiny or even of their own daily routines. Not uncommonly, they wait for indefinite periods, living in an unknown state with regard to past, present, and future; unclear of what happened to their family and friends, of how to spend each day, of when they will be moved and where to, etc.

Finally, the phase of Adjustment covers the entire period of when the involuntarily dislocated persons settle in a new location which is meant to become their new home, at least for a period of time. The challenges they face are enormous, and several have already been addressed. It is not easy for involuntarily dislocated people to grasp the realities of their new place, new ways of being, new language, new codes of interpersonal relating, new status, etc. while struggling to hold all these together in the context of a coherent sense of self, to digest what they have endured, and to plan for their future. It is indeed a most arduous task to strive to connect meaningfully with their new environment (geographical, cultural, educational, etc.) while processing all their adverse experiences, past and present.

The concept of‘adjustment’ is problematic because it points to a unidirectional effort, implying that it is the involuntarily dislocated persons who have to fit into their new contexts. Other terms used for this phase are equally awkward, e.g. adaptation, integration, acculturation, assimilation. Without entering into a comparative evaluation of them, it needs to be said that to vaiying degrees, all of them

(each with a different emphasis) suggest the newcomers’ own effort to fit into their new environment. Perhaps the term ‘integration’ leaves open the possibility of some mutuality, but even that one has its own questionable implications.

What should not be forgotten is that it is only relatively recently (over the last couple of decades) that the relevant literature started appreciating the importance of this phase. Earlier, the emphasis was almost exclusively on the ‘trauma’ of the Devastating Events phase, taking it for granted that the difficulties people encounter in their receiving countries are inconsequential.

Identifying these four phases not only offers a more differentiated and accurate understanding of what the affected individuals actually go through but also reminds us that each of these phases can be ‘traumatising’ in its own specific way. When considering the causes of the ‘refugee trauma', it should be remembered that they are not a product of one phase. Each phase constitutes a distinct universe in its own right, within which the affected persons perceive themselves and others in a unique way, experiencing their fears and aspirations, their worldview, their past, present, and future in a distinct way. Each phase affects them in their totality, i.e. the intrapsychic and interpersonal as well as socio-political facets of their being. In short, it is not an exaggeration to argue that the affected individuals experience themselves as having a different sense of personal identity during each one of these phases.

However, the very fact that a person experiences oneself in successively different ‘universes’ has also another effect. In addition to (and not instead of) all the suffering and disorientation, they also experience another obvious reality: that despite all the upheavals and all their transformation, in some sense, they remain the same person. This self-evident realisation can have a remarkable impact on them, over and above all the other effects discussed here. Experiencing the continuity of oneself through a series of successive and drastic changes, sensing and distinguishing what remains stable about oneself despite all the profound alterations, can lead to invaluable insights, which can lead to equally profound positive developments.

Ultimately, it is essential that when considering the complexities of the dislocationrelocation process we keep in mind all three sets of stages: the ‘two moments’ (‘internal’ and ‘external’) as well as the ‘six segments’ (also from Chapter 1: in addition to the ‘two moments’, the searching for new home spaces, locating them, inhabiting them, and endeavouring to make sense of the entire process). Without this ‘discerning complexity’, we are likely to fall into the epistemological traps of various forms of oversimplification.