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Too much too soon
Why people need stability to deal with the past
27. April 2020
Mostafa Meraji | UnsplashGIZ trauma experts working in countries neighbouring Syria reflect on how to respond to collective trauma among Syrian refugees. Taking into account the specific cultural context, GIZ staff question the well-known but rather individualistic concept of self-care and stress the need for collective care.
Syria – a fragmented society
The horrors of a war which blurred the lines between victims and perpetrators have left Syrian society deeply fragmented. Reports claim that over 12 million Syrians have been displaced, fleeing for their lives across internal, regional and international borders. Some have already returned “home”, but for many others this will never be possible. Syrians will have to find ways of integrating a legacy of mass violence and cumulative experiences of physical and psychological wounding, which can manifest itself in collective trauma.
Mental Health and Psychosocial Support (MHPSS) practitioners inside Syria are trying to strengthen individual and collective coping skills, but properly trained staff are scarce. Even before the war began, the country averaged one specialist per 200,000 people. Many of these specialists have since emigrated, and the practitioners who try to fill the gap suffer loss and fear themselves. While narratives of collective trauma and classifications of victims and perpetrators are usually defined by regional and social groups, survivors from all backgrounds are likely to share a collective guilt which can express itself in different ways: for being alive while others are dead and, especially for those outside Syria, for being relatively safe while others are constantly fighting for survival.
Focus on the basics: safety and stability
In the face of such helplessness, the best psychosocially informed work is focused on very basic steps, which are often the most difficult: creating some moments of relative safety and nurturing the stabilizing power of solidarity and connection. While it is true that many people develop traumatic disorders in the aftermath of armed conflict, many more find ways to cope, experience self-efficacy, and support others.
People need emotional, mental and physical stability to survive ongoing violence and loss. Asking someone about life-threatening (traumatic) experiences in circumstances where they feel insecure does not generate stability. A person can feel a sense of stability in a moment of feeling safe while talking to a friend, even if this is only for a short while; their body can relax, and they breathe more easily. Or perhaps at the market, where the joy of buying a new dress can momentarily overcome the constant fear of being harmed. But most of all, stability is felt in moments of feeling connected and supported by others. Good practices are therefore interventions that focus on identifying and reflecting on (re)sources which offer stability to an individual or group. These can evolve and change over time, and differ from one person or group to another.
Since we consider safety and stability to be crucial human rights for all people, regardless of whether or not they are in need of MHPSS, we also work with projects from sectors which are providing basic services such as employment and education, rather than primarily working to improve psychosocial wellbeing. These projects have made great efforts in adapting their planning and implementation to create more safety and stability by physically establishing safe spaces, providing transparent information, sensitising field and management staff to the psychological consequences of war, and carefully connecting their beneficiaries to MHPSS support services.
How to generate stability in MHPSS services
As a Regional Programme which supports service providers, we listen to frontline staff, feed their realities back to donors, and advocate for long-term interventions that generate stability for both project beneficiaries and service providers. To foster safety and stability for the latter, we strengthen self- and staff-care capacities. One of our major lessons learned in this field is that to create some feelings of stability for MHPSS practitioners, an alternative, more collective self-care concept is needed. Self-care that presents itself as a self-serving, individualistic privilege is incompatible with the survivors' guilt felt by practitioners. Instead, MHPSS staff require a collective understanding of mutual care, as well as protection from the adverse impact of continuously facing their beneficiaries’ extreme suffering.
While defining a collective care concept that creates a feeling of safety and stability for practitioners, we came across a quote from Nakita Valerio, a Muslim community activist and academic. “Shouting ‘self-care’ at people who actually need ‘community care’ is how we fail people.” Collective care is “about being there for people without them having to take the initial first step. It's about adopting an ethos of compassion and very intentionally applying that”. As opposed to the concept of self-care, it stresses the need to look at systemic factors that affect people’s wellbeing, and to consider our responsibility as communities.
Applying this to a conflict area such as Syria, where structural violence and global interests provide both the context and its cause, means that we should not propagate collective care without trying to change the structures which force collectives into resilience.