Unpacking and understanding the 'triggering' depths of refugee trauma

Your story. It’s full of personal intricacies, that you may or may not breathe to another soul. Like every human being, it tells your tales of anguish, sorrow, anger, resentment, relief, pride and happiness. It protects your traumas until you are ready to share them and requires nothing but trust from the shelves on which you choose to place it.

"Trauma is an emotional response to a distressing experience. It can be collected at various and multiple stages of a refugee’s life"

Many refugees, who have encountered unfathomable degrees of distress, choose to share their stories during the UK’s Refugee Week in June, with hopes it may trigger greater societal awareness and action within the realm of refugee rights. The week coincides with the yearly UN-designated World Refugee Day and is aimed at building an understanding of refugees’ "plight and to recognise their resilience". 

But what happens when the party’s over? When months pass and the shelves on which you placed your story move on and collect new books?

The unfortunate reality is that while a single designated day may help a more privileged population to understand the depths of refugees' struggles and traumas, refugees require thousands of single days to truly unpack and become one with them. That’s if they ever really do.

Dealing with trauma and deteriorating mental health

Trauma is an emotional response to a distressing experience. It can be collected at various and multiple stages of a refugee’s life.

This includes their experiences of conflict in their home countries, their – often perilous – journeys as they flee from their homes, and their experiences when they settle into their new host countries, counselling psychologist Farah El Miligui told The New Arab.

"Upon arrival in their host countries and despite many refugees feeling safer after landing on shores free from conflict, refugees can experience a wide variety of mental health conditions, ranging from mild to severe"

Farah, who has several refugees on her caseload, highlighted that trauma of refugees who had to resettle twice may be greater. This applies to individuals brought into the UK through its refugee resettlement scheme UKRS, which brings in refugees who are already in a country of asylum.

It also applies to Syrians who were a part of the UK’s Syrian resettlement programme VPRS, which only accepted refugees who had fled Syria and were living elsewhere in the Middle East.

Upon arrival in their host countries and despite many refugees feeling safer after landing on shores free from conflict, refugees can experience a wide variety of mental health conditions, ranging from mild to severe.

The most common of which are acute stress reactions, complicated bereavement, depression, anxiety, post-traumatic stress disorder, and in fewer but more severe cases, psychosis, and mania, the UNHCR told The New Arab.

However, these conditions, alongside past traumas, can often be swept under the carpet and remain unresolved, as refugees dive headfirst into the hardships that accompany arriving in a socially, culturally, and linguistically unfamiliar location.

"These conditions, alongside past traumas, can often be swept under the carpet and remain unresolved, as refugees dive headfirst into the hardships that accompany arriving in a socially, culturally, and linguistically unfamiliar location"

“The best thing here is the safety that I was missing in Syria because of the war… but, of course, I faced difficulties adapting because I started a completely new and different life,” Israa who arrived in the UK from Turkey after fleeing Syria told The New Arab.

“The biggest thing I struggled with is my lack of a social life… I am away from my family and friends, feeling alone has been a big obstacle and affected my psyche” she added.

The issue of loneliness and unfamiliarity has deeply affected many refugees, triggering and exacerbating ill mental health within them. Syrian national and refugee Abdulrahman explained this resulted in his self-confidence being completely shattered – which contributed to his mental health struggles – after his arrival in England.

"When I came to the UK I didn’t speak a word of English, if you don’t speak English you feel scared of everything around you," Abdulrahman told The New Arab. "I started to lose all my confidence… I started judging myself on everything and felt like I wasn’t good enough to be a member of this community," he continued, explaining that his mental state often left him "on the edge of giving up".

Abdulrahman – who threw himself into learning English, working with refugees and being an ambassador for the most recent Refugee Week – highlighted that "being in a safe country does not mean your mental health will be ok…it’s just a continuing issue and it requires continued support. For me I don’t think it will ever end,” he said. 

The ambassador also highlighted his frustration at having to repeat his story just for others to support his rights. "Sometimes I feel angry because I have to repeat my story to just make people think about their decision [to help us]… to remember your story and the people you love and how you left them and telling that to other people just to get your rights… it’s a very bad situation to put yourself through," he explained. 

"Being in a safe country does not mean your mental health will be ok…it’s just a continuing issue and it requires continued support"

Unpacking trauma and healing in the UK

A "real danger" here is that refugees could be re-traumatised when they speak about their past if they’re not yet truly ready to," Farah says.

"You can’t just ask them what happened to you, it's not helpful," Farah told The New Arab. "Refugees are used to telling their stories multiple times, so their story almost becomes a substitute for their identity… that’s very triggering and they have to keep reliving those experiences so sometimes they end up very dissociative because they don’t want to go through it again and again," she explained.

Trauma should therefore only be uncovered once an individual is ready and has their existing needs met. “In order for you to process traumatic experiences you need to anchor yourself in a safe present moment... [otherwise] it’s actually going to trigger you more," Farah said.

Working through and overcoming trauma can take around five to six years for some refugees, for others, the trauma may never be completely resolved. Accessing the correct help is an additional issue, as Abdulrahman stressed that refugees in the UK do not receive adequate mental health support – a view which appears to be widespread.

"As part of our regular assessments of refugees across the country, many have told us that mental health challenges and a lack of adequate support negatively impact upon their ability to integrate into their new home," the UNHCR told The New Arab. 

The refugee agency said they "continue to monitor the situation of refugees in the UK and advocate with local authorities and partners to improve their access to mental health care".

They also say they have recommended targeted support for refugee women, LGBTIQ+ refugees, minors and elderly refugees, "who are often most affected". The New Arab contacted the UK home office to comment on this but they did not respond at the time of publication.

"Working through and overcoming trauma can take around five to six years for some refugees, for others, the trauma may never be completely resolved"

Breaking down taboos and language barriers

It is also worth noting that working through such traumas can be more difficult for refugees from backgrounds where discussing mental health is taboo – including those from the Middle East.

However, Farah stressed that facing ill mental health is an incredibly normal component of the human experience, particularly when a person is going through a distressing and abnormal situation.

"When you’re responding to abnormal situations you’re expected to respond in an abnormal way… if you’re responding to it in a normal way it’s more of an indication of… detachment to reality… [our] mental health is not who we are… it’s our response to things that happened to us," she explained. 

"Working through such traumas can be more difficult for refugees from backgrounds where discussing mental health is taboo – including those from the Middle East"

Farah is working on a project called In Our Own Words with other practitioner psychologists, after realising a need for a greater understanding of British mental health services when diagnosing and examining foreign patients. "How we use language influences how we experience mental health," she says.

Farah explained it is unlikely Arabic speakers will tell practitioners they feel depressed, and that due to the language of psychology in the Arabic world, they are more likely to say “my heart hurts” – which may be taken literally by British practitioners.

Similarly, she says “the word anxiety doesn’t really exist in the Arabic language, it’s only ‘nervousness’, so it doesn’t really capture the existential experience of anxiety”.

The project is therefore an attempt to “understand how people in mental health settings actually present their symptoms and build an understanding of mental health in the region through ground-up research”.

It is clear that there are numerous components to consider with regard to aiding refugees and helping to alleviate their mental health struggles.

Using knowledge gathered through initiatives like World Refugee Day and the UK’s Refugee Week, is extremely important, both for those in positions through which they can influence change, and for members of the general public, so their understanding of refugees' struggles can be further enhanced for the betterment of society.

However, it is also important to remember that their traumas should be acknowledged and dealt with sensitively and efficiently all year round, as with the right attention, understanding and help, refugees could receive the support they have been calling for, and that deserve.

Aisha Aldris is a staff journalist at The New Arab. 

Follow her on Twitter: @aishaaldris