Trauma, resilience and healthy and unhealthy forms of dissociation.

This paper outlines the difference between healthy and unhealthy forms of dissociation following, and in response to, traumatic experience, in particular the experience of refugees, calling on 30 years' experience in working with refugees in voluntary and public sectors, including 20 years at the Refugee Therapy Centre, London. It differentiates dissociation from repression, and looks at some of the specific traumatic experiences associated with refugees' displacement and situation, particularly relating to loss. Four key characteristics of resilience are described: 'psychic space', 'sense of self', and the use of a 'listening other' and 'healthy dissociation/resiliency'. Two vignettes are given to illustrate the difference between healthy and unhealthy dissociation.

Cet article souligne la différence entre des formes saines et des formes pathologiques de dissociation, qui surviennent à la suite d'expériences traumatiques et en réponse à ces expériences. L'article s'appuie en particulier sur l'expérience de réfugiés ainsi que l'expérience de trente années de travail de l'auteur auprès de réfugiés dans le secteur public et privé, dont vingt années au Refugee Therapy Centre à Londres. L'article fait la différence entre dissociation et refoulement, et étudie les expériences traumatiques spécifiques des réfugiés, concernant le déplacement et le statut, et particulièrement l'expérience de la perte. Quatre caractéristiques de la résilience sont décrites: « l'espace psychique ¼, « le sentiment de soi ¼, l'accès à « quelqu'un qui écoute ¼ et la « dissociation saine/la résilience ¼. Deux vignettes cliniques sont données pour illustrer cette différence entre dissociation saine et dissociation pathologique.

El presente trabajo da cuenta de la diferencia entre formas saludables y no saludables de disociación, en respuesta a experiencias traumáticas, en particular, la experiencia de los refugiados; a partir de 30 años de experiencia trabajando con refugiados en sectores públicos y privados, incluyendo 20 años en el Centro de Terapia para Refugiados, en Londres. Se diferencia la disociación de la represión, y se atiende a las experiencias traumáticas específicas asociadas a los desplazamientos de los refugiados, y a la situación particular relacionada con la pérdida. Se describen cuatro características de la resiliencia: 'espacio psíquico', 'sentido del sí mismo', 'y el uso de 'otro que escucha' y 'sana disociación/resiliencia'. Se presentan dos viñetas para ilustrar la diferencia entre la disociación saludable y no saludable.

Children, torture and psychological consequences.

Torture is a strategic means of limiting, controlling, and repressing basic human rights of individuals and communities that is often covert and denied by authorities. Deliberate infliction of pain and suffering or intimidation or coercion on children to obtain a confession or information, for punishment of real or perceived offences on the basis of discrimination about race, ethnic or political affiliation, is practiced in many places around the world. Impact of torture on children may vary depending on the child's coping strategies, cultural and social circumstances. We at Refugee Therapy Centre provide psychotherapy and associated treatments to people who have been tortured, giving priority to children. While our main objective is provision of clinical services, our focus is also to influence policy and practice by searching for evidence and demonstrating solutions to improve the lives, homes and communities of children disadvantaged by torture and the services that support them. We seek to provide some remedies to children of refugees who are suffering the consequence of trauma that they experienced and demonstrate good practice. In this paper I will give a brief introduction of our work at the RTC. I then discuss and reflect on children and torture. I will present a vignette and some examples of clinical intervention.