Trauma, Mental Health & Psycho-social Well-being

Last Updated: March 5, 2009

 
There is an identifiable need to confront trauma and support the healing process in post-conflict societies. Societies caught up in long-term violent conflict can also undergo serious changes as a result of long-term exposure to violence. New social patterns may emerge, such as widespread prostitution, rape, and domestic violence. Violence experienced by specific social and ethnic groups can reinforce a sense of group identity and victimization, and can encourage the emergence of markers of group identity, expressed through dress, language, and social practices. Almost all opinions of psychiatrists and psychologists coincide in emphasizing the intergenerational effects of trauma.1  If individuals cannot cope with their past trauma, there is a high chance that they will pass it on to the next generation. Collectively, “societies transformed in these ways by long-term conflict can become engaged in highly (self)-destructive political dynamics in which they become locked in unending conflict with their hated enemies. In such cases, reconciliation will not be achieved through the signing of a peace treaty alone but will also require adjustments at a more fundamental psychological level.”2
 
Despite growing evidence of the individual and collective consequences of trauma, concrete actions to address these ‘invisible wounds’ are considered by many experts as still often inadequate, if not entirely missing, from paradigms of assistance and development employed by relief and development organizations in post-conflict transition. The field of trauma studies is growing, but it remains relatively new and its findings often do not enter the plans of national and international groups engaged in post-war recovery programs. The discussion also remains largely disconnected from the overall peacebuilding community. A growing number of organizations have tried to develop interventions that take into consideration these dimensions through innovative approaches involving local cultural resources, for instance. However, such interventions remain relatively marginal in peacebuilding practices.

Even among experts, many debates remain in terms of what is an appropriate mental health program in a post-war society. There is no agreement, for instance, on the post-traumatic stress disorder concept and no agreement on the appropriateness of vertical (separate) trauma-focused services. Experts disagree on the degree of medicalizing trauma, individual vs. collective approaches to it, or the appropriateness of cultural approaches.
 
 
 
A range of social and mental health intervention strategies and principles seem, however, to have the broad support of expert opinion. Along with more traditional national mental health programs, support to hospitals and community mental health centers or training of local specialists, methods for psychosocial intervention are diverse and include “creative expression through arts and storytelling; the development and promotion of self-help groups; assisting with the completion and reburial rituals; an emphasis on re-training, re-education and re-skilling; the reintegration and reunion of individuals dislocated from communities and families; counseling and group support; information dissemination and connecting people to resources; and at times simply focusing on creating a safe environment where those affected by conflict can meet, network, share experiences and focus on establishing new routines.”3
 
 
 

This subsection explains the importance of linking these practices and issues with other dimensions of peacebuilding. It provides a range of useful tools and key references and refers to many concrete experiences from different parts of the world as well as case studies.
1. Danieli, Yael, ed. International Handbook of Multigenerational Legacies of Trauma. New York: Springer, 1998; Brahm, Eric. "Trauma Healing."’ Beyond Intractability.org.; Summerfield D. "The psychological legacy of war and atrocity: the question of longterm and transgenerational effects and the need for a broad view." J Nervous Mental Dis 1996; 184: 375-377; Lykes, M. Brinton and Marcie Mersky, “Reparations and Mental Health.” In The Handbook of Reparations, edited by Pablo De Grieff. (New York: 2006), 589-622.
2. Barsalou, Judy. Trauma and Transitional Justice in Divided Societies. Washington, DC: Untied States Institute of Peace (USIP), 2005, Special Report no. 135, 9.
3. David Bloomfield, Teresa Barnes and Luc Huyse,(Eds.) Reconciliation after Violent Conflict: A Handbook. Sweden: International Institute for Democracy and Electoral Assistance (2003), 83.

 

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