No abstract

Growing recognition that the world faces a modern epidemic of torture has stimulated widespread interest amongst mental health professionals in strategies for the treatment of survivors. In this article we outline the distinctive experiences of torture survivors who present for treatment in western countries. These survivors are usually refugees who, in addition to torture, have suffered a sequence of traumatic experiences and face ongoing linguistic, occupational, financial, educational and cultural obstacles in their country of resettlement. Their multiple needs call into question whether "working through" their trauma stories in psychotherapy will on its own ensure successful psychosocial rehabilitation. Drawing on our experience at a recently established service, we propose a broader therapeutic aim.

Re|:)etition Strain Injury (RSI), a non-specific and controversial constellation of work-related hand, arm and neck symptoms, became endemic in Australian industry in the early 1980s. Fifty two women who worked in a telecommunications organisation and chicken processing factory and had been diagnosed as having Repetition Strain Injury were interviewed about their perceptions and experiences of the illness. Their accounts ofthe effects of the pain and limitation on their work, home lives and identity reveal pervasive and ramifying consequences, including unemployment, a reduced capacity to do housework, disruption to family relationships and plans for the future, financial hardship, emotional and mental distress, loss of sleep, and an erosion of self-esteem and involvement in leisure activities. Dominant themes in the interviews are the ambiguity of the illness and uncertainty about the prognosis, the disbelief of others which marginalises sufferers and contributes to a sense of loss of 'self and integrity, and the emotive political climate in which the women are forced to renegotiate roles and adapt to the limitations which RSI places on their lives.