Fighting with Spirits: Migration Trauma, Acculturative Stress, and New Sibling Transition—A Clinical Case Study of an 8-Year-Old Girl with Absence Epilepsy

Abstract

In this article, we discuss the impact of migration and acculturation processes on the cultural, personal identity, and mental health of children who immigrate to a Western, multicultural environment, and the challenges clinicians in such environments face, when confronted with non-Western idioms of distress and healing practices. We do that by presenting a challenging clinical case of an 8-year-old girl who presented with very disorganized behavior, which matches a culturally accepted construct of spirit possession, in the context of migration trauma, acculturative stress, and new sibling transition. We identify cultural conflict in school and bullying as major mediators between acculturative stress and mental distress. We also aim at identifying vulnerability, risk and protective factors, and the importance of cultural coping resources. We explore in depth the patient's cultural background and the family's belief system and culturally shaped narratives, in order to arrive at a cultural formulation, which focuses on the significance of idioms of distress in shaping psychopathology and influencing the personal and interpersonal course of trauma- and stress-related disorders. We also call attention to the finding that in children, idioms of distress may manifest themselves in a somatic manner. We argue, together with other researchers, that spirit possession deserves more interest as an idiom of distress and a culture-specific response to traumatizing events. We finally emphasize the importance of an anti-reductionist clinical stance, that is able to use different levels of understanding processes of distress and healing, and seeks to reconciliate cultural divides and integrate different explanatory frameworks and help-seeking practices.

Colonialism in Early Education, Care, and Intervention: A Knowledge Synthesis

“…Despite our search criteria, many articles focused on specific categories of impairment such as speech and language support (Peltier, 2017), occupational therapy (Gerlach, 2007), behavioural concerns (Chartonas & Bose, 2015), autism (Mandell et al, 2009), or educational achievement (Faircloth, 2006). There was also a body of work that included Indigenous experiences of disability in early childhood generally (DiGiacomo et al, 2013) and in special education (Hibel, Faircloth, & Farkas, 2008), as well as specific discussion of Indigenous early learning (Greenwood, 2006), service navigation (Green et al, 2016), and health (Kenney & Thierry, 2014).…”

“…A number of articles address the difficulty of assessing Indigenous children (Halle, et al 2011;Niles et al, 2007;Ukrainetz et al, 2000) due to cultural translation (Chartonas & Bose, 2015), differing perspectives regarding the trajectory of development (Peltier, 2010), and limited interaction with diagnostic professionals in some regions (Aakhus & Hoover, 1998). Culturally appropriate adaptations of developmental screening tools are largely regarded as a strategy to mitigate cultural conflicts in early childhood assessment and the disproportionate representation of Indigenous children in special education and child welfare (D' Aprano, Carapetis, & Andrews, 2011;D' Aprano et al, 2016;Morrier & Gallagher, 2011).…”