Stories of trauma in family therapy with refugees: Supporting safe relational spaces of narration and silence

Abstract

With the sharp increase of refugees' arrival and resettlement in western communities, adequate mental health care forms a pivotal dimension in host societies' responses to those individuals and communities seeking protection within their borders. Here, clinical literature shows a growing interest in the development of family therapy approaches with refugees, in which therapeutic practice engages with the pivotal role of refugee family dynamics in posttrauma reconstruction and adaptation in resettlement and aims at supporting posttrauma reconstruction through strengthening capacities to restore safety, meaning and connectedness within family relationships. In this article, we focus on the narrative restoration of meaning as central mode of posttrauma reparation and explore its specific dynamics and relational complexities in the context of therapeutic practice with refugee families. Hereto, we integrate theoretical and clinical scholarly work on trauma narration and its intersection with empirical findings on trauma communication in refugee families. Furthermore, we develop case reflections to illustrate different processes of engaging with trauma narration in refugee family therapy. This analysis develops an understanding of the multivoiced ways in which refugee families engage with traumatic suffering through different modes of expression that may entail both narration and silence and explores how family therapeutic practices can engage and mobilize voices of narration and silence as relational stories of restoration.

Working With the Encounter: A Descriptive Account and Case Analysis of School-Based Collaborative Mental Health Care for Refugee Children in Leuven, Belgium

“…Throughout this identification of migration-related stressors and their meaning within family relationships, an explicit focus of exploration lies on how this cluster of cumulative traumatic stressors encroaches upon family functioning. This necessitates exploring and connecting to the specific mode of trauma communication adhered to within the family (e.g., De Haene et al, 2018 ). Many refugee parents emphasize their pattern of active silencing of the traumatic past within family relationships, and may voice hesitation on an open sharing regarding family migration history with their child.…”

“…Many refugee parents emphasize their pattern of active silencing of the traumatic past within family relationships, and may voice hesitation on an open sharing regarding family migration history with their child. This parental silencing strategy might be oriented at avoiding a reactivation of distress or harm in their children or themselves (e.g., Dalgaard and Montgomery, 2015 ; Dalgaard et al, 2016 ; De Haene et al, 2018 ). Validating parental protection and care, and voicing the network’s engagement to carefully align with parents’ orientations on finding secure ways of sharing on traumatic history without breaching their orientation on avoiding reactivation of distress or further harm in their children or themselves, may often provide a starting point for further engaging parents in an exploration of intra-family sequelae of forced migration stressors.…”

“…Next to a substantial number of reception schools, Leuven also houses the oldest university in Belgium, KU Leuven, where, at PraxisP, the Clinical Centre of the Faculty of Psychology and Educational Sciences, the Transcultural Trauma Care Team develops and provides outpatient care for refugee families. This care derives from an integrative approach rooted in family systems therapy, transcultural psychiatry, and refugee trauma care, with a particular focus on mobilizing family and community relationships in coping with the relational impact of forced displacement and exile and in shaping post-trauma reconstruction (e.g., De Haene et al, 2018 ; Kevers and Rober, 2020 ). In a project within the larger frame of the Education Council (Samen Onderwijs Maken; SOM) of the Leuven municipality, an initial project (January 2018–June 2020) set up school-based collaborative networks for the integrative provision of academic and psychosocial support to refugee children, resulting in the operational provision of school-based collaborative care for refugee children and their families as integral part of the municipal policy in support of refugees’ social integration.…”

Présentation du dossier thématique « Jeunes et récit de vie : l’identité narrative à l’épreuve du monde contemporain »

“…Toutefois, bien que les approches narratives constituent des voies prometteuses, plusieurs chercheurs et cliniciens mettent en garde contre l'injonction de la mise en récit de la souffrance (Rousseau et Measham, 2007). Les récits de vécus traumatiques recèlent des risques de revictimisation tant dans l'intervention clinique que dans l'espace familial (De Haene, Rousseau, Kevers et Rober, 2018). Dans une société où le dévoilement de soi et la transparence sont valorisés, le rôle protecteur que peut jouer le silence paraît ainsi souvent sous-estimé, voire négligé, d'autant plus qu'il n'y a pas toujours de « sens » qui puisse émerger de la souffrance.…”

Refugee mental health and human rights: A challenge for global mental health

“…Repression creates fear, which is a key part of the political strategy. (Crépeau, 2018)Given that silence is often a survival strategy (De Haene et al., 2018; Rousseau et al., 2001), the question of when and how to amplify migrant voices requires careful ethical reflection and consideration of the relative power and privilege of ‘non-displaced’ researchers. The call for ‘nothing about us without us’ demands a shift in our methodological approaches and consistent effort on the part of researchers to avoid repeating the exploitation and exclusion that result in epistemic injustice (Fricker, 2007).…”