Psychotherapeutic work with children and adolescents seeking refuge from political violence
This chapter explores the external and internal situations of asylum-seeking children and adolescents. Abusive external events in the life of a refugee child, both during times of community con¯ict, and in exile in Europe, are clearly internalised and impact on subsequent development. A holistic focus is required, on rehabilitation, social integration, care, asylum, education, practical support, health and therapeutic needs. Refugee children usually come from `good enough' (Winnicott 1960) functional families and clearly experience abuses and their consequences in later phases. Abuses are usually perpetrated by authority ®gures from outside their families, and often only later result in the symptoms of the complex post-traumatic state, separation and disrupted attachments. Thus treatment should focus as much on developing resilience as on understanding vulnerabilities. Young people often need time and help in sharing their stories, which initially emerge as a series of fragments that may be unspeakable and shared non-verbally. Gradually, they become able to articulate these experiences. This process, where a young person shares aspects of his story with the psychotherapist who bears witness to a variety of experiences, is itself therapeutic, providing antidotes to unbearable emotional pain. The psychotherapist must build a relationship of trust (a therapeutic alliance) with each young person and hold their experiences for an extended period, gradually returning aspects of experience to the young person in bearable chunks. Slowly the young person becomes able to take responsibility and ownership of their experiences.