ABSTRACT
This chapter presents the results of a workshop where experts who have been involved in field work with refugees discussed the mental health problems of refugees, together with psychoanalysts and psychotherapists, focusing on questions like: Can we say that there are more mental health problems among refugees than among the normal population? Are there specific pathological phenomena seen in refugees? What kind of psychosocial and psychotherapeutic interventions are possible? It was pointed out that refugees find themselves in a protracted traumatising situation and almost everyone is emotionally disturbed. An omnipresence of negative emotions – high anxiety, rage (turning into resignation and depression) – can be observed. Refugees may have all kinds of mental health problems that other people have, but there are also some specific pathological phenomena observed in them. For instance, men (“heads of their families”) travelling with their families can become completely disorganised, whereas women manage to remain calmer. There is also the issue of transgenerational transmission of trauma: What will happen with the children of refugees? The secondary gain from the illness (compensation neurosis) seems to be an important driving force. After determining what kind of help they need most, all kinds of psychological interventions are possible with refugees. They may benefit from crisis intervention and prevention measures; also, psychotherapy can be applied once they settle and reach stability. Psychoeducation may be indicated to educate the parents how to talk to their children. Other appropriate interventions might be rehabilitation, social support and work with communities in order to create a safe environment. It is important to adjust the therapeutic approach to the specific needs and cultural specificity of the clients, to have respect for the refugees and not “feel sorry” for them, but treat them as mature persons.
