Relationship as healing in the treatment of a survivor of genocide : the case of H. / Amana Ayoub
Includes bibliographical references (p. 166-174)
- External Link
Electronic version from ProQuest
Through an integrated case study I examine the complicated process of treating a female survivor of the genocide against Bosnian-Muslims, positing that developing relationship is integral to healing. Transference evolves throughout each stage of treatment; the therapeutic relationship, likewise, takes on different functions at different stages of treatment, as the client struggles with basic issues of trust and safety that have been destroyed by her perpetrators. I examine here how the relationship itself can be utilized in treatment of the trauma. It is hypothesized that treatment of survivors of genocide is most effective when it is relational, client-centered and existential, based on an empowerment model that addresses the unanswerable why ? Transferential and counter-transferential issues become not just a facet of the therapy, but a crucial factor in the actual treatment. To learn to trust and love another human being is a basic task that the patient must attempt over and over until it is mastered. In circumstances of surviving genocide, basic trust must be relearned. The author explores how an authentic relationship can allow this learning to occur in a safe, supportive holding environment. I have developed a three-stage model of treatment via a case study. In the first stage, the war trauma is addressed and vividly evoked, with the therapist seen as other. This is a crisis period in which suicidality and hopelessness must be actively addressed, as well as physiological distress. Behavioral techniques and psychopharmacology are utilized to build trust and provide temporary relief. The therapist conveys a strong sense of cultural respect as well as moral, and political, solidarity. In the second stage, trust must be cautiously established and prewar trauma and dynamics explored. Issues are explored that to the client may be as traumatic as the genocide itself. This stage provides a forum for the therapist to understand how the client and her family functioned in the past, how they functioned during the war, and how they are functioning now as refugees. In this stage the similarities of the therapist and client are emphasized and explored, versus the vast differences of culture and circumstance. The relationship takes on more depth; the full scope of the survivor's life is now accessible, not merely the trauma of war. The third stage shifts to current adaptation, a more prolonged focus on the daily struggles of adjusting to life as a refugee. Healing becomes a tangible possibility, as the refugee is able to explore how Americans perceive refugees and how refugee status affects self-esteem and recovery. In this last stage the interpreter becomes representative of Bosnia as a whole and the therapist representative of America, with the client struggling to incorporate both.
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