Intersections of war trauma, culture, and socioanalysis in mental health intervention for post-traumatic stress

Abstract

“Refugee war trauma” is a poor adjunct to post-traumatic stress, lacking context for a civilian survivor of war. The “therapeutic mission”, or consolidating a therapeutic agenda with political reconstitution, has its tensions: Such founders embody politics of “emotionology” (Humphrey, 2005, p. 205) bound largely to pharmaceuticals, from a land of “freedom” (where emphasis is on market) and “democracy” (where emphasis is on autonomy of choice, not accountability). Additionally, how people “cope” or “solve problems” is not universal: Therapy speaks of self-empowerment, self-actualisation, and self-control; reconciliation speaks of collective citizenship, national participation, and group reform. Instituting participation in rituals that ‘help” according to predefined norms of an American prescription to suffering speaks more to the globalisation of the American psyche (Watters, 2010; Venne, 1997) than of humanitarian relief. This paper looks at the absence of cultural and socio-political specificities within the dominant discourse on “war trauma”, that are however of ultimate relevance for people affected by war. Using a case example from my own practice with a Rwandan woman living now in Canada, I question the “helpfulness” of post-traumatic stress treatment with this instance of refugee war trauma, and the impact of power systems in mental health care. How can the therapeutic encounter, given its genesis in Eurocentric, patriarchal, enlightenment thought, pause to better consider its potential for injury, especially within contexts of post-colonial genocide? How to avoid a new “mission to civilise”? What tensions to note as the advent of “trauma counselling” seeks more global application and transnational legitimacy?