Editorial - AJTS

Healing the wounds of trauma

Healing the wounds of trauma is at the heart of the Peter C. Alderman Foundation (PCAF) as it is at the heart of all NGOs dealing with conflict and postconflict situations.

Central to this exercise are the trauma workers themselves who may be from the areas of conflict themselves or from elsewhere, including coming from outside the country. The trauma workers go under a variety of names and have varied backgrounds
ranging from lay therapists, faith healers, traditional healers to highly trained ones like nurses, social workers, psychologists or psychiatrists.

Whereas the principle of giving therapy may be standardized, their various experiences may not. Often the therapists may have different motivations for engaging in this work. Therapists from areas of conflict may themselves have suffered trauma and may be suffering from their own post-traumatic disorders. On the other hand, in giving therapy, all therapists, irrespective of background, do experience the pain of listening to and seeing the trauma on the victims. Often the therapists may feel traumatized (vicarious traumatisation), may feel fatigued/ burnt out by the exercise or may develop counter-transference reactions to the patients or the perpetrators. Moreover, they work in very hard conditions of poverty, misery and adversity.

Others have been direct targets of the conflicted parties who may see them as taking sides as they advocate for the rights of their clients or the down-trodden.

Caring for care givers (therapists) therefore becomes the central theme of any trauma work. The literature is full of what could be done for therapists and these include:

i)  Short periods of exposure to the work with frequent holidays to allow for refreshening
ii)  Adequate training and preparations for the therapists including cultural re-orientation
iii)  Good pay, good supervision and good peer support
iv)  De-briefing at the end of each exposure
v)  Assessment of possible psychological disorders in the therapists (depression, substance abuse, Stockholm Syndrome, family problems etc)
vi)  Self support groups (Balint groups) for the therapists where they can discuss cases and problems in confidence

This editorial therefore advocates for the inclusion of in-built programs for caring for the carers and for their continued support and training. In this issue of the AJTS, papers from various authors will present their experiences in trauma therapy in Africa and beyond.

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