Many survivors of torture who are assisted at the CSVR's trauma clinic have experienced multiple forms of violence and torture in their countries of origin, during transit and within the borders of South Africa. From data collected in our centralised M&E system, it is clear that depression and PTSD severely and negatively impacts clients who have experienced torture, displacement and war, as well as continuous traumatic events in South Africa. However, over and above the psychiatric conditions, somatic indications of pain that are fundamentally linked to depression are often expressed as a means to indicate depression and other psychiatric conditions.
Torture and war affect the emotional, cognitive, physical, familial and community aspects of a client. On a personal level, this may be expressed in severe negative affects such as depression and anxiety. However, Western notions of depression may not appropriately capture the nuances of the expression of depression from a collectivist society. Rather, depression in African clients may take on a somatisation that is distinct from Western concepts of depression.
Using qualitative and quantitative data from our centralised monitoring and evaluation system, this paper attempts to explore the psychosomatic symptoms experienced by clients at the Trauma Clinic at CSVR and how these relate to alternative expressions of depression within a non-western clinic sample. It further attempts to elaborate on the complexities of providing such services to victims of torture for psychosocial professionals given their training and skills. The therapeutic implications and implications on clinical assessments are expanded upon.
Given Western based training in psychotherapy and counselling, this paper attempts to understand whether psychologists in African settings may miss essential cues to clients’ suffering and distress which is communicated in a somatoform manner. Additionally, is effective treatment of depression delayed or hindered due to the misinterpretation of somatic symptoms? How can we close the gap between distinctly different expressions of distress?
Funding & No Conflicts Declaration
Funding for this study is provided by USAID. The authors declare that there are no conflicts of interest.