The experience of torture results in profound psychological consequences for survivors. Resettlement as a refugee or gaining political asylum in host countries contributes to an experience of continuing trauma. Yet, torture survivors often demonstrate internal capacities that contribute to their resilience. Despite the useful- ness of the construct of resilience in understanding trauma recovery, Western psychological concepts do not always match survivors' diverse worldviews and cultures. Providers need to understand the subjective meaning of resiliency for survivors and survivor-identified innate or therapeutic strategies that promote coping and healing. Therapy informed by the survivor's experience empowers both provider and survivor.
We conducted six focus groups with torture survivors from November 2013 to December 2014. Groups took place in Washington, D.C., Chicago, IL, Salt Lake City, UT, and St. Louis, MO. We held three male (N = 16 individuals) and three female (N = 23 individuals) focus groups with members between the ages of 21 and 71 years old and from the following countries: Afghanistan, Bangladesh, Bosnia, Cameroon, Central African Republic, Congo-Brazzaville, Democratic Republic of Congo, Iraq, and Rwanda. We invited all participants to voluntarily join the focus groups through partner treatment programs. One interviewer conducted five of six focus groups and all focus groups took place in space provided by the partner program. We used interpreters to facilitate communication in the focus groups. In each meeting, the interviewer provided the group with a definition of resiliency for discussion. The interviewer directed conversation with questions about resiliency as a concept, the applicability of resiliency to torture survivors, what factors support recovery, and recognition of positive psychological growth. We transcribed each interview and reviewed the transcriptions for accuracy. Using qualitative, phenomenological analysis, we identified participant statements that relate to resiliency, grouping them into categories that describe shared and differing experiences.
Participants described seven factors that were important in their recovery processes and contributed to their sense of resilience. These included maintaining a positive mental attitude, having significant relationships and connections with others, activities that engage their interest and serve as distractions, faith in God or a belief in a higher purpose, an ability to maintain a sense of future, feeling safe and secure, and access to specialized care where the impact of being tortured is understood. We also noted a gender difference with women distinguishing between a public presentation that responds to the demands of family, community, and culture from a private self of quiet suffering. Resiliency can be promoted by teaching skills/behaviors that support the survivor-identified factors, thus having clinical implications for treatment. Additionally, the importance placed on security, relationships, and access to care has policy implications for the ongoing support of specialized centers of care.
Funding & No Conflicts Declaration
We received no funding for this study and declare no conflict of interests.