Anecdotal evidence based on multiple sources including, UN and media reports and client accounts suggest that the intense dread many asylum seekers experience when threatened forced repatriation, is directly linked to extreme forms of torture, sexual violence and rape they have endured. Specific forms of torture, especially details of sexual violence and rape are seldom mentioned by male asylum seekers even in the safety of a therapeutic relationship. It is likely that desperate acts, such as self-harm are considered by victims as an alternative to cope with the humiliation, intense pain and the sequelae of torture and sexual violence.
Many refugees may not be ready or able to process their horrific trauma experiences. Therapeutic approaches have therefore utilised a combination of strategies that predominantly rely on psycho-education, mindfulness and behavioural activation to sustain and facilitate improvements in functioning. However, it has been observed, that despite acquiring the above skills symptoms could persist as refugees may be unable to disclose the horrors of their past. Their inability to form a coherent narrative and integrate the past is perceived as a potential barrier to healing.
To address this issue the authors decided to adopt an approach that combines group and individual treatment and simultaneously tackles the long standing belief that refugees may not be ready or willing to process their difficult past prior to the resolution of their claims for protection. Survivors were assisted to form a meaningful narrative of their past, by integrating culturally sensitive practices such as Pranayam, recitation of mantras and principles of Narrative Exposure Therapy. As survivors began to integrate and construct a narrative of their past traumas it resulted in a gradual reduction in the intensity of their symptoms of anxiety, avoidance and arousal, and instilled in them courage and confidence to share their traumas.
Preliminary data based on feedback from participants, observations and scores on psychometric tests like HTQ and HSCL, indicate that MANTRA facilitated participants to connect with their past and feel more self -regulated. Participants also reported sleep improvements, decrease in anxiety and isolation. The results cannot be explained by a singular theory or approach, as multiple strategies that complemented each other were utilised. Assisting clients to narrate trauma experiences, gradually led to habituation to these experiences. The reduction in anxiety and the intensity of the emotional response to the traumatic memory led to the onset of a recovery process. Exposure to distorted and fragmented traumatic memories and consequent reorganisation and integration of these memories could have also resulted in changes in the brain. The focus on breath (Pranayam) with its potential to activate lower brain waves and make the brain more resilient and adaptive may have also influenced these results.
Funding & No Conflicts Declaration
MANTRA has been funded through STARTTS funding. The authors Pearl Fernandes and Yvette Aiello report no conflict of interest.