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26 August 2015

Karin Griese, Head of the Trauma Work Department: “Trauma as the consequence of experiencing violence cannot be treated solely by treating the symptoms.”

During war and post-war periods, women and girls experience rape, sexualised torture, sexual enslavement and other forms of life-threatening, gender-specific violence. In order to be able to regain stability, survivors need both empathic specialist support and a trauma-sensitive social environment that does not tolerate violence. Karin Griese, Head of the Trauma Work Department, explains in this interview the trauma-sensitive approach developed by medica mondiale and its long-term impacts.

Which aspects of the way of working at medica mondiale demonstrate its trauma-sensitive approach?

In all assistance which medica mondiale offers we adopt a fundamental attitude of trauma-sensitivity and solidarity with the women. Survivors of persistent so-called domestic violence or sexualised wartime violence suffer from psychological, physical and social consequences. In order to strengthen and stabilise them, it is important to build up trust and give them a feeling of security and recognition. This is the reason why it is also necessary to ensure that legal assistance or healthcare is also provided in a trauma-sensitive way. The staff involved need to recognise that the survivor is subject to a very stressful situation and they learn how to provide some relief and contribute to a de-escalation. For example, healthcare specialists are taught that telling their patient to lie on their back for an examination puts her in a situation which might remind her of the violent experience. This can trigger an inner re-experiencing of the dramatic experience, which is referred to as ‘retraumatisation’.

How do you see the trend of treating the consequences of trauma with standardised short courses of therapy focused on the symptoms?

I consider these rapid procedures to be problematic. Trauma as the consequence of experiencing violence cannot be treated solely by treating the symptoms and then believing that the women will be able to carry on with their lives as before. That is a short-sighted approach. A major role is also played by wider issues such as governmental attitudes to war crimes, securing livelihoods, stigmatisation and societal causes of violence. So trauma work requires an integrated approach. At Medica Gjakova, for example, there is a women’s agricultural cooperative in addition to the one-to-one and group psychosocial sessions. This farming work enables the women to secure their livelihoods and lead an independent life, which in turn contributes to their long-term ability to deal with what they have experienced. Furthermore, Medica Gjakova also lobbies the government to recognise women raped during the war as war victims and grant them the corresponding pensions.

What role does societal context play in coping with trauma?

Women often feel that their society does not recognise or appreciate their traumatic experiences. In fact, they are often made to feel responsible for what happened, thrown out of their families and excluded from their community. For this reason, many survivors never even speak about the violence committed against them. This leads to symptoms becoming worse and the women becoming less stable. medica mondiale campaigns for changes in the attitudes in society. Training courses are provided for police officers, judges and state prosecutors, informing them of the effects of traumatisation and gender-based violence. medica mondiale also raises public awareness of sexualised violence in wartime and its consequences. For the affected women, the psychosocial counsellors in the projects also monitor their family surroundings, including husbands, in-laws and children. This is necessary if the survivors of sexualised violence are to find their way back to a normal way of living.

What does ‘resilience’ mean in the context of coping with trauma?

Our approach is intended to stabilise the women and make it possible for them to live a life worth living in spite of their terrible experiences. A trauma-sensitive approach to counselling and advice strengthens the women’s resilience. The term ‘resilience’ here refers to the capacity to cope with an experience and recover from it. However, focussing on an individual’s resilience should not mean forgetting society’s responsibility. The aim has to be a society where no women and girls are subjected to sexualised violence; the aim is certainly not to strengthen their resilience so they can cope with a rape that might happen to them.

Does the main office in Cologne also follow a trauma-sensitive approach?

Symptoms of stress and trauma can be transferred to staff via direct contact with survivors of violence or via reading and hearing about violent acts – this is referred to as ‘secondary traumatisation’. In order to break through the cycle of stress and trauma dynamics, an organisational culture characterised by mindfulness is important. Learning and practicing techniques of stress- and trauma-sensitive communication helps to ensure constructive cooperation within the organisation and its teams. This is important for the workers in Cologne as well as the local staff in the project countries.

We would like to thank Karin Griese for the Interview.