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Immigrants Coping with Traumatic Loss - Selah - Israel Crisis

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					                      Immigrants Coping with Traumatic Loss
                         Eleanor Pardess, Clinical Psychologist
      Conference on Multiculturism; Probing the Boundaries -Vienna, December 2005

Introduction-Immigration and Traumatic Loss - Points of Intersection

The migration of people across the globe has become part of our current landscape. It is
estimated that there are 130 million migrants worldwide (Kosic, Kruglanski, and Manneti,
2004). The high rate of traumatized individuals and families among immigrant populations
raises unprecedented challenges for the social systems of the host countries. Understanding
the transformation of identity that immigrants face can help us offer useful interventions that
may strengthen individuals and families coping with the difficult geographic, cultural, and
linguistic transitions and sense of disruption and dislocation.

A. How Does Immigration Affect Identity?

Immigration involves a painful transformation of identity. The transition from one country to
another often involves changes in almost every aspect of everyday life - from the language
that one speaks to the ways in which individuals and groups interact, including major life
events (e.g., the loss of social networks, changes in work status), as well as ongoing daily
challenges (e.g., communicating in a new language, encountering discrimination, coping with
the maze of beaurocracy). This process of cultural transition has been defined as acculturation
and the stresses associated with it as acculturative stress (Berry, Kim, Minde, and Mok, 1987;
Mena, Padilla, and Maldonado, 1987; Williams and Berry, 1991). Specifically, acculturative
stress refers to stressors caused by contact with the new culture that individuals experience
while undergoing cultural transition. According to Wodarski (1992), one of the most stressful
aspects of the acculturation process is the re-evaluation of one's role within the new culture
and one's sense of not belonging. Cultural differences, according to Comas-Diaz and Minrath
(1987) and Ogbu (1978), bring feelings of uprootedness, identity confusion, and
worthlessness.

As S. Akhtar put it in his book, Immigration and Identity: Turmoil, Treatment, and
Transformation (1999, Northvale, NJ, Aronson) "The necklace of identity has many beads to
be sure, but they need to be connected by a meaningful adaptive thread." Finding this
meaningful adaptive thread is no simple matter. The "psychic flux" (Akhtar, 1995, 1999) of
immigration demands a need for reorganization of the self, as the immigrant attempts to cope
and adapt to the huge changes being experienced in the transition to a new culture.

Immigration involves multiple losses that precipitate a process of "mourning" (Grinberg and
Grinberg, 1989) over the loss of family, friends, language, music, food, and so forth. Two
major themes encountered by immigrants are: (a) dealing with a loss of the sense of
belonging and connection to people, and the consequential search for a renewed feeling of
connection and family; and (b) dealing with a loss in self-esteem and self-image as a
competent, achieving individual.




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B. Immigrants Coping with Traumatic Loss


The death of a loved one can challenge or shatter fundamental assumptions about the world.
As Parkes (1998) has expressed it- For most people in the early stages of bereavement the
world is in chaos; They feel as if the most central, important aspect of themselves is gone and
all that is left is meaningless and irrelevant-hence the world itself has become meaningless
and irrelevant.
Trauma shatters one's identity. Disconnected fragments of life need to be reintegrated,
together with the new meanings acquired through the process of coming to terms and making
sense of loss.
In the aftermath of traumatic loss one needs time and space in which to grieve (Volkan and
Zintl, 1994). Immigrants facing multiple stresses usually do not have either the time or the
space to let themselves grieve. The overburden due to having to cope simultaneously with
multiple demands and stresses may lead to a depletion of resources.

For those immigrants coping with sudden death in the family, the identity crisis, the sense of
dislocation from one's self and one's lifeline, alienation and estrangement due to trauma are
compounded with the disruption of continuity and loss of identity due to immigration.
Disconnected fragments of life - before migration and after migration, before the traumatic
event and after the traumatic event - need to be reintegrated into one’s identity, together with
the new meanings acquired through the process of coming to terms and making sense of loss.
The above paragraphs focus on families coping with sudden death in the family. A wounding,
leaving the individual with physical scars or disability, is another example of traumatic losses
and a severe blow to one's identity.

The support program described in this paper -- for immigrant families coping with traumatic
loss -- is based on extensive outreach. The program has been developed by SELAH, Israel
Crisis Management Center over the past ten years in response to the pressing needs of
immigrants coping with traumatic loss, due to disasters, terror attacks and other tragic events,
after immigrating to Israel.

Immigrants are often isolated, lacking the natural support networks of family, friends, and
isolation is a risk factor in the wake of loss. It is well known that social support may serve as
a buffer against the adverse effects of sudden loss. The goal of the SELAH support network
is to strengthen informal support networks, address problems of loneliness and social
isolation, and engender a sense of belonging and meaning.

C. The SELAH Model - A Comprehensive Outreach Support Program for New Immigrants

1. Emergency Outreach- SELAH operates through a countrywide volunteer network
providing immediate and long-term support to the traumatized as they move through the long
and painstaking process of adjusting to the new circumstances in the aftermath of trauma.

Since it's founding in 1993, Selah has helped over 11,000 distressed immigrants, providing a
safety net for newcomers without the support system of family and friends. In cases of
emergency, SELAH offers direct practical aid and emotional support. The support includes:


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home and hospital visits; transportation and travel funding to bring relatives from abroad;
assistance with finding shelter, household items, and furnishings for fire and flood victims;
burial costs for bereaved families; medical equipment for the wounded or severely ill; and
other kinds of support that bridges the gap until government services step in.

Responsive to the varied cultures within Israel’s immigrant population, outreach is targeted to
all new immigrants, particularly those from the FSU, who continue to be the main source of
immigrants to Israel, and to a large population of immigrants from Ethiopia. SELAH extends
help to target groups including, victims of terrorist attacks and their families; bereaved
parents whose children were killed in the military or from other causes, orphaned children
being raised by a grandparent, an older sibling or another relative and victims of road, work,
or drowning accidents.

SELAH volunteers include psychologists, psychiatrists, social workers, specialists in trauma
work, and others. The teams are notified of cases through a 24-hour hotline, local police,
hospital trauma units, and social workers, and news broadcasts. Emergency situations are
addressed without delay. In a large-scale national disaster, emergency volunteer teams are
immediately dispatched to all receiving hospitals and the pathological institute, where the
dead victims wait to be identified.

The emergency teams consist of veteran Israeli volunteers who work side by side with the
immigrant volunteers. Each team includes at least one Russian or Amharic (Ethiopian)
speaker and one Hebrew speaker.

Some of SELAH volunteers are themselves survivors of terror attacks or other traumas and
past recipients of support. They play an important role in the support programs, offering the
special understanding and extending help based on first-hand experience.

SELAH's volunteers stand at the side of the wounded and newly bereaved from the first
terrible moments after tragedy strikes, and continue to accompany them, giving personalized
care and support, in the long and painful journey ahead as they begin to cope with their loss.
The strong bond they form with volunteers from the start is due to their sensitive and
responsive caring. This human and humane interaction is the core of the program. It is what
enables the immigrants to leave home and join SELAH's healing retreats and other support
groups. Without this individual bonding with the volunteers, they definitely would not be
prepared to even consider such a possibility.

2. Group Support Programs: In addition to individual support, SELAH offers ongoing healing
programs, workshops, seminars, and retreats that build on shared personal experiences, help
develop essential coping skills, and provide opportunities for mutual support. These programs
consist of challenging hikes, nature trails, outdoor nature-based group experiences,
expressive arts, and cultural activities. Many of the activities are planned around holidays,
memorial days, and vacations when the absence of loved ones can be the most painful. The
whole family is involved in these programs, though individual care is given. Led by trained
volunteers - including psychiatrists, psychologists, social workers, doctors, and experienced
youth guides, the programs offer separate activity tracks for adults, youth, and children,
though all participants come together for specific activities. Each program is designed to have
a comfortable balance of activities, combining touring - which gives the adults a chance to
learn some of the history of the country and the younger participants to engage in more
strenuous treks - with workshops and seminars.


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Examples of some of SELAH programs include:
             Seminars for bereaved families
             Healing retreats for the wounded.
             Parenting seminars for grandparents raising orphaned grandchildren
             Orphaned children - Siblings raising younger siblings
             Teens supporting other teens - wilderness experiences and camping for youth
              who have experienced terror attacks and other tragedies.
             Summer camp programs for children (bereaved siblings, orphans, etc.)

The programs break through the isolation of trauma, enabling each person to mourn his or her
losses in a way that is sensitive to his individual and culturally shaped ways of coping.

All of the support programs are culture sensitive. In order to reach out to immigrant families,
we need to understand where they come from, how their identity has been transformed by
their immigration. To do this, we must learn about their culture and coping strategies while
respecting cultural differences, validating feelings of dislocation, and facilitating mourning. It
is important to feel that one’s past is respected and validated. If the immigrants are in a place
where others respect where they come from and what each of them brings from the past, they
can gather the strength to move on.

Working with new immigrants has challenged the team into developing new ways to reach
out and provide support to a population that is often difficult to reach. The programs have
combined verbal and non-verbal strategies in a way that crosses cultural and language
boundaries. Outdoor activities in nature create a special climate for this bringing together of
families from diverse backgrounds. The use of metaphors from nature can assist in opening
channels for communication and creating a shared "language of grief."


Promoting a Sense of Belonging

Being part of a community is a most important part of the program. Many of the participants
leave the support programs feeling close to other members of the group, maintain contact and
meet outside the programs. The sense of community that evolves among the members
eventually allows them to support each other. Acknowledging the richness of one’s cultural
heritage is also an important part of supporting immigrants. Group work, during the seminars,
in addition to meetings between seminars (activities around holidays such as Chanuka,
Pesach, etc.) harnesses the power of arts and create a meeting point between the individual
and the collective, bringing them into a space that is beyond the boundaries of the self and
others.


Keeping roots alive

Strong roots are essential to post-traumatic adaptation. It is a mistake to think that post-
traumatic growth is only future-oriented. Indeed, moving forward often entails moving
backward in terms of re-tracing one’s steps and re-connecting to one’s roots, as well as to
nourishing memories. When a plant is uprooted and transplanted somewhere else, for the
transplanted plant to thrive it is necessary to take some soil with it, something, at least, from
its former natural surrounding. It is the same with people: trying to shake off everything


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connected to the roots will reduce the probability of adjustment and growth in the new
surroundings.

In order for experiences to be moving in the direction facilitative of post-traumatic growth,
they have to culturally appropriate. People respond and resonate most strongly to music,
songs, art, and rituals that are familiar from their cultural background. In order to create a
growth-enhancing environment, at least something should be taken from the past.

Building bridges and restoring the flow between past, present, and future is the most
important part of the programs described above. Building bridges to the past and
strengthening continuing bonds with the deceased, as well as with the motherland, can also
play an important role in paving the way to post-traumatic growth.




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