Hala

Martha Little, LCSW, specialist in the treatment of trauma

 “Everything can be taken from a man but one thing: the last of the human freedoms—to choose one's attitude in any given set of circumstances, to choose one's own way.”
Viktor Frankl

I think this quote summarizes my work in the RTI psychosocial team in the Idomeni Refugee Camp, in northern Greece. Everything in my 30 years of training and work as a clinician had to be thrown out, with a daily adjustment of attitude and beliefs-boundaries, safety issues, abuse and neglect reporting standards, response to suicidal ideations- all took on a new meaning and interpretation in the camp environment. Here I will attempt to summarize the work we set out to do, and try to give a critical analysis of the efficacy of the work.   Our workspace was a little tent that was constantly being blown around, flooded, taken up and taken down. The door was almost always open due to the heat, which added another element to the concept of confidentiality.  My work focused on treating 3 populations in the camp-children, ages 2-12; adolescent girls ages 12-22; and women. (Please see the power point included for pictures of the groups.) We did most of our work in groups, focusing on art therapy and mindfulness techniques.  

 

I think this quote summarizes my work in the RTI psychosocial team in the Idomeni Refugee Camp, in northern Greece. Everything in my 30 years of training and work as a clinician had to be thrown out, with a daily adjustment of attitude and beliefs-boundaries, safety issues, abuse and neglect reporting standards, response to suicidal ideations- all took on a new meaning and interpretation in the camp environment. Here I will attempt to summarize the work we set out to do, and try to give a critical analysis of the efficacy of the work.  

Our workspace was a little tent that was constantly being blown around, flooded, taken up and taken down. The door was almost always open due to the heat, which added another element to the concept of confidentiality.  

My work focused on treating 3 populations in the camp-children, ages 2-12; adolescent girls ages 12-22; and women. We did most of our work in groups, focusing on art therapy and mindfulness techniques.  

I will give the case of Hala as an example of a successful intervention with a single mom. Hala was a 23 –year old new mother, referred by Nurture International for depression. I went to her tent, where her mother and 19-year-old brother were hovering above her as she slept (4pm in the afternoon.) I asked them to leave, which was a surprise to all, but ended up being a powerful intervention with her, as they were clearly manipulating her and increasing her helplessness. After telling her story (husband being tortured in a prison in Syria, loss of family members in the war), it was clear that she was suffering from a severe post-partum depression.  

Hala had a university education, and was clearly very intelligent, but also very angry and impulsive. In evaluating her suicidal ideation, it was apparent that she had the intention, the means and the plan to kill herself and her baby. She was going to take her baby and jump in front of a truck on the highway, which was 20 meters away from her tent. I spent the first half hour exploring her strengths with her- her intelligence and her faith. She identified some spiritual practices that she did regularly in the past, and we practiced them together. She immediately burst into tears, and said how much she missed her faith, and how full it made her feel to connect again. I made a plan with her to visit every 2 days to help her continue connecting to her practices, and she agreed to let MSF doctors and psychologists give her meds, vitamins, and do daily checks.  

She stabilized, and the next time I saw her she was beaming and laughing about “how trivial all her worries seemed.” Over the next few weeks she continued stabilizing.  

How to summarize this work, which is so diverse, compelling, heart breaking and rewarding? I can say I left Idomeni with more hope for humanity, and a clearer sense of human resiliency. A population who has lost everything but their hope can teach us a lot about our own work and values. I guess I feel a better person after this experience, although maybe not a better therapist. The blurred lines between acting as a human being, verses being “therapeutic”, doing things you’ve been taught not to do as a clinician (giving clothes and food to children, crossing all sorts of boundaries by sitting in enclosed tents with families) really made me reach in to the core of my beliefs of my work, and our true role as healers. This work is something that I believe can fundamentally change how we practice, and help define a new paradigm in psychosocial work.