Trauma

Wanting and Liking

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As I said in my blog entry on the depressive effects of the countermeasures fighting the Covid-19 pandemic, I have enough energy during the morning. So I finish this article which sat in my draft folder whilst I am freshly energized, and before running out of steam…

Every now and then some articles on the science of addiction hit the public realm. They attempt to make a very complex phenomenon understandable to the general public. But the underlying neurophysiological and biochemical aspects of cognitive science, they are not that easy to be appreciated. Because they challenge a fundamental way of how we perceive the unity of our “self”: What we perceive as “one thing”, “me” feeling emotions, “me” thinking, “me” deciding, “me” acting, “me” believing that I am in control of deciding. In reality this “me” is based on contributions from distinct sub-systems within our brain. This “me” appears to be a composite, and most of the time the “thinking part” of my brain wants to tell me a story about that this thinking part is the “real me”, everything else in my brain being an accessory to it. The evolutional achievement which appears to set humans apart from other living beings, the part of our brains being able to compute logic in dizzying complexity, it constantly attempts to tell me a story about that this is the seat of the “me”. This -scientifically wrong- understanding may also contribute to why we label behavior that contradicts a given intent to follow a norm as a moral failure, as weakness, setting apart those who “fail” from those who “succeed”.

Until cognitive science is proving it wrong. Which is the case. Still then, in common belief we like to think about that we are “in control”. Whilst the psychology of advertisement has already understood since many decades and in ever growing depth how people can be made believing that a buying decision, or a voting decision, or a choice about anything in life, can be influenced in ways invisible to the “rational” self. Individuals believing they are subjects in control of a decision not being aware that they have become objects of most subtle manipulation. Nowhere it is more obvious for me than within the science of understanding addiction.

To say that cognitive decisions, the ability to decide to do something, or the ability to decide to abstain from something, are not a consequence of an independent supreme mind that is attached to a physical structure called the brain, it challenges notions of how we may have been educated, and how we would like to see ourselves. It can challenge concepts of accountability, of ethical and moral behavior, it runs counter a common attitude to, for example, labeling an addict as a “weak” person. Somebody who is morally questionable. Somebody who has failed on basic requirements which are considered to be common individual and social skills.

In my law education at the beginning of my career, I learned about the three aspects being fundamental for having committed a crime: (1) I need to do something that is objectively considered a criminal act; (2) In order to establish a crime, there must be an absence of a cause of justification, like self-defence can justify harming another person who is attacking me; (3) For establishing individual accountability, I must be culpable, meaning that my physical capacity allows me to see that I am committing a crime and that I have no justification. A deeply insane person might not be able to have this mental facility. But those face being locked up as a danger to the public, if they commit severe crimes without being culpable.

My education included that, for example, I am usually considered to have the capacity to refrain from an act that I want to do. Like that, even if I use my car after having intoxitated myself through alcohol to an extent that I can not even remember what I did the following day, I still am considered culpable and can be convicted for DUI.

I find this not so easy. Take a person who has experienced that self-abusive behavior became compulsive, and then over time that person became addicted to this behavior. This person struggles with never-ending despair after doing what he or she did not want to do, all over again. Yet, this person also lives in the delusion that he or she is able “to fix it”. Only to discover, after the next drinking binge; the next shot of heroin; the next relapse into gambling; the next round of self-harming sexual behavior; the next over-eating binge, or bulimic action; the next time of cutting oneself with razors; or a myriad of other acts that initiate a kick of dopamine in the brain, that all intention to stop it failed. Over and over again.

Look at this BBC-article from December 12, 2020: “The science of addiction: Do you always like the things you want?“. David Edmonds has a go on explaining the role of a substance called dopamine. Dopamine is a so-called neuro-transmitter acting in the brain. In every brain, at least I’d say in brains of mammals. Its function and its effects are not entirely understood, neuroscience is cutting edge science and we are learning more by the day. Classically one of its effects led to giving dopamine the name “happiness hormone”. That is a simplification which is challenged with the findings as described in the article. There are many other effects and a considerable number of identified brain functions in which dopamine play an important role, and I am not a neuroscientist, I won’t venture into that. However:

The BBC article explains findings which challenge the notion that we always like what we want. This is not true, according to modern neuroscience. The sub-systems of the brain regulating a desire, or an irresistible want are distinct from those parts of the brain which are responsible for what we like. An early experiment quoted in the article refers to a person who, in 1970, was subjected to a specific electrostimulation by his psychiatrist. Amongst other issues this patient struggled with addiction. When he received electric stimulation of the pleasure-center in his brain, he felt a very strong arousal and he would act compulsively on it over and over again. But when he was asked whether he liked what he was doing, the answer was a decisive no.

Same with lab-rats. Rats will rapidly learn that an object in their cage gives them an electroshock. They will stay far away. Unless you do the same stimulation of their pleasure-center in the brain. Then they will touch the object over and over, despite the electric shock. It is possible to interpret their facial expressions: Experimenters can tell whether lab-rats like something, or not. And like the human patient in the experiment in the 1970’s, they don’t like the unpleasant experience of being electrocuted. Yet, they continue to do it.

The article goes on to modern neuroscience and efforts to understand the effect of dopamine. What now seems to be established is the mainstream knowledge that “wanting” and “liking” are attributable to different sub-systems of the cognitive system. Dopamine is only affecting the “wanting”, and not the “liking”. As the article says: “Dopamine increases temptation”.

These biochemical and neurophysiological functions of a brain exist since millions of years. I would not know about when they emerged, but they were in existence before humans walked the earth, otherwise rats and other mammals would not have them. They serve clear functions which made sense in an environment when primates were our ancestors. They made sense when Neanderthals walked the Earth, and they continue to be existentially necessary in our contemporary environment. They exist since long before the frontal lobe of our human brain began to develop, long before we gained what we would name our self-awareness, our thinking mind, our sophisticated way of communicating, of forming bonds between tribes, and they continue to exist and to fundamentally drive us whilst we have set up a world of highly organized complex societies. The neurophysiological setting of an agnostic and a believer in any religion is identical. You can be tied in the strongest ethically or moral ways to behavior that you like, and that is socially accepted, but if your dopamine-regulation systems runs amok, you will be tortured by an urge to do things that you do not like, and which are labeled morally harmful, or forbidden.

Substance abuse is one thing. Then there is behavioral self-abuse. If the compulsion sits with a neurotransmitter, or several, running out of balance, the urge to stimulate pleasure is also strongest where behavior is rewarded with huge kicks. From sexual behavior to gambling, from over-eating to bulimic, behavioral disorder is often more powerful than substances, and leaves you entirely powerless.

Another question is why the hormonal and neurological systems in the brain can loose their state of delicate balance. Why something becomes compulsive, until the damage to the neurophysiological setting has become permanent. There seem to be many reasons for it, including genetic predisposition, but one main driver is trauma, and early childhood-trauma sits front and center. Read my blog entries on trauma. They are tagged.

We find it so counterintuitive that our actions depend on the delicate balance of complex sub-systems in our brain. We feel like “one” entity. We do not feel the fact that our awareness, our cognitive setup, is a complex interaction between a large number of parts. Put a person who is heavily suffering from addiction into a MRI-scanner and you will see that parts of the brain which usually communicate, don’t. Those areas remain literally black whilst other parts of the brain are being displayed in vivid colors. And once that individual manages to abstain from this substance or behavioral self-abuse for, on average, ninety days, you will find that those parts of the brain which were silent do work, and communicate, again.

I have grown up with the notion that, whatever humans do, they are accountable for it. Only in case of severe causes affecting culpability, a human action can establish unaccountability. The subsequent mainstream thinking is: Those who can not control themselves, they are weak, or morally questionable beings, or both.

Of course, law, criminal law, and criminal procedural law gradually catch up with modern science. As is the case for penal management, at least to some degree, and at least in the country I live in. But when it comes to drug policies, to criminalisation of substance abuse, to law enforcement and prosecution of behavior which an individual has no control over, we are still a far-cry away from a full-fledged understanding of that we can not address a public health issue with criminal law. This debate is happening, though. At the same time, this debate is subject to the winds of change which come from the never-ending dispute between conservative or liberal politics, for example. Some say “Lock them up”. Others say “Help them, they are sick and suffering”.

What do I want to say? We need education about science. We can not govern ourselves the best way possible, if we base our beliefs on wrong predicaments. Of course we can govern ourselves without that. The result is societal control, and locking away those who “fail”. And sometimes, science might be in the way of just exerting control. So, even here, the question as to which extent we allow ourselves to put governance under the guidance of science (like with the Covid-pandemic) is based on whether we apply values to our governance, or use values as a pretext for control.

Concluding this:

Dopamine showers can be the result of many actions, as I have shown. However, one interesting fact remains: Dopamine showers in the brain can be the result of allowing myself to be angry. Many of us have experienced the results of a constant flow of angry news, of angry tweets, of angry antagonizing shares on social media. Many of us have experienced how the constant stream of anger flowing from news was making us continuing to engage with these angry posts. There are those who know how to manipulate us into this vicious cycle. Who feed the beast of anger. Who antagonize exactly because it makes people continue to follow these news. There are those who do it for reasons of manipulating people into a world of false beliefs. And there are those who benefit from it because creating followerships allows for placing advertisements into these highly emotionalised feeds. As I said, psychology of advertising knows exactly how to create compulsive and addictive patterns.

With the events surrounding the insurgency at the U.S. Capitol, January 06, something changed. Reaching a tipping point, things boiled over. And some of these raging feeds were cut off by social media. Then, January 20, a new U.S. administration reverted to a culture of educated discussion. In discussions with many friends, inside and outside of the U.S., we observe that the absence of this rage element in the realm of communication on social media appears to feel like a “cold turkey”. Strangely enough, we miss the rage, we feel a void.

Exactly. Because of dopamine. To be continued.

The Pandemic and its Impact on Domestic Abuse and Violence

/ stefanfeller / 2 Comments

This -slightly longer- article focuses on gender-related aspects of domestic violence. After some introductory comments, I will present a view on the general scope of an endemic problem. I will also look into the specific context of the role of weapons, especially firearms, in that context, and the significantly higher victimisation of women including through the use of firearms. After that, I will discuss the alarming rise of domestic violence which we observe as a consequence of various measures undertaken to contain the Covid-19 pandemic. I will advocate the protection of the most vulnerable first. In this, I will focus especially on women and children.

As an introduction:

I began this blog entry based on discussions with friends on the consequences of the pandemic for women through heightened levels of aggression, abuse, and violence. So I wanted to write about the impact of the restrictions and lockdowns on domestic abuse and violence experienced by women. Though this still is a major thread in my writing here, after some research and thinking my reflections on the topic of domestic abuse during the pandemic became broader.

Physical and emotional abuse including violence are a disturbing reality in intimate relationships and families. I will reference data published by the NCADV and other information a few paragraphs below, but for starters: Already before the pandemic, in the United States, 1 in 7 women and 1 in 25 men have been injured by an intimate partner. At least once in their life, 1 in 3 women and 1 in 4 men have experienced some form of physical violence by an intimate partner. And according to statistical data just taken from the United States, 1 in 5 women and 1 in 71 men has been raped during their lifetime. 1 in 10 women suffer from rape within what they would consider their own zone of safety and comfort: Within an intimate relationship. I don’t have to look for other data sources but can state due to heuristical and professional experience that the situation, for example in countries in Europe, will not reflect a significantly less disturbing picture. Exact numbers might vary, but we are not talking about a fringe problem. We are talking about a huge challenge.

However, there is an emerging body of data indicating that phenomena of domestic abuse and violence are on the increase throughout the pandemic. As the pandemic lasts, lockdowns are protracted and are getting more and more rigid throughout this winter. It is all but certain that the problem will continue to grow, perhaps exponentially, the longer and more severe these restrictions are. As the fight against the pandemic is now reaching a full year of implementation, and will continue, there is no reasonable doubt that these developments will have a medium and long term negative impact.

Why should this make all of us concerned? Like every parent I want to see my children experiencing only safe friendships, happy relationships, and I want to see them becoming capable of raising happy children of their own. The thought of witnessing a beloved child being on the receiving or giving end of an abusive relationship is a horror scenario for every loving and caring parent. It is only natural to push this thought aside, hoping that this may be something that my children, our children, won’t have to go through. Parents may engage in wishful thinking, and some denial, hoping that this may not happen to own daughters and sons, but may just be some distant risk, a risk more for other societies, other communities, may be for less privileged people, or just plain and simple for others. The reality is starkly different: Your daughter has a high chance to experience violence in sexual relationships, your son may be significantly at risk becoming a perpetrator, and to a lesser extent, a victim. Both your daughter and your son may experience helplessness and mutual abuse in toxic relationships. Both will experience the stress of raising children, many will experience single-parenting, and they will likely experience the crushing defeat when, despite best intentions, they yell at their own children, or slap them, or worse. It has happened to most of us in various shades of grey, let us be honest. We have been on the receiving side, and we have been on the giving side. And this prediction, based on time-tested statistical data, is one main reason why to focus not only on women, but equally pressing on the suffering of children experiencing violence and abuse in domestic environments, and their social neighborhood: Every statistical data will confirm that those who have been victimised in their childhood are way more likely to repeat this abuse, or to subject themselves to abuse, by way of what psychology calls re-enactment, once they have grown out of age. In addition, their proneness to alcohol, substance, and behavioral abuse leading to addiction is exponentially higher. What we do to our children, our children will carry this into their parenting and into their intimate relationships, and into their coping strategies.

That is why we need to be concerned about the widespread phenomenon of domestic violence and abuse. And that is why it’s increase throughout the pandemic is so much a concern for all of us.

So, on Covid-19: Statistical data and personal experience in a vast network of friends make it clear to me that this already existing problem is amplified by how we try to contain the spread of the Covid-19 virus. We need to talk about how to protect the vulnerable, and how to capacitate people so that they are able to withstand the frustration, fear, and anger, instead of leashing out against the vulnerable. Of course, we need a sound combination of prevention together with deterring measures, we need education as much as vigilance in detecting abuse. We need zero-tolerance. But all of that starts with numbers, and with understanding the problem, and then the challenge.

As a consequence, an already serious problem is becoming even more dangerous, and especially so for vulnerable groups including women and children. This matters to all of us, because it can happen to ourselves, and to our loved ones. This is not a scenario one can stay distanced from. Like I, many readers will be able to reference situations within their own social circle where violence happened. We need to find solutions, and we need to collectively engage now. Shaming and fingerpointing is no option, people who we deeply care about may find themselves being victims, or perpetrators, tomorrow.

Some more detail on the general problem of domestic violence and violence in sexual and intimate relationships:

Throughout my international work violence against vulnerable community members and against women and children has been a constant experience I am faced with in literally every heart-numbing aspect. Of course this is especially visible in situations of conflict and war. I have written several times about the fundamental impact of trauma that victims of such horrible violence have to experience.

Letting war and conflict aside for a moment, domestic violence against vulnerable individuals, often women and children, is a tragic daily mass-occurence within all societies. It affects the fabric of families and communities and is often not allowed to be visible, because of taboo, denial, and shame. It is challenging to see in all its aspects for external observers because of this built-in hide-and-deny-mechanism. It requires active communication to see it. International humanitarian workers see it, of course. Social workers see it, directly or indirectly, of course. You have to be “within” to be able to see.

My national policing work before I entered into international work was riddled with experiences of this domestic violence against women and children, and violence against members of the LGBTQ-community. My understanding of the primary reasons for why it can be challenging to detect such abuse roots in this time. It also transcends into my international experiences, because this mechanism of how domestic violence is being kept away from visibility as much as perpetrators and victims can manage (and neighbors looking the other way), it appears to be pretty universal. It is the same in all societies I have been in.

When I talk about violence in domestic contexts, I do not mean physical violence only. As horrible as forms of physical violence are, they are a sub-set. There are forms of emotional abuse and violence which equal the severity of impact and consequences and in some cases create even more pain, suffering, and long-term damage. Victims of violence can also be men, and perpetrators can be women, even children. Statistical data exists aplenty. Here are a few reference points for a more general narrative: A Deutsche Welle article, and one in The Guardian. For an initial mapping of the scope of the problem, I will refer as an example to statistical data published by “The National Coalition Against Domestic Violence (NCADV)“, a U.S. NGO. Some excerpts:

“1 in 4 women and 1 in 9 men experience severe intimate partner physical violence, intimate partner contact sexual violence, and/or intimate partner stalking with impacts such as injury, fearfulness, post-traumatic stress disorder, use of victim services, contraction of sexually transmitted diseases, etc. 1 in 3 women and 1 in 4 men have experienced some form of physical violence by an intimate partner. This includes a range of behaviors (e.g. slapping, shoving, pushing) and in some cases might not be considered “domestic violence.”

“1 in 7 women and 1 in 25 men have been injured by an intimate partner.” “1 in 10 women have been raped by an intimate partner. Data is unavailable on male victims.” “1 in 4 women and 1 in 7 men have been victims of severe physical violence (e.g. beating, burning, strangling) by an intimate partner in their lifetime.”

“The presence of a gun in a domestic violence situation increases the risk of homicide by 500%. … 19% of domestic violence involves a weapon.”

“1 in 5 women and 1 in 71 men in the United States has been raped in their lifetime.”

So, before focusing on aspects of violence during the Covid-19 pandemic, I needed to set the record straight by at least indicating that women and children form a majority of victims, but that violence against men, carried out by their female or male partners, is not the rare expection, but albeit smaller, a considerable case group.

On the role of weapons in cases of domestic violence:

For the United States, NCADV states that “The presence of a gun in a domestic violence situation increases the risk of homicide by 500%. … 19 % of domestic violence involves a weapon.” This points directly towards the area of support by the German Federal Foreign Office assisting other countries in reducing the illicit impact of small arms and light weapons and effectively controlling the legal aspects around them. This support policy of the German government is very broad in its strategic motivations, it includes, for example, reducing stock and illicit possession of leftover weapons from war and conflict, support to harmonization of law, policy, enforcement and criminal justice aspects, curbing the illicit flow and criminal use of weapons by organised crime and terror inside and outside the European Union, and more. However, in this holistic undertaking the German government places strong emphasis on all gender related aspects. Germany has founded the “Gender Equality Network for Small Arms Control GENSAC” as a global initiative. On this website you find the following description: “The Gender Equality Network for Small Arms Control (GENSAC) aims to make Small Arms and Light Weapons (SALW) control more gender responsive and amplify international, regional, national and local best practices of those who have been doing “arms control behind the curtain”, including representatives from civil society organizations, women’s groups, conflict prevention and development communities.”

Like the scope of the problem of domestic violence and the significant over-representation of women becoming victims is huge, so is the role of firearms and other weapons in it. At the same time, practioners like myself stress that women are under-represented when it comes to policy-making in areas where they are much more affected by a problem than male members of a society. We want this to change, and it includes the dangerous role that weapons play in cases of domestic violence. I invite you to look into the very comprehensive material which has been made available by one main partner of the German government in my current line of work, the “South Eastern and Eastern Europe Clearinghouse for the Control of Small Arms and Light Weapons (SEESAC)“. On their very comprehensive website, gender in Security Sector Reform features high, and you will find various publications and research on domestic violence and the over-representation of female society members in the group of victims. The gemstones of gender related analysis which can be acccessed in SEESAC’s publication library are numerous. Scratching the surface, here some select fast facts, this time valid for South-East Europe (SEE):

97.2% of all legally owned firearms in SEE are owned by men. Men committed 98.4% of firearm-related criminal offenses in South-East Europe, 98.5% of all firearm-related incidents and 98% of all firearm- related homicides. Men account for 83.8% of victims of firearm-related homicide compared to 16.2% of women.

Most telling is SEESAC’s Fast Fact – collection on the misuse of firearms in domestic violence in South East Europe: Homicide committed by a family member is the most common form of femicide in SEE. 61% of all killed women were killed by a family member, compared to 12.4% of all killed men. 38.6% of all killed women and 1.2% of all killed men were killed by an intimate partner. 43.5% of all women killed by an intimate partner in SEE were killed with firearms. 68.9% of women killed with firearms were killed in their homes, apartments or yards. 37.4% of reported domestic violence incidents which involved firearms had a lethal outcome.

Interim conclusion: Because of it’s short-, medium, and long-term damaging consequences including for future generations, domestic violence must be considered a zero-tolerance-topic, and the highest investment into how to prevent and to tackle consequences must focus on violence against women and children.

On emerging data related to the Covid-19 pandemic:

November 25, 2020, German news media reported warnings issued by the United Nations and the European Union: Lockdowns in Europe cause a worrying increase of registered cases of domestic violence against women and girls. December 19, 2020, the magazine “The Economist” focused on this increase with the headline “Covid-19 threatens girls’ gigantic global gains“. December 21, 2020, “The Wall Street Journal”, in its article “Covid-19 Is Pushing Women Out of Work. Just Look at Italy.” focused on structural abuse harming gender equality. December 26, 2020, German news media reported about warnings issued by the German victims protection organisation “Der Weisse Ring”, a highly renowned NGO. According to their own data, approximately 10 % more victims of domestic violence called their helpline during the first ten months of 2020. December 28, 2020, German new media reported a warning issued by EUROPOL. According to EUROPOL, cases of sexual abuse of children during the pandemic are strongly on the rise and perpetrators of pedophile behavior do not only increasingly look for child pornography in the Internet, but also attempt to increasingly contact children for purposes of abusing them. And concluding a list of disturbing data reference points, the Organisation for Economic Cooperation and Development OECD, a global organisation, issued a report “Women at the core of the fight against COVID-19 crisis“, starting with the sentence “The COVID-19 pandemic is harming health, social and economic well-being worldwide, with women at the centre.”

Enough references. There is a ton more. However, whenever I make a statement, I try to provide evidence. Evidence still matters, truth still matters. And the truth is: An already existing worrying phenomenon with implications for all of us and for our children is becoming worse, the longer the pandemic lasts. In my prediction, this is not a linear deterioration, but will resemble exponential developments.

If I wanted to come up with a list of comprehensive action points, I think I would fail. And perhaps, nobody would continue reading this already long article.

However, a few points based on what I say at various points in my writing:

  • Domestic violence is a wide-spread phenomenon with very damaging short-, medium, and long-term, including generational, harming consequences.
  • With children being victims through witnessing this violence, or being subjected to it, long-term damage to their entire lifes is likely. For reference, I refer to my blog articles on trauma.
  • Prevention and deterrence has to focus on the most vulnerable groups first, and that includes especially women and children. Every prevented case of violence contributes to less domestic violence in future generations.
  • Women are under-represented when it comes to discussing, and implementing policy that affects, globally, their own well-being, economic, and security interests. This has to change.
  • The more relaxed the weapons policy of a country, the more likely is that women and children disproportionately suffer from severe forms of abuse, and violence, including through homicide and femicide. We have to continue to outlaw “male behavior” that equals masculinity with possessing and displaying weapons. Personally, I do encourage parents to even consider limiting the existence of toy-weapons in their households. Whilst I have professionally operated a large variety of small arms as a police officer, my children have not seen us parents encouraging, or condoning, the use of toy weapons.
  • Counter-measures curbing the spread of infections during the Covid-19 pandemic increase anger, frustration, fear, and aggression. At the same time the opportunities to “vent” these emotions in a healthy way have become unavailable. We have to increase a policy-discussion about this, and we have to do this now, instead of hoping that vaccinations may bring us to the end of the crisis quickly. We are, still, witnessing the darkest chapters of the pandemic, and this is not changing anytime soon enough.

Die Wahrheit bis zur Unkenntlichkeit verzerrt – Truth Distorted Beyond Recognition – On Gaslighting

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Mary Trump, estranged niece of Donald Trump, daugther of Donald Trump’s late older brother Fred Trump jr, published a book this summer. One of these tell-alls, “Too Much and Never Enough: How My Family Created the World’s Most Dangerous Man”. Mary Trump is a practicing psychologist. In this world where truth is what I tell you, and lies are what the others say, you will probably find references to her credibility widely represented in one side of the media, and scathing attacks on her personal and professional credibility on the other side of the aisle. In a widely published interview she was recently saying that she thinks her uncle genuinely believes he won the election and that he’s the only person she knows ‘who can gaslight himself’. The Internet is chock full with references to her statement, in all languages. So, look it up also for yourself.

One person and his sycophants are gaslighting half of the population of the United States. Why does this matter over here in Europe? Because it has not only a real impact here as well, it is also happening here on its own, and interconnected with what is happening on that other continent. The gaslighting is not limited to an individual victim, not to a community, a society, a political party, a State, or the continent of North America. The systematic imprisonment of individuals into a fake reality which is being established by the gaslighter, it happens all over the world. It has become viral, people being gaslighted who further spread the manipulative messages, mixing with people who may realize what is happening and who hook up to the viral development because it resonates with how they think and feel and how they want to influence things for their own motives. This is not a linear thing which can be traced back to one person, so to speak, at the top. There is no mastermind. There are people who are good at it, and certainly this includes Mary Trump’s uncle. But it happens so widely because there seem to be many conditions being met which allow for the relentless attack on truth and values that we have believed in for decades. Again, Anne Applebaum’s book which I quoted from in a previous entry provides many regional examples, whether from Poland, Hungary, The United Kingdom, or Spain. And my country, Germany, is a breeding space for the same thing as well. Unfortunately, again. History appears to repeat itself.

Gaslighting requires control over the victim and where the victim gets his or her information from. Ideally total control. I will explain in a second, after having said something on the Internet, related to the aspect of “control”: In principle, the Internet knows no geographical border. It has been designed to withstand control. It’s roots are deeply anarchic, allowing for the freedom to exchange anything that can be transmitted through it’s cables and wireless connections. That is why autocratic systems undertake every effort under the sun to control the Internet, including attempting to establish regional versions, or fighting encryption tooth and nail. Whether it is in China, or elsewhere. Shutting down the Internet, in times of a crisis with unrest, it sounds innocent. But it is always a matter of the motive behind: Why does one exert control? Because of a danger for, say individual lifes or the general public? Or because of the danger for an autocrat, his family, and the oligarchy on which’s back he can thrive? Think Belarus, just for example.

Control over what people see, hear, or are meant to believe, you can exert that control by means of physical, or technological deprivation. You do it by making sure that your victim does not communicate with anyone outside the realms of your control: The messaging includes that the other side is your enemy, and you don’t talk to your enemy. One of the oldest tricks under the sleeves of autocrats, dictators, but also terrorists. Gaslighting adds a most perfidious layer: It will lead to that people do not trust other sources of information any longer. They may have a nagging feeling in the back of their minds that something is not adding up. But since they don’t know a way out, they give in. Once you give in, you need to make yourself believing that you are not a victim. So you rationalize why you’re allowing yourself being part of the group you have been coerced into. The “Stockholm Syndrome” is based on the same mechanism.

Like the car dealer has sold the most expensive car to you and you make yourself believe that this was solely a calculation which you came up with yourself, you don’t need to take away access to news channels such as CNN or the NY Times anymore. The victim of gaslighting won’t trust them and won’t use them. Recently, Fox News began to experience this downfall, too.

So, what is “gaslighting”? Gaslighting is an expression being used for a form of psychological abuse and violence. Victims of gaslighting are being purposefully disoriented, manipulated and ripped off their self-confidence. Gaslighting means to gradually take away any ability to trust reality as it is. In individual psychology, gaslighting includes means to deform and eradicate any form of self-esteem of the victim. Here, for once, a German definition of it. The term “gaslighting” gradually appears to become a mainstream expression, including in other languages.

Unfortunately, gaslighting is a common and widely spread form of psychological and emotional abuse. I will use examples for explaining what it means. At the core of why I am writing this blog entry also sits my belief that Mary Trump is wrong by exclusively attributing the ability to gaslight oneself to her uncle. I believe that this is a common phenomenon. In case of need, I make myself believe my own lies, until I have reached the point where I have created a genuine alternate reality, and memory. The current incumbent of the Office of the President of the United States is anything but special in this, except that he may have become really very good at it.

Why is it useful to say that one can become victim of own gaslighting? Like so often, things are not black and white only. Gaslighters are as much perpetrators as they are victims. And the act of gaslighting happens on a scale that can include single-instances, perhaps beginning with negligent, thoughtless, selfish behavior. It can become a self-reinforcing habit, since one has embarked on a path leading to more of the same, and then ultimately to breakdown and severe damage. On its exteme end, gaslighting is pervasive, endemic, and monstrous in acts and damage. Monstrous gaslighters are sociopaths on the extreme side of the spectrum. Their behavior is deeply anti-social, anti-human, and often criminal in nature.

The sibling of gaslighting is denial. Which is, in terms of brain development through hundreds of thousands of years of humankind, a very ancient capability of our brains that allowed for survival. Like, in the stone-age. Denial is a mechanism which shields the brain from overwhelming events and situations posing a threat to physical survival and mental and emotional sanity. It is meant to be a temporary fix. But like many other human capabilities, it requires a balance of threatening events and peaceful times, and when this balance is absent, things get out of control, permanently. Neurophysiologically out of control. Denial alters the way how we perceive, and relate to, reality. And in that, the gaslighter is no better equipped than his or her victim.

The underlying motivation both for denial and gaslighting is fear. Strong fear. More often than not this fear may not even be acknowledged by the gaslighter him- or herself. It is about loosing control. Cold blooded sociopaths can do that without losing the knowledge about that they are creating a fake reality in which they imprison the victim. But most of us are not carrying such extreme sociopathic traits that would allow us to do that.

Like everything else above, sociopathy is a form of human behavior that happens on a scale. There are extreme ends of the scale but to some extent or the other sociopathic traits are common parts of the individual psychology of many people. But even if I say that there are sociopaths who are displaying extreme forms of this disorder, it does not mean that these people do not feel emotions. Severe forms of sociopathic conditions become a disorder entailing to be progressively unable feeling emotions of other people. Note: I say “of”, not “for”. But sociopaths are not machines. Whilst they struggle with understanding and acknowledging emotions of others, they do feel their own emotions. The combination of not feeling what others feel gives space for disproportionate and intensified feelings for oneself, and this is especially true for fear. It is creating extreme forms of selfishness and self-centeredness.

Let me bring the parts of the picture alive with a personal case study. Like I said, the world is not black and white, things can be on the less extreme end, or they can be serious, or, if allowed to, they can develop from less severe to monstrous.

When I was nine years old, I went through a really difficult time at school. It was part of an overall development, I grew up with a raging father using physical punishment as a form of education. Because he had grown up under the same circumstances. Likewise, when he was not able to control his own rage, verbal, emotional and physical violence were something he had no control of. He had experienced the same with his father. As always, it hurt himself when it happened, but the result would not be an apology, but fierce denial. So I grew up with the distorted view that everything which happened to me was my own fault. Since this is not a blog entry for full personal disclosure, I will leave it with that, stressing that I love my father and that I reconciled, many decades later.

However, at the age of nine my difficult times at school fueled my low self-confidence. I had no friends. And getting bad grades wasn’t something that helped me building self-confidence. Rather, it established profound, existential fear. Fear from punishment at home. This fear grew so strong that I would not reveal the bad grade I once got. I simply could not. But the bad grade is in your exam book. And sure enough, the next test would be as bad as the previous one. What to do? Telling? No way. Soldiering on in denial that one day the story would break. But fear grew to panic levels. At one point I found myself physically removing pages from my exam book, just in case my parents would want to see and control it. I went to greatest length in this manipulation, again, with fear in my stomach going through the roof. There were two occasions when I ran away from home. I hated the days, escaped into my bed at night. It was horrible.

Then my teacher lost her patience. She gave me a note to be delivered to my parents, requesting a talk. And she asked me to bring this note back to her, signed by my father or mother. This was the worst development ever, but I was not capable to give up. What did I do? During a long afternoon session, I created a birthday card for my mother. In an insane story I had come up with, this birthday card for some reasons had to include a signature. But where the signature on this card was meant to show up, I cut a hole into that card. Underneath, the note from school. And finally, I used a blank paper as a third level, again with a hole where my mother was supposed to sign the card. I designed it in a way that the decorative elements of the fake birthday card were visible through the cover paper. And I went down to my mother, explaining in full panic mode that I was preparing something as a surprise for which I needed her signature, and that I could not tell her why. My mother was stunned, but she was also seeing me being upset, crying and begging. Whilst she had all reasons to suspect that something was wrong, I made her doubting herself, and trusting me. I gaslighted her. She finally signed.

Well, that signature was so small that my teacher immediately suspected a fake. Subsequently, my cover broke and armageddon came down on me. But why am I exposing myself here? Because this was the first, perhaps mild, form of gaslighting I did. And I never forgot it. I would refer to it for decades to come. But it would not prevent me from doing the same thing again, almost fourty-five years later, when the fear level in relation to my life breaking apart was reaching the same gigantic proportions.

People can grow apart for many reasons, but one chief reason is dishonesty. The bond between a mother and her child may forgive, but marriages and any relationship less likely do so. Dishonesty to oneself and to others is the chief reason for relationships breaking up. I believe the same is true for communities, societies, and States. If there is no honesty in communicating with each other, the catastrophe is inevitable. It may take a long time, but like with me at the age of nine, being a child, this is true because I believe it is a universal truth. And until this catastrophy happens, denial and also gaslighting are common features of an underlying condition of fear. Fear of losing control in a situation which increasingly is slipping out of one’s hands.

In my personal case, this happened roughly fourty-five years after the events of my childhood. I am so NOT proud of it. I’m sparing details, but it had to do with how my marriage had developed into a meaningless hull. Over those many years leading to the final stages, denial led me to believe that the reasons for this deterioration were not sitting with my own behavior. Rather, I victimised myself with an inner narrative with which I made myself believe I was the victim of sad circumstances, and that I deserve some relief. And means of relief, including alcohol, were just sedatives of which I needed more and more. This came with secrecy. I was dishonest to myself and my loved ones. Which wasn’t going unnoticed on the side of my loved ones. In a close relationship it is virtually impossible to entirely hide things, even with the best tricks possible.

But what happens in this case on the side of the partner? He or she will develop a feeling that something is not right. Controlling the other person may not be an option, including because it just doesn’t feel right. So, denial is kicking in on both sides in a relationship. But some things do not add up, and when this happens, gaslighting is coming into play.

“I sometimes have the feeling that you want to make me believing that I have wrong perceptions.” Whenever my then wife would say this, after there was enough despair on her side to speak her truth, there was a little corner in myself mumbling that she is right. But overwhelmingly I was making myself and her believing that this wasn’t the case, that I did not establish a fake reality, that it was her who saw things in a distorted way. And again, though I learned a lot about the neurophysiology behind, I am NOT proud of it. I try not to be ashamed either. I just try to be honest, and hold myself accountable, and to do amends.

It was only after we broke up and my ex-wife had gone through enough recovery from her own pain, anger, grief, and also understanding of how the dance of two persons was based on wrong belief systems on both sides that she was able to repeat the above statement towards me with not too much own pain. And it was only because I went through my own recovery with intense work on myself that I was able to see, and to acknowledge, my own behavior. But it took years. When our relationship hit rock-bottom, and I hit rock-bottom, I found myself in so much pain and fear that I literally saw myself repeating my behavior that I had as a nine-year-old: I systematically trained the use of a lie in order to make myself believe the fake reality, so that I could use the narrative without blushing, stuttering, and with a heartbeat beyond 180 bpm.

Because my world broke into pieces, I had the chance to see it. If I would have succceeded in my fear-driven control, I would have progressively believed my own lies. It would have driven my then-wife into insanity. People who discover that they have been subjected to severe forms of gaslighting have a really hard time regaining mental sanity and the ability to trust other people. My ex-wife and I are friends today. Not only parents, good parents, but good friends. It is the gift of my lifetime. On my part, this is the consequence of a rigid decision to always remain honest to myself and others. And after many years of practicing this, my ex-wife saw enough reason to trust me, and to love me for my commitment, to myself, and to the people in my life who I love, and who love me.

Of course, this is only a personal case-study. It is not meant to establish an academic argument on gaslighting. It is meant to underpin why I believe that truth matters. Gaslighting is destroying truth, and the ability to trust. It leads to personal self-destruction, demolition of relationships, even criminal behavior. It leads to incredible suffering and pain. When it happens on a societal scale, it leads to societies running rock-bottom. And yes, like in personal cases, recovery of trust is possible on the level of communities and societies as well. But is doesn’t come as a Christmas present. It requires hard work. Better now than after the breaking-up. Because one way or the other, more often than not breaking up comes with violence. In my personal case, I am so grateful for the peaceful transition into healing and trust, and then love and friendship, through all the endless pain and discomfort. Thus, I believe, we can do it in larger contexts, too.

It requires profound honesty. Zero-tolerance to lies. Avoidance of anger, resentment, and rage. The ability to listen, rather than talking. Humility. Willingness to admit mistakes immediately. And the willingness to forgive. Oneself and others.

A High-level View on Reform Needs for Peace Operations

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This article combines an analysis of current reform efforts, and reform needs that I see following my four previous posts on the impact of trauma on sustainable peace and reconciliation. So, partly, you will see language coming from there. Opposed to these four pieces, this one does not make reference to external sources through footnotes. If you want to “check the fact-checking” for my conclusions, read the more detailed analysis.

Since taking office January 2017, the UN Secretary General has made the reform of how the UN engages in the field of peace and security a top priority. His vision includes efforts to improve the complex architecture through which the many UN actors within the Secretariat and within UN agencies contribute. More importantly, it also includes improving the conceptual approach: A historically grown delineation between peacekeeping and peacebuilding efforts, with the latter following the former, is being gradually replaced by more integrated approaches which put conflict prevention at the fore. Sustained peace and security is the best approach to prevent relapse into renewed conflict.

In his own words, the SG describes the challenge in his report to the General Assembly and the Security Council on peacebuilding and sustaining peace: “An important breakthrough … was the recognition that efforts to sustain peace were necessary not only once conflict had broken out but also long beforehand, through the prevention of conflict and addressing its root causes. More countries have recently experienced violent conflict than at any time in nearly three decades. Forced displacement has reached unparalleled levels. In too many places, the cohesion of societies and the well-being of people are at risk. Building a common vision of society must involve paying attention to the causes of those problems. In the resolutions, it was recognized that the international community must redouble its efforts to support Member States in preventing crises that exact such unacceptable and growing human and financial tolls.”

The Secretary General thus points at the inherent connection between well-being of people, the cohesion of societies, and the likelihood of violent conflict: Health, including mental health, and cohesion of communities and societies are inseparable. In the currently increasingly challenged global system, with a rise of populism, nationalism, disregard of achievements on human values and rights, and erosion of vital elements of democracy including the rule of law, international organizations such as the United Nations are experiencing distrust and at times open hostility. A credible implementation of the UN SG’s vision requires to give him utmost support.

UN policy has not kept up with developments in peacekeeping, which has seen an increasing number of mandates that have changed the principles which have traditionally defined it as based on consent, limited use of force, and impartiality. The 2008 Capstone Doctrine sought, based on the findings and recommendations of the 2000 Brahimi Report, and on the aforementioned principles, to place peacekeeping within a spectrum of “Peace and Security Activities”, a “range of activities undertaken by the United Nations and other international actors to maintain peace and security throughout the world”.

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Whilst the Capstone Doctrine places peacekeeping within a larger set of concepts, the other elements remain largely undefined policy wise. This is also true for UN Special Political Missions. As one of the consequences of a changed environment in which these missions operate, peacekeeping has focused more and more on the grey zone with peace enforcement, making it more difficult to create a distinction to peace enforcement which is required if one is to uphold the traditional principles of peacekeeping. Peacekeeping is challenged by having a conceptual identity that is less reflected in contemporary mandates. With regard to it’s current reform, there is a common tendency to focus on those parts of this reform that make operations fit for work in less benign environments where there is less and less consent of stakeholders with the presence of a UN operation that includes more coercive capabilities. As another consequence, the distinction between peacekeeping operations and special political missions, which have been growing over the years since then, has become more difficult as well. At the same time, no follow up to the Capstone Doctrine took place. The “scattershot, incoherent and occasionally contradictory or competitive international efforts as a significant source of failed peacebuilding efforts”, as described by the SG in his 18 January 2018 report, comes as no surprise.

The 2015 report of the “High-Level Independent Panel on United Nations Peace Operations”, in conjunction with the 2015 “Report of the Advisory Group of Experts for the 2015 Review of the United Nations Peacebuilding Architecture” have set the stage for the current reform activities. Yet, a unifying policy that would reflect the views of all stakeholders within the United Nations how best to combine existing tools under the primacy of the Secretary General’s vision of putting conflict prevention to the fore is not yet visible.

At the same time, again with the SG’s own words in his report as of 18 January 2018, “the 2030 Agenda for Sustainable Development contains the blueprint of the common vision of society towards which the world is trying to move. Inclusive and sustainable development not only is an end in itself but also happens to be the best defence against the risks of violent conflict. The 2030 Agenda also contains the promise to leave no one behind in the quest to build such societies.”

It can, therefore, be argued that the reform vision of the UN requires a fundamental discussion about how to proceed with outdated and incomplete doctrine: Peace operations need to be more integrated, which is one of the objectives behind the SG’s reform initiative of the peace&security architecture of the UN Secretariat: The UN is currently implementing a new organizational setup. This absorbs most capacity that is not already consumed by operational needs. However, in order to drive change, in this fundamental discussion there is a need for guiding strategic principles for mandating peace operations, and how they integrate the political objectives of the UN and its constituency. Growing rifts between members of the UN Security Council, and between the driving forces of the Security Council and the general constituency represented in the UN General Assembly can significantly paralyze future success of this reform.

If identifying root causes of conflict, as stated by the SG, sits at the heart of conflict prevention activities, then identifying root causes for relapse into conflict is a core activity of conflict prevention as well. It has often been stated that, in order to get peacekeeping done right, important opportunities of assistance during the early “golden hours” need to be addressed better. This is true for transnational threats including the combined effects of transnational organized crime, violent extremism, and terrorism, but it is also true for early assistance to peacebuilding, which often is missing recognition in mandating peacekeeping operations. Even more then this is vital if a renewed strategy of the United Nations is meant to lead to more integration and coherence between what currently is understood as peacekeeping and as peacebuilding.

Innovative approaches are needed in support of the Secretary General’s vision to make the entire system fit for contributing to the 2030 Agenda for Sustainable Development. The context between conflict- and war related trauma of entire young generations and their caregivers through many forms of abuse on one hand, and the ability of communities and a society to move forward towards sustainable peace on the other hand, remains part of the scattershot activities of actors attempting to help, but without a guiding high-level policy.

At all times children have witnessed their fathers being killed and their mothers being brutally raped, and they have suffered from the same cruelties themselves, committed by armies, militias, gangs, and mobs. Children have been separated from their parents, endured unspeakable atrocities. This is the reality until today. Nowhere this is more devastating for communities and societies than when acts of severe war crimes or genocide are being committed. Generations suffer. Never before in human history the number of civilian casualties has outnumbered the military casualties as much as today. In contemporary conflicts, as much as 90 percent of casualties are among civilians, most of whom are women and children. Women in war-torn societies face specific and devastating forms of sexual violence, systematically deployed to achieve military or political objectives. It is in this context that entire traumatized generations emerge.

Children grow up with the consequences of what has been done to them and their parents, others again grow up with the knowledge that they are born because their mothers were raped. Raped mothers struggle with acceptance in patriarchal societies. Raped men even more. Children of rape, raised by a traumatized raped mother already struggling to love her unwanted child unconditionally, they also experience being pariahs in their communities. In all this suffering, childhood trauma is different from the trauma of adult survivors of conflict in that trauma is perceived as an event or a series of events in life for adults. It is defining the life of children. It is their never ending reality, and the younger they are, the fewer, if any, cognitive tools they have to comprehend what happens to them and to put it into a context of accountability of others. Mental health is severely affected by irreparable damage to the developing brain, and mitigating coping mechanisms within families or communities are dysfunctional or absent.

Sustained severe trauma through conflict-related violence profoundly impacts on the world of a toddler who has no concept of complex human relations. Subsequently, the adult survivor will suffer from a deformed capacity to establish healthy human relations. Because of neurophysiological damage inflicted by enduring trauma this is true for all cultures.

The International Community is also defined by the helplessness of many who care about humanity and decry the atrocities through soldiers, militia, gangs, mobs, violent extremists and international terrorists against civilian populations including children, whether in Syria, Yemen, Afghanistan, Iraq, Somalia, Sudan/Darfur, South Sudan, Central African Republic, Democratic of Congo, Burundi, Niger, Mali, Libya, recently Mozambique, Myanmar, and so many other places. Increasingly the divisions within the UN Security Council do not allow finding a common position that can be enforced. In cases of mandates being given to UN or partner organizations, we are confronted with an increasing inability to stop atrocities under our eyes, and to help countless trauma victims in the aftermath of conflict: Respect for ceasefires or commitment to peace agreements is as much waning as the acceptance of the UN itself, not least because of the disunity amongst those who constitute the UN: Member States, and especially the Security Council Members. Peace operations that can not sufficiently engage in deterring atrocities lose political credibility, such as in South Sudan, peace operations that engage in order to protect civilian populations with robust means, such as in Mali or the Democratic Republic of Congo find themselves being accused of bias, increasingly getting under fire themselves. The plight of civilians, especially children, continues. Billion-dollar peacekeeping operations get stuck in conflict where there is no peace to keep, losing capacity and credibility to contribute to peacebuilding.

Global migration of surviving traumatized young people throws them into the merciless arms of organized criminals and spills them into societies which are overwhelmed and increasingly hostile. Across the globe, whether in the U.S., Europe, or in Bangladesh facing refugees from Myanmar, traumatized children continue to experience severe traumatizing even in places they have been told might be their hope for a better future. Families with cruel abuse stories at their place of origin find themselves in another horror: The arrest of the adults and the forced and cruel separation of their infants, toddlers and children from them without any prospect to know how to maintain contact, or when they may be re-unified. Children who have been thrown on smuggler’s boats by their parents experience that a country denies access to a port of entry to vessels operated by aid organizations. Trauma becomes a constant fact of life. Alienation both on the side of victims and receiving host societies’ communities leads to “why bother” on either side. Antagonization leads to mutual resentment and hate. The spiral of conflict continues. Deported forced migrants come back to their country of origin, with little hope for peace, security, and some economic future. What do we know about the impact of mass trauma on children and adults by conflict and war? How well do we understand the connection between healing of individuals and communities, and societies, on the one hand and reconciliation as a core pre-condition for lasting peace?

On a high-level policy level, a much better appreciation of the damaging neurophysiological consequences of sustained childhood trauma within communities within and post conflict is necessary. A health-focused discussion needs to happen, recognizing the importance for peacebuilding efforts. Notwithstanding the different conditions created by different conflicts for whether, and how, the effects of severe trauma can be addressed through international assistance, its impact itself on communities and a society are deep. Whilst the crippling, life long, and intergenerational impact of trauma, especially during early childhood, on individual mental and physiological health is well documented and increasingly better understood, less knowledge exists about how it affects conflict- and post-conflict communities in different cultural settings. Even less studies have been undertaken on how such communities affected by large scale mental health deficiencies contribute to societal healing, or are supported in healing by those societies they exist in. Yet, any practitioner will agree on the relevance, perhaps with varying degrees of helplessness when it comes to the question how to help. Studies about how to overcome this within peace operations do not exist.

Closely connected to efforts raising awareness, a path towards identifying mitigating measures within peace operations needs to be charted. This is important in order to make a difference to the current situation: Practitioners and policy-makers acknowledging the problem in principle, but not sure about how to better and more holistically address it. However, the impact on building sustained peace, including through reconciliation, is critical. Therefore, the question must be how to incentivize an increased focus within support efforts for peace and security.

Without doubt, scattershot efforts to the best of the abilities of many actors do exist, including through humanitarian actors working in peace operations with so-called multi-dimensional mandates. An effort collecting views, practice, and potential best practice needs to be undertaken.

A new approach – Part Four in a series on Trauma and Conflict

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In Part I I have shown that pro-longed and intense trauma creates dysfunctionality in many forms, and that the impact of trauma during formative periods of brain development goes even deeper1.

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(Picture taken from: https://www.cdc.gov/violenceprevention/acestudy/about.html, retrieved June 27, 2018)

The longer a young child exposed to repeating trauma through forms of childhood abuse, the higher are both chances of, and the depth of, life-long badly damaging consequences. One very important reason for the unmitigated impact of trauma sits with that parents or caregivers either are the source of the child’s trauma (abuse of any form), or that they are not appropriately able to nurture a traumatized child.

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(Picture taken from: https://www.cdc.gov/violenceprevention/acestudy/about.html, retrieved June 27, 2018)

Children who, for example, get victimized by sexual abuse through third persons, depend on that their caregivers are able to respond appropriately. If they don’t or can’t, life-long dysfunctions include severe depression, compulsive pain medication leading to addiction, and a general struggle with building healthy relationships. Health problems can be severe, leading to premature death, including through substance abuse, and suicide.

In Part III I am referencing studies that confirm this for children who survive abuse in countless forms happening in conflict and war. There is evidence for that social relationships and the existence of culture-specific coping strategies, can mitigate the impact of trauma. Healing can happen. But where there is an absence of these mitigating factors, because the parents are traumatized themselves, and because cultural mechanisms struggle or have broken down entirely, dysfunctionality becomes a feature of communities and even an entire society. The plight of caregivers deprives the traumatized children from healing.

How can we expect that large percentages of trauma survivors do not influence the functioning of communities and societies? It might be difficult to find studies that confirm the relationship between trauma-induced life-long and inter-generational dysfunctional behavior on the level of entire communities and the ability of communities and a society to move to lasting peace including through its ability to reconcile. But simple logic tells that this is the case: Reconciliation is, as I have said, about restoring inner harmony, integrating memory and behavioral impact of trauma into a healthy form of living. Dysfunctional individuals can not contribute to restoring a healing and healthy community, as the community is made from these individuals who need to heal in order to contribute their healthiness to the Whole. My personal experiences in this regard, stemming from living in and visiting so many communities support this. So goes the experience of every health worker, every humanitarian, every peacekeeper. We do collectively know that a country relapses into internal conflict easier than plunging into an internal all-out conflict without having suffered from precedents. We do know that vulnerable communities in a weakened society are subject to efforts of violent extremism and international terrorism to establish control by a reign of terror.

How can we neglect a fact that is so obvious?

  • Is it because we have to mainstream the understanding of what trauma really does?
  • Is it because we are simply overwhelmed and do not know an answer to the question what could be done?
  • Is it, as I have shown, that we collectively fail to act appropriately on assisting complex systems to regain their balance?
  • Is it that we still have to act more boldly on the UN Secretary General’s vision and intent to put conflict prevention front and center? Effective peacebuilding is conflict-prevention, and thus it can not be emphasized, in my view, enough how important it is to factor early peacebuilding into peace operations. After all, the United Nation’s “Capstone Doctrine2” from 2008 emphasizes exactly that. But I know of no comprehensive follow-on to the Capstone Doctrine. It explicitly sets a framework for peacekeeping, within a larger realm that encompasses conflict prevention and peacebuilding. The larger realm remains insufficiently addressed since 2008.
  • Why is global policy not matching reality?

In the most recent comprehensive analysis of UN Peacekeeping Doctrine in book form3, “UN Peacekeeping Doctrine in a New Era: Adapting to Stabilisation, Protection and New Threats“, Chiyuki Aoi, Cedric de Coning, and John Karlsrud4 bring it to the point when they describe how mandates given to the most recent peacekeeping operations challenge the traditional UN peacekeeping principles. The authors argue that these missions operate without a peace agreement in place and that, as a result, the current focus is on projecting more force, including undertaking offensive operations at times, engaging in intelligence and using special weapons and tactics.

We have heard the UN Secretary General and his Undersecretaries constantly referring to that we deploy peacekeeping operations into environments where there is no peace to keep. In short, the focus which is absorbing almost all energy of policy- and decision makers is heavy on the military side. More or less the rest of all energy currently goes into reform efforts of the United Nations and UN peace operations. The above book makes the case that this development widens a gap between existing peacekeeping policy and practical developments on the ground. Anticipating that more of the same may come in Syria, Yemen, or elsewhere, this is of concern for the collective of twenty authors from all over the globe and with in-depth practical and academic perspective on peace operations of the UN.

Whilst my series here on trauma is not the place for a larger analysis of these developments, it can, however, be said that the development of policy how to effectively contribute to restoring peace and security runs breathtakingly behind the rapidly changing reality on the ground. This gap may contribute to challenges on advising political bodies, such as the Security Council, on what should be done, what needs to be done when being confronted with the heavy-handed conflicts of these days, and their consequences for communities and societies. Policy with no operational impact is as problematic as operational decisions based on outdated policy.

For example, I have repeatedly argued that we continue to miss the “golden hour” of early engagement through peacekeeping operations by not being provided with the necessary expertise to address the endemic consequences of emerging transnational crime influencing such peacekeeping processes negatively: “Let us get boots on the ground first” is a mantra that can often be heard. But the difficulties addressing root causes immediately makes it almost impossible to address emerging threats later.

If we engage with peacekeeping within a larger framework as we, I believe, have to, then we want to get it right. We want to see that the enormous effort, including the human tolls that we take, do effectively help getting communities and societies on a path to peace. It appears to me that those have a point who argue giving up the traditional division between peacekeeping and other forms of activities towards a unified term “peace operations”. The entire reform of the United Nations initiated by its current Secretary General is based on this.

In this series of articles I argue that the same is true for the impact of trauma on post-conflict development: We think reconciliation only later, we associate it with peace building. Like with emerging threats that include transnational organized crime, we appear to prioritize a select toolset which, though it is necessary at times, must be incomplete if it is not taking into account threats that can not be mitigated by military capacity. We postpone other action, or leave it to others, and it may be that we collectively fail to follow up.

Reconciliation empowers societies to chart their own way towards lasting peace. Whilst this is widely acknowledged, it would also appear that efforts of the assisting international community fostering this healing power have been futile. I have witnessed many discussions about how model processes, such as the South African path towards seeking truth and reconciliation, could be adopted for different post-conflict societies. But looking just at the very same country today, South Africa’s crisis of endemic corruption also demonstrates the relevance of a truly owned rule of law for a sustainable way forward. The relevance of security and rule of law for economic development, and vice versa, has become part of the core of contemporary multidimensional mandates of peace operations. What is missing is the recognition that reconciliation belongs to the critical needs from the outset on, too, and how to support it. Today, reconciliation is considered being part of a peacebuilding process, which may be emphasized later. The “paramedic approach” of peacekeeping operations focuses on protection of civilians and on political processes. Assistance to restoring security capacities is considered a secondary task which may require later action. Even more so, this is true for reconciliation. Parts of the process are recognized in what we call “transitional justice”, but even there we seem to fail seeing the relevance of deep trauma on individuals, communities, and the society as a whole.

The triangular relationship between providing security and order, applying criminal justice, and allowing meaningful penal management based on humanitarian principles and human rights is well known and often quoted as an example for the need for integrated thinking. However, the triangular relationship between governance, rule of law, and reconciliation is less strategized and even lesser operationalized.

2 In it’s own words, the Capstone Doctrine as of 2008 aims to define the nature, scope and core business of contemporary United Nations peacekeeping operations, which are usually deployed as one part of a much broader international effort to build a

sustainable peace in countries emerging from conflict. It identifies the comparative advantages and limitations of United Nations peacekeeping operations as a conflict management tool, and explains the basic principles that should guide their planning and conduct. In doing so, it reflects the primary lessons learned during the past sixty years of United Nations peacekeeping. It draws on landmark reports of the Secretary-General and legislative responses to these reports, as well as relevant resolutions and statements of the principal organs of the United Nations.

https://www.un.org/ruleoflaw/files/Capstone_Doctrine_ENG.pdf

3 UN Peacekeeping Doctrine in a New Era: Adapting to Stabilisation, Protection and New Threats (Global Institutions) (p. 1). Taylor and Francis. Kindle Edition; Loc 385

4 Ibid, Introduction – Addressing the emerging gap between concepts, doctrine, and practice in UN peacekeeping operations

The impact of trauma on communities and societies ravaged by conflict and war – Part Three in a series on Trauma and Conflict

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How trauma and reconciliation are linked needs to be examined from the perspective of an individual, a community, and a society. Reconciling⁠1 means to restore to friendship or harmony, or to settle or solve conflicts. Thus, an individual may heal from consequences of a traumatic event by restoring inner harmony, integrating memory and behavioral impact of trauma into a healthy form of living. In that sense an individual reconciles his/her memory as a condition for a path to learn healthier forms of behavior than those which he/she suffered from through trauma. Psychotherapy is based on that, and so are all, very successful, self-help groups following the 12-Step-principles⁠2.

But what happens if trauma, triggered by the same events, essentially affects all members of a community, or a majority? What happens if these events last for a long time, when those who suffer have no way to escape? Recent history is filled with so many examples, whether Syria, Yemen, or so many more. 

However, let me introduce a country in which I spent four years of my life: I lived in Sarajevo, the capital of Bosnia & Herzegovina, between 2008 and 2012, arriving twelve years after the end of an all-out war.

When Bosnia&Herzegovina declared it’s independence from Yugoslavia, the Yugoslav People’s Army laid siege to the town between April 1992 and February 1996. For 1425 days⁠3, Sarajevo’s citizens had to move under sniper fire and mortar shelling raining down on them from hilltops overlooking the city. They had to flee from violence along frontlines moving backward and forward multiple times. Frontlines where ground forces of the Yugoslav People’s Army and the Bosnian government defense forces clashed for years. Every surviving Sarajevan who came out of that with severe trauma. Bosniaks, Croats, and remaining Serbs.

Bosnia & Herzegovina is home to a multi-ethnic society in which individuals mainly identify themselves as members of either the Bosniak, the Croat, or the Serb nation. For centuries they had lived together in peace. Sarajevo was the glaring example for a multi-ethnic and multi-religious society, Muslims, Catholics, and Orthodox Christians lived together, the rate of inter-marriages was high. Sarajevo’s hospitality and friendliness during the Olympic Winter Games of 1984 are unforgotten. 

The brutal atrocities between 1992 and 1996, carried out under General Ratko Mladic and under political control of Radovan Karadzic and Slobodan Milosevic changed that, forever. Between 2008 and 2012 I was the Head of a European Union Mission assisting in restoring police and the rule of law. In this Mission hundreds of local Bosnian staff members served alongside their international colleagues. Thus, I had ample opportunity to listen to members from all walks of life of today’s Bosnian society. The memories of the war, the impact of traumatic memories, they run deep in every individual I met. Bosniaks, Serbs, Croats have slowly restored a way of living peacefully together. However, the fearful memories of the past impact on them in every aspect of today’s life.

What struck me most was the seeming inability of these three nations living in one State to move on into reconciling with the past. The historical narrative has become very different: Bosniaks in Bosnia will tell a different history opposed to, say the Bosnian Serbs. Nowhere is this more visible than in acknowledging the Srebrenica genocide. There is simply no joint narrative, and I have not seen successful efforts to find a path towards reconciliation. The efforts of all sides are frozen. Until today, the annual commemoration at the Potocari memorial and graveyard site happens without participation of political representatives of the Republica Srpska, the Serb part of the Federation of Bosnia & Herzegovina. As another example, Bosnia & Herzegovina knows the concept of “Two Schools Under One Roof⁠4”. An unknowing passer-by would see Bosniak and Croat school children use the same school. But in reality, they are enlisted into two distinctly different schools. Why else than for the purpose of establishing a different history, and maintaining a different identity?

Years earlier, between 2000 and 2004, I lived in Kosovo. The violent conflict between Milosevic’s Serbian Forces and the Kosovo-Albanian Kosovo Liberation Army had just ended less than a year earlier, through a military campaign carried out against Milosevic by NATO. Very early at the beginning of the post-conflict period in Kosovo, I saw the same like later in Bosnia: Ethnic Albanian and ethnic Serb children did not receive any joint education⁠5. The memory of communities in Kosovo is altered forever. I lived both in Albanian neighborhoods and Serb enclaves. Especially in Serb enclaves, depression and fear ran high. 

These are just two illuminating examples of a more comprehensive personal experience which I made in post-conflict societies all over the World. I share this experience with hundreds of thousands of people in the peace and humanitarian community. One has to get out of the “international bubble”, out of the walled compounds and protected hotels and out of heavily armored vehicles. By living with and within ravaged communities, the heuristic knowledge about the depth of impact of trauma is gained. But what is it that academic research tells us?

The PubMed Central (PMC)⁠6 is a free full-text archive of biomedical and life sciences journal literature at the U.S. National Institutes of Health’s National Library of Medicine (NIH/NLM). As of this writing, it offers access to 4.9 Million articles from 2138 journals that participate fully, 330 NIH portfolio journals, and 4692 selective deposit journals.

 A research of it’s database with the search term “PTSD” offers 33.829 articles. The search term “PTSD conflict war” leads to 3273 references. “PTSD reconciliation” leads to 362 offerings.  “PTSD reconciliation war” references 219 articles. Amongst these, I have undertaken an initial scoping which is not complete. I selected articles that could give some answers to the questions above. To document this, all examined literature can be found in the footnote section⁠7. 

I find the following statements being supported by the selection of scientific research that I have examined:

  • Communities and societies that have come out of conflict include an extraordinary high percentage of individuals with health conditions including PTSD, and other forms of trauma impact, including depression. The impact of war on the mental health of members of communities is most significant.
  • Women are more affected than men, other significant groups with high numbers of trauma survivors include children, elderly, and the disabled.
  • Some studies find very high percentages of trauma survivors in children in refugee camps and displaced populations, and almost as high amongst their caregivers.
  • Among war-affected youth, the association between war exposure and psychological distress is mediated by daily stressors. The breakdown of societal structures in conflict directly affects the impact of trauma on mental health. Within childhood, experiences of family violence and external violence were significantly related to increased mental health symptoms.
  • The availability (or not) of physical and emotional support affects the consequences of traumatization. The use of cultural and religious coping strategies is frequent in developing countries. Where such traditional spiritual and religious support structure break down, coping strategies are severely hampered.
  • Physical disability and depression and PTSD correlate. 
  • Mental disturbances and feeling upset correlate.
  • Trauma effects from conflict, such as somatization, PTSD, anxiety disorder, major depression, alcohol and drug misuse, and functional disability are trans-cultural.
  • Studies support that the above symptoms are the same for victims of rape and forms of conflict-related sexual exploitation and abuse. 
  • Effective public mental health services are needed to address large scale effects of traumatization.
  • The impact of trauma in such societies can be traced for decades, there is also supporting evidence for intergenerational consequences.
  • The trauma impacting on victims and perpetrators of violence leads to different coping strategies. Perpetrators of violence against civilian populations might display less symptoms. The impact of trauma on former child-soldiers can be mediated through family- and community-based care. Conversely, where this is not the case, severe traumatization persists.
  • Some studies mention that there is no established consensus on how war- and conflict-related traumatization should be addressed from a public health perspective.
  • One study (South Sudan) finds that most participants thought reconciliation was not possible without prosecuting perpetrators or compensating victims and did not support amnesty. Participants with probable PTSD were more likely to endorse confessions, apologies, and amnesty, and to report that compensation and prosecution were not necessary for reconciliation. The more traumatic events people experienced, the more they endorsed criminal punishment for perpetrators and the less they endorsed confessions.
  • One study, based on 160 reports, finds that the five most commonly reported activities were basic counseling for individuals; facilitation of community support of vulnerable individuals; provision of child-friendly spaces; support of community-initiated social support; and basic counseling for groups and families. Most interventions took place and were funded outside national mental health and protection systems.

To reduce the findings and my own conclusions even more: 

(1) Conflict- and war-related trauma affects communities and societies significantly and this impact spans over generations.

(2) The most vulnerable suffer most.

(3) Large scale coping strategies depend on the availability of culture-specific services and functions that often have broken down in conflict.

(4) There is little analysis of the effects of traumatization on post-conflict reconciliation.

(5) There is, however, a dire need to look into how the international community factors this context into work assisting in peacekeeping, peacebuilding, and conflict prevention processes.

August 26, 2002, the General Assembly of the World Psychiatric Organization approved a statement on mental health implications of disasters. It begins as follows⁠8: 

 

“The World Psychiatric Association would like to draw the attention of psychiatrists and other mental health professionals, health authorities, decision-makers and the general public to the serious and potentially catastrophic psychological and psychopathological effects of disasters. These effects can be diverse in character, intensity and potential for chronicity, but acute stress reactions, post-traumatic stress disorder (PTSD), mood, anxiety and psychotic disorders, and permanent changes in the personality are the ones that, if left untreated, may have the most serious consequences. Disasters can result from a variety of causes such as earthquakes, floods, hurricanes, fires, naval and plane accidents and terrorist attacks, but also from acts and consequences of war and negative conditions affecting important groups of population like famine, sanctions, forced migrations and similar deprivations. All of them produce very serious effects on the population and particularly on children, having a negative impact on the social structure and systems, which increases the effect of the disaster on individuals and population.”

  

So, whilst it appears that a context between trauma and reconciliation can be established, these findings are a first indicator for that the context with reconciliation, and thus the context with efforts to sustain peace, requires more attention.

Do policy of the United Nations and political decision-making processes such as by the Security Council take the above impact into account? What do we know about systematic or non-systematic efforts of peace operations to factor this into their mandated work. What do we know to which extent peace building efforts take this into account? Are there practices and best-practices?

1 https://www.merriam-webster.com/dictionary/reconciled

2 A twelve-step program is a set of guiding principles outlining a course of action for recovery from addiction, compulsion, or other behavioral problems.

https://en.wikipedia.org/wiki/Twelve-step_program; retrieved June 19, 2018

3 For many more comprehensive documentaries, here a brief video:

4 https://en.wikipedia.org/wiki/Two_schools_under_one_roof

5 At least for ten years preceding the Kosovo-Albanian insurgency, Milosevic maintained rigid control over the previous largely autonomous province of the former Yugoslavia, surely leading to the same effect, but with the curricular written under Belgrade’s control. After the war, the Kosovo-Albanian leadership in Pristina wrote the curriculae for the Albanian schools, and Belgrade maintained as much control as possible over the northern parts of Kosovo and Kosovo-Serb enclaves south of the river Ibar.

6 https://www.ncbi.nlm.nih.gov/pmc/

7 (1) Mental health consequences of war: a brief review of research findings; R. SRINIVASA MURTHY, RASHMI LAKSHMINARAYANA; in World Psychiatry 5:1, February 2006; 

retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472271/pdf/wpa050025.pdf, June 20, 2018

(2) Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study, Theresa S. Betancourt, Elizabeth A. Newnham, Ryan McBain, and Robert T. Brennan;  THE BRITISH JOURNAL OF PSYCHIATRY, 2013 Sep; 203(3): 196–202; 

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3759030/, June 20, 2018

(3) Psychological Consequences of Rape on Women in 1991-1995 War in Croatia and Bosnia and Herzegovina; Mladen Lončar, Vesna Medved, Nikolina Jovanović, and Ljubomir Hotujac; in Croat Med J. 2006 Feb; 47(1): 67–75.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080379/, retrieved June 20, 2018

(4) Mental health of victims of sexual violence in eastern Congo: associations with daily stressors, stigma, and labeling; An Verelst, 1 Maarten De Schryver,2 Eric Broekaert,3 and Ilse Derluyn; BMC Womens Health. 2014; 14: 106; Published online 2014 Sep 6. doi: 10.1186/1472-6874-14-106

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237834/, June 20, 2018

(5) The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees; Alvin Kuowei Tay, Susan Rees, Jack Chen, Moses Kareth, and Derrick Silove; in: BMC Psychiatry. 2015; 15: 111; Published online 2015 May 7. doi: 10.1186/s12888-015-0480-3;

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4459680/, June 20, 2018

(6) Youth mental health after civil war: the importance of daily stressors; Elizabeth A. Newnham, Rebecca M. Pearson, Alan Stein, and Theresa S. Betancourt; in: Br J Psychiatry. 2015 Feb; 206(2): 116–121; doi: 10.1192/bjp.bp.114.146324

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4312966/, June 20, 2018

(7) Prevalence and factors associated with Posttraumatic Stress Disorder seven years after the conflict in three districts in northern Uganda (The Wayo-Nero Study); James Mugisha, Herbert Muyinda, Peter Wandiembe, and Eugene Kinyanda; in BMC Psychiatry. 2015; 15: 170. PMCID: PMC4513792; Published online 2015 Jul 24. doi: 10.1186/s12888-015-0551-5

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4513792/, June 20, 2018

(8) Relationships of Childhood Adverse Experiences With Mental Health and Quality of Life at Treatment Start for Adult Refugees Traumatized by Pre- Flight Experiences of War and Human Rights Violations; Marianne Opaas, and Sverre Varvin, Dr.Philos, MD; in J Nerv Ment Dis. 2015 Sep; 203(9): 684–695. PMCID: PMC4554230; Published online 2015 Aug 31. doi: 10.1097/NMD.0000000000000330

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554230/, June 20, 2018

(9) Cognitive-Behavioral Therapy versus Other PTSD Psychotherapies as Treatment for Women Victims of War-Related Violence: A Systematic Review; N. Inès Dossa and Marie Hatem; in ScientificWorldJournal. 2012; 2012: 181847. PMCID: PMC3345529; Published online 2012 Apr 19. doi: 10.1100/2012/181847

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3345529/, June 20, 2018

(10) Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study; Lukoye Atwoli, Dan J Stein, David R Williams, Katie A Mclaughlin, Maria Petukhova, Ronald C Kessler, and Karestan C Koenen; in BMC Psychiatry. 2013; 13: 182; Published online 2013 Jul 3. doi: 10.1186/1471-244X-13-182 

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3716970/, June 20, 2018

(11) Pathways from Victimization to Substance Use: Post Traumatic Stress Disorder as a Mediator; Jung Yeon Lee, Judith S. Brook, Stephen J. Finch, and David W. Brook; in Psychiatry Res. 2016 Mar 30; 237: 153–158; Published online 2016 Jan 22. doi: 10.1016/j.psychres.2016.01.049

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769948/, June 20, 2018

(12) Posttraumatic stress disorder, trauma, and reconciliation in South Sudan; Lauren C. Ng, Belkys López, Matthew Pritchard, and David Deng; in Soc Psychiatry Psychiatr Epidemiol. 2017 Jun; 52(6): 705–714; Published online 2017 Apr 11. doi: 10.1007/s00127-017-1376-y;

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5510537/, June 20, 2018

(13) From War to Classroom: PTSD and Depression in Formerly Abducted Youth in Uganda; Nina Winkler, Martina Ruf-Leuschner, Verena Ertl, Anett Pfeiffer, Inga Schalinski, Emilio Ovuga, Frank Neuner and Thomas Elbert; in Front Psychiatry. 2015; 6: 2. PMCID: PMC4348469;  Published online 2015 Mar 3. doi: 10.3389/fpsyt.2015.00002

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4348469/, June 20, 2018

(14) Mental health and psychosocial support in humanitarian settings: linking practice and research; Wietse A Tol, Corrado Barbui, Ananda Galappatti, Derrick Silove, Theresa S Betancourt, Renato Souza, Anne Golaz, and Mark van Ommeren; in Lancet. 2011 Oct 29; 378(9802): 1581–1591; Published online 2011 Oct 16. doi: 10.1016/S0140-6736(11)61094-5

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3985411/, June 20, 2018

(15) The enduring mental health impact of mass violence: A community comparison study of Cambodian civilians living in Cambodia and Thailand; Richard F Mollica, Robert Brooks, Svang Tor, Barbara Lopes-Cardozo, and Derrick Silove; in Int J Soc Psychiatry. 2014 Feb; 60(1): 6–20; Published online 2013 Feb 7. doi: 10.1177/0020764012471597

PMCID: PMC4737641 NIHMSID: NIHMS753770 PMID: 23396287

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737641/, June 20, 2018

(16) Transgenerational consequences of PTSD: risk factors for the mental health of children whose mothers have been exposed to the Rwandan genocide; Maria Roth, Frank Neuner, and Thomas Elbert; in Int J Ment Health Syst. 2014; 8: 12. PMCID: PMC3978019 Published online 2014 Apr 1. doi: 10.1186/1752-4458-8-12

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3978019/, June 20, 2018

(17) Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide; Lawrence Rugema, Ingrid Mogren, Joseph Ntaganira, and Gunilla Krantz; in BMJ Open. 2015; 5(6): e006778. PMCID: PMC4480039; Published online 2015 Jun 24. doi: 10.1136/bmjopen-2014-006778

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480039/ Jun 20, 2018

(18) Aggression inoculates against PTSD symptom severity—insights from armed groups in the eastern DR Congo; Tobias Hecker, Katharin Hermenau, Anna Maedl, Maggie Schauer, and Thomas Elbert; in Eur J Psychotraumatol. 2013; 4: 10.3402/ejpt.v4i0.20070. PMCID: PMC3651955; Published online 2013 May 13. doi: 10.3402/ejpt.v4i0.20070

Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3651955/ June 20, 2018

8 Disasters and Mental Health (World Psychiatric Association) (Kindle Locations 3385-3390). Kindle Edition.  Emphasis (bold text) added by me.

The Trauma of Children in Conflict and War – Part Two in a series on Trauma and Conflict

/ stefanfeller / 1 Comment

The stories about pillaging and raping soldiers and marauding militias are part of the entire history of mankind. There is no doubt that this shameful aspect of human cruelty haunts us since our earliest pre-historical times. In narratives it plays a side role at best. The heroism and the suffering of the soldier comes first. However, at all times children have witnessed their fathers being killed and their mothers being brutally raped, and they have suffered from the same cruelties themselves, committed by armies, militias, gangs, and mobs. Children have been separated from their parents, endured unspeakable atrocities, survived the murder of their peers under piles of dead bodies or hiding in the bush. This is the reality until today. And never before in human history the number of civilian casualties has outnumbered the military casualties as much as today.

Nowhere this is more devastating for communities and societies than when acts of genocide are being committed. Generations suffer. The Holocaust, the genocide of Srebrenica, or the genocide in Rwanda are only examples of these darkest chapters of mankind, which is still persisting against all vows to let it never happen again. Ethnic and political cleansing by brutal dictators adds, during World War II, and today: Even where genocide could be prevented by bold action, such as perhaps recently in Burundi, or the Central African Republic, the run-up violence exceeds all imagination, creating thousands or hundreds of thousands of victims surviving the worst atrocities of mankind.

Children grow up with the consequences of what has been done to them and their parents, others again grow up with the knowledge that they are born because their mothers were raped. Raped mothers struggle with acceptance in patriarchal societies. Raped men even more. Children of rape, raised by a traumatized raped mother already struggling to love her unwanted child unconditionally, they also experience being pariahs in their communities1. As has been said earlier, childhood trauma is different from the trauma of adult survivors of conflict in that trauma is perceived as an event or a series of events in life for adults. It is defining the life of children. It is their never ending reality, and the younger they are, the fewer, if any, cognitive tools they have to comprehend what happens to them and to put it into a context of accountability of others. For young children, often the only way to make sense to painful events is to believe that they themselves must be responsible for it.

If their mothers and fathers suffer from being unable to love them unconditionally, they inevitably believe they are responsible for what happens. If a mother is separated by militias from her infant, and if the mother or the infant, or both, are abused, the infant will conclude that it is punishment for something they are responsible for themselves. If children are abducted by Boko Haram, or recruited as child soldiers by the Lord’s Resistance Army, mere survival under conditions known as “Stockholm Syndrome” will add.

Trauma therapy is over-boarding with stories of adult survivors of childhood abuse who finally recognize that the inability, say for example, of their mother to prevent them from their father’s rage, also constitutes abuse: Their mothers could not save them. Understanding abuse requires to take the view of the victim, notwithstanding whether malicious intent, involuntary action, or omission constituted the trauma. Abuse profoundly impacts on the world of a toddler who has no concept of complex human relations. Subsequently, the adult abuse survivor will suffer from a deformed capacity to establish human relations, in countless variations.

That black sheep within their own peacekeeping forces and civilian parts of peace operations contribute to this trauma in conflict and post-conflict situations, is collectively shame-driving the International Community. This sits at the heart of current zero-tolerance efforts against sexual exploitation and abuse of local populations by soldiers, police, and civilians in national or multilateral engagement of United Nations2 and regional actors, such as NATO, EU, AU, and others. Being aware of the harm beyond imagination, the International Community at least has begun to “clean it’s own side of the street”, which is laudable.

But the International Community is also defined by the helplessness of many who care about humanity and decry the atrocities through soldiers, militia, gangs, mobs, violent extremists and international terrorists against civilian populations including children, whether in Syria, Yemen, Afghanistan, Iraq, Somalia, Sudan/Darfur, South Sudan, Central African Republic, Democratic of Congo, Burundi, Niger, Mali, Libya, recently Mozambique, Myanmar, and so many other places. Increasingly the divisions within the UN Security Council do not allow finding a common position that can be enforced. In cases of mandates being given to UN or partner organizations, we are confronted with an increasing inability to stop atrocities under our eyes, and to help countless trauma victims in the aftermath of conflict: Respect for ceasefires or commitment to peace agreements is as much waning as the acceptance of the UN itself, not least because of the disunity amongst those who constitute the UN: Member States, and especially the Security Council Members. Peace operations that can not sufficiently engage in deterring atrocities will lose political credibility, such as in South Sudan, peace operations that engage in order to protect civilian populations with robust means, such as in Mali or the Democratic Republic of Congo find themselves being accused of bias, increasingly getting under fire themselves. The plight of civilians, especially children, continues.

The situation is getting worse: The systematic use of violence against civilian populations, and especially of sexual violence as a weapon of war and conflict, spreads. Until recently the opinion that conflicts and victims of armed conflict constantly fell to a low after the end of the Cold War could be heard frequently3. Since a few years however, voices, including the Secretary General of the United Nations himself, express worry about the renewed increase of conflicts4 and the return of the Cold War5. These messages seem to indicate another, reverse, trend in terms of numbers of conflicts. Research is surfacing that demonstrates that 60 % of conflicts in the early 2000s relapsed within five years6. The trend towards an ever more increasing share of civilians in casualties from conflict and war is reaching horrible numbers: In contemporary conflicts, as much as 90 percent of casualties are among civilians, most of whom are women and children7. Women in war-torn societies can face specific and devastating forms of sexual violence, which are sometimes deployed systematically to achieve military or political objectives. It is in this context that entire traumatized generations emerge.

Global migration of surviving traumatized young people throws them into the merciless arms of organized criminals8 and spills them into societies which are overwhelmed and increasingly hostile. Families with cruel abuse stories at their place of origin, attempting to get into the United States, find themselves in another horror: The arrest of the adults and the forced and cruel separation of their infants, toddlers and children from them without any prospect to know how to maintain contact, or when they may be re-unified9. Across the globe, whether in the U.S., Europe, or in Bangladesh facing refugees from Myanmar10, traumatized children continue to experience severe traumatizing even in places they have been told might be their hope for a better future. Children who have been thrown on smuggler’s boats in Libya by their parents experience that a European country denies access to a port of entry11. Trauma becomes a constant fact of life. Alienation both on the side of victims and receiving host societies’ communities leads to “why bother”. Antagonization leads to mutual resentment and hate. The spiral of conflict continues.

Heartbreaking stories on display in memorial sites such as Potocari12 on the Srebrenica genocide, or the memorial site in Kigali on the Rwandese genocide exemplify the plight of children with examples. And every now and then, media is creating attention, such as on the children of rape in Rwanda. The world needs examples in order to generate understanding and compassion, but does this translate into action in light of the sheer size? What do we know about the impact of mass trauma on children and adults by conflict and war? How well do we understand the connection between healing of individuals and communities, and societies, on the one hand and reconciliation as a core pre-condition for lasting peace?

So, how well do we understand the threat, how well do we understand the vulnerability of peace processes by this threat, and how much do we know about mitigation of this threat? As a deeply involved practitioner since almost twenty years my answer is depressing: Those who know appear to be overwhelmed. Political operatives defining policy are aware but have to make priority decisions that have to exclude this problem, simply because of it’s magnitude and the limitations both on knowledge how to help, and how to generate willingness and resources to do so. Boots on the ground come first. But if the trauma of entire generations contributes to most crucial impediments to reconciliation processes, is it not that we should focus on, at least, to the same extent? Again, as a practitioner, my experience is that prevention will be acknowledged as being necessary by All, but it does not generate awareness and public willingness to act: The story of a dog biting a man does not carry news. The story of a man biting a dog will make the news. The story of preventing a man to bite a dog hasn’t been tested and may be similarly boring than the story of a dog biting a man, except from a bit of amusement in social media. In the same vein, robust military action may catch the public attention, but the more silent work of civilians, and international police under the UN umbrella, assisting in the recovery of communities and societies from conflict, does not.

If this already is true, how much more must be true in relation to a phenomenon of whole young generations being badly traumatized and how this may carry forward the potential for future conflicts? In his book “The Responsibility to Protect”13 Gareth Evans sums up a disappointing account of scientific methods to predict conflict, so that preventative action can focus on it. At the end we only know one thing, he says: The likelihood of conflict is twice as high in countries where there was a conflict earlier. For me, a link to entirely traumatized generations is obvious.

11A very insightful example is this documentation by France24:

Against the odds: The Rwandan women raising a family despite genocide and rape – France 24

http://www.france24.com/en/20180531-focus-rwanda-genocide-rape-children-born-women-discrimination-hutu-tutsi-families

22For the UN: https://peacekeeping.un.org/en/standards-of-conduct; retrieved June 18, 2018

Other organizatons have established similar policies

33http://www.fallen.io/ww2/ leads to an amazing data visualisation within an interactive documentary that examines the human cost of the second World War and the decline of battle deaths in the years since the war.

This is the crucial point: this extraordinary visualization puts battle field deaths and civilian deaths until WW2 into a proportion that demonstrates the ever higher number of civilian casualties. However, the project is not able to generate other figures than battle field deaths for the time post WW2 until 2015. Towards the end of the demonstration, the argument that we live within an extraordinary long period of peace is being upheld.

44Sebastian von Einsiedel, Louise Bosetti, James Cockayne, Cale Salih & Wilfred Wan – Civil War Trends and the Changing Nature of Armed Conflict;

United Nations University, Centre for Policy Research; April 25, 2017;

https://cpr.unu.edu/civil-war-trends-and-the-changing-nature-of-armed-conflict.html, retrieved June 17, 2018

66Ibid

88See my article “Why global cooperation on peace and security is needed – An argument against divisiveness from the perspective of fighting organized crime”, June 9, 2018

https://durabile.me/2018/06/09/why-global-cooperation-on-peace-and-security-is-needed-an-argument-against-divisiveness-from-the-perspective-of-fighting-organized-crime/

99For many:

‘I Can’t Go Without My Son,’ a Mother Pleaded as She Was Deported to Guatemala – The New York Times

https://www.nytimes.com/2018/06/17/us/immigration-deported-parents.html

Statement of APA President Regarding the Traumatic Effects of Separating Immigrant Families

http://www.apa.org/news/press/releases/2018/05/separating-immigrant-families.aspx

U.N. Rights Chief Tells U.S. to Stop Taking Migrant Children From Parents – The New York Times

https://www.nytimes.com/2018/06/18/world/europe/trump-migrant-children-un.html

1111Italy’s New Populist Government Turns Away Ship With 600 Migrants Aboard – The New York Times

https://www.nytimes.com/2018/06/11/world/europe/italy-migrant-boat-aquarius.html

1313Gareth Evans: The Responsibility to Protect: Ending Mass Atrocity Crimes Once and For All; Brookings Institution Press (September 4, 2009)

The Impact of Trauma on Individuals – Part One in a series on Trauma and Conflict

/ stefanfeller / 1 Comment

Trauma1

a : an injury (such as a wound) to living tissue caused by an extrinsic agent

b : a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury

c : an emotional upset

Work in neurophysiology has altered traditional views on brain development and the impact of trauma. It is now better understood how thought processes, behavior and memory are formed. The notion that the brain develops until early adulthood and then remains neurologically static for the rest of its life is replaced by the concept of neuroplasticity2 which teaches that literally everything we do or get exposed to creates physical pathways between neurons or leads to pruning of existing pathways between connected neurons. The brain keeps resonating to external stimuli by changing itself on a physiological level for its entire life.

The view that traumatic experiences cause a disordered psychic or behavioral state is too narrow. A quick Google search finds many variations of an understanding that differenciates between physical damage by physical trauma, and psychological trauma as a damage inflicted to the psyche. However, it is now increasingly acknowledged that every traumatic event leads to neuronal changes which are beginning to be understood and which include temporary or lasting brain damage. In plain language: Some physical trauma leads to wounds that one can see because they are bleeding, traumatic events can inflict physical damage that is visible on a MRI or PET scan3. Survivors of severe trauma often suffer from a brain condition with biological, psychological, social and spiritual manifestations. Lacking public awareness is responsible for erroneous or plainly wrong, even moral, judgment of trauma survivors and their struggle.

Ever since the end of the Vietnam war psychology and psychotherapy grappled with what became known as post-traumatic stress disorder, or PTSD. Growing understanding about its severe impact led to efforts helping soldiers, police officers, public servants, nurses and other vulnerable groups, all of which are mostly composed of adults, with exceptions being mostly cases of catastrophes that include children. Responses comprise first-line support which includes a debriefing by a trained individual who will refer cases of visible and more severe affects to specialists. Public views often equal trauma with PTSD, the understanding of consequences of all forms of trauma and it’s consequences is too limited. A huge variety of known self-harming and self-destructive behavior is rooted in exposure to trauma. Depression and addiction medicine present examples of a growing understanding how childhood abuse affects the entire lifetime4 of individuals. This still evades broader public awareness: The view that depression equals weakness and addiction equals moral failure can be found in large swaths of discussions which would occasionally be sprinkled with sensational news such as about mass shootings by military veterans, for example.

In cases of mass exposure to traumatic events the coping ability of a society is limited: Man-made catastrophes and natural disasters with large numbers of victims strain first-line responders and second-line support mechanisms beyond limitations and imagination. Whilst the size of societies can act as a buffering mechanism that mitigates the societal effect of trauma on individuals, mass exposure of a community alters the entire community, not only individual members. Like in the case of individuals, these consequences can affect following generations.

It is the impact of trauma on the brain development of infants and children that gives reason to most serious concern: Significant consequences for the concept of self, self-esteem, empathy and the capacity for intimacy are amongst those aspects documented by a sound body of scientific research, at least in the Western world. Today we know that brief exposure of infants, children and adolescents to highly traumatic situations and longer exposure to less traumatic but longer-lasting events cause the same catastrophic consequences5. Child abuse in all forms belong to the events that constitute extreme forms of this trauma. Yet, a public understanding of the term “child abuse” is too narrow as well6. Immediate7 and life-long deviation from a healthy norm include depression, self-destructive behavior ranging from compulsive disorders to addiction, rage and anxiety and premature death in countless forms, from suicide through overdosing to cancer.

The life-long manifestations from early childhood trauma root in the specific vulnerability of the developing brain. As David Eagleman8 puts it: “In a newborn brain, neurons are relatively unconnected to each other. Over the first two to three years, the branches grow and the cells become increasingly connected. After that, the connections are pruned back, becoming fewer and stronger in adulthood.” It is, therefore, that early childhood trauma impacts on the neurophysiological development of the brain. This is also the reason why long-lasting exposure to trauma has a lasting impact notwithstanding its intensity.

Imagine a pristine piece of grassland. Once trespassers begin to cross this land, there will not be a random use of all possible connections between all possible points. Instead, after a short while pathways will emerge. Some of them will get more trodden over time, some remain small, some will not be used after some time. From now on trespassers will use existing paths. Just crossing the land the shortest possible way will not be a convincing option any longer. After years or decades main paths may have become roads. Within human society roads are known that exist for thousands of years, today’s super highway may have carried caravans of traders millenia ago. In the same way the developed brain builds and prunes along pathways that have formed during the initial development phase. Because the brain learns from any event, trauma throughout this formative period is especially prone to form lifelong consequences. Trauma can deform vital pathways in the brain and affects whole regions and their interaction and contribution to the whole. Pruning and building new pathways may lead to later correction, but only partially. Like a severe wound leaves a life-long scar, and pain, the same is true for the physical reality of the brain.

A second profound impact of early childhood trauma may be especially related to longer lasting traumatic events: They cause stress. Stress leads to release of stress hormones9. A part of the brain’s response to stress is a cascade of biochemical changes in hypothalamus, pituitary, and adrenal glands, as well as in the sympathetic nervous system. According to Louis Cozolino10, increased levels of glucocorticoids, epinephrine, and endogenous opioids are particularly relevant to a discussion of the psychological impact of stress and trauma, in that they alter attention, cognition, and memory. Long exposure of the developing brain to trauma effectively leads to that it is permanently exposed to hormones that hold functions both in the realm of pain and the realm of pleasure. A proneness to mental disorders such as depression and addiction is created early on. Likewise, the permanent activation of the amygdala within a fight-or-flight reaction causes the permanent repetition under exposure of events or situations that the brain later associates to the initially learned trigger during childhood trauma, as they do for PTSD victims11. However, to the child traumas are not experienced as events in life, but as life defining12. The effects of early and severe trauma are extremely widespread, devastating, and difficult to treat13.

Whilst it can be assumed that these two major consequences are culturally neutral, a third complex of trauma consequences may depend on a social context. In western societies it is well documented that early childhood trauma, especially through forms of abuse, creates psychological and spiritual manifestations: The concept of self, and of self-esteem, is negatively affected. “Abusive parenting creates a painful sense of shame, inadequacy, or superiority in children, which, if left unacknowledged and untreated, results in the prolongation of these wounds into adulthood14.” It is very obvious that the wide definition of childhood abuse often runs confrontational to traditional parenting. Sentences about the forming of character through (mild) forms of physical violence can be found in many societies, and as long as, for example, the punishment of children is still legal if approved by parents in some jurisdictions in the United States of America, this will continue. However, contemporary science and therapeutic fieldwork tell another story.

11 Merriam Webster Dictionary

https://merriam-webster.com/dictionary/trauma

22 Neuroplasticity: The brain’s ability to reorganize itself by forming new neural connections throughout life. Neuroplasticity allows the neurons (nerve cells) in the brain to compensate for injury and disease and to adjust their activities in response to new situations or to changes in their environment.

https://www.medicinenet.com/script/main/art.asp?articlekey=40362

33 Encyclopedia Britannica:

“Studies employing positron emission tomography (PET) and functional magnetic resonance imaging (MRI) have shown that people with symptoms of PTSD have altered activity in the brain, primarily in the regions of the medial prefrontal cortex, thalamus, and anterior cingulate gyrus.”

https://www.britannica.com/science/post-traumatic-stress-disorder

44 Centers for Disease Control and Prevention

https://www.cdc.gov/violenceprevention/acestudy/about_ace.html

Page last reviewed April 01, 2016, retrieved June 16, 2018

55 A very good example is the self-examination abuse-checklist in: Carnes, Patrick J., A Gentle Path Through the Twelve Steps: A Classic Guide for All People in the Process of Recovery; Hazelden Publishing; Expanded, Updated edition, June 1, 2012; Kindle edition; pg. Loc 662 of 3435

66 For Pia Mellody, childhood abuse can be constituted by any less than nurturing behavior of parents and caregivers.

77 Complex Trauma in Early Childhood

by Kim Cross LSCSW, B.C.E.T.S.;

The American Academy of Experts in Traumatic Stress;

http://www.aaets.org/article174.html;

Copyright 2014, retrieved June 16, 2018

88 David Eagleman, The Brain: The Story of You; Vintage; Reprint edition (October 6, 2015); Kindle eBook edition, pg 9

99 A good general description:”

Adrenaline, Cortisol, Norepinephrine: The Three Major Stress Hormones, Explained”

The Huffington Post, https://www.huffingtonpost.com/2013/04/19/adrenaline-cortisol-stress-hormones_n_3112800.html; April 19, 2013, retrieved June 16, 2018

1010 Cozolino, Louis, The Neuroscience of Psychotherapy: Healing the Social Brain; Second Edition; Norton Series on Interpersonal Neurobiology; W.W. Norton & Company, June 21, 2010; Kindle Edition; pg 240

1111 Ibid, pg 264 ff.

1212 Ibid, quotation of Christopher Bollas, pg. 267

1313 Ibid, pg. 267

1414 Pia Mellody, Lawrence S. Freundlich, The Intimacy Factor; HarperOne; Reprint edition (October 13, 2009); Kindle edition, pg 11

Us, and Them

/ stefanfeller / Leave a comment

“What does your brain need to function normally? Beyond the nutrients from the food you eat, beyond the oxygen you breathe, beyond the water you drink, there’s something else, something equally as important: it needs other people. Normal brain function depends on the social web around us. Our neurons require other people’s neurons to thrive and survive.”

David Eagleman, The Brain; Chapter introduction to Chapter 5: Do I Need You?; 2015; New York

Unnoticed by many, neuroscience, the science of the brain, has made progress over the past ten to twenty years which one can perhaps only describe with moving from the medieval ages to enlightenment with lightning speed. We research on the brain since hundreds of years, may be even much more, if all early attempts to understand it are included. We do apply modern methods of science since a century, or more. But it is the cutting edge result of research of the past fifteen years which makes us say that we are entering a new phase of understanding who we are; who we are not; what is constituting our conscious self awareness; and how this is embedded into a much larger context of the subconscious which we mostly are not aware of. But even more, modern neuroscience begins to help us understanding to which extent we need the interrelationship between us and others, and what it means for the “self”, and what it does to us. The borderline between the self and the outer world becomes more and more porous. We are all more interconnected with the entire world than the concept of an independent self makes us want to believe.

David Eagleman’s book is based on a PBS series “The Brain”. These six episodes are the most awesome piece of popular science made public I have come across in many years. It should be viewed in schools and universities, and everybody can, you can get it in the iTunes Store, for example.

In Chapter 5, findings of neuroscience are demonstrated that connect to my personal understanding of the effects of trauma, how it affects me, and people like me. Chapter 5 also includes important clues to understanding societal interactions of many people that lead to violence, destruction, xenophobia, and genocide. As Eagleman says, brains have traditionally been studied in isolation, but that approach overlooks the effect that an enormous amount of brain circuitry has to do with other brains. Our brains are primed for social interaction, from a moment on we appear to not have memories of, from the moment we are given birth. Babies at the age of one year have a complex capacity to differentiate between trustworthy action and the opposite, before even understanding language.

The self does not exist in isolation to others. We know that, we would agree to it, and perhaps the extent to which this is true can be seen when looking at persons who suffer from having less ability to empathize, such as persons suffering from autism, or from sociopathy. Both are deficiencies in complex interaction of subsystems of the brain circuitry. By no means they are moral or behavioral deficiencies, emerging understanding goes deep into the knowledge of the brain being interconnected with other brains.

The understanding of how individuals relate to Ingroups and Outgroups, to groups to which we belong, and to groups we feel we do not belong, it all is affected by how the trillions of synapses of a brain relate to other sets of trillions of synapses, and billions of those. It is kind of a challenge to accept that interdependency with others is not something that we decide, but that is built into our fabric on most fundamental levels. To those who are challenged by the thought that we depend on entities outside of ourselves on a deep level, here is another thought: The average adult human being is carrying several pounds of living matter that appear to not belong to the body itself, with entirely different DNA, living in co-existence, sometimes parasitic, sometimes in symbiosis: Bacteria. But it goes beyond: Take these bacteria away from your body, and you will die in a very short while. You can simply not exist without of these billions and billions of other living beings inside yourself.

The same goes with empathy. Empathy is a fundamental mechanism of the brain, and it is activating the same brain circuitry that is activated when you feel pain. Especially when you are being left out: If people do not cooperate with you, but leave you out, fMRI scans show that the parts of your pain fire up which also light up when you feel physical pain.

So, belonging to a group makes us feel good. Meaning that the question arises how we relate to people which we wold categorize as not being part of the groups we feel good with.

It is here where Eagleman’s book is becoming so fascinating read for me: He is referring to the genocide in Rwanda, the genocide in Srebrenica, and also making it clear that so many more of these situations exist, like the killing of millions of Armenians by Turks in 1915, or the Nazi Holocaust, and much more. All of a sudden, when reading his book, I am back in Sarajevo: Eagleman interviews Hasan Nuhanovic, who worked as a translator in the United Nation’s mission UNPROFOR on the compound where his family was seeking refuge. He survived, and he lost his family, when the UN commander decided to open the gates, exposing 8.000 Bosniak Muslims to the hellhounds of Ratko Mladic’s genocidaires. I know Hasan personally, I employed him in the European  Union Police Mission, we revered him, and we made it a regular habit to have him educating the International Community about the consequences of the genocide in Srebrenica.

Eagleman tries to understand what transforms neighbors into killers. Individuals who have been in more or less peaceful coexistence for a lifetime, and their ancestors since hundreds of years, they seem to be able to mutate into monstrous torturers and killers within a brief moment.

I would not conclude, from what I understand, that the reasons for this are entirely understood. But neuroscience offers clues: Empathy works with Ingroups. The brain shows visibly less activity in circuitry related to empathy when considering somebody to be part of an Outgroup. As he says, these areas of the brain become short-circuited, they do not longer participate in decision making. Empathy disengages. We don’t care any more. To me, this is the entry point into dehumanization.

Read, or watch, his experiment: Brain scan people who see pictures of hands being stabbed by a needle, and how the brain reacts in case you tell the person that this hand belongs to somebody in a group you identify with, or not. The same picture can create either a firestorm in the brain, let me say, in case you are a Democrat and you are being told that this person is a Democrat, or a Republican. Or, a German, and a migrant from North Africa. Or a Christian, and a Muslim. Depending on which side you belong to, your brain reacts different to the same picture, depending on how you label the picture: For example, the medial prefrontal cortex (mPFC) of the brain is engaging differently in case we are thinking of other people, or inanimate objects: People looking at pictures of homeless people show much less activity in the mPFC compared to pictures of people they relate to. Dehumanization, made visible on a brain scanner.

Now, I am leaving the narrative of Eagleman’s book of my beautiful city Sarajevo to the reader. But I do ask how this translates into contemporary empathy with people suffering in conflict areas, and when they arrive, millions of them, having successfully escaped, at the borders of, say, European Union States.

Think about it: Your reaction to a picture of a child found on a shore, drowned because the boat overloaded with refugees capsized, it creates viral replication in social media, storms of empathy flare up, because you can identify: A child is a child. But if you see troves of people waiting at some European countries border, your reaction might be different, though the only real difference is that these people did not drown, they made it. Empathy makes all the difference in your reaction.

I want to leave it there for today. My thoughts go deeper, naturally I am trying to find an entry point into the xenophobic elements of a discussion that also has justified elements, such as respect of migrants for societal values in those countries welcoming migrants escaping from horrible violence, and the way how the social networks in these societies appear to explode with fear, and hate.

Education is the key. The great simplifiers, those who trumpet their rallying sounds for hate from the TV stations and the Internet, they need to be countered by an educated debate. Fair, tough with those who disrespect values, but also tolerant with those who may want to learn values they have never been exposed to before.

How can I blame somebody who, from the moment of being a baby on, has been either taught male supremacy, or female subordination? We all learn from copying what our parents and caregivers tell us.

But we can engage in discussions, learn, and help in learning.

On Trauma and Societies

/ stefanfeller / Leave a comment

This entry amends and deepens my earlier article “Trauma – An Entry Point”. So some is a repetition, but put into a larger context.

There is a group of conditions with damaging impact which’s members, at first sight, may seem disparate. These conditions fundamentally affect development, personality, and behavior, and impact on forming relationships. Scientific understanding of these conditions, and what they do to individuals, has made significant progress over the past decades.

However, in my experience they also impact on communities, and societies, especially when some of them occur on a large scale, to a huge number of members of a society, as a consequence of violent conflict.

To my knowledge, this area is less charted, in psychology, and in sociology.

The three conditions are:

(1) Trauma;

(2) Compulsive behavior and addiction and their interrelationship; and

(3) Certain personality disorders which, at least, seem to occur as a consequence of trauma especially when exposed to it at an early stage of life.

These conditions can be examined using a multidisciplinary approach including genetic, neuronal, biochemical and environmental/behavioral  sciences. This is especially useful when it comes to the various degrees of their influencing each other and working together.

These conditions, in principle, can be seen in any living organism, at least of some complexity, and to varying degrees, again depending on the complexity of the organism in question.

We all know the story of the dog where it’s owner knows or suspects that the animal has been abused, say, the dog was rescued from being chained and beaten frequently, for example. We immediately see the impact, some animals are extremely anxious, others may be aggressive and can not be held around children. I have not seen anyone who does not understand the causal consequence between the abuse and the behavior of an animal. The dog may even have been adopted for reasons including pity. Animal adoption online markets are full of narratives about abuse.

My experience with human beings who have experienced trauma, especially early trauma, is different. The layers of human development from child to adult, and within an adult’s life, seem to make the causal context less visible. I may hear on a party sentences like “Our new dog was clearly abused as a puppy”. I can neither remember or imagine a similar easygoing discussion about a human being. These conversations are very different.

It appears to me that we can readily appreciate the impact of violence on an animal, but my personal experience with the set of reactions when confronted with somebody who has been subjected to violence, to trauma, to injustice on an extraordinary scale, is different. The scale of reactions includes indifference, disinterested attitude, or inability to appropriately interact with such an individual. Reactions can include gossip to third people like “He or she should get over it”, they can, not only in extreme cases, even outright victimize and traumatize this individual again.

Why? I struggle to come up with a comprehensive answer, but to me it stands out that the topic of abuse appears to be a societal taboo: Victims, if they can remember that they were abused, regularly don’t talk. The reasons include shame, and alienation by others. Every police officer knows (or should…) the term “secondary victimization”. It happens, for example, to rape victims, through the sometimes helpless, sometimes outright malicious, and always inappropriate reactions of family, friends, law enforcement, and justice.

Moreover, in my experience the reactions to human abuse appear to include other elements which make the consequences so difficult to see, and to deal with. They include uneducation, sometimes almost medieval belief, and disinterest. As an example, I take a sentence many of us have heard all too often: “A slap does not harm a child, it’s good for the child”.

Despite well-documented negative impact on the development of children, this belief is very common. To my disbelief, I had even to learn that some State legislation in the U.S. still allows physical punishment of children. Just read this one.

I do believe that massive experience of violence, and especially sexual and gender based violence on a mass scale which occurs in conflict, not seldom deliberately used as a weapon of war, of individual and societal destruction, leads to the occurrence of all three conditions on a scale that affects that societies’ ability to move on, and to reconcile, or not. I have made practical experience of that everywhere where I have worked.

Our ability to appreciate these phenomena and to relate to the behavioral consequences of their existence in an individual is radically different, in my view, within the three following groups, which I introduced in my first article:

(A) Those who don’t have one or several of these conditions;

(B) Those who have, and often don’t know; and

(C) Those who recover from one or several of these conditions, and/or integrate the knowledge of their partly unalterable consequences consciously into their lifes.

These three constituencies mix and may communicate about these issues on basis of a vastly different understanding:

The person who is not affected (A) has limitations to relate, and thus, to understand. Relapse into addictive behavior, compulsive disorders, anxieties, anorexic behavior, just to name very few, appear to be alien to these persons. They have genuine difficulties grappling with relating to why this is happening, beyond an intellectual level. Read “Confessions of a Sociopath: A Life Spent in Plain Sight” by M.E. Thomas. Try to relate to her narrative, assuming you, the reader, are not a sociopath. It’s really demonstrating the case.

The person who is affected (B), does not, at least fully, know and/or is in a condition excluding understanding, through complex denial mechanisms. This person is genuinely unhappy and may even be ready to admit that, but understanding does not suffice and denial adds. The denial can be visible to (A), but that person has often no idea what this denial really means, and how it works. Often, a person (A) concludes that a person (B) is weak. An addict has character deficiencies, full stop. A traumatized abuse victim is weak, he or she should get over it. Full stop. A personality disorder, like, let me just say, frequent panic attacks and inability to be with other people, may establish pity at best. But that person is weak, full stop.

In order to appreciate my entry point into this discussion, read, for example, the definition of the American Society for Addiction Medicine ASAM. According to this definition, based on what we now know through sophisticated science, addiction is a brain disease. I will come to addiction much later, the point here is “brain disease”. The very same way, trauma is a wound inflicted on the brain.

Whilst we may talk about brain injuries and diseases on a neuronal level in educated academic discussions, my impression is that much of society approaches these conditions including from a perspective treating them as character deficiencies.

The person who recovers (C), increasingly understands, as his or her recovery progresses. Recovery is hard work. Thus, the recovering person develops an intimate understanding of what happened, and why.

It is from this perspective that I see and want to examine the impact on societies where large groups of individuals are victimized. Understanding the impact helps finding better ways to help addressing it, increasing the ability of a society to reconcile.

Because if there is no reconciliation, there is high likelihood of relapse into new conflict.

For further reading, here is just one personal account. I will use some more in future entries.