Intersection of Individual and Community Trauma and Loss

Politically motivated violence, persecution, and torture affect a growing number people and communities worldwide. Some estimates indicate that over half a million survivors now live in the United States. As a profession, the impact of collective violence - endless war, forced migration, traumatic loss and the human rights abuses that occur in these contexts have never been more clear. Larger numbers of patients impacted by such violence find their way to our offices and to our care. Many practitioners feel at a loss to intervene when the violence, loss and displacement have been pervasive. These patients a...re also coping with numerous post-conflict psychosocial stressors such as housing, language and health care barriers, as well as traumatic grief, many of them having lost family members to targeted and untargeted killings. In fact more and more people live in ongoing insecurity, in long term displacement, such as camps where the term post-conflict like post-traumatic stress disorder does not apply. Further, when patients do make it into care, what we often observe is that their experience of war or collective violence can obscure earlier traumatic experiences that patients have experienced such as childhood sexual abuse and these ‘personal’ traumas are exacerbated by more recent ones, leading to a complex symptom picture, both medically and psychiatrically. This workshop will address the impact of collective violence: the various manifestations of PTSD and complex PTSD, the psychic injuries of torture and prolonged sexual violence, and common somatic presentations. This workshop will also enumerate the nature of traumatic grief when one has lost family members to large scale violence and displacement. There will be clinical and group discussion and attention paid to the impact of this work on the clinician.

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Learning Objectives:

• Describe the factors that distinguishes political and/or collective trauma from other types of trauma and violence.
• Identify the nature of traumatic grief following homicide and/or a traumatic loss from community violence.
• Enumerate some clinical approaches to treating patients impacted by community and/or political violence and displacement.

Diya Kallivayalil, PhD, is a staff psychologist in the Outpatient Psychiatry Department at the Cambridge Health Alliance and a faculty member in the Department of Psychiatry at Harvard Medical School. She completed a 2-year postdoctoral fellowship at the Victims of Violence (VOV) Program, specializing in the assessment and treatment of psychological trauma. In addition to her clinical practice, Diya has published in the areas of psychological trauma, feminist therapy, the impact of trauma and migration on mental health in minority and immigrant communities, narrative methods, and cultural and gender socialization and identity in minority communities. Diya is one of the co-authors of the book, The Trauma Recovery Group: A Guide for Practitioners.