Can destination harbors be the start for a new destiny? The psychic pain of refugees

To the Editor,

The tragic case of Alan Kurdi, the Syrian boy whose body was found on the Turkish beach of Bodrum, alerted the world to an increasing phenomenon which humanity tends to ignore: the plight of refugees. The powerful image of Alan was symbolic as it came to represent the war in Syrian and Europe’s angst to handle the refugee crisis (The Washington Post, 2015). The UN is warning us about the threat of a humanitarian catastrophe. He also mentioned persistent problems such as overpopulation, scarce food and drinking water and the lack of sanitation. As a result, diseases there are spreading like brushfire, and women agree to be raped in order to get at least some food. Unfortunately, all these things are happening in state-controlled camps too. He also mentioned persistent problems such as overpopulation, scarce food and drinking water and the lack of sanitation (Sputnik International, 2017).

Refugees are people who flee their countries to escape conflict, war and persecution. According to international laws, deporting refugees to the country where their lives are being threatened is forbidden (Veja, 2015). In Sweden, apathy has been the colloquial term for a condition characterized by global and severe loss of function affecting children and adolescents seeking asylum or undergoing migration process. Typically prodromal anxiousness and depressive symptoms, in particular lethargy, progresses into stupor and finally complete lack of any response behavior even to painful stimulus. At this stage, patients are seemingly unconscious and tube feeding life sustaining. After months to years, remission ensues with gradual return to what appears to be normal function (Sallin et al., 2016).

Syria has the most refugees, followed by Afghanistan and Iraq. Germany is the greatest destination in Europe, sheltering more than 35% of the continent’s refugees. Even more, Hungary has the highest rate of refugees per 100.000 habitants. Thousands of men, women and children traverse through the Mediterranean or Balkan Peninsula, in what often is a lethal journey. More than 4.000 people lost their lives last 2 years (BBC, 2016). On a social extension, the projection of a culturally sanctioned idiom of distress also interpretable in a predictive coding framework (Sallin et al, 2016).

Refugees go through a unique situation in which they are forced by survival instincts to abandon their past life, work, language, culture and even their own identity. Facing that, refugees experience a disruption of self, perceived as psychic pain. Psychic pain is a disturbance provoked by severe emotional pressure, usually violent in nature. This causes a defensive reaction of self, a process that causes intense suffering as it involves a drastic separation and loss of an object to which one was intimately connected to as is the case with refugees. These multiple losses act in synergy, characterized by intense and progressive pain that is not easily visible or detectable by those who have not lived through such a traumatic experience. According to the Medics Without Borders (MSF) international humanitarian organization, the overpopulated refugee centers in Libya are unable to meet even the most basic needs of the migrants, which leads to the spread of scabies, small pox and other diseases. The lack of ventilation results in all kinds of respiratory problems. The MSF also points to the lack of legislations regarding the work of these refugee camps (Sputnik International, 2017). In this context, refugee women face rape, sexual abuse, sexual extortion, and physical insecurity. Such violations precipitate their flight, characterize their attempts to gain refugee status and continue during their tenure in refugee camps, where they are excluded from positions of authority (Beyani, 1995).

One condition in which psychic pain compromises the references of space, time and identity of the refugee is the Resignation Syndrome (RS), characterized by the installation of a vegetative state in which the subject loses the communication, cognitive and motor skills. A person becomes non-responsive to external stimulation. The syndrome, so far reported only in refugee children in Sweden, has unknown etiology. There is a hypothesis that it may be a reaction to trauma, a state similar to being in a coma and a protective mechanism to avoid their new reality (G1 Globo, 2017). RS designates a long-standing disorder predominately affecting psychologically traumatized children and adolescents in the midst of a strenuous and lengthy migration process. Typically, a depressive onset is followed by gradual withdrawal progressing via stupor into a state that prompts tube feeding and is characterized by failure to respond even to painful stimuli (Sallin et al., 2016).

Such is the case of a 9-year-old, with the pseudonym of Sophie, a refugee in Sweden who witnessed the hearing in which her family had their asylum request denied. This combined with past traumas triggered the definitive stage of her syndrome, the ultimate expression of psychic pain (BBC, 2017). Hamadeh, Head of the Social Health Service and Primary Health Care Department of Lebanon, makes clear the current state of the refugee mental health crisis: ‘With the arrival of refugees, health care needs skyrocketed’ (ACNUR, 2016). The impact of overwhelming negative expectations are directly causative of the downregulation of higher order and lower order behavioral systems, in particularly vulnerable individuals (Sallin et al., 2016).

Among the 10 countries that most receive refugees, only Germany is financially prosperous, all the others are developing countries. Two of those countries, Jordan and Lebanon, sheltered 1.7 million refugees since the beginning of the Syrian crisis, while the United States sheltered a little more than 12,000. Paradoxically, it seems that the ones with less gave their maximum and those with more gave their minimum. (The Denver Post, 2017)

The refugees’ destination port, despite providing the promise of a new life, often works only to induce more suffering. It is necessary to reexamine the refugee crises and adapt viable systems so they are not just received in a new country, but truly welcomed as human beings to a new life.