Counseling survivors of traumatic events

Before I came on my mission to Papua New Guinea, I studied everything I could find written about the country, and especially about the violence and the treatment of the survivors...

Like most others, I was stunned by the rates of violence and the individual stories I came across. I wondered if my knowledge and experience would suffice for treating survivors of such extreme experiences.

My insecurity was reflected in the number of psychology books I dragged with me for theoretical support across the globe; way too many. I have used one of them as reference so far. Without wanting to blow my own horn, it turned out that my insecurity was uncalled for. The staff at the Family Support Center is knowledgeable and relatively skilled at counseling. In retrospect, I also noticed that I was afraid that the patients would not benefit from the kind of counseling and emotional support I am used to working with, but would need highly specialized therapy that I could not to provide. I was also thinking about the fact that counseling is a very new phenomenon in this area –would it work here at all?

These fears turned out to be unfounded. We notice qualitatively that patients benefit from the counseling and we see it in our data. However, I would love to have more research conducted nationally and locally about mental disorder prevalence, contributing factors to mental illness and comparisons between different treatment models. As it is now, the available literature is almost non-existent.

Someone who survives a traumatic event like violence is likely to manifest significant stress and distress. Even though violence may be much normalized in the patient’s society, when experiencing it, the survivor is confronted with information that often is conflicting to their existing conception of the world. It is rarely really part of anyone’s world view that they will be subjected to severe violence.

When counseling violence survivors, the Family Support Center counselors help the patients regain a sense of control and reduce the feeling of helplessness. The counselor helps the survivor ventilate and talk about his or her experiences and exploring feelings related to these, which helps processing and structuring the traumatic event. She psychoeducates the patients about reactions to traumatic events and lets them know that what they are feeling is basically a normal reaction to an abnormal event. The counselor helps them find adequate coping mechanisms, to find their own solutions to practical problems and enhance their every-day functioning. Often the counseling also includes relaxation and breathing exercises.

Sometimes we see patients who need more specialized counseling because the traditional counseling would simply not be enough. A couple of weeks ago we saw a 14 year old girl*, who had been kidnapped for two and half weeks by an unknown man, raped daily and finally released when the perpetrators wife was about to return home from a trip. Before seeing this patient, I trained and advised the counselor to use cognitive therapy techniques to treat this deeply traumatized girl. This patient spent a couple of hours at the Family Support Center, receiving medical care and counseling. We also let her sleep and rest here for a while. Despite the horrors she had experienced, she went home feeling better and could start her recovery.

*Some details changed to protect the girl’s anonymity