In this brief summary we have condensed our personal experiences from 12 years consultancy for UNICEF in war affected areas. The focus is on how knowledge and methods from child psychology can contribute to alleviate the child's sufferings and mental struggle to integrate the horror of war into a sustainable preparedness for the future.
Talking to children after wars or internal armed conflicts, their mental struggle revolves around three focal points. The first point we have decided to name The Betrayal, the immeasurable impact from and the strong feeling among children of wars of being let down and betrayed by the entire, adult world. These mental blows have different aspects, or layers, related to the age and the developmental stage of the individual child. At all stages, however, the total collapse of the normal, functioning adult world has an immense mental impact and causes many types of reactions. In many ways it shatters the childs entire "world view".
The first and the worst experience is when the parental role deteriorates. The primary roles of being a parent is to be an adult who is able to feed the child, to protect the child from danger and preventable diseases and to plan the future for the child.
The disruption of the parental role in times of war, is probably the most destructive experience for a child. The depth of the impact from this is dependent upon how the parents themselves manage to cope with the catastrophic situation. The most common mental features seen, as we have observed, are that the parents become angry or sad or both. This makes their communication with the child, who is predominantly sad, very difficult or often causes a total blocking. At the most dramatic stage of this process we have seen that parents almost reject the child and the child detaches from their parents.
And as soon as we became aware of this most dramatic effect, we also saw it more often. Actually it is no surprise that a parent who has become powerless, a father or mother who sees no possibility to feed or protect the child, conveys messages about this that are received by the child. At the same time, we have to understand that a child who for a long period gets nothing but despair and sadness and even rejection from the parents, goes on with their life on his/her own by trying to relate to other adult-made opportunities, like orphanages or available camps for unaccompanied children or simply by trying to survive in the street.
In many cases we have also seen that even when the child is not really without a family, he or she is "mentally unaccompanied". The most dramatic display of these phenomena that we have seen is in refugee camps, where young children have to pretend to be without family to be taken care of. One has thus created a macabre emergency if it becomes a life threat for a child to have parents alive!
Not all of the parents become helpless, some of them are strongly involved in the political struggle related to the conflict: for example fathers as soldiers or activsts on the political scene. Often children relate to us that the only thing they have understood in a given situation is that their father´s secret activity made them refugees. With horror many children have witnessed the transition from being a "normal" father and peaceful farmer, to becoming a deadly dangerous warrior doing things that under other circumstances were totally unheard of.
Children at certain age levels, even as young as six and seven, know about the power structures and hierarchies within their communities, leading up to the local chief. In times of peace and progress, they are regarded as good-doers, almost as an extension of their parents. Now again they witness a horrible transition of their local community. In many internal conflicts, the adult society at this level is often divided, and former neighbours, friends and acquaintances are suddenly becoming deadly dangerous enemies.
Children know that shooting, shelling, bombing and killing are willful acts, planned and arranged by adults. Older children, but as young as eight to ten years of age, know that they are part of a nation, controlled by a president and a government, the great-fathers in the capital. In good times many of them perform a daily ritual at school in front of the flag and the picture of the president, thanking him for school and health. Then suddenly the president is sending soldiers, grenades and bombs to kill them all.
At all levels children in war often express the feeling that the entire adult society has derailed and thus collapsed. Children´s former assumptive world is blown to pieces and they struggle to restore their earlier held trust. At the same time they struggle to understand and to regain hope for the future of their family and themselves. They are not able to obtain peace of mind, actually they report that they feel very bad in this situation of confusion and loneliness. The only comfort many of the children find in this context, is through a deep, intense hatred of the officially declared enemy.
The first step to help children with the mental problems as described above, is to secure their immediate needs for food, protection, and comfort and as soon as possible restore the adult authority and trust by empowering their parents. The next vital step is to bring them back to some sort of schooling. Talking to children in emergencies, it has also become clear to us that they very much appreciate the presence of international rescue organizations. One should therefore plan to make direct information available to children about who, how, and why all these new actors on the scene are there. This could be a significant signal that representatives for the adult society still care tor children.
After that it is of great importance to convey both conflict understanding and better methods for conflict resolutions for the future generation hopefully able to secure and live in peace. From our experiences, like in Mozambique, it is clear that political understanding conveyed to children both soften the enemy picture and contribute to a sustainable mental structure, important for a better and peaceful society.
The second area of tremendous emotional impact on children in times of war stems from The Loss of lives. Since modern wars affect more and more civilians, and since even children are becoming the target of the parties in conflict, the loss of all categories of close relatives has increased. In the worst-hit areas in an armed conflict, you seldom find a child who is not affected by loss of close persons. Almost everyone may report loss among close family members, at least in their extended family or network of relatives.
In the case of Rwanda, the amount of loss reached levels never seen before. Children we have talked to were able to name more than 20 persons close to them now confirmed dead. The only way to compensate for this tremendous loss, is to take all measures to reunite children to a functioning adult network with relatives or with foster parents. The most important factor that can ease and help the child overcome and integrate their grief, are persons who care for them, who love them. Persons who are able to become emotionally close to them and persons who represent continuity and responsibility. In this case, help programs have to be made to support foster families so that the new child is an asset and not an extra burden. Gradually the child learns to live with the pain of grief and integrates the loss into their shattered world view.
These new parents should also be able to plan the future for the child, as a part of the restoration of the adult society, by providing them schooling. The teacher plays an extremely important role in times of war, both as a signal of a functioning adult society returning to "normalcy", but also as a caring, understanding and helping person. To train the teachers to be sensitive to a grieving child and to be able to receive the child´s need to confide the sorrow to someone they trust, would be of great importance in this context.
In many ways we can justify a conclusion that powerless children who are helped, later on in adult life, may become helpers themselves. In a recent Unicef seminar on emergency management for the region, the partcipants met with a group of unaccompanied boys from Southern Sudan. When one of the partcipants asked a boy about his hope and prospects for the future, he simply stated "I will pay back the people who have helped me here by helping others in need. Every time I hear about people's sufferings I feel a strong push to go and help them. I will do that in the future."
The third issue to cover the mental sufferings of children in war and crisis, is The Trauma. This is about the way children are tormented by traumatic sense impressions that are stored as anxiety and tension in their memories. Images and sounds which are constantly bothering the child by returning to the mind as vivid, sudden and uncontrolled recollections. These recurring, intrusive memories seem to disturb the whole network of feelings and thus become very disruptive to other cognitive functions. One explanation may be that the traumatic memories, because of the state of the human organism when the critical event occurs, enter the implicit, "bodily" memory in the brain and thus becomes partly inaccessable to the explicit, declarative memory. These new theoretical frames, have shed new light to our understanding of the most workable trauma healing methods.
Even though trauma theory is complicated, and many of its features still remain unclear, many of the trauma treatment methods are simple and can be implemented in the social life of the child even at an early stage of a conflict or immediately after some resolution has been established. And more important for our topic, the methods can be used in group approaches and even as a message to the masses. This can be done through religious leaders, health workers and teachers within the framework of their role and as parent advisors. The advantage of many of the African cultures, namely it´s expressivity, should be fully explored and again, every effort should be made to empower the parents, to care also for the child´s mental life and health.
We have to face the fact that all the good things we are doing to children in a crisis, catastrophe or war, even though we realize that they have to be given priority since food, protection, and medical assistance secure the child´s survival, does not heal the trauma. It may give the child strength, mental preparedness and will to confront the trauma and work it through, but in itself the very act of bringing a distorted life back to order does not heal the distorted mind. One of the most widely known trauma researchers, Leonore Terr, has even stated that life is not long enough to heal the trauma if we only leave it to the time effect. We have to help the child overcome the trauma by confront the bad memories. We have to keep our promise given in article 39 in The Convention on the Rights of the Child.
The way to do this cannot be covered by an article like this, but we constantly need to remind ourselves that it is not done by encouraging the child to make a drawing depicting their worst memories and simply talk about it to someone. Although trauma healing methods are simple in the way that we use children´s natural ways of expressing themselves, drawing, writing, singing, dancing, praying, it has to be done in a systematic context by trained persons. Thus guarantee a proper follow-up of the child or the group of children attending trauma healing programmes.
New research focuses on the way we store dramatic, life threatening events in our memory. Parts and fragments seem to be loaded in the implicit, non-reportable memory system and from there haunt and disturb the mental functioning of the child. Thus trauma healing, by the evaluated methods mentioned above, may be seen as a way of bringing the suppressed and repudiated memories into the conscious reportable, integrated sphere of the mind.
Miriam (11) I met in Baidoa and she volunteered openly in the class when I asked if someone wanted to talk to me about their bad memories from the war. I followed my usual procedure and made it clear that I would only see them three times, but could promise that they would be followed up by the interpreter who was a social worker.
Miriam started talking as soon as we were alone with the interpreter. The story she presented could shake the most experienced professional, but I managed to remain calm and opened my hands and encouraged her to continue. The female interpreter comforted her in a good and gentle manner by stretching out a hand or patting her gently on the back.
"I need to talk about it", she stated:
Late one evening the soldiers banged their way into the house searching for her father and older brother belonging to an opposing clan. They had fled and the two armed men started to torture her 9 month pregnant mother to reveal their hiding. In frustration they at last cut open her womb with the bayonette and killed the baby inside. Miriam was shaking and crying loudly when she related this horror. She could actually there and then see the whole scene in front of her like on a movie. I asked her to describe it in detail and after a break and a walk she started to draw the scene, now a little less affected. After terminating the session that all in all lasted for three hours including pauses, we made a "contract" that I should see her every day the next coming days and after that she should see the interpreter (a social worker) regularly after I had left.
The next days she was obviously very sad and she also reported that to me. When I asked her if she felt more sad now than before I talked to her, she confirmed that. When I asked her if she now should have wanted me not to talk to her, she strongly opposed that.
- you had to talk to me, because now I know that it really happened.
When I after a little pause remarked that she knew that it had happened before she told me, otherwise she could not have told me, she thought for a long time and finally replied:
- yes, you are right, I knew that it had happened before I told you, but then it was like a dream.
Now it was real. The reality had been confronted. The first reaction was sadness and grief. But she was even able to express that this painful, active process was a much better state than the earlier, blurred, dream-life that mentally kept her cornered by her trauma.
Matteus (11) I met in Angola in a group of the most traumatized children I have seen during these ten years, namely the mine victims. Many of them were still in a state of numbness, even 2 years after the critical incident. Why are the mine victims as a group seemingly more traumatized than other war affected children? There are two obvious reasons for this, seen in the perspective of trauma studies. One very strong feature of trauma impact is the degree of "suddenness". Stepping on a landmine gives you NO time for preparation. Secondly the indvidual is maimed for life by damage to vital body parts like legs and hands.
Matteus had his leg amputated and he was very fond of his doctor because he managed to save his leg beneath his knee. But his mind was not treated. He simply stated that his whole life was destroyed by his anxiety and bad memories. I asked him if he had talked with his good doctor about this, and he gave this almost shocking answer: - He cut my leg, but he could not talk about it. When I asked him what he should have liked to talk to the doctor about, he quickly replied:
- I should have liked to know what he did with the part of my leg that he cut off.
Then I asked what should you have liked him to do with the part of your leg that he cut off.
- I think they should have burned it and given the ashes to me! .'
Where are we now?
Now we are at a stage where humanitarian organizations could be able to formulate and distribute a knowledge based, standard trauma first aid message to all relevant institutions and groups helping children and families affected by war; from the very onset of an armed conflict. Realizing that we have promised the suffering children psychological recovery from war trauma and that this has to be done by trained and responsible persons. Now we are at a stage were all good forces could bring together professionals from the area of childhood trauma psychology and experienced field workers to write standard guidelines for systematic trauma healing programmes. Guidelines which only need to be adapted to the specific situation and adjusted to the unique culture before they can be immediately applied by the teachers.
We have reached the stage of knowledge and experience to declare the nineties as the New Emergency Age where schooling and trauma healing are planned from day one after the break out of wars or internal armed conflicts. Seen from the viewpoint of a child psychologist, we have also reached the point where we should broaden our scope and include other vital issues like detuning aggression and reducing ethnical tension created by wars and internal conflicts.
The spirit, and the very core of the Convention of the Rigths of the Child, is strongly related to child psychology. Translated into "our" language, we could summarize it in two sentences:
Childhood lasts for life.
A good future society is pre-loaded in childhood.
Or as Olof Palme phrased it in his great speech on children in 1975: "The only practical link we have to the future, are the children."
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