Beyond Survival: The Importance of Psychological Support in Refugee Aid

The refugee crisis is often presented in facts and statistics, strategies and policies - but for me, it is deeply personal. Sweeping labels such as ‘migrants’ bring faces to my mind that are as dear to me as my own flesh and blood family. Certain images have shaken the world into an international conversation about refugee rights, from the drowning of Aylan Kurdi to the daze of Omran Daqeesh. An estimated 60 million people are now displaced in the world due to war and violence, a number higher than those displaced after the Second World War. Of those 60 million, I think of my friend who does not know what country she will give birth in, I think of children who have held my hand tightly while we walked through the busy streets of Athens.

I traveled to the island of Lesbos, Greece in November of 2015 to assist refugees who had just landed on the beaches. While only there for a short time, my life was forever impacted. In my final year of college I researched and studied the psychological impact of refugee status and after graduation moved to Athens, Greece. While in the city, I was involved with various programs including teaching English, children’s programs, and providing clothing and food. More than anything though, my time brought about rich and deep friendships which I treasure to this day.

While refugees are still daily risking their lives in pursuit of peace, those who have survived the journey struggle with additional hidden battles. While no one would deny that food, shelter, and clothing are necessities for survival, what about agency? Access to clear information? Empathy and respect?

The magnitude of the crisis has made providing even the bare essentials for physical survival difficult in many circumstances. Yet, despite the struggle, we cannot equate keeping someone alive with the end mark of success. The injustice of someone suffering in a tent camp in cold winter rains grieves me just as much as the injustice of their powerlessness and isolation.

We are holistic beings with spirits that crave dignity just as much as our bodies crave food. The psychological wounds of refugee status are often unvoiced and misunderstood, but of vital importance if we truly strive to provide an opportunity to thrive in this new life.

Most are familiar with Post Traumatic Stress Disorder, a diagnosis which first appeared in the third edition of the Diagnostic and Statistical Manual of Mental Disorders in 1980. The diagnosis was a result of studies on war veterans, ultimately presenting trauma as a severe or catastrophic event outside normal experience. Trauma is a relatively young field in psychology, but rapidly growing in importance. We are still understanding the intensity and gravity of psychological trauma and its widespread effects on all areas of life.

In more recent years, attention has been drawn to the potential gap of current trauma literature in relation to refugees. Two researchers, Eagle & Kaminer, presented the concept of ‘Ongoing Traumatic Stress’ (OTS) as “Highlighting the kind of traumatic stress suffered primarily by systematically  oppressed, deprived, and marginalized populations.” This distinction focuses on a lack of general safety, corruption, and overarching powerlessness. A systematic review examined 7,000 refugees and found those resettled in Western countries were 10 times more likely to have PTSD than age-matched general populations in the host countries.

We cannot equate keeping someone alive with the end mark of success.

This information should not cause us to view refugees as damaged or broken, but should lead us to ask: “How do I engage these unseen wounds?” or “How do I avoid misjudging a person’s pain?” Merely addressing the physical is not recognizing the full narrative of our refugee brothers and sisters.  

I’m haunted by conversations I had, sitting in an abandoned school building turned shelter. I sat across from friends, who with a glazed look in their eye, told me: “I wish I had stayed in Syria. At least there I would die quickly and with dignity. Here I will die unnoticed and humiliated.” Almost everyone I asked told me they had repeated nightmares and flashbacks, some experienced physical pain just at the thought of their home. Beyond the trauma they experienced in their home country, they endure a different form of emotional stress through the constant dependence on others for information and daily needs in the asylum process.

Sitting with others in their woundedness and grief is much more difficult than donating food or writing a check. Coming face to face with brokenness and stripped of ‘easy fixes’, we realize we cannot keep our distance to love well. The deep pain of displacement cannot be healed in the absence of relationship and community. As Mother Teresa said: “The hunger for love is much more difficult to remove than the hunger for bread.”

While I am in no way negating the true and urgent need for physical aid, I long to see an equal urgency to committing time and emotion, an urgency to clear space to be with people in messy, unedited ways. To acknowledge the person behind the title “refugee,” to learn their story in all its triumphs and tragedies. In some ways, this will involve an increased support of psycho-social resources to refugees and access to mental health education. In other ways, this involves ordinary people practicing radical hospitality.

I’ll never forget sitting across the table from her, crayons in hand. I had asked where her mother was and she closed her eyes, sticking her tongue out. Her younger sister giggled and formed a gun with her tiny hands and they took turns laughing and acting out being shot. Later, after playing games and hilariously jumbled conversations half in English, half in Arabic, she looked up at me with her arms tight around my waist and asked, “Mama?” The enormity of the crisis narrowed into that one moment for me. Her dark eyes shining up at me, eyes that had seen things no child ever should.

I believe we have a responsibility to care for these people, and in particular these children, to the absolute best of our ability. We should weave empowerment into every level of care - through clarity of information and giving refugees a voice and role in the programs designed to support them.

Aid organizations like Doctors without Borders, IRC, and many others are providing professional psycho-social support to refugees internationally. While you may never have the chance to work directly with refugees in a crisis situation, the chance to welcome and mentor a newly settled refugee family is an incredible opportunity to invest time and form relationships. World Relief is a refugee resettlement agency based in 27 U.S. cities and has an incredible volunteer program.

Most importantly, we must remember the humanity of refugees and never let our rhetoric reduce them to a number. We are called to love refugees as ourselves, not merely keep them alive. Challenging injustice will always be uncomfortable, yet it is our charge and our privilege to call out the image of God in each individual life.

-Lizzie Goddard is a recent Covenant College graduate with a degree in psychology. She is currently working in Europe with Middle Eastern refugees and is passionate about mental health care, advocacy, and empowerment. Photo courtesy of Russell Watkins, UK Department for International Development.