Psychoanalysis in Social and Cultural Settings

Upheavals and Resilience

Sverre Varvin

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781000439649
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

Psychoanalysis in Social and Cultural Settings examines the theory and practice of psychoanalysis with patients who have experienced deeply traumatic experiences through war, forced migrations, atrocities and other social and cultural dislocations.

The book is divided into three main sections covering terrorism, refugees and traumatisation, with another two focusing specifically on transcultural issues regarding establishing psychoanalysis in China and on research related to themes outlined in the book. Major key psychoanalytic themes run through the work, focusing on identity and the self, fundamentalism, resilience, dehumanisation, cultural differences and enactment.

Offering key theory and clinical guidance for working with highly traumatised patients, this book will be essential for all psychoanalysts and therapists working with victims of terrorism, war and other deeply traumatic life events.

Part I

Social terror

DOI: 10.4324/9781003206057-101

Introduction

In regressive situations of upheaval and social crisis, situations can develop where a need to find a group or another nation who can serve as the cause of problems. In such processes, facts and ideologies mix, and animosity and hate towards others may develop. There are many examples, historic and actual, where this need to define a group to blame and hate has dominated and caused destructive consequences for the population. The recent situation in the United States is an example. A deep split in society has come to the surface during the Trump regime, a divide that has historical roots in societal atrocities done by one part of the population against another (e.g., genocide against original settlers, slavery and racism).

The historical background for the development of hate against groups is complex. It has, however, repeatedly been shown that societies, especially leaders, experience difficulties in addressing this issue or even deny these past atrocities, which is an important aspect (Bohleber, 2002, 2010).

Impediments in working through these past atrocities characterises societies where internal wars, genocides and attacks against other people and groups have happened throughout society. Some examples are the genocide of Jews, the genocide in Rwanda, Apartheid in South Africa and other countries, the wars and genocide in the Balkans, the atrocities during the cultural revolution in China and the recent genocide of Yezidis. There are too many examples, with each situation having its own special characteristics and historical background but also having striking similarities on several levels. A common feature seems to be the need to find someone, whether a religious group, an ethnic group or a nation, to blame when internal problems arise. A “solution” is proposed, often by deviant leaders, that can activate the masses, which may be turned into a mob with enormous destructive potential. The masses then find something that binds them together; these are not bonds of love and care but of hatred.

A constant work on several levels is thus needed to preserve human decency and avoid human rights violations to counteract the inherently violent tendencies in individuals and groups.

The need to curb aggressive and destructive forces was also central in Einstein and Freud’s dialogue on war. Einstein asked Freud whether it is: “.. possible to control man’s mental evolution so as to make him proof against the psychoses of hate and destructiveness”? Freud’s answer was simple. While affirming, “an instinct for hatred and destruction”, he held that the best way to counteract war and violent aggression is supporting “emotional ties between (a group's) members” (Freud, 1933, p. 201).

In this section of the book, I have assembled articles that attempt to approach the problem of societal aggressiveness and destructiveness from different perspectives and in different situations. It is my experience that psychoanalytic reflection and human rights practices based on these reflections can be essential in understanding and relating to situations of destructiveness and atrocity. I am convinced that Freud’s simple statement on supporting emotional ties between groups is accurate and salient – but also extremely difficult to achieve.

Chapter 1

Terror and mourning in Norway

DOI: 10.4324/9781003206057-1

The day after the July 22, 2011 terror attack on Norway’s governmental buildings and on a labour youth’s summer camp outside Oslo by Anders Behring Breivik that took 77 lives, Vamık Volkan wrote to me:

Dear Sverre,

I am very, very sorry about the tragedy in your country. It will be a huge task to help people to mourn. I am thinking of you.

Your friend, Vamık

It was a national tragedy that affected almost everyone in Norway. In the chaos we felt then, Volkan’s words warmed our hearts and gave a direction that was difficult to imagine at the time it happened.

The attack came very close to my world.

Ten minutes after the attack, my daughter called in desperation, saying she was safe. She had managed to get out of the building that was targeted by the bomb. What’s more, she was in a terrible situation, being pregnant in her last trimester.

The following night, a call came from the national television station asking for a psychiatrist to come and help. As the severity of the catastrophe and the number of deaths slowly became clearer during the evening hours, it was too much for experienced news reporters to handle.

Yes, we know now – it is a huge task to help people mourn. Some losses are not possible to bear. Many who were at the summer camp on the Island of Utøya, where 69 young people were brutally killed and 110 wounded amidst total terror, still suffer and mourn. The survivors of the bombing in the governmental section of Oslo can never feel the same safety when going to work again.

But they moved on, most of them. Life slowly went back into a daily rhythm for most, but something had changed forever. Grief takes a long time, and we know that for many, the wounds have not healed (Stensland et al., 2018). When death and loss happen brutally close, it is never forgotten.

We have learned about large-group identity from Vamık Volkan. This collective identity is a silent but important part of our personality. On July 22, Norway’s large-group identity came shockingly to the surface. First, many almost instinctually thought – rather unpleasantly – that this must be a new Al Qaeda attack, and as a result, started chasing foreign-looking people in the streets. But it was a narcissistic blow upon discovering that the perpetrator of the attack was one of us, even one who claimed to be more Norwegian than most. Thus, we could not project our anger at an alien enemy. Self-blame and guilt came to the fore, as well as justified anger at the perpetrator.

After this blow to our self-esteem, the ceremonies and memorials brought us together on another level, not the level of ostracism and naming enemies, but more in the direction of self-scrutiny. The official and cultural elite took part in the ceremonies and helped the mourning process.

The trial was a shocking confrontation with another large-group identity thriving in right-wing milieus, especially on the Internet. The perpetrator, Breivik, who showed no remorse, was deemed sane and sentenced to life in prison. His thinking and ideology have, however, affected a large group of adherents and is still thriving.

Breivik attacked the social democrats in the government and the youth camp of the Norwegian Labour Party. The social democrats were targeted as the enemy because they had allowed an Islamic “invasion” in Europe and created what Breivik called Eurabia. To him, it was a religious war where traitors had to be executed. An interesting parallel to Breivik’s personal history appeared in the aftermath. The reports that were made public regarding his childhood experiences revealed that he lived without a father present and with a mother who treated him as dangerous and evil and tried to control him in every way. Child-care institutions were involved in his upbringing, and the recommendation from the child psychiatric team was unanimous: Breivik must be removed from his mother. His father fought to get custody, but both he and the psychiatric team gave up after court fights (Borchrevink, 2012).

Breivik was then left with the evilness his mother projected on him. This led him to form an ideology where Islam became the evil force, and the social democrats failed to protect against it. They were traitors – as his father was – and deserved to be killed (Varvin, 2013a).

Breivik and those who think like him desire a society that is autocratic and segregated: enemies of this social order should either be deported or killed (Berwick, 2011). One could see this as one man’s lunatic fantasies, but the right-wing groups flourishing in parts of Europe today demand it be taken seriously. Violence and persecution of so-called strangers are alarmingly high (Leirvik, 2012).

Volkan’s theory on large-group identity is of help here. When threatened, large groups regress. Volkan has 20 characteristics of this regression, including, among others, group members who lose their individuality, and the group is divided into those who “obediently follow the leader” and the bad ones who oppose. The division between “us” and “them” becomes a high priority, and projective and introjective forces are utilised to purify the group. The chosen trauma solidifies identity, and magical thinking dominates (Volkan, 2004).

The “Breivik society”, as this lone wolf terrorist described it in his manifesto, is a prescription for a large group to regress and subsequently become even more violent (Berwick, 2011). (Andrew Berwick was the pseudonym the terrorist Anders Behring Breivik used when publishing his manifesto on the Internet).

The terror attack on July 22nd was preparation for what was deemed necessary in order to purify Europe: it was a true “anti-Jihadist” action performed by a so-called “lone wolf” who was based in an Internet community. This community functioned, to a large degree, as a projection screen for the large group’s regressive and primitive aspects, and it allows for instant contact with and support for the individual, who, even if alone and othered, may feel supported by the community and feel his identity enhanced by a large-group identity that focused on a common cause.

Understanding large-group phenomena may help counteract this regressive development of creating the division between us (the good) and them (the bad), and it is necessary to maintain some cohesion. Just after the bombing and killings, the belief that this was an act of foreign groups like Al Qaeda spontaneously appeared, and attacks in public against foreign-looking people happened. This instant regression to a paranoid state transitioned into confusion when it was known that the perpetrator was “one of us”. In this situation, leadership is of paramount importance.

How the process was managed afterwards proved important. Rather than promote a narrative of revenge, leaders, with the prime minister as the central force, helped the population through mourning rituals and took care that self-scrutiny could take the upper hand, not projection.

There is still a way to go, even ten years after. The task of helping people to mourn is still going on, however, and will have to continue for years to come.

Chapter 2

Psychoanalysis and the situation of refugees

A human rights perspective¹

DOI: 10.4324/9781003206057-2

Introduction

Millions of people experience Human Rights Violations (HRV) worldwide. Many groups live under conditions that make them vulnerable and being exposed to HRV under such conditions can have devastating consequences. This concerns, among others, those exposed to trafficking, violence in close relations (mostly women), abuse and neglect of children, victims to paramilitary groups and terrorist groups, victims of religious violent groups, state organised violence, victims of civil wars and so forth. Many are forced to flee.

Today, 79,500,000 people are displaced worldwide due to conflict and persecution (this includes refugees and internally displaced people or IDPs (Internally Displaced People)). Of these, more than 34 000 000 are refugees. There are also 10,000,000 stateless people who have been denied nationality and access to basic rights such as education, healthcare, employment and freedom of movement.

The magnitude of the problem is staggering. Approximately 34,000 people were displaced every day in 2015 and 2016 (UNHCR, 2016). One out of every 133 people in the world today is displaced. Over the past five years, 50 families in Syria were displaced daily and we have seen unimaginable suffering due to indiscriminate attacks on civilians. More than half of refugees and displaced persons are children. The suffering due to war and persecution is today enormous and we can expect serious consequences of massive traumatisation in the years ahead, especially for coming generations.

For refugees, flight has become increasingly dangerous and death tolls are rising (UNHCR, 2016). Women are raped and abducted for prostitution, many are killed or die at sea, children are violated and forced into the sex industry or slavery (there is increasing evidence that human trafficking networks cooperate with organised crime syndicates (Europol, 2016)), and many are maltreated and/or tortured by police, border guards or organised crime syndicates during flight. One study from Serbia testifies to this sad situation: 220 refugees were examined, and it appeared that torture and degrading treatments were more frequent during flight than in their country of origin (Jovanović et al., 2015).

Conditions for refugees upon arrival are getting worse. Stranded in the refugee camps of Greece, Italy, Serbia, Bangladesh and on islands outside Australia, thousands must survive with little or no access to health care, poor sanitation, insufficient food and minimal human concern. In refugee camps near war zones, conditions have worsened since 2015 when UNHCR budgets were cut by more than half (Clayton, 2015). There are further several neglected crises that seldom reach headlines but where atrocities done are frequent and cruel. This concerns, among others, the situation in Kongo, Yemen and South-Sudan, where millions are displaced, and humanitarian aid is insufficient.

Many refugees or asylum seekers describe their conditions after arrival, even in more affluent countries, as the worst part of their refugee journey. On a daily basis, they face long waiting times, bureaucratic red tape, inactivity and the possibility of being forced to return to their homelands. It is described by many as mental torture. There are reports that the mental and physical health of refugees today are deteriorating (Hassan et al., 2016) not only due to traumatisation in their home countries but very much as result of the conditions during flight (violence, torture, rape, slavery and so forth) and due to the conditions offered to the refugees in centres at the border of Europe (Greece, Italy) and outside, for example in Libya.

It has repeatedly been shown that refugees as a group have endured many potentially traumatising experiences before and during flight, such as near-death experiences, seeing close ones be maltreated or killed, torture, rape and so forth. These experiences represent gross HRV. Most research finds higher levels of known post-traumatic conditions in refugee populations like PTSD, anxiety disorders, depressions, somatising disorders and psychotic disorders (see for example Alemi et al., 2013; Apitzsch et al., 1991; Drozdek et al., 2014; Kroll et al., 2011; Opaas & Varvin, 2015a, 2015b; Teodorescu et al., 2012; Vaage et al., 2010; Vervliet et al., 2013). The complex traumatising experiences of refugees may disturb personality functions, relational functions, affect regulation and somatic regulation (Allen & Fonagy, 2015; Allen et al., 2006; Rosenbaum & Varvin, 2007a; Schore, 2003; Varvin & Rosenbaum, 2011a).

Those who develop mental health problems in exile often suffer from complex conditions with multi-layered aetiology while living in difficult social situations (poverty, poor housing, lack of support, stressful acculturation process), resulting in poor quality of life. Whole families may be affected and there are possibilities for transgenerational transmission of suffering, for example, related to insufficient early care, traumatisation of children and stressful family situations (Blanck-Cereijido & Grynberg Robinson, 2010; Daud et al., 2005; de Mendelssohn, 2008; Krell et al., 2011; Romer, 2012; Ruf-Leuschner et al., 2014; Silke & Möller, 2012; van Ee et al., 2012; Wiegand-Grefe & Möller, 2012).

In spite of the high degree of resilience, the consequences for refugees in the present situation are potentially very serious both for present and coming generations. It is important to place the situation not only in a psychiatric, psychological and medical perspective but see it as consequence of serious violations of basic human rights. What many refugees and displaced persons have experienced and are experiencing should not happen if human rights, as formulated in internationally accepted conventions, are respected. The psychological consequences are moreover marked by the fact that these basic rights have been violated. ...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Contents
• Lists of Illustrations
• Contributors
• Foreword
• Permissions
• Part I: Social terror
• Part II: The situation of refugees: The enigma of traumatisation
• Part III: Research
• Part IV: Psychoanalysis in China: A transformative dialogue
• References
• Index