Helping hand

Eva van Keuk heads the Psychiatric Department at the Psychosocial Center in Düsseldorf. The center place for refugees who have experienced traumatic events in their homeland or on their way to Germany. In addition to therapy, social support is also offered by the center. Annually, around 400 people from 40 different countries find help here.

Deutsche Welle: Extremely traumatized refugees come to you. What are the biggest problems they face?

Eva van Keuk: Trauma research shows that severe traumatic events can be "digested" relatively well if they are followed by good living conditions. When people are protected, safe, feel recognized and loved then they are usually in a position to deal with even the heaviest of burdens.

The problem is the combination of trauma and external circumstances. On the one hand there are extremely difficult situations of loss; for example, if families are separated on the run, or a brother drowned on the way here. Experiences of civil war in adolescents and children are very serious, including when rebels force them to fight and kill as child soldiers. All of their contact with their family is broken off and they feel isolated.

Then there are the poor living conditions in Germany: a ban on working in the first few months is a key point. Refugee centers are usually quite a distance from cities and are often poorly serviced by public transport. Or refugees find things in food packages that they don’t know how to prepare, let alone match up with their regular diets.

Many refugees in Germany have to deal with adverse living conditions. Is there anything you can do about it?

It's our ambition is to improve the living conditions of individual refugees. Here's an example, I was treating a Kurdish woman who had been tortured and spent more than four years in prison. She lived in Germany in a refugee home, in a room that was next to a fire door that opened and closed at least 30 times a day. That was the same sound that her old cell door made. In a case like this it makes more sense for me to make sure that she gets moved to another room, or is even able to get her own apartment, instead of having her come to a therapy once as week for the next two years.

You also work with children and adolescents. Is that more challenging than working with adults?

It is clear that it is easier for young people who come to Germany because they usually attend school. They learn the German language quickly and quite often integrate into German society faster than their parents.

It's quite traumatic for young people who come as so-called "unaccompanied minors" to Germany. In addition to those from Africa, we also currently have a lot of young men coming from Afghanistan - young men who have had extremely traumatic experiences. We recently had a young man here who managed to get into a high school, now he's facing deportation. He was severely whipped by the Taliban, and he's been very affected by it. The trauma he faced, his reasons for leaving are not officially recognized: it all runs contrary to EU conventions. But, the law in practice and the law on paper are two different things.

As a German, do you find it difficult at times to empathize with your patients who come from other countries and cultures?

Luckily, we have a large team made up of people from many different countries and with very diverse experiences. Just two examples, we have a woman from Rwanda on the team who is herself a genocide survivor, and we have a woman from Iraq who in addition to her work as a psychiatrist also works as a journalist.

It's imperative to develop an educated cross-cultural team. Then the barriers aren't as high as a lot of German psychotherapists might think. It's a job that enriches many interpersonal moments that transcend language and culture barriers.

Interview: Klaus Dahmann (ds)

Editor: Sean Sinico