Let’s not psychiatricize the pain and trauma of refugees – Mental health in difficult times

Let’s not psychiatricize the pain and trauma of refugees – Mental health in difficult times

To the pain suffered by the refugees who are arriving in Europe in very difficult circumstances, we run the risk of adding a plus: considering that they suffer massively from mental disorders, especially in relation to overdiagnosis as a mental disorder of the traumatic situations they have experienced.

It is well known, and we have already commented on it in other texts on this same blog, that there is an overdiagnosis of depression, which today covers a large part of the area of ​​stress and grief, but today I want to mention the issue of psychiatric overdiagnosis. of the traumatic situations experienced by refugees with the so-called Post-traumatic Stress Disorder, a condition that is frequently discussed in the media with little contrast and that for many researchers is strongly overdiagnosed. Thus, in the war of Former Yugoslavia, it was even said that half the population of the Balkans suffered from Post Traumatic Stress Disorder

Already the very history of how this diagnosis of post-traumatic stress disorder arises is clarifying the dangers of its abusive use, since it was introduced into psychiatric classifications after the Vietnam War due to the enormous pressure of the powerful associations of war veterans. who seek to have more economic aid and social benefits from the government when they return to the United States. Thus, the disorder is included in the DSM-III without field studies to support it, given the tremendous pressures placed on the writing committee. As University College London professor Chris R. Brewin points out in his book “Post-traumatic stress disorder, myth or reality?”, a mental disorder becomes something that is part of the normal reaction to traumatic situations and that most people are capable of producing

The result of these successful campaigns to promote this disorder by the associations of war veterans, in the following years, the diagnosis of the disorder grew almost exponentially, after impressive marketing and promotion campaigns, even in the press.

However, years after this massive promotion of the disorder, there is great controversy and great concern in the United States about the effects of these campaigns due to the enormous negative effects that they have given rise to.

Because after all these campaigns, the situation of war veterans, massively diagnosed as suffering from post-traumatic stress disorder, is very negative, very problematic, which has generated a great debate.

As noted, why the veterans of the Second World War, who lived through all the atrocities of Nazism, recovered with hardly any problems from the traumas of war, They integrated into American society without significant difficulties and yet now war veterans are a group full of problems and with serious integration difficulties? For some authors, the cause is the massive proliferation of the diagnosis of post-traumatic stress disorder, which has stigmatized those who return from the war and has turned them, in the eyes of the population, into sick, “dangerous madmen”, violent. … All this has led to their isolation, that they are not hired, that they are feared. and logically this rejection increases their frustration, their anger… their maladjustment… their non-integration.

And this overdiagnosis occurs not only within the framework of the growing psychiatrization of daily life, but sometimes, due to an attempt to emphasize the seriousness of the problems that these people suffer in order to seek help, resources… .. the truth is that, as we will point out, this psychiatrization of the pain of immigrants has very negative consequences

There are numerous meta-analyses that show that no more than 20% of people who experience traumatic events develop mental disorders, including post-traumatic stress disorder. In my experience since the early 1990s serving immigrants and refugees at SAPPIR, many of whom arrived by boat in dire circumstances, this diagnosis is even well below that 20% figure. In any case, the fact that these refugees do not suffer from this disorder does not mean, obviously, that they do not need support, containment, because it is normal for someone who has experienced a trauma to re-experience it at some point for a while, while it is being elaborated and dissipated, but that does not mean that he suffers from a mental disorder. The long evolutionary history and natural selection would have provided the majority of the population with the ability to handle traumatic events well, to be resilient

Therefore, an in-depth review of all this subject is urgently needed, lest, speaking of traumatic situations, “it backfires on us”

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