ASPECT THREE – CHILDHOOD EXPERIENCES

This chapter describes the third aspect of the framework, “childhood experiences”. Combined with the refugee/immigrant situation and the other aspects of the framework, insight into the individual’s childhood experiences should generate a deeper understanding of present emotional difficulties and the ways in which these might be handled.

On a psychodynamic viewpoint, people tend unconsciously to reestablish and repeat certain childhood experiences and relationships. These have been active or passive experiences, ones that have been peaceful, calm and full of love, or – by contrast – frustrating, conflicting, painful and traumatic.

Experiences vary and are unique to each person. He/she is influenced by his/her childhood experiences throughout life. At times, a person may seem unconsciously to regress to these, especially during periods of difficulty, crisis and change (Bowlby, 1969; Erikson, 1950, 1968, 1976; Fairbairn, 1943; Fenichel, 1946; Freud, 1917; Jacobson, 1943; Klein, 1932). In psychotherapy and support work with the refugee and the immigrant, complete psychodynamic and environmental factors can be important to consider. The person comes to the new country with his/her unique constitutional and genetic makeup. He/she sees and deals with life in the new country through experiences gained in early childhood in the homeland (Mezey, 1960). Combined with the refugee/immigrant situation and other aspects of the framework, consideration of the person’s childhood experiences can lead to a deeper understanding of present emotional difficulties and the ways in which these should be handled.

THE PSYCHODYNAMIC PROFILE

Clinical observations based on the psychodynamic viewpoint suggest that the nuclei of character formation are patterned in the infantile and early childhood phases. The psychodynamic view stresses that the care of parental figures, as well as the secure or insecure environment of infant and child, influences the adult personality – the total character structure and basic feelings of security (Freud, 1917; Klein, 1932; Mahler et al., 1975; Piaget, 1929).

Gender

The gender of a child may determine his/her way of seeing, understanding, surviving and struggling later in life. The attitude to the male or female infant at birth and how he/she is handled and treated by the mother or initial carer, and afterwards by others in the child’s surroundings, shapes the way

he/she experiences him/herself, and also his/her gender role later on in life.

The child may have been lovingly nurtured into a particular gender role, or it may have been demanded of or forced upon him/her (de Beauvoir, 1953;

Coles, 1964, 1986a, 1986b; Deutsch, 1945).

Age at the time of specific experiences

Age, and the specific experiences that occur over time, have a significant impact on the developing child. Traumatic experiences, such as separations, sudden changes in environment, man-made and natural catastrophes and war and its atrocities, can affect the child’s personality development. According to the child’s age and mental development, he/she interprets, reacts to, and has conscious and unconscious feelings and memories about these experiences (Bibring, 1953; Bowlby, 1973;

Mostwin, 1976).

Reinforcement

Another factor in the total character structure – and the way the child (as an adult) will react to and solve psychological and outer difficulties – is the reinforcement the child is offered within the environment. When parents and the people around the child have been rigid, harsh and punitive, or open, gentle, permissive and fair, the super-ego codings of that individual later in life will also turn that way (Miller, 1983).

Constitutional and genetic factors

Regardless of culture, each person inherits a unique constitutional and genetic heritage that affects his/her total character structure.

Constitutional factors and how they are dealt with and satisfied in the early years influence later personality (Eriksson, 1950, 1968; Fenichel, 1946; Mahler et al., 1975).

Environment

From accounts of the total population of the study, the outer environment in which the individual spent his/her childhood comes across as important for the therapist and support worker. Was the person born in the city or in the country? Did he/she grow up under primitive or modern conditions? Was the area he/she was born in afflicted by natural catastrophes? Did the person grow up in a peaceful atmosphere without outer tension, or was the environment one of war or revolution? Were his/her surroundings afflicted by both natural and man-made catastrophes? If the country was in a state of revolution or war, were the people or family members directly involved in

it? Was the area in which the person was born and raised raided by soldiers and/or police? Were people ostracized, violated, tortured, maimed or killed? Were there air strikes, bombings? How much did the person hear or see of this as a child? To understand the refugee and some immigrants, it appears to be of utmost importance to know about the outer chaos and violence they were part of before coming to the new country.

Cases – childhood experiences

The following cases illustrate the influence of childhood experiences on the other aspects of the framework. The first provides an example of how a childhood trauma can influence a current life change – a difficult mourning process.

Case 7.1

A traumatized male refugee, age 38, 10 years in Sweden, a kiosk owner; his wife, age 32, a housewife. They have 2 sons, 12 and 8 years old. Reason for treatment: hospitalized in a near-psychotic condition.

Form of treatment: conversations with psychologist, twice weekly.

Duration: 5 months.

Case summary:

He is a deeply religious Moslem. He lives in exile in Sweden because he and his 2 brothers had worked actively for the rights of their people. Several months before his hospitalization, he received news that his mother had died in a camp in the occupied area in Israel where he was born and raised. He could not go back for the funeral, as it would have been too dangerous for him. He mourns her, spending day after day in constant prayer. He cannot work. Several months later, after an air trip within Sweden to visit friends, he goes into a state of near-psychosis, and is hospitalized.

His family calls the psychologist whom he had met for a few sessions when he first came to Sweden. Then he was restless, couldn’t concentrate and was not sure he could stay in Europe away from his people and the direct political struggle. But his life was at risk if he returned. In those sessions, 10 years before, the psychologist recalled he spoke with deep love and admiration for his mother, who had raised her 3 sons alone after his father had been killed by soldiers in a camp raid. He was 7 years old at the time. He saw his father killed and afterwards his bloody, bullet-ridden corpse. He explained that his mother had given up everything so that her sons would have enough food, education and if possible freedom. Ten years before, the sessions were conducted in English. Now he spoke fluent Swedish, with almost no accent. He greeted the psychologist when she came into the hospital ward to see him. He then explained what had happened.

Case excerpt (from session 1):

P: “In the airplane I was nervous and afraid. I am used to flying, but I was scared. I spent the weekend with my friends and when I flew back,

there was a storm. The plane shook. I felt sick. The stewardess tried to help me, but I had to hold my mouth so I wouldn’t scream out in fear, and put my hands over my ears so I wouldn’t hear the noise,” he explained. T: “What was the noise like?” P: “The plane was shaking,” he said. “I thought of my mother. I would be close to her, if I died, I thought. Then I thought of my children and I wanted to cry. But I was in a plane. I missed my mother so. I do now too.” T: “You were a scared little boy on that plane and maybe now, too.” He laughed. P: “I am grown up. I have kids of my own. I’ve been fighting for my people’s rights.” T: “I know, and now you are scared. You long for your mother. You want to join her. You feel guilt for feeling that way. I think you do now. That’s why you are here.” P: “I can’t work. It’s been months. Not since she died. Why was I so scared? Why am I so scared now?” T: “I don’t know. We must try to understand why. Were you scared when you were a little boy?” P: “No! I started working for my people when I was eleven.” T: “I know, but you might have been scared anyway.”

P: (Angry) “No!”

He is not the first refugee who worked politically as a child and denies, at least consciously, the fear a child, 11 years old, must feel running through machine-gun fire and/or bombings to get messages or food through.

T: “The noise? What could it have reminded you of?” T: “I don’t know.” T: “You heard so much noise as a child…bombs, airplanes, machine-guns…” He put his hands over his ears and screamed. P: “My father. my father…,” in Swedish and then Arabic. Then he sobbed and cried.

P: “I am an orphan now…he said. An orphan. I have no one.”

He cried and sobbed like a frightened 7 year old, a 38 year

old man who had worked in guerilla warfare under extremely hazardous circumstances most of his life.

The sessions continued for several meetings at the hospital, until he could be released. He mourned his mother deeply, and the past and his life in exile. Shortly after release from the hospital, he was able to start working. The sessions continued for several more weeks until he came in one day, and said:

P: “God is enough for me now. He gives me strength. I am not alone.

I have Him, my people, my family. Thank you.”

The next case describes ways in which childhood gender roles in the homeland can affect the refugee/immigrant in the new country.

Case 7.2

A female traumatized refugee, age 33, 5 years in Sweden, a physician. Reason for treatment: suicidal thoughts, confusion, nightmares, fear of depression. Form of treatment: psychotherapy, once a week. Duration: 3 years.

Case summary:

The woman was forced to seek exile in Europe because of her work for equal rights for women in her native country. She was a human rights activist during her student years and afterwards. She had been imprisoned several times and tortured. During her last imprisonment she had been raped. She told no one. After she was released, her family insisted that she flee the country. Her brother was already in exile in Sweden.

The therapist met the woman a year after she had begun to work as a physician in Sweden. In the first sessions, she explained that she liked her work at the hospital and felt accepted by her patients and the staff. She had been dating a fellow colleague, a Swedish physician. He was very polite, she explained, and although they liked each other very much, there was no sexual relationship.

Case excerpt (from session 8, after 2 months of treatment):

The woman explains:

P: “In my country, a woman who has been raped is considered a useless being, dirtied, unacceptable for marriage, unfit even to live.

Though it is illegal, families kill these women, to keep the family honor. I worked to change this tradition in my country. I tried to have these girls and women protected. Neither my family, nor anyone else, know that I was raped. You are the first person I have told. They were always against my political work. My brother, who also worked for human rights in our country, was a bad example to me, my father always said. He is a teacher and has always kept out of politics. If he knew I had been raped, I don’t know what he would have done to me. He is very traditional.” T: “You have kept this to yourself for many years.” P: “Yes, and now I have met someone who loves me and I love him. He wants to marry me. But, I can’t.” T: “Why not? Because he is a Swede?” P: “No…I think my father would accept that, as I am so old now…in their eyes.” T: “Then why?”

P: “I have been raped.” T: “So you feel useless, dirtied, unacceptable for marriage, unfit even to live. I am just repeating your words…”

The woman starts to cry. She nods her head, “yes”. Many of the following sessions were focused on the sexual, mental and physical tortures she endured during imprisonment, and also on the role of a woman, and her sexuality in her culture. The therapist mostly listened.

After 13 months of treatment, the woman married. By the end of the psychotherapy, she had given birth to a child. She plans to continue to work after her child leave.

The following case has been chosen to illustrate the way in which the refugee/immigrant’s childhood environment can affect presented difficulties and/or other aspects of the framework.

Case 7.3

A female immigrant, age 37, 12 years in Sweden, employed as a janitor; she is divorced and has one daughter, 11 years old. Reason for

treatment: feelings of panic, unable to work. Form of treatment:

psychodynamic crisis support work, twice weekly. Duration: 5 months.

Case summary:

The woman had been married to a Swede, who had met her when he was on vacation in her country. They had divorced several years before.

She was experiencing severe feelings of panic, so much so that she could not continue to work. She had no reason to feel panic, she explained to the doctor who encouraged her to contact a psychologist. After several sessions with the woman, the psychologist was perplexed as to the reasons or underlying causes of the woman’s panic. She discussed the case with the supervisor, who asked about the woman’s psychodynamic profile.

The woman was the fourth child of 7 siblings. Her father was a fisherman. As a child, she had lived in primitive conditions in an area that was plagued with lightening, hurricanes and floods. The supervisor mentioned that the weather had been very harsh lately, and wondered if that could have been one of the reasons for the woman’s feelings of panic.

It’s probably not the only reason for her feelings of panic, but it could have helped to bring them on, she explained.

In the session that followed, the psychotherapist encouraged the woman to talk about her childhood environmental conditions, and whether the recent weather conditions in their area could have reminded her of them. The woman thought a long time.

P: “I remember as a child how afraid I was of the lightening, of the floods, of the hurricanes. I was always afraid my father would not come home. One day, a few weeks ago, I waited for my daughter, when the lightening started. I was nervous until she came home. She was on her bicycle and I was afraid she would get caught by the lightening. Maybe that was the start of the feelings of panic.” T: “You are afraid of losing her, like you were of losing your father.” P: “Yes.” T: “Let’s talk more about that.”

8. ASPECT FOUR – RELEVANT BACKGROUND CONDITIONS