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PART I – A CONCEPTUAL FRAMEWORK

Stage 3 – flashback

8. ASPECT FOUR – RELEVANT BACKGROUND CONDITIONS . 179

8. ASPECT FOUR – RELEVANT BACKGROUND CONDITIONS

· the way in which the individual feels and experiences him/herself;

· the present inner and outer life-situation;

· the individual’s opportunities and limits in the new environment.

The physical and mental age of the person and how it is regarded by the inhabitants and society of the new country also appear to influence the way the refugee/immigrant will feel about him/herself (Adler, 1927;

Brody, 1967; Condon and Fathi, 1975; Deaux et al., 1993; Ellemers et al., 1999; Tyler et al., 1999).

Sex and gender roles

The individual’s sex, and the attitudes and roles of gender in the environment in which he/she was born and raised seem always to be important factors to consider. These factors may influence the person’s pattern of thoughts, feelings and actions. During difficulties in the new country, even the refugee/immigrant who has revised his/her attitude to gender roles may regress back to a gender role inherited from where he/she was born and raised. To fully comprehend the refugee/immigrant, such gender roles should be considered (Gaw, 1976; Hartog, 1971;

Kaplan, 1961).

Homeland

The homeland is defined as where the individual was born. Inhabitants of a country may have varied background origins and ways of life, and different groups may have limited or no contact with one another. A person arriving in the new country could be from a different background to the majority population of his/her homeland. He/she might be as foreign to someone from the homeland as he/she is to the people of the new country. He/she may accept and tolerate others from the native land, or have passive or active prejudice toward them. If a person’s attitude to his/her homeland, or the new society’s view of it, has affected him/her in the new country, he/she may be enabled to recognize its effects during a psychotherapy or support work process founded in the described framework.

Environment

The homeland environment and social circumstances of the person’s childhood and adult life continue to influence him/her later on. Ability to handle the outer environment of the new country may well depend on experiences in previous environments (Peterson, 1967; Vargás, 1977).

Landscape

Within a country there can be different landscapes (countryside, mountain, island, desert, jungle, sea, city, town, metropolis). A person born and raised in a certain landscape appears to be formed and affected by it in some ways. Even the person who has spent several years in a certain landscape is influenced by it as far as being accustomed to a specific way of life and attitudes. In changing these, a person may not usually be aware of how it can affect their inner world (Durkheim, 1968;

Handlin, 1951).

Climate

As with landscape, the climate we are accustomed to might affect our inner world, with regard to what our bodies and minds seem able to cope with. It may intensify feelings and moods already existing within the person, or cause and create them. An individual who is depressed in a climate he/she is not used to may experience depression more deeply because of the cold or heat, the lightness or darkness. This is an important factor to consider (Durkheim, 1968; Handlin, 1951).

Culture

The individual takes to the new country the particular culture of his/her homeland. Depending on the person’s unique character structure, he/she may or may not be open to the differences of the new country. Such differences are many, and he/she might have to confront them in a some times lifelong process which can lead to confusion and guilt, and also to conflict. Each family member seems to have to confront and make compromises between the homeland culture and the new one, rejecting some of the differences of his/her culture which are difficult or impossible to integrate into the new one, or vice versa. Each person appears to solve these cultural confrontations in his/her unique way. During times of personal confusion, an individual might want to, or does, return to the cultural background in which he/she was born and raised to find security and a sense of belonging. In working with the refugee/immigrant, it is important to realize and respect this, so as also to be able to recognize the samenesses between us all. A deeper understanding can be gained by the carer who has insight into the individual’s homeland culture and how he/she and each family member deals with it in the new country (Deane, 1957).

Edward Stewart (1971) developed a framework (on a number of dimensions) to comprehend the components of the cultural reality an

individual brings with him/her into a different culture. He explains that culture provides us with a set of assumptions and values about ourselves and the world around us. Each person carries these assumptions and values in his/her mind, and they serve as the context within which we relate to ourselves, to others and to the physical environment. Since these are often unconscious, the person tends to assume that his/her own cultural assumptions are right and natural. The individual fails to understand that these are by no means common to all human beings:

“Research on culture and the self-concept has suggested that the members of Eastern and Western cultures evaluate the self in radically different ways” (p. 106). Researchers such as Triandis (1989) and Markus and Kitayama (1991) have argued that whereas Western cultures encourage people to adopt an individualist orientation to the self, many other cultures (especially Eastern ones) encourage people to adopt a collectivistic orientation to the self (Tyler et al., 1999).

Cultural differences

If the cultural differences of the refugee/immigrant are met with tolerance in the new country, his/her confrontation with the new culture can be facilitated. If not, he/she may not feel accepted, and will find it difficult to accept or to make compromises with the new culture (Berry and Kim, 1988;

Callao, 1973). Outwardly, people of different cultures may seem different.

Inwardly, however, they appear to have similar basic needs and feelings that cut across cultural boundaries. However, the way we express and deal with these can be different from culture to culture. How we express and deal with pain, sorrow and anger can be culturally different. These begin to evolve when different cultures meet and influence each other.

Inner conflicts, life changes and life crises

People of different backgrounds may have different culturally conditioned ways of perceiving mental disturbances. A person who is considered psychotic in one culture can in another one be considered close to God or viewed as holy. In yet another culture this person could be considered to be possessed by the devil or evil powers and be treated accordingly – as a witch if a woman, or feared if a man (Campbell, 1970).

How we react to life changes can vary culturally.

Religious/political background

Some immigrants may have left their native countries because of passive prejudice and the oppressive attitudes of others. Refugees have been

forced to flee because of open oppression, prejudice and violence. These refugees/immigrants are a mixed group, encompassing highly educated people with skilled professions and/or economic resources to invest in the new country, people from the middle or working classes, and the uneducated poor. Most of them have suffered in one way or another for their political or religious beliefs. Many have experienced the atrocities of violence and war, mental and physical torture, prison, loss of possessions and disappearance or killing of family and friends. Many have endured traumas because of these experiences.

Religious background

The religion that a person is born to and raised may affect the person throughout life. Some persons are raised in a strict, at times fundamental religious atmosphere, following religious tradition and values through prayers, rites, ceremonies, observances and holidays. Others are not, and instead may be surrounded by the religion in the environment or society, and have both aware and unaware knowledge of it. Interpretation of the same religion can be very different from person to society to country (Johnson, 1959). Each person may comprehend, follow and be affected by religion in different and unique ways.

Different religious/political beliefs – their consequences

According to reports in the casework, religious and political beliefs can lead to a strengthened identity or a confused one. These beliefs seem to complicate the refugee/immigrant situation as well as other aspects of the framework. Sometimes, they may give the person strength throughout his/her lifetime outside the native country (Bettelheim, 1960; Epstein, 1979; Erikson, 1968; Lichenstein, 1977).

From the reports of individuals in the study, on arrival and for a short time afterwards, regardless of other background conditions or experiences, people can become overwhelmed on encountering another religion or political system. They can feel confused by the new religious environment and/or political system. It may not affect the person or his/her family more than to recognize the outward characteristics of places of worship, traditions, ceremonies, observances, holidays, etc. in the new country. This also pertains to political refugees and immigrants who recognize the different political system and way of life that it entails.

After a time, the refugee/immigrant and each family member may be affected by religious and political differences. It is here that the

individual’s education and past experiences can help him/her intellectually to analyze, tolerate and accept the differences. The person may do this, either on an outward and superficial level or on a deeper one.

However, religious and political differences can take a long time to tolerate. After a time in the new country, a refugee/immigrant may become even more religious or political than he/she ever was in the homeland. This may be caused by the desire to hold on to the homeland or to find an identity in the new country. It may also occur because the person now genuinely comprehends the beliefs, and finds wisdom and strength in them from a distance. A child who was born in the new country or grew up there, may turn to the religion and political beliefs of parents and forefathers as a part of searching for his/her identity or because of his/her own religious and political convictions. For other reasons, another child may do the opposite in the new country; i.e. turn against the religious/political beliefs of the parents.

Skin color

It emerges clearly from the casework that skin color can affect life in the new country. It can produce a momentary first impression of little or no importance. However, it can also lead to fear, generalizations, passive and active prejudice, oppression, persecution and violence.

When a person of one hue comes to an environment where he/she is distinctly different in appearance from the inhabitants, he/she can be affected by it – on arrival, for a short-time afterwards or during his/her whole lifetime in the new country. This is based especially on the refugee/immigrant situation, caused by the reality of the person’s different appearance, or an exaggerated experience of that reality. In the search for identity, the child of a different appearance from the majority population who comes to a new country or has been there many years (even one born in it) may over-identify with the appearance of the majority. This can occur in both destructive and constructive ways (Sluzki, 1979; Sylvander, 1982).

Ethnicity and ethnic background

There is “a basic social constructionist model of ethnicity that commands a considerable amount of support within anthropology. … the model’s four elements are as follows:

· ethnicity emphasizes cultural differentiation (although identity is always a dialectic between similarity and difference);

· ethnicity is cultural – based in shared meanings – but it is produced and reproduced in social interaction;

· ethnicity is to some extent variable and manipulable, not definitely fixed or unchanging; and

· ethnicity as a social identity is both collective and individual, externalized and internalized” (Jenkins, 1997, p. 40).

The ethnic background of an individual may effect his/her total identity.

The word “ethnic” has many meanings. In this dissertation, it is used to designate a member of a minority or nationality group that is part of a larger community. Ethnic group is defined sociologically as an assembly of people racially or historically related, having a common and distinctive culture. Glazer and Moynihan (1975) state that social scientists tend to broaden the use of the term “ethnic group” to refer not only to subgroups or minorities, but to all the groups in a society characterized by a distinct sense of difference owing to culture and descent. This itself reflects the somewhat broader significance that ethnicity has taken on in recent years.

People of the same ethnic background can be part of different cultures, societies and countries. Refugee/immigrants from different parts of the world may stem from the same ethnic background, such as the Kurds.

The ethnic background of the refugee/immigrant may be different from that of the inhabitants of the new country. Perhaps the refugee/immigrant has never been in an environment where there are people from ethnic backgrounds different from his/her own and has never had to see him/herself as different from others. How he/she solves these confrontations is based on the experiences gone through in the new country, his/her childhood experiences, other relevant background conditions, past experiences in the homeland, and his/her life-situation in the new country.

Society

An individual is a part of the society in which he/she was born and raised.

From working with these groups, it emerges as essential to comprehend the meanings that their past and present societies have for them. Society is defined in several closely inter-related ways. In the Oxford Dictionary (1961), it is defined as an “association of persons united by a common aim or interest or principle” (p. 1023). Asociety can have one or many cultures and ethnic groups within it. Each society can have a different structure, and ways, means and mechanisms of functioning as far as right and

wrong, laws, bureaucratic and institutional systems, etc. are concerned.

For example, societies can have different ways of dealing with the individual in mental incongruence. In many cases, care for the mentally ill is so cruel that individuals fear seeking help.

The refugee/immigrant knows the society in which he/she was born and raised. He/she is then faced with learning the new one. Each person handles this learning process differently. It can take a shorter or longer period of time, sometimes a lifetime, to fully understand another society.

When both the carer and the person are aware of this, the individual’s way of dealing with the new society might more easily be confronted – if this is necessary.

Language

In understanding the refugee/immigrant, the native language may be a significant background condition to consider. It is important to note that there may be language differences within one and the same language, which can create misunderstandings and conflicts even between people with the same language (Casement, 1984; Edgarton and Karno, 1971;

Henle, 1972; Kristal-Andersson, 1978). On arrival and for a short time afterwards in the new country, the native language and the way the individual uses it may influence how he/she encounters the new language.

It may also affect how he/she will come to express him/herself in the new language.

Education

Education can be defined as formal schooling or training, but the concept may also encompass informal instruction, apprenticeship and tutorage.

Education in the homeland can affect the individual’s world in the new country, especially with regard to how he/she meets and perceives people in it and the way he/she is met by them.

Employment

The casework reveals how important it is to know how the refugee or immigrant was employed in the homeland as well as what he/she is doing at present in the new country. Most immigrants arrive in the country with an opportunity for employment – of the kind they had in the homeland or something else. The refugee has usually been forced to leave his/her employment. It is uncertain whether he/she will be able to do the same kind of job in the new country. This may have a severe effect on the individual.

Socioeconomic background

It emerges from the case material that people from different economic and social backgrounds within the same country may sometimes express and handle inner difficulties differently. For example, someone coming from a lower socioeconomic background may not be able to express in words the anguish he/she is experiencing in the same way as someone who was raised under better conditions. There seems to be little scope for expression of feelings when reality is the outer struggle for daily survival for such basic needs as food, water, or shelter. At least some emotions appear to be shared by all, but within the varying economic and social strata of a country, the expression of these seems to differ. A person coming from oppressed or poor economic conditions tends to endure mental anguish without words or expression. He/she seems not to take his/her emotions seriously until they became so unbearable that they lead to crisis. He/she denies his/her emotions, and they may find expression in psychosomatic symptoms or destructiveness (d’Ardenne and Mahtani, 1989; Baker, 1983; Brody, 1967;

Feldstein and Costello, 1974; Freire, 1972; Hunter, 1964; Martinez, 1973;

Minuchin et al., 1967; Reissman et al., 1964).

Refugees and immigrants from the same country have differing socioeconomic backgrounds. The economic and social status of a person is usually closely related, but not always. For social or religious reasons, in some areas, a person might live under poor economic conditions but have high standing in the community or culture. This is so, for example, in Hindu and Moslem countries.

Regardless of their past socioeconomic background, in the new country, refugees, and also many immigrants, are most often forced to take low paid, unskilled jobs. The often drastic changes, both social and economic, that they are confronted with appear to influence the other aspects of the framework, especially the states of being and the adaptation cycle. This can lead to lowered self-esteem, which can last until the employment situation improves.

Downward socioeconomic change in the new country

Refugees may come from a relatively high social and economic level in the homeland. Political refugees, in particular, may have lived in affluent circumstances as children, but worked politically in their homeland for the rights of the poor and working class. Accordingly, the adult refugee may identify with these groups in the new country. However, during times of

difficulty, a person may regress back to childhood as a means of solving life’s dilemmas. He/she can then experience added self-hatred and guilt because he/she desires the accustomed economic and social comfort of childhood.

Upward socioeconomic change in the new country

After a while in the new country, the refugee/immigrant may work his/her way up to a higher economic level and better social conditions than he/she had in the homeland. The casework suggests that this can lead to guilt and feelings of self-condemnation – “Everything is going well for me, but what about the others who are left at home?” These sometimes unconscious conflicts are due to the improved economic situation in the new country and can deepen an emotional crisis. Past economic and social conditions should be considered in understanding the refugee/immigrant.

It seems also important to assess the change in the refugee’s/immigrant’s economic and social position in the new country and how it has affected him/her and the family. He/she may retain the same reaction patterns in the new country, produced by past socioeconomic circumstances in the homeland.

Cases – relevant background conditions

The effects of relevant background conditions on the individual/family in the new country are considered in cases throughout the dissertation. Here are three examples.

The following case illustrates how a person’s religious background can cause or complicate presented symptoms and problems.

Case 8.1

A female refugee, age 29, 7 years in Sweden, a psychology student;

her husband, age 31, is a social worker. They have 2 children, 5 and 3 years old. Reason for treatment: her initial reason for seeking psychotherapy was for her professional training. “But there is so much about myself I have to understand.” She also had feelings of depression, indifference to school and at times her family, and also suicidal thoughts.

Form of treatment: psychotherapy, once a week. Duration: 3 years.

Case summary:

The woman and her husband had fled to Sweden while at university in a Latin American country. Several of their friends had already been imprisoned or disappeared because of the political activities they were involved in. Their children were born in Sweden. The marriage seemed to be a harmonic and functioning one. Her husband was now a social worker in Sweden, and she would soon be a psychologist.

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