Systemische Praxis in globalen Zusammenhängen – zwischen Solidarität und Abwehr

This paper explores some of the challenges in developing an approach to working with survivors of war, torture and other human rights violations, and offers some broad principles based on the experience of two colleagues working in this field for nearly three decades but based in different countries. The work with people that have been uprooted, violated, tortured and are in or after flight is highly demanding for health workers involved. In Europe, the dominant discourse remains the ›trauma discourse‹, depicting refugees as traumatized, damaged and in need of expert psychological therapy. In regions where these conflicts continue, the dominant discourse amongst health practitioners is the discourse of ›MHPSS and humanitarian intervention‹. This article looks at both of these discourses, their limitations and consequences, and it calls for a change in the »trauma paradigm« as well as looking at the specific questions that the German professional therapeutic community is facing. Some broad principles based on systemic thinking, including a human rights framework, are suggested as a useful way forward for practitioners in health and social care. We should not shoe-horn survivors into our pre-existing, Western notions of suffering, symptoms and psychiatric disease – but focus on the encounter as a catalyst for change.

The attached manuscript is an English translation.