Facing the (Political) Elephant in the Room: On the Depoliticisation and Re-Politicisation of Refugee Trauma Amongst Therapists in Germany

Abstract

PTSD is commonly diagnosed in refugees, and since 2015 refugee mental health programmes in Germany have increased (BPtK in Bericht zur Mentalen Gesundheit Geflüchteter, 2019). Despite the vast literature on refugee trauma (Silove et al. in World Psychiatry, 16(2), 130–139, 2017), there has been little engagement with the role of therapists therein. This article addresses this lacuna by drawing on 23 semi-structured interviews conducted in 2020 and 2021 with therapists in psychosocial centres for refugees in 14 German federal states. From these interviews, it emerged that therapists occupy an ambivalent position which is characterised by a simultaneous depoliticization and repoliticization of refugee trauma. Believing that it is “so bad it is impossible to do nothing”, therapists started to engage in public political resistance, through therapeutic interactions and lobbying for change. Most therapists sought to engage in political action through a prism of detached professional neutrality. This comprises a particular conundrum since the premise of neutrality directly contravenes the practice of political action as such but also reverts to a mode of individualised medicalisation that cannot fully recognise the political nature of their client’s trauma. We propose to solve this tension through a novel German critical theoretical understanding of trauma as a form of status subordination, wherein the taken for granted presupposition of intersubjective equality is so violently breeched it results in existential disorientation and speechlessness (Matthies-Boon in Breaking intersubjectivity: A critical theory of counter-revolutionary trauma in Egypt, Rowman and Littlefield, 2022). Casting trauma in such intersubjective socio-normative terms means that therapists have the analytical tools to fully embrace their political aspirations whilst simultaneously improving the efficacy of their therapeutic interventions on an individual level.