The Relationship Between Genocide or Massacres and PTSD from a Specific Perspective: Collective Trauma
Psychological trauma is a phenomenon that includes physical and psychological threats and is handled under two titles according to its occurrence. The first earthquake, floods, etc. occur naturally, and the second are those that are created by man. Traumas caused by human beings are also divided into two. The first is accidental, such as traffic, and aircraft nuclear accidents; the other is conscious and purposeful traumas such as wars, genocides, massacres, harassment, rape, torture, and terrorist incidents. Although the majority of victims of such mass events struggle with the consequences, a significant part may experience long-term psychological disturbances such as PTSD.
The genocide, which is as old as human history, has been talked about a lot and researched, and its causes and consequences have been discussed. One of these results is the mental traumas experienced after the events. We will examine the relationship between these two variables, with dozens of examples of these traumatic wounds occurring in societies but often invisible.
Unresolved collective traumas and related mourning processes are passed on from generation to generation and are experienced in dimensions that can affect the identity and destiny of the society. For example, the losses suffered by the Ottoman Empire after the Balkan Wars were later inherited by the Republic of Turkey as an ideology of paranoia. While the Jewish Holocaust turned into a trauma that cannot be mourned and the wounds cannot heal in the next generations, causing the Jewish community to live in isolation, while the fathers of the second-generation Germans lived in World War II. It is a striking fact that they were traumatized when they learned what they had done to the Jews in World War II. 10 years after the Rwandan Genocide (1994), which emerged as a result of ethnic conflicts and resulted in the death of millions of people, symptoms of Post Traumatic Stress Disorder were still encountered in society, and it was found that they were close to believing in social unity and solidarity with other ethnic minorities. While the 35-year war of independence in Northern Ireland has caused pathological signs of mourning not only for the victims of the war and their relatives but also for the next generations, in the former Yugoslavia, Sierra Leone, and Liberia the work on justice, truth and reconciliation has not yet begun. violations increase and cause consequences that make the symptoms of trauma chronic.
At this point, we would like to mention some studies which investigated the relationship between genocide-mass murder events in history and PTSD.
A cross-sectional study of PTSD and associated factors in Juba, South Sudan.
Studies revealed high levels of post-traumatic stress disorder (PTSD) among populations in South Sudan at the time of the conflict. A cross-sectional, randomized cluster survey of 1242 adults (over 18 years) was conducted in Juba, the capital city of South Sudan, in November 2007. More than a third (36%) of participants met the symptom criteria for PTSD and half (50%) met the symptom criteria for depression. This study provides evidence of high levels of mental distress and associated risk factors in the Juba Town population. Comprehensive social and psychological assistance is urgently needed in Juba.
Psychological disorders experienced by Rwandan orphans and widows who survived the Genocide
Nearly one million Rwandans were killed in 1994, in one of the worst genocides of the 20th century, over 3 months. This study investigated the nature and extent of exposure to traumatic events and psychological reactions among Rwandan orphans and widows who survived the genocide. In conclusion, the present study shows a high level of present PTSD and symptoms of anxiety and depression in 41% of surviving widows and 29% of orphans who were interviewed 13 years after the Rwandan genocide.
Burden of post-traumatic stress disorder in postgenocide Rwandan population following exposure to 1994 genocide against the Tutsi
The 1994 genocide against Tutsi resulted in a massive death toll that reached one million people. Despite the tremendous efforts made to mitigate the adverse effects of the genocide, a substantial burden of mental health disorders still exists including the notably high prevalence of post-traumatic stress disorder (PTSD) among genocide survivors. However, a synthesized model of PTSD vulnerability in this population is currently lacking.
A total of 2957 out of 11,746 individuals suffered from PTSD. The summary proportion is 25%. The tau^2 is 0.06 in the absence of subgroups, and the Q-statistic is 2827.65, all of which suggest high heterogeneity in the effect sizes. The Year of data collection and Year of publication were significant moderators. PTSD pooled prevalence in the genocide survivor category was estimated at 37%.
The PTSD prevalence among genocide survivors is considerably higher compared to the general Rwandan population. The burden of PTSD in the general Rwandan population declined significantly over time, likely due to the treatment of symptoms through strong national mental health programs, peacebuilding, and the resolution of symptoms over time. To the best of our knowledge little evidence has reported the burden of PTSD prevalence in African post-conflict zones, particularly in Rwanda.
Limitations of our review include the use of retrospective studies and studies with very small sample sizes, as well as language criteria.
Symptoms of PTSD in 124 survivors of the Holocaust
This study investigated PTSD symptoms in Holocaust survivors with well-documented exposure to trauma.
The German files of 124 Jewish Holocaust survivors who were judged to be free from bipolar affective disorder, obsessive-compulsive disorder, and organic brain syndrome were selected from those of 145 applicants to West German compensation boards. The psychiatric assessments were reexamined for explicit descriptions of current PTSD symptoms according to the DSM-III-R diagnostic criteria. A subgroup of 20 Auschwitz survivors with tattooed identification numbers was also compared with the 45 survivors who had not been in concentration camps.
Sixty-three percent of the total sample had been detained in concentration camps, and an average of 78% of their first-degree relatives were reported killed in the Holocaust. Forty-six percent of the total sample met the DSM-III-R criteria for PTSD. The most common symptoms were sleep disturbance, recurrent nightmares, and intense distress over reminders. The tattooed Auschwitz survivors had significantly more symptoms and were three times more likely to meet diagnostic criteria for PTSD than the survivors who had not been in concentration camps.
The results suggest a greater risk of chronic PTSD in survivors who were exposed to atrocities. Most survivors had not received adequate psychiatric care.
A CURRENT PERSPECTIVE ON GENOCIDE: COLLECTIVE TRAUMA
Violence, which is systematically applied to a particular community and accompanied by severe emotions such as fear, helplessness, and anger, destroys the spiritual, social, cultural, and economic building blocks of that community, destroys the desire and hope to live, and creates a "traumatic memory" in the victims.
If the experienced traumas are not resolved and the sorrow of the losses is not completed in the minds, the traumatic memory is transferred from generation to generation by pouring into bodily practices by the members of the community.
The concept of 'epigenetic inheritance' expresses the idea that environmental factors such as smoking, malnutrition, and stress can be passed on to children and perhaps even grandchildren through genes.
With the detection of genetic change from trauma, the 'epigenetic inheritance' thesis that human experiences can also inherit by future generations has found its clearest evidence yet.
The reason for many ongoing wars and conflicts between countries today can be shown as the transmission of the psychological consequences of social traumas from the past and unresolved through generations and keeping them alive.
Trauma Cycle
It is argued that forgetting violence is inextricably linked with remembering violence because it results from the inability to fully remember or forget traumatic experiences. Trying to remember or completely erase the trauma causes the trauma to be stuck in the memory as it cannot be digested spiritually and turns into an invariable part of the identity. Based on Botcharova's (2001) Seven Steps Towards Revenge Model, Yoder et al.'s trauma cycle show the pain caused by trauma, how the individual and society identify with trauma, how the victim/group turns into aggressor with revenge plans to restore their dignity and find justice. It is a very important model. The offender and the victim can get stuck in this cycle.
The family's upbringing (the stories we are told about the enemy), the socio-cultural structure we live in, our belief systems, our emotional and spiritual development are the most important factors that affect the victim and the criminal to be stuck in the trauma cycle. The most dangerous thing is that people and groups who have committed acts of horror continue to believe that what they did was one of the best choices and move on.
The trauma cycle shows that apart from the individual memory of each person in the society, which is made up of his own experiences, it is also another form of memory that consists of the kneading of the events that many individuals in the social experience in an emotional context. This memory accumulation, which Bergson defines as the accumulation of the past on the past, is the product of collective identity construction.
Parent-child bonding has an important place in the construction of this common identity. Even though past unresolved traumas are kept a secret, their bodily and spiritual expressions are reflected in the child's world. While past traumas are the source of parents' nightmares, the most striking findings are that children also have similar nightmares. Child-rearing practice, parent-child attachment, and other environmental factors are very effective in the transmission of trauma.
Yehuda and his team's epigenetic studies have shown that trauma has a biological memory and that it is transmitted from generation to generation through sperm, particularly through the release of cortisol, by finding similar signs of trauma in the children and grandchildren of Holocaust survivors. In other words, although each child has his psychological characteristics and organization, he is stigmatized by familial psychodynamics and becomes hostile or allied with others in his group. As a result, leaving the traumas inherited from previous generations unresolved means that their children and even their grandchildren may experience the effects of these traumas in the future.
RECOMMENDATIONS FOR GENOCIDE SURVIVORS THERAPEUTIC INTERVENTION AND IMPROVEMENT
Community-based interventions are needed to restore the psychological functioning of survivors of mass violence. However, the treatment of trauma spectrum disorders does not only mean symptom reduction but also includes significant improvements at the social level and can also help overcome marginalization and stigma. Treatment approaches should also address existing social problems at the community level that may arise as an indirect result of violent conflict.
REFERENCES
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