Erin Martz Editor Trauma Rehabilitation After War and Confl ict Community and Individual Perspectives 123 Trauma Rehabilitation After War and Conflict Erin Martz Editor Trauma Rehabilitation After War and Conflict Community and Individual Perspectives 123 Editor ErinMartz Rehability Portland,OR USA [email protected] ISBN978-1-4419-5721-4 e-ISBN978-1-4419-5722-1 DOI10.1007/978-1-4419-5722-1 SpringerNewYorkDordrechtHeidelbergLondon LibraryofCongressControlNumber:2010923780 ©SpringerScience+BusinessMedia,LLC2010 Allrightsreserved.Thisworkmaynotbetranslatedorcopiedinwholeorinpartwithoutthewritten permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY10013,USA),exceptforbriefexcerptsinconnectionwithreviewsorscholarlyanalysis.Usein connectionwithanyformofinformationstorageandretrieval,electronicadaptation,computersoftware, orbysimilarordissimilarmethodologynowknownorhereafterdevelopedisforbidden. Theuseinthispublicationoftradenames,trademarks,servicemarks,andsimilarterms,eveniftheyare notidentifiedassuch,isnottobetakenasanexpressionofopinionastowhetherornottheyaresubject toproprietaryrights. Printedonacid-freepaper SpringerispartofSpringerScience+BusinessMedia(www.springer.com) Reflections on Healing Howpeoplesurvive inacircleofhell I’ll neverknow. Howtheytrust againinthe humanfamily I’ll neverknow. Howtheycan smileoncemore afterseeingevil deeplyandrepeatedly I’ll neverknow. Howtheyletthe horrorsfadeand liveforthefuture I’ll neverknow. Howtheylearn totrustthemselves againandfindtheirvoices– thisIknow. ErinMartz Acknowledgments Aresearchermeetsmanymindsalongthepathofinvestigation.Whiletheideational influenceofmanyresearchersisacknowledgedbycitationsinthisbook,otherindi- viduals have been influential by their interaction with me at various stages of the developmentofthisbook;theseinclude,butarelimitedto,thefollowingpeople. I would like to thank the Organization of the Security and Co-operation in Europe (OSCE) in the Czech Republic for opening their archives to me during my time as a Researcher-in-Residence in the summer of 2008 and to thank Alice Nemcova at OSCE for her enthusiastic help. I would also like to thank Dr. Pam CogdalforencouragingmetomoveforwardwiththeideathatIhadforthisbook in 2007, which was at a time when I did not want to tackle such a new mountain. IwouldalsoliketothankSamantha Daniel,whohelpedmeretrievesomearticles and books for this research. Thanks are due to Jennifer Hadley (the current) and Carol Bischoff (the previous), Senior Editor at Springer of New York; they both havebeenfriendlyandsupportiveduringthewritingofbothofmybooks.Thanks alsoareduetoDr.HanochLivnehforprovidingvaluablefeedbackonChapter2(by Martz and Lindy). Thanks also go to friends (Hanoch, Catherine, Zehavit, Kakali among numerous others), for their support, humor, and memorable conversations duringthe3-yearprocessofcreatingthisbook. Iwouldliketothankmyparentsforprovidingencouragementandcreatingearly- life conditions, in which I could expand my mind, absorb ideas, and eventually exploretheinternationalsphere(eventhoughthelattermayhavecausedthemalot of anxiety); I am dedicating this book to them out of appreciation. And a hearty thank-you goes to all of the chapter authors for their dedication and hard work— Ilearned a lot from you! Echoes of the horror of war prompted my writing of the precedingpoemcalled“ReflectionsonHealing”thatseemingly‘fellout’ofmeafter visitingaformersiteofWorldWarIIatrocities. vii Contents 1 Introduction to Trauma Rehabilitation After War andConflict . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 ErinMartz 2 ExploringtheTraumaMembraneConcept . . . . . . . . . . . . . 27 ErinMartzandJacobLindy 3 ForgivenessandReconciliationinSocialReconstruction AfterTrauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 EverettL.WorthingtonandJamieD.Aten 4 A Public-Health View on the Prevention of War andItsConsequences. . . . . . . . . . . . . . . . . . . . . . . . . . 73 JoopT.deJong 5 Community-Based Rehabilitation in Post-conflict andEmergencySituations . . . . . . . . . . . . . . . . . . . . . . . 97 ArneH.Eide 6 ASystemsApproachtoPost-conflictRehabilitation . . . . . . . . . 111 SteveZanskas 7 HumanPhysicalRehabilitation . . . . . . . . . . . . . . . . . . . . 133 PiaRockhold 8 PsychologicalRehabilitationforUSVeterans . . . . . . . . . . . . 159 ThomasA.Campbell,TrevenC.Pickett,and RuthE.Yoash-Gantz 9 Psychological Rehabilitation of Ex-combatants inNon-Western,Post-conflictSettings . . . . . . . . . . . . . . . . 177 AnnaMaedl,ElisabethSchauer,MichaelOdenwald, andThomasElbert 10 Psychosocial Rehabilitation of Civilians inConflict-AffectedSettings . . . . . . . . . . . . . . . . . . . . . . 215 LauraMcDonald ix x Contents 11 ShameandAvoidanceinTrauma . . . . . . . . . . . . . . . . . . . 247 K.JessicaVanVliet 12 Psychosocial Adjustment and Coping inthePost-conflictSetting . . . . . . . . . . . . . . . . . . . . . . . 265 EricaK.JohnsonandJulieChronister 13 HelpingIndividualsHealfromRapeConnectedtoConflict and/orWar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 MeghanE.McDevitt-Murphy,LauraB.Casey,andPamCogdal 14 ThePsychologicalImpactofChildSoldiering . . . . . . . . . . . . 311 ElisabethSchauerandThomasElbert 15 The Toll of War Captivity: Vulnerability, Resilience, andPrematureAging. . . . . . . . . . . . . . . . . . . . . . . . . . 361 ZahavaSolomonandAviOhry 16 Trauma-Focused Public Mental-Health Interventions: AParadigmShiftinHumanitarianAssistanceandAidWork . . . 389 MaggieSchauerandElisabethSchauer Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 429 Contributors JamieD.Aten UniversityofSouthernMississippi,Hattiesburg,MS,USA, [email protected] ThomasA.Campbell VAMedicalCenter,Richmond,VA,USA, [email protected] LauraB.Casey UniversityofMemphis,Memphis,TN,USA, [email protected] JulieChronister DepartmentofCounseling,SanFranciscoStateUniversity,San Francisco,CA,USA,[email protected] PamCogdal UniversityofMemphis,Memphis,TN,USA, [email protected] JoopT.deJong VUUniversityMedicalCenter&BostonUniversitySchoolof Medicine,Amsterdam,TheNetherlands,[email protected] ArneH.Eide SINTEFHealthResearch,Oslo,Norway,[email protected] ThomasElbert UniversityofKonstanz,Konstanz,Germany;vivoInternational, Konstanz,Germany,[email protected] EricaK.Johnson WesternWashingtonUniversity,Bellingham,WA,USA; UniversityofWashington,Seattle,WA,USA,[email protected] JacobLindy UniversityofCincinnati,Cincinnati,OH,USA,[email protected] AnnaMaedl UniversityofKonstanz,Konstanz,Germany,[email protected] ErinMartz Rehability,Portland,OR,USA,[email protected] MeghanE.McDevitt-Murphy UniversityofMemphis,Memphis,TN,USA, [email protected] LauraMcDonald PsychiatricEpidemiology,JohnsHopkinsUniversity BloombergSchoolofPublicHealthintheMentalHealth,Baltimore,MD,USA, [email protected] xi xii Contributors MichaelOdenwald UniversityofKonstanz,Konstanz,Germany, [email protected] AviOhry TelAvivUniversity,TelAviv,Israel,[email protected] TrevenC.Pickett VAMedicalCenter,Richmond,VA,USA, [email protected] PiaRockhold ConsultanttoWorldBankandEU;ChairoftheNorthSouthGroup forPovertyReduction,Ashton,MD,USA,[email protected] ElisabethSchauer DepartmentofPsychology,UniversityofKonstanz,Konstanz, Germany;vivoInternational,Konstanz,Germany, [email protected] MaggieSchauer CenterforPsychiatryReichenau,UniversityKonstanz, Konstanz,Germany,[email protected] ZahavaSolomon Tel-AvivUniversity,Ramat-Aviv,Israel, [email protected] K.JessicaVanVliet UniversityofAlberta,Edmonton,AB,Canada, [email protected] EverettL.Worthington,Jr. VirginiaCommonwealthUniversity,Richmond,VA, USA,[email protected] RuthE.Yoash-Gantz VAMedicalCenter,Salisbury,NC,USA, [email protected] SteveZanskas TheUniversityofMemphis,Memphis,TN,USA, [email protected]