Psychotherapy with children in refugee families who have survived torture: Containment and understanding of repetitive behaviour and play

Children of refugee families who have survived torture often have emotional, psychosomatic and behavioural problems as well as problems with learning. In order to understand the difficulties of these children, we have to recognize the complicated interaction of cumulative traumatic strain and recurring exposure to shocking violence. The traumatic experiences of the child in the country of origin take place in the broader context of chronic danger and persecution, often to be followed in the country of exile both by recurrent family strain and social estrangement. In the transference this complicated mixture of repeated trauma and chronic strain may show as a pervasive tendency to retreat to defensive survival strategies combined with continual repetition of more specific traces of the impact of the trauma on the individual. This paper focuses on how the enacted survival strategies can be contained and understood in the transference. In due course the compulsive repetition can be given meaning as a precondition for better integration through symbolic thought and self-understanding.