Living in Fear After the “Beast” Is Gone: Navigating GBV, Survival and Trauma in Asylum Settings

April 5, 2023

Introduction

On an early winter morning of 2017, I was sitting in my office preparing for an interview with a GBV survivor who was also seeking asylum. It was an interview that I knew beforehand would be like no other interview, as it touched on highly personal topics related to my interviewee. It was an investigative interview regarding the rape incident my interviewee was subjected to. While doing the final preparations, I received an unexpected phone call from the guards at the main gate of the organization I used to work at. An anxious and worried voice came from the other end of the line, urging me to “come down quickly and bring an interpreter with you.” When I asked about what was going on, the man at the other end of the line said that they “are in a bit of a situation with the woman [I] will interview today”.

Apparently, my interviewee arrived earlier than expected, but when I went downstairs, the air was frigid, and my client was shivering against the cold and crying hysterically. I approached her slowly with the interpreter and asked everyone else to leave the room, after which I leaned forward and introduced myself gently, asking her for her name. I informed her that it is obvious that she is not feeling okay and that is understandable and completely normal. When I inquired if there is a way I can help and make things easier for her, she sobbed and said that she “feels super scared here. I traveled by bus for four hours to arrive here, and it is my first time in this city. I do not know anyone here, and the three men who were around looked scary. They were blocking the door and told me that I cannot enter the building prior to my appointment, so I feel really scared here.” Any witness to this situation may ask if traveling by bus to an unfamiliar place, or having somebody hindering their entrance to a building, can be a reason for hysterical crying and experiencing terrifying feelings.

For people who do not have a traumatic history, this can be very unlikely, so what happened with my client? The prominent American Psychiatric Judith Lewis Herman answered that question in the following brilliant way: “After a traumatic experience, the human system of self-preservation seems to go onto permanent alert, as if the danger might return at any moment.” What does this mean? This means that trauma survivors may become over-alerted and regularly assess potential threats around them for a long time after the traumatic incident occurs. In other words, trauma survivors may remain on the outlook for danger or risk, and they can re-experience symptoms of trauma when exposed to reminders of it. Trauma survivors may also experience what is known as a ‘freeze response’. In turn, this will lead us to ask the following question: How do these responses happen? The following sections will answer this question. 

The Fight, Flight, and Freeze Responses

The Fight or Flight response is a natural and involuntary physiological reaction to an event that is perceived as threatening and terrifying. The two parts of the brain that are responsible for this response are the neocortex and the amygdala. The amygdala (The Emotional Brain) responds swiftly to emotions of fear, while the neocortex (The Thinking Brain) basically considers how it will react to fearful feelings in a calm and logical manner. Another part of the brain that is involved in this process is the prefrontal cortex, which alerts the amygdala when the fear response is no longer necessary. The neocortex and the amygdala play an equal role in keeping us secure when we see and experience danger. Without the amygdala, reactions to hazards will happen slowly, and without the neocortex, all responses would be impulsive and lack cognitive control. In other words, the amygdala and the neocortex compliment each other’s functions, meaning that the amygdala uses fear to rush us out of the path of an oncoming vehicle. If we wait for the neocortex’s slower cognitive process, we would, without a doubt, get hurt. As for the freeze response, it is an automatic reaction that manifests as an inability to speak, respond or engage in any form of self-defense and self-preservation as a response to danger. This response happens when our brains decide that we are unable to fight or flee. In other words, the brain explicitly says, “Stay still or you will get hurt”. Nonetheless, how do the three responses manifest for trauma survivors?

The Effect of the Trauma on the Brain

Evidence was found in the literature that trauma disables the prefrontal cortex. Thus, it becomes impaired and fails to notify the amygdala when the fear is just a perceived threat and the fear response is no longer needed. As a consequence, the amygdala becomes overly responsive and responses to fear continue to trigger, even when a threat no longer exists. Take our client from before as an example: She was exposed to reminders of the GBV event she was subjected to a long time ago. Then, the amygdala sent a false alarm about her perceived threat, and the prefrontal cortex could not stop that false alarm from resulting in an exaggerated response, startling our client in the process. With the freeze response in trauma survivors, the amygdala also becomes overactive, and the neocortex ­– which is known as the thinking part of the brain – takes the back seat. The freeze response can be recognized in trauma survivors during sessions and interviews through the signs of numbness, lack of energy, inability to talk, staring with wild eyes and inability to think.  It is worth pointing out that the freeze response goes by different names, such as tonic immobility, death feigning, and orient phase, among others.

How to Skillfully Work With Trauma Responses During Interviews and Sessions

Evidence points to the fact that grounding and relaxing techniques can calm and relax the amygdala. The following are some tips interviewers/caseworkers might follow to help their clients/interviewees overcome their triggers. It is also worth mentioning that these tips are not meant to treat symptoms associated with trauma, but rather aim to help the client/interviewee to cope with their feelings at the time of the interview so as to provide them with psychological safety  and bring them to the here and now in order to calm their brains to enable them to answer the interview questions:

1. To disarm the feeling of symptoms and normalize the interviewee’s response to triggers (e.g. by demonstrating empathy for the interviewee’s reaction and expressing acceptance that their reactions are normal).
2. To ask them to count things in the room and name the colors they see, or to show them calming photos, such as nature photos and ask them questions about the colors they see, which photos they like the most and why. This strategy can actively regulate the clients/ interviewees’ feelings and can bring them to the here and now.
3. To make the interviewee feel as though they have a sense of control by asking them to focus on things that they can control, such as their breathing, or by asking them  to take three to four deep breaths.
4. To help the client feel safe, and to tell them that they are in a neutral and safe place that aims to help them. You can also ask them to name people who are perceived as a source of safety for them.

In short, Trauma is highly prevalent among migrants and refugees. Furthermore, refugees and female migrant workers are extremely vulnerable to gender-based violence, especially sexual assault incidents.

This article is part of the IMS blog series on ‘Trauma, GBV and Refugeehood’ that will be published throughout the month of April, and culminate in a webinar tentatively scheduled for early May 2023. To learn more on the series, please contact Dr. Jasmin Lilian Diab at jasminlilian.diab@lau.edu.lb or Ms. Dana Azzeh at azzeh_dana@yahoo.com.