Trauma' and the lives of women refugees in resettlement

'Trauma' has emerged as a central defining construct within professional and popular discussions on refugee health. Refugees are considered to be at risk for psychological distress due to traumatic events experienced in the context of conflict and natural disasters in their countries of origin as well as in the context of exile. Following migration, life in resettlement is often an unstable process marked by poverty, social exclusion, as well as poor health status. The importance of 'trauma' in the discussions on refugee health has left health professionals struggling to make sense of and react to groups of people now defined as 'traumatised'. However, we have little understanding of how trauma is understood, experienced and addressed by individuals, their advocates and the service provider's impacts upon the experiences of refugees in resettlement. Juxtaposing information from three distinct sources, I examine the discourse(s) surrounding refugees and health in resettlement, focusing upon the definitions and meanings attached to the issue of 'trauma'. The analysis draws on 16 qualitative interviews with health and social care professionals, qualitative 'resettlement history' interviews with 25 women refugees, as well as an examination of a selected body of authoritative knowledge (academic articles and conference reports) in the UK. At the heart of this analysis are contrasting perspectives in relation to the dominant paradigms of psychiatry, the metes and bounds of localised frameworks of distress, and the margins of socio-political action and interpretation. Definitions of trauma as a psychiatric disorder have implications for the clinical and social care responses of health professionals. In turn, women refugees are encouraged to engage with psychiatric systems of care and to learn a new language of distress that is psychologically informed, and may be distant from the socio-cultural context of their lives in resettlement. At the same time, the construct of 'trauma' has significance in the context of political asylum, where a diagnosis of , trauma tis ed' may be perceived as evidence supporting asylum claims. The highly politicised context of resettlement raises issues of social justice, which are interspersed with notions of trauma, as professionals seek to reconcile ideas of testimony and therapeutic interventions. These ways of seeing trauma rely upon the use of conventional Western notions of mental health and well-being that are grounded in a psychiatric paradigm and make use of related clinical strategies. Particular emphasis is placed upon the value of 'talk' as a means of achieving recovery. The women interact with popular and professional discourses on trauma in their daily lives. How they perceive and respond to these discourses (whether accepting it in whole, in part or rejecting it) offers insights into the meaning of trauma in resettlement and the coping strategies they employ in response to a psychological framing of their experiences