Conversation - 'Psychological First Aid' Courtesy: The United NationsEducation Is Essential in Post-conflict Situations www.un.org/Pubs/chronicle/2003/issue4/0403p53.asp
Speaking to the 2,000 participants of the 56th Annual DPI/NGO Conference in New York, Nila Kapor-Stanulovic addressed the psychological aspects of human security and dignity. She experienced first-hand the effects of multiple armed conflicts in the Balkans and treated patients affected by the crises in Bosnia and Herzegovina and in Macedonia. She pointed out that she had been a recipient, as well as a provider, of psychological aid, at times filling both roles simultaneously. Although it had not been easy, Ms. Kapor-Stanulovic explained that the most difficult times were those when she was only receiving such support due, she believes, to the sense of helplessness that results from having encountered traumatic experiences. She strongly endorses the idea of helping victims restore a feeling of being somebody. An expert in "emergency psychology", which includes crisis intervention techniques, post-trauma interventions and psychosocial rehabilitation, she is continuing her work to ameliorate the consequences of the armed conflicts in the former Yugoslavia.
Biko Nagara of the Chronicle spoke with Ms. Kapor-Stanulovic on 10 September
On the psychology of dignity and securityDignity and security within the context of psychology have been addressed but never fully explored. The psychological aspects of life are frequently disregarded by humanitarian agencies and non-governmental organizations (NGOs) because psychology is often associated with illness and psychopathological problems. When I say that I am a psychologist, it is these kinds of problems people tend to associate me with. Psychology, however, is intended for people who have suffered and endured crises, causing a loss of dignity. It is very important to break the misconception that psychology and psychosocial rehabilitation are aimed only at a small number of sick individuals.
On upgrading the role of psychological welfareThe United Nations is primarily concerned with physical survival, which is indeed a priority. Nevertheless, psychosocial welfare has assumed too much a secondary position. Having worked for the United Nations Children's Fund (UNICEF), I understand that the problems are many, while staff and resources are limited. More attention should be paid to questions relating to non-physical survival. We need to disseminate basic knowledge of psychosocial assistance and rehabilitation. It should be understood that we are not here to treat sick people; we are here to promote the well-being of the general population and the recovery of those affected by man-made and natural disasters, such as armed conflicts, poverty, hunger and diseases.
On psychological first aidPsychological first aid is a relatively new concept, which is as important as medical first aid. When someone is bleeding, you don't immediately take that person to a specialist; you do something to stop the bleeding and then take him/her to a specialist. Likewise, you do not take a person who is in need of immediate psychological assistance for psychoanalysis or psychotherapy. Everybody should know the basic principles of psychological first aid to help others recover faster and better from a crisis. What I did in my country and in other places was to make a list. Psychological first aid is a very simple concept that can be broadcast over the radio or printed on brochures and leaflets for anyone to learn and apply. During the NATO bombing of Yugoslavia, I asked local radio stations to explain one principle of psychological first aid every evening for one minute before the news.
It took just one minute over twenty consecutive evenings to describe twenty valuable aid techniques. It is thus simple and inexpensive to publicize such first aid to everyone who is listening to the radio or watching television. People who are empathetic, motivated and willing can apply it without training, while others may need very basic training.
On the long-term effects of collective traumatizationCollective traumatization is a more complex issue. In some countries, like Afghanistan and Iraq or my native Serbia, virtually everybody is traumatized because they have all been affected by a crisis. One can only try to support their recovery by re-establishing dignity, self-worth and appreciation for life and individuals; some will recover on their own, while others will not. Unfortunately, people tend to return to violence soon after being exposed to chronic, continuous trauma. Thus, the future is very bleak for countries where the population has been heavily traumatized as a whole. In many post-conflict countries, crime increases, especially among the youth; one cannot expect young people to understand and embrace tolerance once they have been exposed to the violent acts of others. People, especially the young, come to believe that war, anger and hatred are acceptable ways of dealing with others. I don't know exactly what should be done, and so far I don't see any serious willingness to invest in the necessary rehabilitation programmes. Priority has been given to housing, food and medicine, and people therefore will remain traumatized.
On cycles of violence in post-conflict countriesA generation who endures years of brutality will simply take violence as a model of behaviour in relating to other people, so this is a long-term problem-it doesn't stop when the first episode of violence ends. I know from my own country that one cannot just introduce peace in a post-war environment. Although the international community removed our President, who was a dictator, young people continue to be aggressive towards others and we are having great difficulty in introducing programmes to change their beliefs about how conflicts should be resolved. Several programmes on peaceful conflict resolution and tolerance have been implemented, but they cannot reach everyone. Bombs, however, did reach the whole population five years ago, and now huge efforts are required to remedy the damage done in a short time.
On the relevance of educationEducation is essential, but all young people cannot be reached through formal education, because many do not attend school. Some have just graduated, others are simply not attending classes, and these young adults will be leading the country for the next thirty years. You will never reach everybody, and this is a problem. I would like the world leaders to attend at least one course on peaceful conflict resolution offered by psychologists. World, community and religious leaders, as well as any figure of authority, should communicate to others that conflict is normal, but violence is abnormal. Conflict is a part of our lives-both professional and personal-but this does not mean that one should be violent to solve problems. It would be useful to keep in mind that every violent act leads millions of people to believe that violence is the only solution to a conflict; that would help solve much more than anything else. Although the United Nations is doing a lot, it does not have enough resources to reach entire populations.
