More than three decades after an estimated two million Cambodians died in a genocide perpetrated by the Khmer Rouge, post-traumatic stress disorder and other forms of emotional trauma continue to prey on the peace of mind of survivors and their descendants, say mental health experts who are advocating culturally adaptive trauma treatment.
“There are differences in human responses to trauma, and it is important to address the idioms of distress and cultural narratives in the response,” said Sandra Mattar, an associate professor of trauma at St. Mary's College of California.“Trauma [that is not dealt with] can transfer from the first generation to the second. It is in the way they raise their children, [their] aggressiveness [and] inappropriate reactions,” said Muny Sothara, a psychologist with the Cambodian Transcultural Psychosocial Organization (TPO), an NGO providing mental health treatment, based in the capital, Phnom Penh.
...“We should not assume that treatments developed for PTSD in the West are helpful or useful in non-Western contexts,” said Mattar, who wrote a report on training traumatologists in culturally adaptive methods in 2010. Trauma therapy based solely on talking and medication runs the risk of “eclipsing the mechanisms that [the] culture has around resilience and coping,” she said.
...Many Cambodians diagnosed with PTSD believe their frequent sleep disturbances occur because the spirits of their deceased loved ones are not at rest. “They have sleep difficulties, and pain, mostly pain in the heart, feeling numb in the heart,” said Sothara, who said patients interpret pain, insomnia and nightmares as signs of the unsettled afterlife of their dead relatives.
Cambodia is a mainly Buddhist country and it is widely believed that the monks are able to communicate with the deceased. TPO has incorporated Buddhist ceremonies, in which families testify about the deaths of their loved ones before monks in a pagoda, into conventional psychotherapeutic treatments such as counselling and, if necessary, medication.
http://www.irinnews.org/report/99528/localizing-treatment-for-emotional-trauma-in-cambodia
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