Testimony Theraphy: Treatment Method for Traumatized Victims of Organized Violence
Van Dijk, Janie A., Schoutrop, Mirjam J. A., Spinhoven, Philip, American Journal of Psychotherapy
Former political prisoners in Chile gave testimony of their traumatic experiences, which resulted in diminishing their posttmumatic symptoms. Based on this experience, testimony therapy has been developed and used in treatment of traumatized victims of war or other organized violence. This short-term therapy, as it applied in the treatment of traumatized asylum seekers and refugees in Centrum '45/De Vonk in the Netherlands, is described in this article. The therapy consists of 12 sessions in which patients tell their life stories, including the traumatic experiences. The narrative is reflected in a written document that, for example, can be read to family and friends, or be sent to a historical archive. This article discusses the preliminary research data on the effects of testimony therapy, finally, hypotheses on the working mechanisms of testimony therapy are offered.
Traumatized victims of war or political violence give testimony of their experiences in different situations and for different reasons. They might tell about their experiences in the media, to human rights organizations or even in therapy. Sometimes, they volunteer to tell their story, sometimes they are forced to tell, for example, to obtain asylum.
Testimony therapy was first described by the Chilean psychologists Cienfuegos and Monelli (1). During the Chilean dictatorship, they tried to get in touch with former political prisoners of the regime. They collected their stories as a way of documenting the oppression, but they also discovered that giving testimony in this way seemed to help these former prisoners.
In testimony therapy, people are invited to tell their life stories, including the traumatizing experiences. In this approach, the political context of the traumatizing events is being stressed. The stories are tape-recorded and a verbatim report of every session is made. Together, these reports form a document that contains the patients' life stories, including the traumatic experiences. Patients and therapists sign these documents. Patients decide how they want to use them; they can keep them for themselves, give a copy to family or friends, or send it to a human rights organization.
Testimony therapy is also carried out with refugees. The Danish therapists Agger and Jensen (2) report positive results based on case studies with refugees from various countries. Weine, Dzubur Kelanovic, Pavkovic, and Gibbons (3) carried out testimony therapy with Bosnian refugees in the U.S.A., with a positive outcome. Laub (4) described testimony therapy with Holocaust survivors. By now, testimony therapy has found its way into textbooks and articles on trauma treatment with refugees (5-18).
So far, testimony therapy has been applied specifically with traumatized victims of war or organized violence. Because of the positive clinical results, we decided to introduce this method in our institute, Centrum '45/De Vonk in Noordwijkerhout, the Netherlands, and to conduct a pilot study in preparation for a controlled outcome study.
For a better understanding of the context of our work, we will briefly describe Centrum '45/De Vonk; then, the treatment protocol, as applied at our center, will be introduced. This will be illustrated with some case examples. Next, outcome studies on the effects of testimony therapy will be presented. Finally, we will describe theoretical ideas about the testimony therapy as a method of trauma treatment, followed by some concluding remarks.
TRAUMA TREATMENT FOR ASYLUM SEEKERS AND REFUGEES AT CENTRUM '45/DE VONK
Centrum '45/De Vonk is a national institute for the treatment of the psychic sequelae of organized violence. Patients are asylum seekers or legal refugees in the Netherlands and victims of war. They are traumatized by several severe experiences of violence or other extremely stressful events, such as imprisonment, threats to life, witnessing or undergoing torture, hunger, thirst, and death of family members. …