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Iraqi Researchers Use Art to Help Sexual-Violence Survivors

DUHOK—When the Islamic State was at the height of its power in Iraq, many people left the occupied zone of the Nineveh governorate for the safety of this city in the mountains of Iraqi Kurdistan.

Some of these refugees were Yazidis, an ethnic and religious minority, who suffered some of the worst persecution that the Islamic State delivered. Yazidi women in particular were often taken by the terrorists as sex slaves.

In a bid to help some of these survivors recover, Deldar Morad, a public-health researcher at the University of Duhok’s College of Adult Nursing, has turned to art.

He is offering an art course to a group of 14 Yazidi women as a form of therapy. All of the women have witnessed extreme violence and have been left mentally scarred as a result. Four of them were also captured and subjected to sexual assault, but later escaped.

He teaches the course with a local artist. “We train the survivors to learn painting, drawing and other artforms to explore and express their feelings,” he says.

At the start of the program, approximately half of the women had either attempted suicide or were contemplating it.

“Within two months their suicidal thoughts were reduced,” Morad says. For some of the women, such thoughts vanished altogether, he says, and for the others they became rarer.

Many of the region’s refugees—from Iraq, Yemen, Libya, Syria and elsewhere—have experienced or witnessed conflict and trauma. This means they are at increased risk for mental health problems. In Syria alone there are an estimated 6.6 million displaced people, in addition to the 5.6 million who have left the country, according to the United Nations.

The scale of the problem is worsened by a lack of trained psychiatrists available to help. (See a related article, “Refugee Youth Traumatized by War: Overwhelmed, Understudied.”)

As a result, experts have argued a different approach may be needed to treat refugees, one that doesn’t rely as much on psychiatrists. Moving responsibilities from psychiatrists  to other people who could provide emotional support and therapy is sometimes referred to as “task shifting.”

“We don’t want to make it sound like anyone can treat [people], but we also need to respond to the lack of mental-health professionals,” says Fadi Maalouf, chief of the division of child and adolescent psychiatry at the American University of Beirut Medical Center.

Maalouf points out that there are some treatments so specialized as to always require a fully trained psychiatrist. “But non-trained people can still offer support,” he says.

Morad’s program at the University of Duhok is one example of task shifting.

“We are not psychiatrists. We’re public health specialists and artists,” Morad readily acknowledges.

While the art therapy in Duhok focuses on 14 women who have experienced extreme psychological trauma, Maalouf stresses that it’s important not to forget that refugees could also have underlying mental health issues.

“They may have their own mental health disorders like attention deficit or autism that could have happened regardless of their refugee trauma,” says Maalouf.

The art therapy course in Duhok is not part of a coordinated treatment program with comprehensive psychological assessment and complementary therapies. Many classically trained mental health experts believe art therapy should be complementary to regular psychotherapy and not substitute for it.

In the right circumstances, researchers have found art therapy to be beneficial for psychological problems, says Susan Hogan, a professor of culture studies and art therapy at the University of Derby, in the United Kingdom.

“It can be transformative,” she says. “It can take a relatively short time. Twelve weeks can be enough time to make genuine change.”

Part of art therapy’s benefit comes from being in a group with people who have had similar experiences. “It’s confidential so they know what they share will stay within the group,” says Hogan. “The once inexpressible becomes expressible.”

“I’ve worked with a woman who had been sexually abused,” says Hogan. “At the beginning she couldn’t make eye contact and she sat hunched. She was a very damaged human. At the end, she was articulate, sitting upright and went on to have a successful career.”

The creative exercise of making art is crucial to the process. “Trauma is embodied, and the art adds the opportunity for embodied feelings to be expressed,” says Hogan. “People will often make an image and then say they’re surprised by what they’ve made. It allows trauma to be expressed in a nonverbal way.”

Morad says his participants have so far found it useful to explore their creativity and that it is helping them, even if not as much as a fully coordinated treatment plan with trained psychiatrists would. For him, it’s about doing what he can.

Currently, Morad has funding to run the course for five months and he is hoping that the participants will see further improvements.

“There is a lot of work to be done to repair the past,” he says.


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