Loss of the World: The Trauma of Dislocation

In this video, Dr Salman Akhtar discusses the trauma of dislocation suffered by immigrants and exiles, and defenses we use to cope with it.

Surprisingly (but immediately it rings true), he says it is not the loss of human relationships that creates the trauma--those we can, and will replace--instead, it's the loss of the world itself. The loss of the way the world looks: the shapes of houses, the lay of the land, the way the everyday objects are designed. And more subtly, the way time is constructed, and the cultural ways we conceive of our lives within the world--ways we don't realise are culturally specific until we find ourselves in a different culture. ("When I was living in India, I was not living in India, I was just living. I didn't realise I had been living in India until I left and came to the US.")

These dislocations cause the immigrant to continually be subliminally looking for aspects of home, however banal--the colour of mailboxes, or the flash of bouganvilea--which feel somehow more trustworthy than the equivalents in the new country. The sudden flash of 'home', and the happiness of recognition of an aspect of home, reveals that we have been missing a feeling of home all this time. Furthermore, without the subtle triggering of memories implicitly evoked by familiar objects and surroundings, we are psychically impoverished.

The clinical situation
In a clinical situation, Akhtar says, it is vital to validate the fact of immigration in the client's identity from the start, showing interest so that this material is flagged as important, and psychic space is opened for its exploration.

People with migration trauma, he says, can take a while to settle into the physical surroundings of the office. The physical surroundings can be crucial to them--being transitional and also totemic objects. These clients bring things in, and want to borrow things, very often. This is all about the trauma of loss.

Defenses
The immigrant defends against the dislocation trauma through several means:
1. Denial, subtly repudiating the host country. "I am not really here."
2. The fantasy of return. "I'm here for a little while but I'll go back." This return is continually deferred, sometimes to the point of "I want to be buried at home when I die."
3. Minimisation, via the fantasy of replication. "I'll re-create my country right here." Home can become a shrine for the immigrant, who owns more cultural artifacts than they would if they were living in their home country.
4. Idealisation of the home country (aka lost and idealised object). This in turn causes wounding if you do return--you can never find what you are looking for when you go back, because it has changed, and no longer the ideal, lost object.
5. Reparation--this is the key to healing. It involves the awareness that I was the one who left, thereby attacking my good internal object. So I have fix it. With this awareness comes altruism, philanthropy and creativity.

Nostalgia for home
The client's nostalgia for home must be analysed. It can often serve to mask aggression and frustration in the now: "Bombay was so lovely" can hide the fact that life right now here seems intolerable. On the other hand, nostalgia can be acting as a method for displacement of transference love: "Bombay was so lovely" can indicate that the client is also happy to be here in your office.

Exiles may never show nostalgia, never mentioning their home country, or only negatively. It's like a bad divorce. They spread the trauma backwards, spoiling the good memories. Here the crucial thing is to analyse the defenses against nostalgia. Even though there was trauma, "there were also trees, and birds, and lollipops..."

Space has to be provided for the migrant to elaborate on the nostalgia. Then it will be easier to analyse its defensive functions.

Non-human transferences
When working with migrants remember and note the issue of non-human transferences. The relationship with objects and places around the child (chair, rain, moon,...). These are not merely symbolic of human relationships, they are important in themselves, particularly for immigrants, because they mediate our difference, and the difference between our worlds, old and new. Environment can be mother, reversing Winnicott's "mother as environment".

Conclusion
Finally, Akhtar reminds us that none of this is the main work in the analysis, but rather it sets a crucial background to the work, with immigrant and exiled clients. Analysis of the immigration trauma allows resumption of development, the search for new objects, and the internal journey of self actualisation.

On a personal note, Akhtar mentions bouganvilea several times. This touched me, because bouganvilea is important to my internal landscape also. Its bright splash serves me as a transitional object, linking me to external landscapes I have lost, and symbolising aspects of myself which I am still seeking to integrate in a new country.