Migration Trauma: Forced Migration, Loss and Rebuilding a Sense of Safety

What is migration trauma and what are its signs? Clear information and concrete steps for coping with loss, insecurity and uncertainty after forced migration.

Not every migration is a choice. Some people leave their countries, cities or homes not because they want to, but because no other way out is left. Concerns for safety, conflict, violence, oppression, disaster, a heavy loss or conditions that make life unsustainable can force a person to set out overnight. This experience is not only a change of place; it is often a deep rupture and upheaval. Migration trauma refers to the marks left on a person's inner world by severe events experienced before migration, during the journey or after migration. In this article we look at the psychological effects of forced migration, the signs of trauma, what a person and their family can do, and how professional support can help, in calm and understandable language. This article contains no political evaluation; its focus is the psychological burden of what you have been through and the paths to healing.

What Is Migration Trauma? The Psychological Meaning of Forced Migration

Trauma refers to experiences in which a person lives through, witnesses or learns of a serious threat to their own life or the lives of those close to them, and feels intense fear, helplessness or horror in the face of this event. Migration trauma does not usually come from a single event but from several stages that follow one another:

• Before migration: Living under threat, witnessing violence, losing loved ones, fear of losing one's job and home, prolonged uncertainty
• During migration: Leaving in a hurry, leaving people and belongings behind, dangerous or exhausting journeys, being separated from family
• After migration: An uncertain legal situation in the new country, language barrier, financial hardship, loss of status, loneliness, worry about those left behind

Someone who migrates voluntarily also faces difficulties; but in forced migration, a person cannot prepare, cannot say goodbye, and the option of return is often uncertain. For this reason, the sense of loss may be deeper and the sense of safety more shaken.

An important point: not everyone who has had a difficult migration experience develops a post-traumatic psychological problem. People can show astonishing resilience in the face of great hardship. But being resilient does not mean not suffering. It is possible to be both strong and wounded.

Signs of Migration Trauma

Reactions to trauma vary from person to person. Some symptoms appear right after the events, while others may emerge months later, when the person has moved into a relatively safe environment. This may seem surprising: "I'm safe now, so why am I doing badly now?" Yet when the mind comes out of survival mode, it can begin to process what has happened.

Common symptoms are as follows:

Re-experiencing:

• Events coming to mind unbidden, vivid memories
• Nightmares
• Intense fear or physical reactions in response to a sound, smell or image that is a reminder of the event

Avoidance:

• Avoiding thinking or talking about the events
• Being unable to watch the news, or conversely, watching it constantly
• Keeping away from places and people that are reminders of the event

Hyperarousal:

• Being constantly on alert, being easily startled
• Being unable to fall asleep or waking often
• Irritability, outbursts of anger
• Difficulty concentrating

Changes in feelings and thoughts:

• Thoughts such as "No place is safe" and "I can't trust anyone"
• Guilt: "I got out but they stayed there," "I should have left earlier"
• Emotional numbness, being unable to feel anything
• Hopelessness about the future

Physical symptoms:

• Headaches, muscle tension, stomach complaints, fatigue
• Palpitations, shortness of breath

These symptoms alone do not amount to a diagnosis. But if they continue for a long time and make daily life difficult, a specialist assessment is important. For more information on reactions after trauma, you can look at the article on post-traumatic stress disorder.

Factors That Make Migration Trauma Worse

As much as the trauma itself, the conditions a person finds themselves in afterwards also affect the healing process.

Ongoing uncertainty. When a residence permit, asylum application or legal situation is uncertain, a person cannot feel fully safe. The mind may remain on alert even though the danger has passed. We covered worries on this subject in the article on residence permit uncertainty.

Those left behind. Worry and longing for parents, siblings, spouse or friends who remain in the country can keep a person tied to the past. Not hearing from them, or bad news coming in, can reopen wounds.

Survivor guilt. Having reached a safe place sometimes brings guilt instead of relief. A person may feel they do not deserve to experience anything good: "How can I laugh while they are in a hard situation?"

Loss of status and identity. Someone who had a profession, a social circle and standing in their own country may have to start from scratch in the new one. This adds a further layer of loss on top of the trauma.

Lack of social support. A shortage of people who understand them and to whom they can tell what they have been through leaves a person isolated.

Difficulties in the new environment. Discrimination, economic hardship or housing problems can make it harder for a person to rebuild their sense of safety.

Healing is not forgetting what happened, but becoming able to carry it without reliving it.

The Effect on the Family and Children

Forced migration often affects the whole family together, but each family member reacts differently.

Between spouses. One may want to talk about what they have been through while the other prefers to stay silent. One may adjust quickly to the new country while the other stays stuck in the past. These differences can lead to misunderstanding, conflict or emotional distance. Roles within the family can change; for example, the person who provided for the household may feel worthless when they cannot find work.

In children. Children cannot express what has happened in words as adults can. Signs of trauma can appear in children as follows:

• Night fears, nightmares, not wanting to sleep alone
• Returning to behaviours of a younger age, such as bedwetting and thumb sucking
• Extreme difficulty separating from the parent
• Replaying what they have been through again and again in their play
• Outbursts of anger, irritability or withdrawal
• Difficulty concentrating at school

In teenagers. Teenagers sometimes try to carry the family's burden and suppress their own feelings. Others may react with anger, risk-taking behaviour or withdrawal.

One of the most important protective factors in children's recovery is the parent's calmness and the warmth of the relationship. For this reason, a parent looking after their own mental health is in fact part of looking after the child.

Let's say a family with young children has had to suddenly leave home and come to another country. The father watches the news all day and cannot sleep at night; the mother tries to behave as if everything is fine for the children but is quietly exhausted. Their six-year-old son wakes with a nightmare every night. Everyone in this family is suffering but no one can talk to the others about it. In such a situation, family members being able to share what they have been through in a way that suits their ages, and getting support if needed, can be an important part of recovery.

What You Can Do on Your Own

Coping with the effects of trauma takes time. The suggestions below are not a substitute for professional support, but they can help support a sense of safety and balance in daily life.

1. Strengthen your sense of safety. Create as regular a daily routine as possible: getting up, eating and sleeping at set times. Predictability gives reassurance to a shaken nervous system.

2. Calm your body. Slow breathing exercises can help. For example, breathe in through your nose for four seconds and breathe out slowly through your mouth for six seconds, repeating for a few minutes. Gentle walks and stretching can also reduce tension in the body.

3. Learn to come back to the present. When memories pull you into the past, you can use "grounding" techniques: count five things you can see around you, four things you can touch and three sounds you can hear. Feel your feet pressing on the floor. Tell yourself, "I am here right now, I am safe right now."

4. Limit your news consumption. Wanting to get information about the place left behind is completely natural. But constantly watching the news and scrolling through social media can increase anxiety. Looking at the news once or twice a day at set times can be a more balanced way.

5. Talk when you are ready to talk. Sharing what you have been through with someone you trust can bring relief. But no one should force you to tell it when you are not ready. Saying "I've been through very hard things and sometimes I'm still affected by them," without going into details, is also a way of sharing.

6. Stay connected. Connecting with people who have had similar experiences, community centres or support groups can ease loneliness.

7. Find small sources of meaning. Small but meaningful activities such as attending a language course, doing volunteer work, helping someone or growing a plant help rebuild a sense of control and purpose.

8. Show yourself compassion. Thoughts such as "It should be over by now" and "Why can't I pull myself together?" make healing harder. What you have been through was heavy; it is natural for healing to take time too.

9. Stay away from alcohol and substance use. Although these seem to bring relief for a short time, in the long term they affect sleep, mood and anxiety negatively.

For children: Try to keep routines, listen to them, and give answers to their questions that are age-appropriate and honest but not frightening. Make room for play and creative activities. Often give the message "I will protect you," "We are together here."

When Should You Seek Professional Support?

Intense reactions in the first weeks after traumatic events are to be expected. However, it is important to get professional support in the following situations:

• If symptoms have continued for longer than a month and are not decreasing
• If nightmares, vivid memories or intense fear are markedly disrupting your daily life
• If your sleep, appetite and energy are seriously disturbed
• If working, studying or carrying out your family responsibilities has become difficult
• If you feel emotional numbness, hopelessness or intense guilt
• If you are trying to cope with alcohol or substances
• If you see prolonged regression, fear or behaviour changes in your child
• If you have thoughts of harming yourself or ending your life

The last item is especially important. In a crisis, call the emergency number of the country you are in immediately: 112 in EU countries, 911 in the US and Canada, 999 or 112 in the UK, and 000 in Australia. Online therapy is not an emergency intervention service; in situations of serious risk, local emergency services and local psychiatric services are necessary. In many countries, mental health services for immigrants and refugees may also be available; your family doctor or social services can guide you. In necessary cases, an assessment by a psychiatrist is also important.

How Do We Work in Online Therapy in Your Mother Tongue?

Traumatic experiences are often felt most strongly in the mother tongue, and can be processed more completely when told in the mother tongue. Speaking in a second language or through an interpreter can make it harder for some people to tell what has happened. Working in your mother tongue can help a person be understood without having to explain either their words or their cultural context. You can find more information on this on the page for Turks abroad.

Working with trauma is a careful, gradual process that respects the person's pace. A Cognitive Behavioural Therapy (CBT)-based, trauma-focused approach generally follows these steps:

• Safety and stabilisation: First strengthening the sense of safety in daily life and learning emotion regulation skills such as breathing and grounding
• Psychoeducation: Understanding reactions to trauma; the person seeing that these reactions are understandable, rather than thinking "I'm losing control" or "I'm weak"
• Working with thoughts: Gently evaluating thoughts such as "It was my fault" and "No place is safe" together with their evidence
• Working with memories: Processing traumatic memories when the person is ready, within a safe framework
• Grief and meaning: Grieving for the home, the people and the life that were lost, and building a new sense of meaning and future

In online sessions, a secure connection, a quiet room where no one can hear and headphones are important. It is also useful to choose a time after which you can set aside a little time for yourself. Payment can be made online; for insurance reimbursement, you need to check the conditions in the country where you live. You can find information about how sessions work on the online therapy page.

Frequently Asked Questions

Does migration trauma go away on its own over time?

In some people, post-traumatic reactions can decrease over time in a supportive environment. But if symptoms continue for a long time or make daily life difficult, professional support can make the healing process easier. There is no need to wait for symptoms to become very severe before getting support.

Do I have to tell in detail what I have been through in therapy?

No. Work on trauma proceeds at the person's own pace. In the first stage, the focus is usually on safety and stabilisation skills. You decide what you tell, when and how much.

I am safe but still afraid. Is this normal?

Yes, this is a common situation. After the danger has passed, the mind and body can stay on alert for a while. Rebuilding the sense of safety takes time, and getting support during this process can help.

Should I tell my child what we have been through?

Children often notice that something has happened in the family. Explanations that are age-appropriate, short, honest and free of frightening details can reduce the child's anxiety about uncertainty. The most important message is that they are safe right now and that they are not alone.

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• #forced migration
• #trauma
• #loss
• #psychological support

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Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

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