“What happened to you?” asked the psychologist
“They raped me” Said the UNHCR male registration officer in a soft and exaggerated feminine voice, and everyone started laughing.
The psychologist carried on with the simulation anyway, playing the role of the humanitarian caregiver responsible for providing psychological support during crisis. He started asking questions in an acceleratedpace: “How old are you? When did it happen? Tell me exactly what happened to you? How did you go back home afterwards? Did they attack you? How many were they? What time did it happened? What did they do to you first? What did they do next? How did you feel? Did you feel terrified? Did you try to resist them?” The registration officer answered the questions in a similar pace.
“This is Debriefing”, declared the psychologist after the simulation was over.“It is making people who went through a violent event relive the experience and get it out of their system by talking about it. It is not efficient because it makes them relive the trauma. We have the tendency to rely on intrusive questions to dig deeper and bring things to the surface. We use this a lot here in Lebanon.”
The psychologist continued his explanation by comparing the psychological distress caused by rape to a wound:
“Let us compare it (the rape) to a wound, to a wounded person. I come and tell him: “are you wounded? Show me your wound” so he shows it to me and I ask him ‘tell me again how it felt’. let’s say I was wounded in my arm here and that the wound healed. I felt at one point that I am able to come tell you about the wound and tell you that ten years ago, five years ago, or a year ago, my hand was wounded and they stitched it, they took me to the hospital, they gave me a vaccination needle and it was okay, it went well. And this is the thin line between Psychological First Aid (PFA) and Debriefing. When someone is ready to talk, he will talk. In PFA it is important to let the person talk. I could have tried to see if the woman (in the simulation) is hungry, thirsty, to satisfy her basic needs before asking her (about the rape). Think of it as a wound, (in Debriefing we say) show me your wound, open it up again and tell me how you felt. Psychological First Aid is not intrusive like Debriefing.”
The simulation described above was part of a three day training on psychological aid for different humanitarian workers around the end of 2012, in a region in Akkar where Syrian displaced communities arrived to seek shelter. The psychologist used this exaggerated simulation to make a distinction between Debriefing and Psychological First Aid (PFA), two global packages of psychological aid that aim to immediately attend for psychological distresses emerging from exposure to violent events. While both packages circulate within humanitarian workers and the communities they assist, Debriefing seems to most capture the popular imaginary of what an emergency humanitarian psychological aid looks like, one that relies on a recitation and a retelling of the traumatic event immediately after it happens. An interventionist model influenced by the intersection of talk therapies, FBI debriefing and psychological disorders of soldiers during war (like Shell Shock and Post Traumatic Stress Disorder), Debriefing has been found to be inefficient, invasive and sometimes causing harm to the individuals and communities it seeks to treat. Both military/security and psychological interrogation techniques inform Debriefing, which aim to heal psychological wounds is caused by violence through immediate and probed narration.
In recent years, Psychological First Aid (PFA) has become the most accepted emergency response intervention to support survivors’ immediate mental health needs by focusing on the victims’ basic needs, rather than interrogating them on the violence they experienced. The model was first promoted as a way to provide psychological relief for military personnel, when expert intervention was impossible or impractical, but was then recommended for use for civilians in war and disaster, as well as any experienced violence. Designed as a less invasive psychological aid technique than Debriefing, PFA offers overall support and assistance through focusing on satisfying the basic needs of the psychologically troubled person.
Rape was evoked in the simulation to show the problems of using Debriefing and how invasive it was. However, the training on PFA soon became a site for debating the ways UNHCR officers could see and tell violence through the psychic wounds of Syrian women exposed to sexual violence and rape. By the end 2012, media and humanitarian reports were highlighting the increasing cases of sexual violence and rape that led many families and communities to flee Syria to Lebanon, sometimes calling the conflict “Syria’s rape crisis”. Identifying women suffering from rape and gender-based violence became a main humanitarian target, not only for medical-reproductive and psychological care, but also for identifying sexually vulnerable victims as the quintessential innocent refugee, through detecting psychological injuries and wounds (The cases of sexual violence experienced by Syrian women in Lebanon and the trading of sex for aid have had some media attention, but have not produced similar urgent humanitarian care, or classification of victimhood). This is crucial for UNHCR, as this article will show, not just for figuring out what care to attribute to the Syrian women, but for achieving a bureaucratized indicator of a ‘true form of victimhood’.
UNHCR special envoy Angelina Jolie, co-founder of the Preventing Sexual Violence Initiative and the global campaign against sexual violence in conflict, meets with a Syrian refugee women in Lebanon
The UNHCR registration & protection officers had requested a psychological training to help them in seeing and telling violence by detecting markers of psychological injuries left by rape and sexual violence. The primary concern they had, and their primary role as registration officers, was to fill the UNHCR questionnaire used to identify and separate victims from non-victims, suffering bodies from bodies of combatants and fighters. As one UNHCR officer remarked, Syrian combatants who engaged in any kind of armed conflict cannot be refugees or victims and therefore should not be registered by UNHCR.
This separation of victim/non-victim required a specific form of interview and interrogation of Syrian men and women around violent events they were exposed to. Psychological injuries were assumed to be an indicator of true victimhood, while sexual violence became a specific form of suffering that enabled an acknowledgement of Syrian bodies as genuine and innocent victims. The role of the registration officers was to figure out whether the displaced Syrians were lying or were truthful about their injuries, a form of telling that became trickier when looking for invisible wounds of war like the psychological scars resulting from sexual violence or rape.
Like one UNHCR registration officer said during the training: “I need to know and have the techniques, so that I know what to write in the claim”. This officer was acquainted with the published reports on cases of rape in Syria, but she was registering people for three months now without catching a case so far: “It is not normal that I don’t find raped women. They don’t say ‘we are raped’. It is not normal. It is the culture ( it is the culture that prevents them from disclosing rape to UNHCR registration officers)” The UNHCR officer here wondered: how can she know what right question to ask? How can she surpass the cultural barriers in order to see the true suffering of the Syrian woman?
UNHCR officers saw the act of “digging deeper” (both a psychological and a security-interrogation technique) into the narrative of suffering of Syrian women as the only way to constitute them as true victims, a technique used by Debriefing that the psychologist declared was invasive and somewhat unethical.Becoming more uncomfortable with the debate around PFA and how to detect sexual violence, the psychologist asserted that it is not the role of humanitarian workers to ask invasive questions about sexual violence. Even psychologists would not seek to ‘know’ whether someone has been raped or not, some people might never disclose this information in therapy, he added, or they might talk about it years after.
Still, the UNHCR officers needed to know. Both to refer the case for proper care, but primarily to file a refugee claim based on sexual and gender-based violence, where women suffering from sexual violence were becoming an important humanitarian category of, embodying “the model subjects of aid”. On the other hand, the psychologist explained that most people engaged in conflict situations have ‘suffered’ one way or another. PFA therefore can be applied to everyone during conflict, without the need to ‘know’ and “detect” one’s specific psychological wound. However, attending to and caring for a generalized understanding of suffering experienced by all parties during conflict was not possible or applicable through UNHCR’s bureaucratic framing of suffering, which relied on specific indicators, variables and information required in order to establish victimhood. What became the center of the debate between the officers and the psychologist during the training was the depth and nature of the biological and psychological data collected about the Syrian refugee. The psychologist argued that ‘knowing’ through psychic data is invasive but also unnecessary since the main purpose is to psychological support the community. The registration officers explained that collecting the most accurate data possible about the Syrian body is crucial for telling the true nature of her suffering, and hence turning her into a refugee.
While PFA as an emergency humanitarian psychological aid was less intrusive than debriefing, the UNHCR questionnaire and the registration interview are highly intrusive by nature, aiming to dig deeper to see whether truth is being told through the Syrian’s narrative of her suffering, and to identify victims. The need to ‘dig deeper’ stemmed from the need to get as much accurate biometric and psychic data from the Syrian body as possible because “sometimes they lie and we need to find out who lies and who does not”
PFA does not allow for psychic wounds of war and conflict to surface and be readable and registrable by experts. It does not allow for a “digging deeper” that normally happens in a psychological or humanitarian interview. This put the UNHCR registration officers in a pickle. In order for them to distinguish between victim and non-victim during the registration interview, they had to identify wounds of war that can produce Syrians into victims and refugees, separating them from those who took part in the conflict, regardless fighting in Syria was for political reasons, self-defense, a rebellion, a better life, etc. Women suffering from rape became the quintessential humanitarian victim that can easily be categorized as victim and refugee, and this a coveted category once detected because of the true suffering it exhibited. Heteronormative men are much harder to get this categorization of true victimhood. Sexual violence constituted one of the easiest way to identify a victim, because it also propagated the image of the suffering distant, “the poster-child of humanitarian aid” other in the way it was imagined by humanitarianism’s definition of suffering. Knowing which women were raped and which we not was crucial to categorizing Syrian bodies as those who have suffered and those who have not.
Humanitarian psychological packages of aid, originally designed for the sake of helping and support violence-affected communities, are also used to generate psychic information about the nature and truthfulness of suffering. Specific forms of violence, like rape, have refocused the violence experienced into the medico-psychological realm, making it a “treatable” form of suffering, thereby detaching it from the politics of war-making, patriarchal regimes, structural inequalities and state violence.
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 Miriam Ticktin. 2011. The gendered human of humanitarianism: medicalizing and politicizing sexual violence, Gender & History, 23 (2): pp.250-265
 Miriam Ticktin. 2011. The gendered human of humanitarianism: medicalizing and politicizing sexual violence, Gender & History, 23 (2): pp. 251