'Grief that has no vent in tears, makes other organs weep.'1 Seeking refuge from trauma in the medical setting

摘要

This paper will look at work carried out with asylum-seeking families and children within a hospital paediatric setting, exploring theories that can help us to understand how highly traumatic experiences, emotionally and cognitively unprocessed, may become expressed bodily. The case examples will show how these shattered and dislocated patients experience a range of physical symptoms from symbolic conversion manifestations to foreclosure of unthinkable and terrorising experiences displaced into the body. In the latter cases, there are particularly powerful and intergenerational effects upon the family as a whole, as the family becomes organised around physical symptomatology that covers 'holes' created by the trauma in their sense of 'going on being' as both individuals and as a family. These families can become over invested or hypercathect the physical fragility of children born into this matrix of trauma. The aim of this paper will be to draw upon psychoanalytic ideas in relation to psychosomatic symptoms, including Freud, Winnicott and Joyce McDougall amongst others and to try and integrate these ideas to some extent with both neurobiological understanding of the bodily aspects of feeling and emotion, as well as important anthropological understanding of identity in a cultural context.