March 3, 2024

Tala Jarjour: That Syria has seen a series of catastrophic events over the past decade is hardly news. The gradual deterioration in the quality of life has been steady, at least since 2012, if not before. If the popular adage that things had to get worse before they could get better was anything to go by, then the early weeks of this winter would have borne the early signs of improvement. But they could not have been further from promising.

Instead of things moving forward, disaster hit, this time in the form of an earthquake. As the terrifying tremor moved through furniture, walls and buildings, it shook the lives of most Syrians and in many ways. The visible destruction — to city streets and entire towns — is heart-wrenching and the mutilation of human bodies is even more so. Thousands of injured people are yet to receive adequate medical care and hundreds of thousands are still sleeping rough.

The number of people affected by the earthquake is much higher than those who remain without urgent housing or medical care. The deeper and more lasting damage such a calamitous event can leave on individuals and communities is, in fact, invisible. Scars on the human psyche may or may not appear immediately, but they are every bit as dangerous as losing life and limb, and in many cases go hand in hand with material and physical loss.

In Syria, as in Turkiye, the need for help exceeds available resources. Countries around the world have pledged, sent and continue to amass aid for devastated communities. Despite the striking disparity between aid promised or sent to Turkiye and that afforded Syria, and despite parts of rural Syria remaining entirely reliant on what little they had before the earthquake, hope at least remains possible — that aid might trickle through logistical and political cracks to reach those who need it most. But one thing remains on the periphery: psychological help.

 

Until recently, the idea of psychological health involved primarily discussions of problems, being in effect about psychological ill-health. But in recent years, the idea that a positive state of mental and emotional being may be pursued or maintained has become widely accepted. A key notion in these discussions is resilience, which refers to the ability of handling stressors while regaining emotional stability after major adversity. For Syrians, who have been enduring prolonged conflict and the compounded losses it continues to cause, resilience has become essential for survival. Still, the earthquake of early February was a shock that remains difficult to process.

Life-changing events, such as natural disasters, count among major stressors that carry the potential of altering the life trajectory of an individual or a community. Their effects, unfortunately, can last a long time and in some cases persist across generations. Similarly to physical trauma, which affects the body, psychological trauma can occur as a result of major adversity.

Research on the aftermath of the 1999 earthquake in Turkiye, for example, has shown that a single event of this kind could cause long-lasting problems such as post-traumatic stress disorder, depression, anxiety and hopelessness. Psychological trauma can also be experienced from a distance. PTSD, for example, first identified with veterans of war, may affect individuals whose experience of war was not associated with physical injury. Among its characteristic features are nightmares and intrusive flashbacks.

The experience of trauma, which varies according to the circumstances that cause it, is also a major trigger for psychological problems, the negative effects of which can last a lifetime. Trauma is also known to be passed to children and grandchildren, even when the traumatic event is not recalled or retold. Recent research in neuroscience and applied psychology has shown that trauma leaves such a deep imprint on a person that it is often encoded in bodily sensations, habits and reactions that can appear to have no connection to the traumatic event. Trauma can also cause physical symptoms and illness, even when it is forgotten or erased from memory. But when the trauma is recent, appropriate interventions can minimize its long-term effects and in some cases can be crucial to future recovery.

In the case of Syria, where life and threats to it have given ample opportunity for trauma to occur and become entrenched in everyday experiences, the earthquake is only adding oil to the fire. Doctors across the country, including in Damascus, where the damage of the earthquake has been primarily psychological, are increasingly noticing somatic complaints rooted in fear. Besides psychological and psychiatric treatments, which some hospitals provide in major cities, today every doctor in Syria is doing the work of emergency responders.

One of the sinister characteristics of trauma is that it is cumulative and, when traumatic experiences pile up, they become more difficult to resolve. Few helpers working on the ground are able or equipped to deal with the immediate impact of psychological trauma. This limitation has to do with the lack of resources (for local volunteers) or with the language barrier (for foreign groups, where they exist). In this respect, the intuition of local helpers has been crucial, where their actions and words have offered survivors a deeply needed sense of recognition and some consolation.

Being seen, in psychological trauma, can have lifesaving effects. If the world is trying to help Syrians in their darkest hour, then effort to provide basic training in emergency psychological support to volunteers on the ground would be well spent. For such interventions to be consequential, the window of opportunity is short.

 

Writer: Tala Jarjour, Ph.D. (cantab), is the author of “Sense and Sadness: Syriac Chant in Aleppo.” She is Visiting Research Fellow at King’s College London and Associate Fellow at the Yale College.

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