Jul 18, 2017 — It’s a topic many U.S. citizens don’t think about—treating the psychological needs of refugees. The trauma that so many refugees suffer does not go away when they reach their new country. In fact, refugees are faced with many new traumas as they adjust to a new culture. Dr. Omar Reda, a refugee himself, is a psychiatrist specializing in treating refugee trauma. Dr. Reda shares his personal journey as a refugee, the unique traumas that refugees face and how to help ease these tensions.

Interview

Interviewer: Helping asylum seeking refugees deal with trauma so they can better integrate into their new communities, we'll talk about that next on The Scope.

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Interviewer: Often when refugees make it to the United States, they've been through a lot before that, and I think a lot of us here at that point think, "They've made it." To some extent, they are safer in their new environment, but they still have a lot to process, especially the trauma that followed them to their new country.

Dr. Omar Reda is a board certified psychiatrist and a refugee trauma expert, and he's also a refugee himself with quite an incredible story. He was a doctor in Libya. His friends became a little bit more politically active. As a result, they and later he found out that he was on Muammar Gaddafi's hit list. His father had found that information out through sort of his own sources and came to his son one day with a handful of cash and said, "You need to leave." He had about five minutes to say goodbye. And eventually, he ended up in the United States of America.

Always wanted to be a psychiatrist, but in your own country, there were no jobs to do that. You were an emergency room physician instead. But when you came here, you got your psychiatry degree. You went to Harvard. You learned more about refugee trauma treatment, and that's what you do now. Welcome, it's a pleasure and a privilege to talk to you.

Dr. Reda: Thank you, the pleasure is mine.

Interviewer: So today, I'd like our audience to better understand what's been described as the "tangled web of trauma" that refugees come from. I'd also like to find out how we would help them deal with that trauma and then, ultimately, better understand how they would integrate into our communities better. So first, if you could briefly paint a picture of what it's like to be a refugee forced to leave your country and come here. What kind of trauma are those individuals dealing with?

Dr. Reda: So many people think coming to a new country is the end of the story. It's usually the beginning because you lose your psychosocial support network that you left behind, and you might face lots of struggles in the new culture, trying to learn a new language and pursue a dream. Many people, they try their best. They work very hard to master the language and maybe navigate the job industry. Many of them, unfortunately, they pursue the American dream and they lose the American dream chasing it, because they will provide materialistically for their families but they will not be available emotionally.

Wounds, the invisible scars of a trauma and war, they go from one generation to another if we don't early intervene and try to come up with preventions. So our youth can be very vulnerable. So I have this little boy and he was extremely anxious, and we found out the reason was because his father was leaving 6:00 in the morning, coming home at 12:00 midnight, seven days a week. And the boy does not have any quality time to spend with his dad.

When we sat down with him and we try to educate the importance of taking care of your family's emotional needs, he said, "What you trying to advocate here is wonderful, but I don't have that luxury. I'm trying to work two jobs. I'm trying to master the language and obtain a Green Card and provide for my family." So this is a very sad dynamic that we see in lots of refugee families that come here.

Also, leaving behind your loved ones and worrying about them, especially the trauma and the war zone, for example, I come from Benghazi, Libya, but I worry about my family every day. There are lots of drama and traumatic experiences that they go through. So there is a lot of stress when it comes to people worrying about the safety of their loved ones. Yes, we are safe here but, in a way, a piece of your heart is left behind.

Interviewer: And that's fascinating because you didn't even really touch on the trauma that may have been occurred in their country as a result of being in a war zone or constantly in danger which adds to what you just explained.

Dr. Reda: Some people come because of choice, some come by chance, and others come by a forced choice. People think, just coming to safety here means that everything that you went through is going to be okay, and maybe now you have the trauma behind you. If you are dealing with PTSD, the post-traumatic stress disorder, and that disorder, many people argue, can actually cause lots of dysfunction in your inter and intrapersonal relationships.

So you might be struggling with your own symptoms but also you can relive the trauma, either in your dreams, or in the flashbacks during the day, and maybe even become more irritable and take your anger on your loved ones. So yes, I mean, I'm not dismissing the trauma that people went through in their own homes, but if we make the system very difficult . . . I come across some of the refugees who, they say, "Maybe staying in Syria was a better decision. Maybe if I am in the Jordanian camp, I still have brothers and sisters and friends and still we will have my language and my culture."

So I mean, many American citizens are wonderfully accepting to the newcomers, our new neighbors, but if we treat them with suspicion and we think that everybody is a potential terrorist, then there is another re-trauma that happens on a daily basis.

Interviewer: Explain to me the model that you use in Oregon to help refugees start to untangle this. It's actually called "untangled."

Dr. Reda: Yes.

Interviewer: It's a program. So explain to me what that is and what you ultimately hope to accomplish with it.

Dr. Reda: Yes, I mean it's a dream of mine to have it as a model of care that's recognized. So I'm working on trying to fund it and also test it so we have an evidence-based support for this model of care. But mainly, we work on psychoeducation a lot. So we try to educate the newcomers that there is nothing wrong about expressing your emotions, talking about your basic needs, and especially the emotional needs.

Many of them, they come from culture that dismisses that. There's lots of stigma. And the mental health clinic that we offer for free one Saturday a month, and we see people when they are quite advanced in their either psychosis or suicidal thoughts or the dysfunction that they go through, and that's very unfortunate. They will traditional healers, they will talk to their local Imams, and eventually, somebody will tell them, "Just go, you aren't really struggling." They come to us at a very advanced stage, and that's a shame.

So I have been doing seminars and workshops on parenting, on marriage and Islam, on how to take care of your youth and empower them, and then just trying to use tools that they bring from their culture, from their religion and try to build on that. So it's quite strength based and solution focused in the here and now, touching on the trauma story. Many of the interventions they shy away from the trauma story because it's painful for me, the listener, or the therapist and that's not fair for the survival of my client because they deserve, when they are ready to tell their trauma story, to have somebody who's ready to listen to it. So psychoeducation is a big one.

Then, we try to build team capacities, so we do lots of training the trainers. We try to establish relationship with the local organizations that are interfaith and also the suicide hotline, for example. And we try to do support groups for newcomers, so we bring our new neighbors and we try to mix them with other neighbors and people who have been in the country for like five years or ten years and people who are born and raised here, and we do panel discussions.

And we see what's the experience of a new refugee, what's the experience for somebody who had been here for a decade or so, and the experience of somebody who's born and raised in America. So just an eye opener how much diversity and strength we try to build, and people come with lots of resilience. Yes, refugees are usually vulnerable but their trauma story makes them or breaks them. And many of them are quite resilient.

Interviewer: Help me as just an individual. If I come in contact with a refugee family, whether they move in my neighborhood or go to my church or start a job at my workplace, how could I be empathetic and help or shouldn't I. I mean, shouldn't I reach out. I mean, I don't know what I should do. What would be considered proper?

Dr. Reda: I mean, humanity has no barriers, so we don't have a language barrier or religious or cultural barriers. If you are genuine and if you are compassionate, people will appreciate that regardless even if they don't understand a word of what you are saying. So if you don't treat everybody as a potential criminal and in some cases, especially with a Syrian refugee had been, "You are potential terrorist." Or, "You have links to ISIS and stuff like that."

So if we just try to say, "These people went through an exhaustive and extensive venting process because at least, 20 steps before you enter the country." Then, we try to just bring, "Let me try to learn something about you."; I think, it doesn't matter who starts the first "hi" as long as we open that bridge of communication and try to start the process of reconciliation and maybe not paint all religion with a single brush or every culture. We try to generalize.

Of course, it's not fair for people to run away from trauma to be stuck in another trauma. It is wonderful to reach out to people and understand that all of us are refugees. Everybody came from somewhere else. And eventually, all of us are brothers and sisters. We have Adam and Eve as our father and mother. So I hope people will just put the differences behind their back and treat each other with dignity and integrity and know that we are in this together. We either stand united as brothers or fall as fools.

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