First and foremost, the clinician treating survivors of trauma must remember that a medical and/or psychiatric diagnosis is a “call to action.” This call to action may not only be to “heal” the patient or to help the patient “recover” from their trauma and related illnesses. It may also be to prevent the patient from experiencing any more violence; to provide forensic testimony in court to prove that an asylum seeker has been tortured; or to help a victim of terrorism receive compensation and legal redress.
Diagnosis demands action whether the patient is a civilian or a soldier; a refugee, an internally displaced person, or an asylum seeker; a torture survivor or a victim of terrorism. Differences in the clinical care of these groups are more theoretical than real. Each of these categories describes persons and communities that have experienced extreme violence, often including horrific acts of human cruelty. Because of this, considerable overlap exists between the traumatic life experiences of each group. For example, many refugees have survived torture, and many internally displaced persons are de facto refugees although they have not crossed over from their country of origin into another country.
Understanding the legal and political definition of each traumatized group is important, because international and national laws and covenants often dictate the human rights, protection, and humanitarian assistance that should and can be provided to the survivor. For example, an asylum seeker suffering from torture may have no legal right to health care in the United States. The clinician in each and every situation must understand the international and national laws affecting their patients.
Yet whatever the patients’ legal or political status, the principles of treatment remain the same.