8888 who had also escaped torture and persecution . In a discussion group , they spoke of the guilt and shame they felt because of what they had experienced , about human rights , about whether they could have prevented what happened to them , whether they could have made other choices , and about violence and the abuse of power .
During these conversations , Louis revealed that in the past he had struggled with suicidal thoughts . A helper told him that the municipality offered psychological support services . She said : “ If the problem is not life-threatening , but cannot wait till you contact your doctor , you can call the local emergency room by telephone . If you think there is any danger that you will injure yourself or take your life , call the official emergency number .” Louis thanked her but decided he did not need this support .
HELP AND ACTION
Louis met a woman , they became lovers and moved in together . It meant a lot to him to share his life with someone who had the same cultural background , who spoke his mother tongue .
Louis was also pleased when it became possible to start a course in the language of his new country . The refugee consultant in his municipality also put him in touch with a kind older man who could tell many stories , and they regularly went for walks . Louis began to learn about the city and its culture .
Nevertheless , he felt a lot of pain where he had been mutilated . Despite several operations , the pain continued to bother him and , worse , triggered bad memories and flashbacks . One of the helpers recommended breathing exercises which helped a little but not enough to tip the balance . Louis slept badly and became depressed and irritable . He was given painkillers , which alleviated the physical pain , but he continued to suffer mentally . A helper taught him some grounding exercises , to calm him when he was tense . One that Louis began to use regularly was called progressive muscle relaxation . He trained himself to release his tension by tensing and relaxing specific muscle groups .
Eventually Louis completed his language training and got a job . This gave him a sense of achievement . In addition , he organised a self-help group for other survivors of trauma and abuse . He was proud to be able to help others and felt better when he shared experiences with them .
3.6.3 Kumar , 61 years old , Sri Lanka . How tools help .
After being tortured in prison , Kumar struggled with several typical trauma reactions , including numbness , intrusive memories , anxiety , restlessness , difficulty concentrating , nightmares , and triggers .
Kumar
To deal with these trauma reactions , the helper can :
• Provide information about using the Istanbul Protocol examination to document injuries .
• Provide psychoeducation .
• Discuss the ‘ minefield ’ metaphor .
• Teach grounding exercises .
• Explain the window of tolerance and teach techniques for staying within it .
• Understanding and building trust
• Acknowledge Kumar ’ s pain .