How Can the Human Soul Survive Atrocity?

I was struggling to find a topic for this last blog post until I came across an incredibly powerful piece on mental health in Iraq. The article follows the work done by psychologist Jan Kizilhan, a psychologist interested in treating people who have experienced extreme trauma, focusing specifically on religious minority groups. This article details the horrors of people displaced and imprisoned by ISIS. Their stories are told and pictures of the children these stories tell of are shown throughout, giving the reader a better connection to the story.

Some of the ideas presented in the article related to the research done by Michael Fanselow. Fanselow studies stress enhanced fear learning (SEFL) and the biological mechanisms involved in the formation of disorders like PTSD. Many studies have shown that the neural circuits related to fear conditioning and response are incredibly complex and interconnected so that our body is able to quickly respond to what is perceived as an immediate threat. In cases of PTSD, these responses are easily triggered, even by non-threatening stimuli.

Iraq has been involved in horrific wars for decades. One of the countries current battles it between minority religious groups and ISIS. ISIS raids towns and enslaves these people in camps where they are tortured and turned to sex slaves. Many of the stories told by Kizilhan are of children who were raised in these unstable and honestly unbelievable situations. Imagine being taken from your home and tortured almost every day of your life. Your body is learning this fear and equipping itself to respond because it is likely that this event will happen again. But what happens when you are finally released?

Kizilhan shares the stories of multiple people, often women who were sexually abused, that use dissociation as a response to stressors. Unfortunately for some of these people there are many stressors that can lead to this dissociation response, leading one woman to faint nearly 20 times a day. These women describe imagining they are somewhere else where they would never have to experience trauma ever again. Even the simplest reminder of the horrors that they lived through causes their worn-down bodies to completely shut down.

While Fanselow has done remarkable work in discovering the neural circuits involved in fear learning and ways to target those circuits, he does recognize that realistically can only do so much for someone suffering from PTSD, especially with cases as severe as these Iraqi people. It is important to treat both associative and non-associative components of SEFL. The treatment of extreme anxiety disorders requires a complex combination of therapies to allow the brain to recognize what is real danger and when to respond.

Kizilhan has been working to find ways to help these Iraqi survivors to have a life again. He is starting by teaching in the first psychology program in an Iraqi university. In Iraq there are currently less than 150 psychiatrists and less than 75 social workers. These numbers are nothing compared to the amount of people who have experiences extreme trauma. Kizilhan is also constantly evolving his behavioral treatment methods as each new patient gives him more insight to the complexity of disorders like PTSD. He is currently working with narrative exposure therapy, asking patients to recall events even of their early childhood, before invasions happened. If the work done by Fanselow could somehow be incorporated with the work done by psychologists like Kizilhan, we could crack into a complex and dynamic approach to helping people continue to be survivors of the worst possible traumatic events.

Fanselow, M.S. (2016). “Induction and expression of fear and sensitization cause by acute traumatic stress.” Neuropsychopharmacology, 41, 45-57. PMC4677128.

Percy, J. (2019, October 31). How Does the Human Soul Survive Atrocity? Retrieved from https://www.nytimes.com/interactive/2019/10/31/magazine/iraq-mental-health.html.