Psychology Department, Université du Québec à Montréal, Montreal, Canada.
Sherpa Research Centre, Montreal, Canada.
J Trauma Stress. 2019 Apr;32(2):186-195. doi: 10.1002/jts.22400. Epub 2019 Apr 1.
Although working with trauma survivors can be a source of both deleterious and positive transformations in mental health professionals, little is known about the experience of clinicians in shared traumatic contexts, particularly in the Global South, where most humanitarian crises occur. In collective disasters or armed conflicts, the personal and professional experiences of mental health staff inform each other, situating the clinical space at the intersection between singular and collective spheres. Drawing on an intersubjective and socioecological perspective, this qualitative study explored the ways in which working in a shared traumatic context affected mental health and psychosocial staff in postearthquake Haiti. We interviewed 22 local mental health workers in the capital, Port-au-Prince, 2.5 years after the 2010 disaster. We coded and thematically analyzed interviews using an iterative process, based on grounded theory principles. Thematic analysis uncovered four dynamic poles in clinicians' narratives: balancing duty and desire to help, experiencing fragility and strength, negotiating separation and connection, and sharing hurt and hope. Our findings suggest clinicians considered their work mainly as a source of strength in the face of adversity, whereas experiences of trauma and growth transmissions were mutual and intimately intertwined. We discuss the complexities of clinical work in shared traumatic settings as well as the dynamic interplay between professionals' experiences of suffering and growth. We conclude with recommendations on ways to involve local mental health clinicians in postdisaster contexts while addressing the special needs that they may have to process their own trauma.
尽管与创伤幸存者合作可能会给心理健康专业人员带来精神健康的有害和积极的转变，但对于临床医生在共同创伤背景下的体验，特别是在人道主义危机发生最多的全球南方，却知之甚少。在集体灾难或武装冲突中，心理健康工作人员的个人和专业经验相互影响，使临床空间处于个体和集体领域的交叉点。本定性研究从主体间和社会生态学的角度出发，探讨了在共同创伤背景下工作如何影响海地地震后的心理健康和心理社会工作人员。我们在 2010 年灾难发生 2.5 年后，在首都太子港采访了 22 名当地心理健康工作者。我们根据扎根理论原则，通过迭代过程对访谈进行编码和主题分析。主题分析揭示了临床医生叙述中的四个动态极点：平衡责任和帮助他人的愿望，体验脆弱和力量，协商分离和联系，以及分享伤害和希望。我们的研究结果表明，临床医生认为他们的工作主要是面对逆境的力量源泉，而创伤和成长的传递经历是相互的，并且紧密交织在一起。我们讨论了共同创伤环境中临床工作的复杂性，以及专业人员的痛苦和成长经历之间的动态相互作用。最后，我们提出了一些建议，即在解决他们可能需要处理自己创伤的特殊需求的同时，让当地心理健康临床医生参与灾后环境。
