Abstract
Broken spirits is one of those books that should be read by everyone involved in mental health care. As the editors state in the Preface this a book about our world and ‘the crevices of society where asylum seekers and refugees existed’. Unfortunately, within Australia in recent years we have created particularly deep and inhospitable crevices which are actually breeding-grounds for mental disorder, breeding-grounds which are being increasingly exposed. The book is also about ‘these disenfranchised people whose life is dominated on a daily basis by fear, shame, guilt and terrorised by nightmares flashbacks or unwanted memories of painful life threatening experiences that they have been through’ – a timely and timeless topic. It is terrific to see that Australian psychiatrists, notably Professor Derrick Silove, Dr Michael Dudley, Professor Beverley Raphael, Professor Sandy McFarlane, Dr Louis Newman and Dr Zachary Steel have been major contributors to this volume. All have been active contributors and advocates for this area of mental health care.
The book is a great resource and is divided into several sections. The first deals with theoretical conceptual and sociocultural aspects, and several of these chapters are extremely important in understanding the nature of trauma, torture and the refugee experience. The second section focuses upon the effects of trauma upon the self, hence the title Broken spirits. Some of this material might seem arcane but we are dealing with extremely powerful and deep psychological issues in this field and it is worthwhile exploring these to the fullest extent.
Part three of the book deals with treatment of posttraumatic syndromes and each of the key elements of treatment is focused upon. The first chapter in this section ‘creating a safe therapeutic sanctuary’ is exactly what we have failed to do in Australia in recent times in response to these issues.
Part four goes on to describe some of the more creative and experiential therapies and will be of benefit to more conventionally trained therapists in understanding how alternative and lateral approaches can be extremely helpful to trauma survivors. Particularly interesting was the chapter on body psychotherapy with survivors of torture, in which the body, the instrument through which psychological as well as physical damage is inflicted, becomes the focus of both physical and mental therapy. The latter section deals with special populations, developmental issues and drug and physical forms of treatment.
The final section deals with legal, moral and political issues and here, arguably the most powerful chapter in the book, an Australian perspective is featured. This is about the politics of asylum and immigration detention and is written by Zachary Steel and colleagues. This catalogues the experiences in Australia and from this derives broader principles from a moral and ethically point of view. This work requires a high level of advocacy as well as a clinical focus, something which has general applicability to other areas of psychiatry but is most necessary in this area of working with trauma survivors, particularly in adverse and persecutory environments such as we live in today. In conclusion, I whole-heartedly recommend this book to all mental health and health professionals in Australia and New Zealand. There is a great deal of experience, wisdom and courage contained within its pages.