The Psychological Impact of War Trauma on Civilians:
An International Perspective
Stanley Krippner, Ph.D., and Teresa Mendonca McIntyre, editors

II. SCOPE OF BOOK
Since the Second World War, there has been a substantial body of theoretical and empirical research literature on war trauma in combat veterans. This work has had important implications in the psychological conceptualization of trauma and its sequelae. The impact of this research has sensitized the psychological field, guiding the design of appropriate interventions for veterans and their families, with the ultimate goal being to affect policymaking. However, the literature about war trauma's effect on civilian populations has been scarce, despite the fact the civilian victims of armed conflict have increased dramatically in the past few decades (most notably in Europe and Africa). This book attempts to fill this void by gathering cutting edge research on civilian populations. The often understated demographic characteristics of age, gender, ethnic and religious groups will be revealed in the light of factors that appear to determine treatment outcomes and through exploring preventative and remedial models that have guided psychological interventions. Generally speaking, the racial, ethnic, and religious aspects of psychological services for refugees, and for civilians caught in war zones, need more visibility among mental health practitioners and health care providers.
Increasing percentages of men, women, and children are being displaced due to the world's three dozen current ethnic, religious, and political wars. (These categories overlap and, ultimately, all wars are political.) Many of these civilian victims suffer from physical, emotional, and/or sexual abuse and the resulting trauma. Furthermore, racial and ethnic violence is almost entirely a gendered phenomenon that is highly related to ideology. In the face of these daunting actualities, what can psychologists, counselors, and other practitioners do to alleviate human suffering? What kind of healing practices engender relief and sustain health? These will be the basic questions posed by the authors of the chapters in this book, most of them psychologists from various areas of specialty. Their experiences offer valuable resources for future therapeutic programs.
Health psychology is the primary orientation of the book's editors, who believe that violence needs to be conceptualized as a public health issue. In its attempts to avoid ethnocentrism, health psychology has emphasized the importance of using indigenous, traditional practices when and where such practices are appropriate. Health psychology also has taken a holistic perspective in treating the whole person as an integral aspect of a larger social and cultural context. These emphases are echoed in several chapters of this book, especially those dealing with children and adolescents traumatized by war and its aftermath.
These chapters range from a single case study to long-range programs for large groups of traumatized civilians. In addition, the book addresses the need for a community based orientation in which health psychologists, counselors, and psychotherapists are social partners. These types of alliances are fundamental to the process of reconstruction during the aftermath of war, and this need is salient across the various international contexts surveyed.
III. INTENDED AUDIENCE
This book is designed for health psychologists, counselors, psychotherapists and other mental health professionals who are working with civilian victims of ethnic and religious warfare, who plan to engage in this work, or who are administering programs in which this work needs to be done. However, the book is also designed for a larger audience composed of those readers interested in war and its traumatic effect on civilians, i.e., trauma specialists, political scientists, social workers, educators, physicians, rehabilitationists, and members of the informed lay public.
IV. EDITORS
Stanley Krippner, Ph.D., teaches at the Saybrook Graduate School and Research Center, San Francisco, California, USA.
Teresa M. McIntyre, Ph.D., teaches in the department of health psychology at the University of Minho, Lago do Paco, Braga, Portugal 4709.
Most of the chapter authors are psychologists representing various institutions.
Their names, chapter titles, and affiliations follow.
V. CONTENTS
Dedication
Acknowledgements
Foreword: Moving the Borders of Psychology to the Aid of Victims of War
Stevan E. Hobfoll

Acknowledgments
Overview: In the Wake of War
Stanley Krippner and Teresa Mendonça McIntyre
SECTION ONE: CASE STUDIES AND ASSESSMENT
Introduction
1. The Women of Afghanistan and the Freedom of Thought
Adam Fish and Rona Popal
2. Healing the Impact of Colonization, Genocide, and Racism on Indigenous Populations
Betty Bastian, Jürgen Kremer, Rauna Kuokkanen, and Patricia Vickers
Children of War: Psychosocial Sequelae of War Trauma in Angolan Adolescents
Teresa Mendonça McIntyre and Margarida Ventura
War on the Internal Self: Memory, Human Rights, and the Unification of Germany
Benina B. Gould
5. Assessing Depression Among Rwanda Survivors
Paul Bolton
Infectious Disease, HIV/AIDS, and War: Impact on Civilian Psychological Health
George M. Carter
An Asian Youth as Offender: The Legacy of the Khmer Rouge
Clay Foreman
SECTION TWO: INTERVENTION AND RECONSTRUCTION
Introduction
War and Refugee Suffering
Daryl Paulson
Self-Therapy Through Personal Writings: A Study of Holocaust Victims'
Diaries and Memoirs
Sandrine Arons
Post
Traumatic Nightmares in Kuwait Following the Iraqi Invasion
Dierdre Barrett and Jaffar Behbehani
Psychosocial Effects and Treatment of Mass Trauma Due to Socio-Political Events: The
Argentine Experience
Lucila Edelman, Daniel Kersner, Diana Kordon, and Darío Lagos
12. Cultural Art Therapy in the Treatment of War Trauma in Children and Youth:
Projects in the Former Yugoslavia
Árpád Baráth

13. Social Sources of Life: Rehabilitation in the Former Yugoslavia
Vesna Ognjenovic, Bojana Skorc, and Jovan Savic
14. Healing, Social Integration, and Community Mobilization for War-Affected Children:
A View from Angola
Michael Wessells and Carlinda Monteiro
15. Somato-Psychotherapy at the Medical Foundation in London
Michael Korzinski
16. Post-Traumatic Stress Syndrome and Related Disorders Among Civilian Victims of
Sexual Trauma and Exploitation in Southeast Asia
Glenn Graves
SECTION THREE: PREVENTION
Introduction
17. Toward a Graduate Curriculum in War Trauma Relief and Ethnopolitical
Conflict Resolution
Ron Fisher
18. Before and After Trauma: The Difference Between Prevention and Reconciliation Activities in Macedonia
Sally Broughton
19. Change Agentry in an Islamic Context
Leila F. Dane
20. Peacebuilding by Woman in Lebanon
Mary Bentley Abu-Saba
21. Legacies of Fear: Religious Repression and Resilience in Siberia
Marjorie Mandelstam Balzer
SECTION FOUR: INTEGRATIVE SUMMARIES
Introduction
22. When Society is the Victim: The Catastrophic Trauma Recovery Project
Steve Olweean
Poisoned Dissociative Containers: Dissociative Defenses in Female Victims
of War Rape
James D. Pappas
24. Challenges and Opportunities for Southeast Asian Refugee Adolescents
Roben Marvit

25. Why War? Fear is the Mother of Violence
Sheldon Solomon, Jeff Greenberg, and Tom Pyszczynski
Afterword
Jeanne Achterberg
Poem: "How Can This Be?"
John Cannon and Harrison Childers

VI. COMPETING BOOKS
No similar books appeared in a bibliographic search. We contacted Martin Seligman, former president of the American Psychological Association, a psychologist with a long-standing interest in this topic. Dr. Seligman, in his presidential address for APA, stated, "In contemporary ethnopolitical conflicts... civilian populations are the primary targets of terror.... When the worst does occur, we can train psychologists to pick up the pieces by helping people and communities heal and learn to live and trust together again." Dr. Seligman, in his letter of 20 October 1999, stated, "Your book sounds unique as far as I know. Good luck with it."
VII. PAGE ESTIMATE
There will be about two dozen chapters in our book. Our estimate is that each chapter will comprise about 15-20 pages, producing a book of about 300 to 350 pages.
VIII. PHOTOS, TABLES, FIGURES
For two or three chapters, some of the data need to be presented in tables. We have a large supply of potential photos and figures that would add interest to the book, but this is a matter for the publisher to determine, based on cost and book length.

. ADDITIONAL COMMENTS
In 1999, we co-chaired a symposium on this topic at the annual convention of the American Psychological Association. We were heartened by the response and were encouraged to prepare a book on the topic. It is our conviction that the wars fought in the early part of the 21st century have and will have ethnic and religious aspects to them. As a result, they will leave civilian victims in their wake because terror, "ethnic cleansing," and "ideological purity" are part and parcel of these conflicts. As a result, health psychologists and mental health practitioners are (and will be) needed to treat the traumatized children, adolescents, and adults who are injured in these wars. This book intends to make a contribution toward the preparation of these practitioners, and to alert its readers to the problems, their treatments, and - hopefully - their prevention.
After reading the draft chapters of this book, we received this letter from Dr. Marc

Pilisuk, former president of Division 48 (Peace Psychology) of the American
Psychological Association:
Something has happened, within the lifetime of those born after the 1920s, regarding the human capacity to kill large numbers of people, to disrupt entire communities through organized acts of violence, and to wage war against civilians. We have left major portions of the world's populations scarred by these events, barely able to understand or collective inhumanity and sometimes frozen in our ability to respond. But whatever we choose to do or not to do with the survivors and refugees will make a major difference as to their well being and our own. Healing is profound and difficult undertaking. The approaches are as varied as the circumstances under which the victims described in this book were devastated, but the compassion and reflection in each chapter is remarkable. Krippner and McIntyre's book covers the range of most of the effective procedures used to treat the traumas of war. With healing comes the hope that the future need not repeat the horrors of the past. This collection is essential reading for those who would hope to understand how we can reweave humanity from the ravages of contemporary conflict. Marc Pilisuk, Ph.D.

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