Norse know-how

In the last of our articles on winners of the Isabel Schwarz Fellowship Award, Marian McHugh tells Natalie Valios about her visit to two Danish centres for traumatised refugees

When research revealed that Denmark was the best place for Marian McHugh to learn more about helping traumatised women form secure relationships with their children, she had no hesitation in applying for the Isabel Schwarz travel fellowship.

McHugh is practice development manager for Family Welfare Association Newpin, which provides a parenting support programme to main carers, normally mothers, and children under five. Her particular focus is working with parents with mental health issues, which range from post-natal depression to bipolar disorder.

“The Newpin model has an attachment-based focus, so we look at the attachment pattern between the parent and the child,” she says. “The aim is to provide a secure base to help the parent and child have a stable relationship.”

Referrals come from child and adolescent mental health services, community mental health teams, GPs or are self-referrals. The organisation works with parents for about two years and most of the work is done through group discussion.

McHugh saw that an increasing number of women being referred to the organisation’s six centres in London had been displaced from countries such as Angola, Kosovo and Uganda. After surviving conflict and brutality they were now left holding the family together after resettling in London and were finding it hard to attach to their children.

“I read information from organisations like Unicef and the United Nations that said that about 80 per cent of displaced people are women and children, because a lot of the men are killed in conflicts. So women are left to carry on and look after the children.”

McHugh wanted to find out more about working with this group of mothers. “It was difficult for them to talk about their experiences within a group. They block out their history, which means blocking out their child, so how do we work with that? You can’t say ‘you need to talk about what has happened’.”

Conversely, it was obvious to McHugh that the women wanted a strong relationship with their children. “Their attachment to their country and relatives has been broken. One woman had every member of her family killed in Rwanda except her child, so that relationship was important and poignant to her.”

During research into how to help these women, McHugh came across the work of the International Rehabilitation Council for Torture Victims (IRCT). This worldwide organisation works with people who have been displaced and tortured, and is a pioneer of psychosocial work. Its birthplace was Denmark and so McHugh determined to visit two centres there run by the IRCT.

At Horsens, in eastern Denmark, the Four-D Rehabilitation and Integration Centre works with refugees, asylum seekers and people who have been displaced. “I wanted to see how they work with that level of trauma, how they get people to talk and help it come to the surface so that it can be worked with,” says McHugh.

The first thing she noticed when she arrived was the level of funding for the centre, which was evident everywhere. The staff room had a beautiful table that everyone sat round to discuss issues and when McHugh asked about it she was told it was designed by architects -“I’m not used to things like that,” she says.

The amenities for users were even better -a quiet room, beautifully decorated using a colour specialist to ensure everything had a calming effect from the wall colours to the soft material and soothing colours of the furniture. There was a room with special lamps for those affected by seasonal affective disorder, a cafe serving food, and users’ artwork was framed and on display all round the centre. “It set a scene, it was all very valuing,” she says.

The centre had several translators to work with people in their own language. A multi-disciplinary team with a clinical psychologist works at the centre and there is group and individual work to deal with trauma. For McHugh, the most interesting work was done by the physiotherapist working with clients’ “embodied trauma”.

“There was a room geared towards working physically with people. If it is difficult to talk about trauma then it gets stored in the body and the work there emphasised physically calming people down through breathing exercises. Because they are traumatised they are hyper alert, waiting for something to happen, so they help them relax the nervous system so that they feel ready to talk.

“Lots of women attending the centre had been raped and they were often compliant with what staff asked them to do. It was important when working with them to give them choices.”

After this visit, McHugh travelled two hours to Copenhagen to visit the Rehabilitation and Research Centre for Torture Victims. It works with parents and children. “They speak to children about their experiences and ask them about their memories, what happened to them, so that they are given permission to talk about it.”

It was McHugh’s first trip to Denmark. “It seemed an affluent country and it was hard to see what the problems might be. In the past the government has been liberal and the country has offered refuge, but it is becoming more conservative.”

McHugh has returned with a different perspective on dealing with trauma. She is considering giving more emphasis to involving children in the work done by Family Welfare Association Newpin. Although she was already aware of the importance of allowing people time and space for mourning, the trip has re-emphasised the importance of providing a place for people to talk about what has happened at their own pace and working individually with women as well as within groups.

She also has a better understanding of the physical impact that trauma has on people. “I don’t think we have the expertise they do, but sessional work with yoga would be a good start. It is quite easy for that side to be left out, but it’s important.”