Trauma

It is estimated that more than 3,700 people died and around 50,000 were maimed and injured during the conflict in Northern Ireland, with each fatality and injury comparable to “a heavy stone dropped into a pool of water, with ripples extending far and wide” (We Will Remember Them: Report of the Northern Ireland Victims Commissioner (1998)). The physical destruction of the violence was instantaneous, quantifiable in lives lost and injured, but the trauma left in the lives of those who lost loved ones, survived injury or witnessed tragedy has been far-reaching and mostly invisible. A World Mental Health survey found that Northern Ireland has the highest recorded rate of post-traumatic stress disorder (PTSD) of any studied country in the world, with 39% of the population having experienced conflict-related traumatic events. The legacy of a violent past has meant that trauma has greatly affected the physical, psychological, social and political needs of the Northern Irish population. David Bolton, the founding director of the Northern Ireland Centre for Trauma and Transformation, writes that without addressing these needs, those struggling are left in “a no-man’s land between the past and the emerging future with nowhere to go back to yet feeling unable to go forward — surviving victims of the conflict become, also, victims of the peace.”

Normalisation

Traumatic events are defined in a 2011 report prepared for the Commission for Victims and Survivors as “experiences that are highly unusual, unexpected or overwhelming, and on experiencing them a person may have a deep sense of powerlessness or helplessness or may strongly believe that they, or others around them, are going to die.” Northern Ireland saw over 35,000 shootings and over 16,000 bombings from 1963 to 2003, with many losing their lives and suffering injury as a result of these events and others throughout the conflict. For some, the experiences of violence alone are not as distressing as the secondary events, the moments spent in “an A&E department, or [when] a police officer calls at the house to bring bad news, or the visit to the mortuary to identify a family member or friend”. The psychological impact of these events can appear immediately or many years later, in the form of depression, anxiety, PTSD or a phobia of leaving the house or dying (WAVE, 2012). Those affected may develop a drug or alcohol dependence, struggle with social isolation or find it difficult to achieve the same quality of life as before (WAVE, 2012). During the Troubles, people lived in a state of stress as the threat of violence became part of their everyday lives. Professor John Brewer calls it the “brutalisation of everyday life”, where even in peace, the world around those affected by the Troubles is dictated by the consequences of trauma. This is seen in a desensitisation to violence, higher degrees of domestic abuse, poor physical and mental health, addictions and higher rates of suicide and depression. In 2020, the suicide rate of Northern Ireland is twice that of England and is among the highest 15 in the world. Since the signing of the Good Friday Agreement two decades ago, the rate of suicide in the region has doubled. Such statistics show that, as Catherine Doyle writes for Shared Future News, “war does not end with peace, but continues with shell-shocked survivors, who relive the violence in flashbacks and nightmares.”

Transgenerational

Trauma reverberates through Northern Irish society, and can potentially impact even the children of those who experienced the Troubles. Called “transgenerational trauma”, the negative mental health impacts of a traumatic event can be passed on from parent to child through bonding, behaviour or biology. As a result of transgenerational trauma, behavioural issues or anxiety symptoms may develop as a result of uncertainty and fear about the past. A report by Queen’s University Belfast discusses a “culture of silence” that is passed from generation to generation. “Sometimes parents choose not to share their memories about a trauma so as not to expose their children to it,” the study says, “therefore, to avoid the parent having to relive the trauma, the child does not ask.” Staying silent about trauma is a way to cope, and to protect others from being traumatised. When this silence becomes part of the culture of a society, then people may be less likely to seek treatment, and children may develop symptoms of trauma such as desensitisation to violence and anxiety.

Measuring the costs

The impact of psychological trauma on life in Northern Ireland is not isolated, but instead ripples outward from the individual, to their family, to their community. In 2012, the report entitled “The economic impact of post traumatic stress disorder in Northern Ireland” was published in an attempt to measure the costs and evaluate the needs of a population where two-thirds live with PTSD. For someone living with trauma, job loss, dependency on benefits, and the costs of treatment may impact their personal finances. For the wider community, direct service costs among individuals with PTSD in Northern Ireland were estimated to be £33 million across 2008, including services such as visits to family doctors and medication prescriptions. Indirect service costs were calculated to be £139.8 million across 2008; examples of such costs include the economic effect of lost work productivity. By quantifying the costs of trauma, the report argued that through developing effective services and treatments for PTSD, humanitarian needs could be addressed through reducing suffering and improving the quality of life for individuals, families and the wider community.

Politics

The legacy of conflict and conflict-related trauma has the potential to “smother the normal dynamics of politics,” writes Vicky Cosstik. Through political and sectarian division, the definition of ‘victim’ can become different for different groups. David Bolton describes how difficult it is for politicians when a hierarchy of victims is created, when there are arguments about “whether they are ‘your victims or my victims,’ or ‘your dead or my dead.’” In 2009, The Report of the Consultative Group on the Past criticised the idea that some victims are more innocent or blameworthy than others and that “the definition of a victim or hierarchy of victims, are hurting the very people we should all be striving to help… the politicisation of victims appears to be perpetuating the pain rather than healing it.” The report had recommended a £12,000 payment to the closest relative of every victim of the conflict. It was rejected, the most common reason being “the potential for recognition payments to be awarded to the relatives of paramilitaries killed during the Troubles.” In asking victims to prove their victimhood, or creating a hierarchy of victims, people struggling with the aftermath of the Troubles risk being retraumatised, or defining themselves solely by their traumatic experiences. Politics, as a result, can fail to overcome the legacy of conflict and, in turn, the legacy of trauma.

Meeting needs

In the foreword to the 2012 WAVE report entitled “Injured in the Troubles: the needs of individuals and their families” the question was asked, “should a modern democracy or any responsible society not ensure that those most affected by the years of conflict and who live with the legacy of that conflict not have their needs met?” It is one that has featured strongly in the conversations around trauma and its effects in Northern Ireland. Treatment for trauma related disorders such as PTSD are vital to ensuring the quality of life can be restored, but excessive waiting periods for services in the region mean that a citizen of Northern Ireland is three thousand times more likely than a citizen of England to have been waiting more than a year for healthcare. Delayed treatment risk exacerbating the effects of trauma in Northern Irish society. “The implications of not taking action are that you are left with a legacy of long-term mental health problems which then run the risk of becoming transgenerational,” David Bolton says.

As research on the impact of trauma is published, and a culture of discussing mental health is constructed, progress has been made to heal the psychological legacy of the conflict. Where early support was most often found in grassroots charities and organisations such as the WAVE Trauma Centre, government action has meant the effects of trauma can be addressed on a broader level. In 2013, the Victims’ Service was established to provide support to those who have been affected by the Troubles. The Stormont Agreement of 2014 also made provision for the development of a service, the Regional Trauma Network, to treat those with trauma related mental illness. The service aims to increase access to trauma services for adults as well as enhancing the services available to children and young people, with planning underway as of March 2019.

Healing through storytelling

Community support, most notably storytelling projects, create a positive process of remembering and dealing with the past for many people affected by the conflict in Northern Ireland. As a means of confronting traumatic experiences, sharing perspectives and learning to live with the legacy of the Troubles, storytelling becomes an aide to bridging sectarian divides through a shared understanding of the past, and what it means to live with its effects. One such project is from the WAVE Trauma Centre. “Everyone is My People” is a collection of audio memoirs from seven men who navigate their lifelong experiences of grief, loss and violence, and articulates the realities of living with trauma in Northern Ireland. “I stand for everyone, even the people who don’t want to listen,” one of the men, Paul, says, “I still try to get behind their thinking, to understand them, to empathise with them. Everyone is my people, even the so-called perpetrators, the unfortunates, and the ones who stood by and did nothing. I stand for everyone; everyone is my people.”

Bibliography

Bolton, David (2017). Conflict, Peace and Mental Health: Addressing the Consequences of Conflict and Trauma in Northern Ireland.

Bolton, David, et al. (2012). The economic impact of post traumatic stress disorder in Northern Ireland.

Commission for Victims and Survivors (2011). Troubled consequences: A report on the mental health impact of the civil conflict in Northern Ireland.

Consultative Group on the Past (2009). The Report of the Consultative Group on the Past.

Northern Ireland Victims Commissioner (1998). We Will Remember Them.

Queen’s University Belfast (2017). The transgenerational impact of ‘The Troubles’ in Northern Ireland.

Ulster University (2019). Review of Mental Health Policies in Northern Ireland: Making Parity a Reality.

WAVE Trauma Centre (2012). Injured in the Troubles: the needs of individuals and their families.

Research by Maeve McTAGGART.

Image by Allan LEONARD used by license CC BY-NC.