Children of Refugees: Torture, Human Rights, and Psychological Consequences, by Aida Alayarian

Addressing the Gap Between the Psychological Needs of Children and the Services Provided

An Afghan refugee girl holds her younger sister stands in an area where Pakistani health workers are searching house to house for children that need vaccination against polio, on the outskirts of Islamabad, Pakistan, Wednesday, Feb. 26, 2014. Pakistanís beleaguered battle to eradicate polio is threatening a global, multi-billion dollar campaign to wipe out the disease worldwide. Because of Pakistan, the virus is spreading to countries that were previously polio free, say U.N. officials. ìThe largest poliovirus reservoir of the world,î is in Peshawar, the capital of Pakistanís northwest Khyber Pukhtunkhwa province, which borders Afghanistan, according to the World Health Organization. (AP Photo/Muhammed Muheisen)

An Afghan refugee girl holds her younger sister

In a world where the torture, maltreatment, and neglect of children shamefully persist, it is incumbent upon all of us to intervene appropriately to put a stop to it – whether in refugee and displaced camps, conference rooms, or through developing more comprehensive campaigns and policies to hold perpetrators accountable (whether governments or rebels opposing governments), or indeed working in clinics where traumatised children and their families seek help. The manner in which we act to improve the opportunity for recovery in children and young people subjected to torture and other inhumane violent treatment should be our primary concern.

afghan-refugees-sept-28-2014-mheisenapChildren of Refugees: Torture, Human Rights, and Psychological Consequences discusses this salient issue, drawing on legal guidelines for child protection in the UK, Europe, US and other countries, as well as looking at the psychological perspectives and traumatic effects of torture and human right violations on children. The book looks specifically at the issue of refugee and unaccompanied children. Understanding challenging behaviour in traumatised children and the effects of refugee experiences on families is discussed, highlighting concern for the lack of appropriate and effective support that is available. Through the presentation of vignettes, it traces the complexity of the child refugee experience while demonstrating the impact of good practice underpinned by an intercultural and resilience-focussed approach. In an effort to eradicate torture and maltreatment of children globally, the author points to the necessity of developing appropriate methods of intervention as a responsibility both to the children and families and to society as a whole.

The largest group of tortured children is found amongst refugees. There are high numbers of unaccompanied children, mainly from Latin America, Africa and the Middle-east, who arrive in foreign lands after fleeing unfathomable forms of violence and oppression. Within this diverse demographic are also child soldiers, children affected by armed conflict and street violence, those tortured as a result of extreme poverty, and others abandoned or subjected to child labour and slavery.


Torture is a strategic means of limiting, controlling, and repressing the basic human rights of individuals and communities, and one that is often covert and denied by authorities. Torture of children includes, but is not limited to, deliberate infliction of pain and suffering to obtain a confession or information; punishment for real or perceived offences; and intimidation, coercion and/or discrimination about race, ethnic or political affiliation. Despite conventions and declarations to the contrary, a wide range of practices exist throughout the world, subjecting children to premature loss of childhood, inappropriate experiences, and various forms of torture.

a-16-year-old-refugee-shows-the-scars-he-received-while-held-on-a-human-trafficking-boat_55715543_h38118517_wide-89b588b2c8bd9b8e2999d58f22c19a0f63df0358-s900-c85before-obtaining-asylum-refugees-musImpact of torture on children may vary depending on the child’s very early life and the level of resilience, coping strategies, and cultural and social circumstances. One of the objectives of this book is to argue for the greater provision of protection of children, blended with the intercultural clinical practice through searching for evidence and demonstrating solutions to improve the lives, homes, and communities of children affected by torture. Vignettes are included of children of refugees who have been tortured and affected as the consequence of the trauma they have endured. It examines the literature related to the protection of children – mainly contemporary conventions and policies – as a means to discuss and reflect on the effects of torture on the future of children, as well as on the development of appropriate psychotherapeutic intervention.

9c132178bdba9cae871303987ed79d17Central to the cognitive development of the children is the ability to construct a mental model of the world. Without this, the child would not be able to make use of information from their present and past experience, or to plan future actions. Development is the progressive reorganisation of mental processes where biological maturation, together with environmental experience, changes the child mentality towards adulthood.

In their process of development, children construct an understanding of the world around them; in situations where they experience intense incongruities and inconsistencies between what is known to them already and what is discovered by them in their environment, this development becomes chaotic and confused. Indeed, torture is the cause not just of physical but also of enormous psychological disturbance for many children around the world.

The perpetration of torture is a complex issue and the torture of children is a worldwide problem. There is a need for universal declaration and legal considerations that can address these complex elements and contextualise the dynamics of human rights. There are as yet no official or reliable independent statistics for measuring the scale of the problem.

screen-shot-2017-01-05-at-20-42-58In this book the author looks at international activities which support the development of the court of law and the trial of perpetrators of torture and other human rights violations. Specifically drawing on the work of the International Rehabilitation Council for Torture Victims, the discussion examines and explores the effectiveness of international conventions on the accountability of perpetrators, making suggestions for further work to coordinate international, regional, and local efforts. In addition, the book also addresses the need for clinical intervention by professionals with children of refugees and unaccompanied minors to lessen the lasting effect of torture on that child’s wellbeing and future capacity to cope with challenges in life. The author discusses the work of the Refugee Therapy Centre, where a substantive portion of research and development has occurred.

The perpetration of torture is a complex issue with practical and abstract legal aspects, socio-psychological factors, and considerations of the influence of institutional support and opposition. Addressing these elements contextualises the dynamics of the impact of torture on those subjected to it. Working with anyone who has experienced extreme human rights violations, including torture and other forms of violence, often brings forth a range of response from those seeking to help, particularly when the abuse has been perpetrated against a child.


Exhausted four-year old Syrian refugee Rashida sleeps between railway lines

Throughout the work, the author looks at the legal issues specifically in line with Article 1 of the Convention Against Torture, which defines torture as: ‘Any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person, information or a confession, punishing him for an act he or a third person has committed or is suspected of having committed, or intimidating or coercing him or a third person, or for any reason based on discrimination of any kind, when such pain or suffering is inflicted by or at the instigation of or with the consent or acquiescence of a public official or other person acting in an official capacity. It does not include pain or suffering arising only from, inherent in or incidental to lawful sanctions’.

3o3bpd3r9u4qjlcgl-7ce55238Article 2 of the Convention prohibits torture and requires parties to take effective measures to prevent it in any territory under its jurisdiction. This prohibition is absolute and non-derogable. No exceptional circumstances whatsoever may be invoked to justify torture, including war, threat of war, internal political instability, public emergency, terrorist acts, violent crime, or any form of armed conflict.

coverAida Alayarian, BSc, MD, MSc, DocSc, PhD, is a consultant clinical psychologist, child psychotherapist since 1986, and adult psychoanalysts since 1998 with a background in Medicine. She has a PhD in both child development and in psychoanalysis, and an MSc in Medical Anthropology and Intercultural Psychotherapy. She is a Fellow of the Royal Society of Medicine and of the British Psychological Society. She is the founder the Refugee Therapy Centre and until 2016 was Chief Executive and Clinical Director. She is currently Director of Education and Training for both the Master and Professional Doctorate Programme in Intercultural Psychoanalytic Psychotherapy.

Dr Alayarian was a winner of the Women in Public Life awards in 2009, and her outstanding work in the field was also recognised by the Centre of Social Justice in 2010. In 2011 she received an award from the London Educational Partnership. She is the author of many books, specialising in psychoanalysis and human rights, trauma, psychoanalysis, and intercultural approaches. Her works include Resilience, Suffering and Creativity: The Work of the Refugee Therapy Centre (2007); Consequences of Denial: The Armenian Genocide (2008); and Trauma, Torture and Dissociation: A Psychoanalytic View (2011).

Her latest book, Children of Refugees: Torture, Human Rights, and Psychological Consequences, has recently been published by Karnac.


Reviews and Endorsements

‘Aida Alayarian is a frontline clinician who works with refugees and her firsthand experience of the reality of their suffering informs and enriches the text of this important and useful book. The current refugee crisis in Europe and the Middle East has exposed large numbers of professionals to unfamiliar difficulties, and it is important to point out that doctors, social workers, nurses and other support staff receive very little and sometimes no training about the needs of refugees, let alone information about the wider issues affecting them. This precise and clear book reviews fundamental questions that underpin the lives of refugee children.’
—Dr Lionel Bailly, University College London Psychoanalysis Unit



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