The Trauma Expert

After a traumatic experience, how do you heal? How do you regain a sense of control? And find meaning among the chaos?

My name is An and I am a psychologist and a trauma expert at the International Criminal Court.

I lead a team of psychologists and our main role is to make sure that witnesses and victims can engage with the Court in a meaningful manner, without suffering psychological harm. Part of our work is to assess ICC witnesses and victims, support them and, especially for children and survivors of sexual violence in conflict, to recommend special measures so they are not retraumatized in Court. Our goal is to help protect them, but also to help them focus on their testimony so the Judges can hear the evidence and justice can be done.

Testimony and trauma

The ICC Rome Statute was innovative in many ways. One thing the drafters insisted on was to make sure that the psychological burden of testimony was acknowledged and addressed. In the Rome Statute it therefore reads that, among the ICC staff who provide: "protective measures and security arrangements, counselling and other appropriate assistance for witnesses, victims who appear before the Court, and others who are at risk on account of testimony given by such witnesses", there must be: "staff with expertise in trauma, including trauma related to crimes of sexual violence."

The explicit mentioning of trauma in the Rome Statute is incredibly important, because the problem of trauma is such a recurring theme. It is very relevant to the work of the Court. If you look at the evidence, most of it is traumatic; the material is traumatic. Child soldiers. Rape as a tool of war. Murder. And more.

Per definition, then, when you ask witnesses to talk about a crime they experienced, witnessed or perpetrated, you ask them to talk about traumatic events. Some people overcome it and are fine, but for others, especially those who had long-lasting or recurrent exposure to traumatic events, it will affect them in a very fundamental way. So, you cannot look at the process of testimony in a war crimes tribunal or at the International Criminal Court without looking at the issue of trauma, at all levels, at all moments of a witness's involvement, so to say.

What is trauma?

Imagine facing a crisis where everything you once knew seems turned on its head – your life as you know it is gone in a flash. Like suddenly losing a loved one in a car crash or from a deadly illness. Now imagine that it was not just you and your loved ones affected, but your entire community, region, and even country. And it was not because of an accident or natural cause – but an intentional, widespread and systematic crime.

This trauma is deeper, more entrenched; the instability is greater. It's hard to regain a sense of control. It's very difficult to heal, to accept, to find meaning, and to find a constructive life story or lesson from intentional destruction and violence. But this is one way to start healing. So, this is a big part of what trauma experts help people do.

How do psychologists work with trauma at the ICC?

Ideally, a person affected by such grave crimes will have access to different forms of support, from family and community to professional help, if needed.

Psychologists working in post-conflict situations – like places the ICC investigates – are dedicated to helping people rebuild their lives. There are a number of psychosocial professionals partnered with the Trust Fund for Victims, for example, who work within affected communities. In fact the world needs a lot more people working on the ground and offering psychosocial support.

But survivors often need more than support alone to heal. Many of them want their story to be heard. They demand justice and they want to be involved.

So there are experts, like those working at the ICC, who assist victims and witnesses to engage with justice processes in a dignified and meaningful way, throughout the different phases of their involvement. Unlike the professionals in the field, we do not build life-long relationships with the people we assess and support. We do not set up a programme to counsel them throughout their healing process, which very often takes many years. Our work is more short-term and focuses on a critical moment in their post-trauma life, and therefore often has a big impact.

We serve the justice process. We tell victims and witnesses: "We provide support to you, because you might face difficulties to bring your story, and you might face a risk to be harmed or to suffer because of the fact that you are a victim appearing before the court or a witness providing testimony." That's why we come in.

Let's put it this way: A trial is about evidence, and a piece of that evidence happens to be the story of the worst moment of your life. You want to give that evidence, but in order to do so, you have to face it, put words to it, and say it out loud to strangers in a very formal, unfamiliar environment.

This can be extremely difficult, or empowering, or both. To offer support throughout this experience, we assess each witness scheduled to appear before the ICC. If we find that a witness is vulnerable, particularly if they faced the crime when still a child or survived sexual violence, we make sure that the right conditions are created for them to testify in way which is good for them. We recommend that the Judges order special measures to help protect them.

Routine vs special measures

With each witness, I always ask myself: "How do I make sure that this person feels comfortable enough to give the evidence he or she has?" What helps is to make them feel in control. To make them familiar with what is about to happen, so it becomes predictable. No surprises, no distractions.

To be honest, little things can often have a big impact. Knowing the schedule so they can predict breaks, or be empowered to ask for breaks. Knowing they can ask for a question to be repeated if they didn't hear or understand it. Knowing someone will be there to assist if they need to refer to a legal document. These things give a sense of calm and control, and can reassure any witness.

However, vulnerable witnesses may need special measures. For example:

  • In cases of sexual violence, we ask the Judges to make sure that there are no unnecessarily intrusive, repetitive or embarrassing questions about the witness's traumatic experience.
  • If the witness is anxious about making eye contact with the accused, we can ask for a screen to be placed between them, to block the view.
  • We can also recommend to change the set-up of the courtroom or ask to hear the evidence via video technology, so that the witness does not have to travel to the seat of the Court or sit in the courtroom.
  • We may ask the witness: "Would you feel more comfortable with a support person sitting next to you?"
  • We can ask that questions are adapted to the level of understanding of the witness.

We deliver our recommendations to the Chamber, and the Judges either approve them or not; it's their decision.

Flashbacks

Sometimes, regardless of special measures and support put in place, a witness will experience flashbacks or other traumatic reactions during interviews or during testimony.

Talking about traumatic events makes those experiences resurface – sometimes so vividly that it is like reliving them. The sights, sounds, physical pain, can all return in a flash. So, while witnesses are trying to recount what happened to them, they might be overcome and unable to speak, sometimes even feel as if they are elsewhere. We work with them so they can keep themselves "grounded", and stay fully in the present, so that they can focus on their testimonies.

A flashback does not come from a normal memory. Like if I ask you: "What did you do last year around this time, can you remember?" You will just think about it, retrieve the memory which has been processed into a narrative you can easily recall and recount. If this would be a traumatic memory, you would go totally back into the situation – to the sensory information which is 'frozen' in time, not processed, often scattered, so with your physical reactions, your bodily reactions, your emotional reactions – as if you were there again at the moment it happened. So, you are literally drawn back into the moment and it is very physical; it's because your body reacts in a way before your prefrontal cortex does, so to say. Your body relives the event and prepares again for danger.

To help a witness avoid or deal with traumatic reactions during testimony, we first ask what they're used to doing when this happens, because usually they have a strategy. We ask: "What do you know already about yourself? What helps? How can we help?" Then we can teach them breathing exercises and some grounding exercises, suggesting, for example, that they can hold on to the table when they feel they're drifting away, or take a glass of water or a tissue – do something physical. Sometimes they know or we observe that they go into a certain posture during flashbacks, so if they can still catch it and change posture – even just by moving their feet – and by literally feeling their body again, they can bring themselves back to the here and now. This is the type of intervention informed by trauma theory.

People come in and out of flashbacks, and they can do that during their testimony as well. Sometimes it's hardly noticeable; it can be very subtle. But sometimes it can also be quite dramatic, and people just are not able to listen anymore, or respond. Or they might get very anxious or emotional in the witness box. Then it's up to the Judges to read the situation and say "Let's take a break". Usually, a short break is enough, because after some breathing exercises, or a chance to rest for a minute and come back to themselves, the witness is ready to go back in and continue. Witnesses also sometimes suffer from nightmares or other reactions in the days or weeks before or after their testimony. We explain to them that is it a normal reaction.

Finding the words

Ultimately, and ideally, a witness's testimony can be empowering and part of the healing process. As can telling your story to a lawyer who can represent you as a victim in a case. But it is just a part. The tip of the iceberg that many people see. What is less visible takes much more time and is perhaps far more important.

Between the moment of trauma and the moment of testimony, a person must process what happened to them and put it into words. This is not always automatic.

At the moment of the crime, the reaction of the body is so overwhelming that a person may go into a state of shock. As part of trying to protect itself, the mind can 'freeze' in a way. The brain is unable to 'connect' what happened to existing information, to what a person knows about the world, which is the way we normally process information, learn and remember.

Traumatic events are often 'unthinkable', so the normal process of putting things into words gets put on hold. The person may at first be unable to accept that the harm actually happened, or they may be in disbelief that another person could cause such harm. They may also try to avoid any thoughts or reminders of the trauma, which can be painful to recall or which they may believe could bring them further harm, as the if the danger were not yet over.

So it may take you time to acknowledge the event, and be willing and able to focus and think about it, before finding words to express what you went through.

The process of recovery from trauma is therefore focused on creating awareness, expressing feelings, turning sensory information into a coherent narrative, and understanding and making sense of what happened. These are important steps towards acceptance and healing.

The broader context: becoming more victim-centred

Recovery, in my view, comes through a long process. It's about piecing together what happened. It is physical, psychological, linguistic... It touches every aspect of the person as a human being.

The testimony or participation as a victim can be the final part of putting the traumatic experience into words, recognizing it and having it be recognized by others.

Whether they are victims or perpetrators or bystanders, we talk to them about issues that were significant in their lives, very often traumatising, and they are always in the process of integrating this into their life story. In the end, it's about how they understand themselves and find meaning in their lives.

The public, legal process of listening to evidence, examination and cross-examination, legal arguments and finally bringing a judgment helps individuals and communities to address the facts, give meaning to what happened, and to turn to a future beyond the collective trauma, towards healing and hope. When we see how communities are watching the proceedings, are talking about the evidence they hear, we know a process of recovery may start, long before there is a judgment, and even sometimes regardless of the outcome of the proceedings.

So, even though the Court's goal as such is not to be therapeutic, by conducting its core business, its activities can have a cathartic effect on those who participate in the judicial process and members of the affected communities. Bringing forward the facts, hearing arguments and counter-arguments and rendering a verdict in itself is a recognition of suffering.

And I think you see, in the broader context of international justice there is a shift of focus from the perpetrator to the victim. In my view, we are very focused on the perpetrators, and of course the ICC has an important role there: it's retributive justice. But, still, I think what we do as psychologists is a little part of making the entire process more victim-centred. This is what drives me, every day.