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Transcultural Psychiatry, Vol. 44, No. 4, 545-565 (2007)
DOI: 10.1177/1363461507083896

Coping with Loss and Bereavement in Post-war Tigray, Ethiopia

Dag Ø. Nordanger

University of Bergen, dago{at}helse-bergen.no

Drawing upon data collected through in-depth interviews with 20 victims of the Ethio-Eritrean war, this article addresses how psychosocial impacts of political violence are coped with in a Tigrayan context in northern Ethiopia. Qualitative procedures of condensation and categorization of interview texts revealed that informants presented three kinds of coping strategies, all aimed at avoiding indulging in sorrow: (1) diverted thinking, (2) distraction, and (3) future investment. As their main rationale for employing such coping strategies, informants reported the belief that grieving and crying would have negative impacts on their health, their household, and on their relationship with God. This belief is discussed in terms of how it is informed by sociocultural discourses of the Tigrayan community in general, and discourses of the Ethiopian Orthodox Church in particular. Some implications concerning the mismatch between the western trauma discourse and local discourses for psychosocial coping are discussed.

Key Words: bereavement • coping • culture • PTSD • religion • trauma

References

  • Agger, I. (2002). Therapeutic approaches to the treatment of refugees — A historical perspective. Available [Accessed 13 April 2005]: http://www.oasis-rehab.dk/Sider/Bibliotek/Artikler/Inger%20Agger.pdf
  • Alem, A., Jacobsson, L., Araya, M., Kebede, D., & Kullgren, G. (1999). How are mental disorders seen and where is help sought in a rural Ethiopian community? A key informant study in Butajira, Ethiopia. Acta Psychiatrica Scandinavica, 100, 40—47.[Medline] [Order article via Infotrieve]
  • Alem, A., Kebede, D., Woldesemiat, G., Jacobsson, L., & Kullgren, G. (1999). The prevalence and socio-demographic correlates of mental distress in Butajira, Ethiopia. Acta Psychiatrica Scandinavica, 100, 48—55.[CrossRef]
  • Alem, A., Shibre, T., Kebede, D., Kullgren, G., & Jacobsson, L. (2002). The Butajira Study — a comprehensive Ethiopian study on mental disorders. European Psychiatry, 17, 47S.
  • American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: American Psychiatric Publishing.
  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorder (4th ed., rev.). Washington, DC: American Psychiatric Publishing.
  • Bazeley, P. (2000). The NVivo qualitative project book. London: SAGE.
  • Bracken, P.J. (2001). Post-modernity and posttraumatic stress disorder. Social Science & Medicine, 53(6), 733—743.[CrossRef]
  • Bracken, P.J. (2002). Trauma: Culture, meaning and philosophy. London: Whurr.
  • Breslau, J. (2004). Cultures of trauma: Anthropological views of posttraumatic stress disorder in international health. Culture, Medicine and Psychiatry, 28(2), 113—126.[CrossRef]
  • Bruner, J.S. (1990). Acts of meaning. Cambridge, MA: Harvard University Press.
  • de Jong, J.T., Komproe, I.H., Van Ommeren, M., El Masri, M., Araya, M., Khaled, N., et al. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. Journal of the American Medical Association, 286(5), 555—562.[Abstract/Free Full Text]
  • deVries, M.W. (1996). Trauma in cultural perspective. In B. A. van der Kolk, A. C. McFarlane, & L. Weisaeth (Eds.), Traumatic stress: The effects of overwhelming experience on mind, body, and society (pp. 398—413). New York: Guilford Press.
  • Eisenbruch, M. (1992a). The ritual space of patients and traditional healers in Cambodia. Bulletin de l'école Française d'extrême-orient, 79(2), 283—316.
  • Eisenbruch, M. (1992b). Toward a culturally sensitive DSM: Cultural bereavement in Cambodian refugees and the traditional healer as taxonomist. Journal of Nervous and Mental Disease, 180(1), 8—10.[CrossRef][Medline] [Order article via Infotrieve]
  • Englund, H. (1998). Death, trauma and ritual: Mozambican refugees in Malawi. Social Science & Medicine, 46(9), 1165—1174.[CrossRef][Medline] [Order article via Infotrieve]
  • Ethiopian Embassy UK. (2004). The state of Tigray. Available [Accessed 16 April 2004]: http://www.ethioembassy.org.uk/fact%20file/a-z/Regional%20States/The%20State%20of%20Tigray.htm
  • Giel, R. (1970). Some patterns of thinking and feeling in 50 neurotic Ethiopian students. Psychiatria Neurologia Neurochirurgia, 73(1), 49—57.
  • Giel, R. (1972). Psychiatric observations on hostility in Ethiopian students. Psychiatria Neurologia Neurochirurgia, 75(1), 73—77.
  • Giel, R. (1999). The prehistory of psychiatry in Ethiopia. Acta Psychiatrica Scandinavica, 100, 2—4.
  • Giel, R., Bishaw, M., & Vanluijk, J.N. (1969). Behaviour disorders in Ethiopian children. Psychiatria Neurologia Neurochirurgia, 72(4), 395.
  • Giel, R., Gezahegn, Y., & Vanluijk, J.N. (1968a). Faith-healing and spirit-possession in Ghion, Ethiopia. Social Science & Medicine, 2(1), 63—79.[CrossRef][Medline] [Order article via Infotrieve]
  • Giel, R., Gezahegn, Y., & Vanluijk, J.N. (1968b). Psychiatric morbidity in 200 Ethiopian medical outpatients. Psychiatria Neurologia Neurochirurgia, 71(2), 169—176.
  • Giel, R., Kitaw, Y., Workneh, F., & Mesfin, R. (1974). Ticket to heaven — Psychiatric illness in a religious community in Ethiopia. Social Science & Medicine, 8(11): 549—556.[CrossRef][Medline] [Order article via Infotrieve]
  • Giel, R., & Vanluijk, J.N. (1968). On the significance of a broken home in Ethiopia. British Journal of Psychiatry, 114(513), 957—961.[Abstract/Free Full Text]
  • Giel, R., & Vanluijk, J.N. (1969). Psychiatric morbidity in a small Ethiopian town. British Journal of Psychiatry, 115(519), 149—162.[Abstract/Free Full Text]
  • Giel, R., & Vanliujk, J.N. (1970). Psychiatric morbidity in a rural village in south-western Ethiopia. International Journal of Social Psychiatry, 16(1), 63—71.[Free Full Text]
  • Giorgi, A. (1985). Phenomenology and psychological research. Pittsburgh, PA: Duquesne University Press.
  • Global Information Network in Education. ( 2003). Trauma projects. Available [Accessed 23 February 2003]: http://www.ginie.org/ginie-crises-links/trauma/projects.html.
  • Goenjian, A.K., Karayan, I., Pynoos, R.S., Minassian, D., Najarian, L.M., Steinberg, A.M., et al. (1997). Outcome of psychotherapy among early adolescents after trauma. American Journal of Psychiatry, 154(4), 536—542.[Abstract]
  • Honwana, A.M. (1997). Healing for peace: Traditional healers and post-war reconstruction in southern Mozambique. Peace and Conflict: Journal of Peace Psychology, 3(3), 293—305.[CrossRef]
  • Horowitz, M.J., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective stress. Psychosomatic Medicine, 41(3), 209—218.[Abstract/Free Full Text]
  • Huberman, A.M., & Miles, M.B. (1994). Data management and analysis methods. In N. K. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 428—444). Thousand Oaks, CA: SAGE.
  • Institute of Peace and Conflict Studies. ( 2003). Armed conflict report 2003. Available [Accessed 16 April 2004]: http://www.ploughshares.ca/CONTENT/ACR/ACR00/ACR00-EthErit.html.
  • International Rehabilitation Council for Torture Victims. (2005). A world without torture. Available [Accessed 13 April 2005]: http://www.irct.org/usr/irct/home.nsf/unid/JREW-5MSCQ2.
  • Jacobsson, L. (1985a). Mental disorders in patients admitted to a general-hospital in western Ethiopia 1960—1970. Acta Psychiatrica Scandinavica, 71(4), 410—416.[CrossRef][Medline] [Order article via Infotrieve]
  • Jacobsson, L. (1985b). Psychiatric morbidity and psychosocial background in an outpatient population of a general-hospital in western Ethiopia. Acta Psychiatrica Scandinavica, 71(4), 417—426.[CrossRef][Medline] [Order article via Infotrieve]
  • Jacobsson, L., & Merdasa, F. (1991). Traditional perceptions and treatment of mental-disorders in western Ethiopia before the 1974 revolution. Acta Psychiatrica Scandinavica, 84(5), 475—481.[Medline] [Order article via Infotrieve]
  • Janesick, V.J. (1994). The dance of qualitative research design: Metaphor, methodolatry, and meaning. In N. K. Denzin & Y. Lincoln (Eds.), Handbook of qualitative research (pp. 209—219). Thousand Oaks, CA: SAGE.
  • Jensen, S.B., Neugebauer, R., Marner, T., George, S., Ndahiro, L., & Rurangwa, E. (1997). The Rwandan children and their families: Understanding, preventing and healing traumatization. An evaluation of the government of Rwanda and UNICEF trauma recovery program (1995—1997). Copenhagen: European University Centre for Mental Health and Human Rights.
  • Kinzie, J.D., Tran, K.A., Breckenridge, A., & Bloom, J.D. (1980). An Indochinese refugee psychiatric clinic: Culturally accepted treatment approaches. American Journal of Psychiatry, 137, 1429—1432.[Abstract/Free Full Text]
  • Kirmayer, L.J., & Young, A. (1999). Culture and context in the evolutionary concept of mental disorder. Journal of Abnormal Psychology, 108(3), 446—452.[CrossRef][Medline] [Order article via Infotrieve]
  • Kirmayer, L.J., Young, A., & Hayton, B.C. (1995). The cultural context of anxiety disorders. Psychiatric Clinics of North America, 18(3), 503—521.[Medline] [Order article via Infotrieve]
  • Kirmayer, L.J., Young, A., & Robbins, J.M. (1994). Symptom attribution in cultural perspective. Canadian Journal of Psychiatry, 39(10), 584—595.[Medline] [Order article via Infotrieve]
  • Kleinman, A. (1988). Rethinking psychiatry: From cultural category to personal experience. New York: Free Press.
  • Kvale, S. (1996). Interviews: An introduction to qualitative research interviewing. Thousand Oaks, CA: SAGE.
  • Levine, D.N. (1965). Wax and gold: Tradition and innovation in Ethiopian culture. Chicago: University of Chicago Press.
  • Lincoln, Y., & Cuba, E. (1985). Naturalistic inquiry. Thousand Oaks, CA: SAGE.
  • Lopez, S.R., & Guarnaccia, P.J.J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571—598.
  • Machel, G. (1996). Promotion and protection of the rights of children: Impact of armed conflict on children. Report A/51/306. New York: United Nations.
  • Marsella, A.J., Friedman, M.J., Gerrity, E.T., & Scurfield, R.M. (1996). Ethnocultural aspects of posttraumatic stress disorder: Some closing thoughts. In A. J. Marsella, M. J. Friedman, E. T. Gerrity, & R. M. Scurfield (Eds.), Ethnocultural aspects of posttraumatic stress disorder: Issues, research and clinical applications (pp. 529—538). Washington, DC: American Psychiatric Publishing.
  • Marshall, C., & Rossman, G. (1989). Designing qualitative research. Thousand Oaks, CA: SAGE.
  • McNally, R., Bryant, R., & Ehlers, A. (2003). Does early psychological intervention promote recovery from posttraumatic stress. Psychological Science in the Public Interest, 4(2), 45—79.[CrossRef]
  • Mjaaland, T. (2004). Ane sugh' ile. I keep quiet. Master's thesis, University of Bergen, Bergen, Norway.
  • Mooren, T., de Jong, K., Kleber, R., & Ruvic, J. (2003). The efficacy of a mental health program in Bosnia—Herzegovina: Impact on coping and general health. Journal of Clinical Psychology, 59(1), 57—69.[CrossRef][Medline] [Order article via Infotrieve]
  • Nordanger, D. (2007). Discourses of loss and bereavement in Tigray, Ethiopia. Culture, Medicine and Psychiatry, 31(2), 173—194.[CrossRef]
  • Patton, M.Q. (1990). Qualitative evaluation and research methods. Thousand Oaks, CA: SAGE.
  • Pupavac, V. (2001). Therapeutic governance: Psychosocial intervention and trauma risk management. Disasters, 25(4), 358—372.[CrossRef][Medline] [Order article via Infotrieve]
  • Refugees International. (1999). Ethiopia: Internally displaced desperately need food, shelter. Available [Accessed 23 April 2005]: http://www.refugeesinternational.org/content/article/detail/703/
  • Schreiber, S. (1995). Migration, traumatic bereavement and transcultural aspects of psychological healing: Loss and grief of a refugee woman from Begameder County in Ethiopia. British Journal of Medical Psychology, 68(2), 135—142.[Medline] [Order article via Infotrieve]
  • Shweder, R.A. (1995). Cultural psychology: What is it? In J. B. Veroff & N. R. Goldberger (Eds.), The culture and psychology reader (pp. 41—86). New York: New York University Press.
  • Silove, D. (2004). The challenges facing mental health programs for post-conflict and refugee communities. Prehospital and Disaster Medicine, 19(1), 90—96.
  • Silver, S.M., & Wilson, J.P. (1988). Native American healing and purification rituals for war stress. In J. P. Wilson & Z. Harel (Eds.), Human adaptation to extreme stress: From the Holocaust to Vietnam (pp. 337—355). New York: Plenum Press.
  • Silverman, D. (2000). Doing qualitative research: A practical handbook. London: SAGE.
  • Stubbs, P. (2005). Transforming local and global discourses: Reassessing the PTSD movement in Bosnia and Croatia. In D. Ingleby (Ed.), Forced migration and mental health: Rethinking the care of migrants and displaced persons (pp. 53—66). New York: Springer.
  • Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Social Science & Medicine, 48(10), 1449—1462.[CrossRef][Medline] [Order article via Infotrieve]
  • The World Bank. (2004). Ethiopia: A country status report on health and poverty. Report 28963-ET. Washington, DC: The World Bank.
  • Tronvoll, K. (2003). Identities in conflict: An ethnography of war and the politics of identity in Ethiopia. Thesis dissertation, London School of Economics and Political Science, London, UK.
  • Utviklingsfondet. (2004). Regional profile — Tigray. Available [Accessed 14 May 2004]: http://www.u-fondet.no/sw294.asp.
  • Victims's Web. (2005, 1 August). Impact of Event Scale. Available [Accessed 9 November 2005]: http://www.swin.edu.au/victims/resources/assessment/ptsd/ies-r.html.
  • Wessells, M. (1999). Culture, power, and community: Intercultural approaches to psychosocial assistance and healing. In N. Dubrow & K. Nader (Eds.), Honoring differences: Cultural issues in the treatment of trauma and loss (pp. 267—282). Philadelphia: Brunner/Mazel.
  • Workneh, F., & Giel, R. (1975). Medical dilemma — Survey of healing practice of a Coptic priest and an Ethiopian sheik. Tropical and Geographical Medicine, 27(4), 339—431.[Medline] [Order article via Infotrieve]

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