Idioms of Distress among Afghan immigrants

Idioms of Distress among Afghan
immigrants
Arezoe Delawar
Symposium Angst en depressie in een
diverse samenleving:
I-psy
07-11-2014
Psychopathologie

De prevalentie van posttraumatische stress, evenals angst- en
depressieve klachten (Gerritsen et al., 2005).

de prevalentie van psychiatrische stoornissen onder
Afghanen in Drenthe is 65%.Van deze groep wordt 49%
behandeld voor lichamelijke klachten (vooral hoofdpijn), 8%
voorpsychische klachten en 43% wordt geheel niet geholpen
(Gernaat et al., 2002).

Gernaat. H.B.P.E., Malwand, A.D., Laban, C.J.,Komproe. J. & Jong. De, J.T.V.M., (2002). Veel psychiatrische
stoornissen bij Afghaanse vluchtelingen met verblijfsstatus in Drenthe, met name depressieve stoornis en
posttraumatische stressstoornis. Nederlands

Gerritsen, A.A.M., Bramsen, I., Dévillé, W., Willigen, L.H. van, Hovens, J.E. & Ploeg, H.M. van der (2005). Physical
and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands. Social
Psychiatry and Psychiatric Epidemiology, 9, 18-26.
Asielzoekers & Vluchtelingen
Asielzoekers & Vluchtelingen
Iedere cultuur heeft zijn eigen culturele constructies, eigen
manieren en idiomen van gevoelens om onwelbevinding uit
te drukken ( Kortman 1996)
IODs onder Afghaanse immigranten
Local indicators of distress
Miller (2006) gebruikte in Kabul een mixed-method design
om de lokale indicatoren van distress te identificeren. Aan
de hand van deze indicatoren heeft hij Afghan Symptome
Checklist (ASCL)ontwikkeld. Deze vragenlijst heeft een
goede betrouwbaarheid(α = .93) en een goede
construct validiteit.
ASCL en IODs
The ASCL heeft volgende items opgenomen:
Fishar-e-Paying and Fishar-e-Bala
Jigar Khuni
Asabi
Beating oneself
Churt/ Dil Khorie/ Tashwiesh (Eggerman&Panter-Brick,2010;
Wolde,2010)
Hoofdpijn ( Wolde, 2010)
Eggerman, M. & Panter-Brick, C., 2010. Suffering, hope and entrapment: Resilience and cultural values in Afghanistan.
Social science & medicine.
Wolde, Ten ,K., 2010. Afghaanse verdriet; pijn van het leven & verdriet van de dood. Sociaal cultureel onderzoek
naar de betekenis van hoofdpijn onder Afghanen in Nederland .
Onderzoek
Dit deelonderzoek is een kwalitatief
onderzoek bij Afghaanse patienten om
IODs in kaart te brengen.
 Vooronderzoek
 Diepte-interviews

Uitkomst Interview
Jigar Khuni
Asabi/Asaboni
Tashwiesh
Churt
Beating oneself
Deltangi
Hoofdpijn(Sardard)
Jigar Khuni
Beschrijving van Jigar Khuni door Afghaanse patiënten
1)



The therapist asks when is a person Jigar Khun? The client answer is when
someone is Jigar Khun she/ he has no interest in talking. Jigar Khuni is the
opposite of Khushi (happiness). The therapist asks again, tell me what is
according to your opinion Jigar Khun. The client says if someone is Jigar Khun
she/ he is Ghamgeen (sadness) and Churti (thinking too much). The
consequence is that one has no interest in others talking to you and no
interest in activities,
The therapist asks under which conditions does someone becomes Jigar Khun?
The client says if one hears something, for instance a family member who
become ill. If my sister is happy, I feel the same. If she is Jigar Khun I also might
feel Jigar Khun. Both my father and sister are ill. If I have a phone contact with
my father and sister in Afghanistan and I notice that they are calm and
everyone is doing well, it makes me happy. If they would say that they do have
health complaints I become Jigar Khun (feeling sorrow).
The therapist summarizes by saying, is it true that if someone in your
environment becomes ill that you become Jigar Khun? The client says, yes.
Jigar Khuni
2)
 The therapist asks her ‘can you describe Jigar Khuni? The client answers I
do not think about Jigar Khuni but is a condition where I am unhappy. It is
like when I watch a movie with a Jigar Khuni situation, when I hear that
someone deceived or when I see a corpse. The personal impact of these
situations is enormous. The therapist asks if it is a stranger who deceived,
does this have an impact on you? The client says yes. The client says I then
have the feeling that I see the deceived person in the corner of my eyes.
Even if this deceived person is not on top of my mind, I feel that she/ he is
around me.
 The therapist asks do these deceived persons give you the feeling of Jigar
Khuni? The client says yes. The therapist asks, what is this feeling of Jigar
Khuni? The client answers I think that it varies per person but in my case
this feeling of Jigar Khuni arises when I am thinking too much, these
feelings are piling up inside my body and are not able to escape from there
(Oqda). The client says that after she feels Oqda she wants to cry or walk
around outside. Apart from walking around she says or I like to be alone
and cry. An last option is phoning a friend and talking about my experience.
This happens when I am Jigar Khun. If I talk with a friend I cannot stop
crying

Jigar khuni

3)

The therapist says: you mentioned several times the word Jigar Khun. Can
you explain me what causes you to become Jigar Khun and worried
(Tashwies). The client says: when something happens at home …. with my
children, I start worrying. When I hear bad news about Afghanistan, I
become Jigar Khun. Examples of bad news are: when a rocket hits an
known area, when a car got an accident, when an explosion took place. Bad
news stays in my heart and bad news ensures that my heart is restless
from the morning till midnight.
Jigar Khuni

4)

The therapist asked: when did you feel for the first time Jigar Khun? The
client said: when my son deceived in Afghanistan. The client says: this feeling
of Jigar Khuny was probably earlier present since my son’s condition
deteriorates. I noticed that when it went worse with my son that the
impact on me increased. The second time that I became Jigar Khun is when
I heard that my daughter has a disease en though the general practioner
said that it is not worse. The moment that my daughter fainted and was
brought to the hospital with an ambulance is still imprinted in my memory.
The therapist summarizes what has been said before. The client indeed it is
still in my memory, it is a moment that reverts. I therefore raised the
question: what might have happened to her when she fainted, what if
something occurs to her. Since that time my headaches increased. Every
time when I heard the sound of an ambulance I thought what might
happened if the ambulance drives to the high school of my daughter. I felt
unrest even if the ambulance went to another direction. My phone was
always in the alarm modus since I felt anxious. This feeling continued till my
daughter came back from school, but I never mentioned this to her.
Idioms of Distress
Dank voor jullie aandacht!
Painted by a cliënt