Judging: a Difficult Job! Trauma and Credibility: Psychological problems that affect credibility in asylum and human rights claims

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1 Judging: a Difficult Job! Trauma and Credibility: Psychological problems that affect credibility in asylum and human rights claims Raggi Kotak Making critical decisions with very limited data. Asylum decisions sit in a complex public policy and public attitude context. There is a lack of empirical evidence. or is there? a co-presentation with How do Judges judge? The Centre for the Study of Emotion and Law a window that Judges try to look through, but... it is really a mirror. Qualitative analysis of Judicial decisions to investigate Judicial assumptions. Hypotheses for further primary and secondary research Graycar, 1991 (Herlihy, Gleeson & Turner) Themes included : Disclosure [if it were true] she would have mentioned this earlier Reasonable behaviour I do consider it implausible that a family in fear, on seeing a man throw something over the fence and into their garden would go to investigate it Telling the truth given that rape is such a serious thing to happen to any women, I would have expected a raped person to know when they were raped. This is not the type of event which I would expect a person to forget about or confuse there was a texture and richness to the details of her evidence that indicates that [it] was true Credibility & Consistency Credibility of the asylum seeker has become a central question in determining asylum status. Unfortunately, credibility often has to be determined in the absence of independent documentary evidence. Possible positive bias against traumatised refugees (eg): PTSD and inconsistent recall Sexual Assault, shame and avoidance Dissociation in the asylum interview 1

2 Decision makers Research A Judicial comment liars take shorter pauses than truth-tellers body movements no indication consecutive deceptive statements are less consistent than truthful ones liars take longer pauses liars make fewer body movements than truth-tellers consecutive deceptive statements no more or less consistent than truthful ones In the case of country evidence, expert evidence can be evaluated against other material In contrast, there will be no similar breadth of evidence to assist in the evaluation of expert medical evidence Our aim is to challenge this assertion... Granhag, Stromwall & Hartwig, 2005 Barnes (2004) Today : Aims Today : Structure For you to Interviewing your client - barriers understand the psychological processes that impact on the ability of an asylum seeker presenting his/her claim understand the research in this area be able to identify psychological issues in clients and effectively apply the research to gain the best outcome i.e positive credibility judgements Memory : Disclosure of traumatic material Memory : discrepancies example / research literature / application 1951 Convention relating to the Status of Refugees Common problems (Barriers to a fair hearing) A refugee is a person with: a well-founded fear of persecution because of one of a number of arbitrary reasons and has no protection in home state. 2

3 Prevalence literature Clinic v Community Common problems: PTSD Depression Issues: Clinic versus community samples Timescales (more prevalent in new arrival groups) Methodologies eg interview v questionnaire Culture Effect of migration Refugees in London (referrals) Kosovan Albanians adjusted (community) PTSD Depression Timescale (PTSD) Methodologies Kosovan Data (Survey of women after rape.) 1 week 2 months 9 months Foa & Rothbaum Questionnaire data (n=842) Interview subset adjusted (n=120) PTSD Depression A Cross-Cultural Problem Pre/Post-Migration Factors [Refugees in London] (n=60) Khmer refugees in Thailand (n=993) Bosnian refugees in Croatia (n=534) PTSD Depression In a group of refugees from Iraq, poor social support was a stronger predictor of depressive morbidity than trauma factors. Gorst-Unsworth & Goldenberg, 1998 In a Tamil refugee and non-refugee sample in Australia, pre-migration trauma exposure accounted for 20 percent of the variance of PTS symptoms; post-migration stress contributed 14 percent of the variance. Steel et al,

4 Depression Diagnosis and Trauma Depressed mood most of the day, nearly every day Markedly diminished interest or pleasure in all or almost all activities Significant weight or appetite change Insomnia or hypersomnia Psychomotor agitation or retardation Fatigue or loss of energy Feelings of worthlessness or excessive/inappropriate guilt Diminished ability to think or concentrate Recurrent thoughts of death (not just suicide) Absence of a diagnosis does not disprove trauma history. Presence of a diagnosis does not prove any particular trauma. PTSD A : Exposure to a trauma (tightly defined) B : Persistent reexperiencing C : Persistent avoidance and numbing D : Persistent increased arousal E : Duration over 1 month F : Clinically significant distress or impairment Persistent reexperiencing ONE OF THE FOLLOWING: Recurrent and distressing recollections, including images, thoughts or perceptions Recurrent distressing dreams of the event Acting or feeling as if the traumatic event were recurring Intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the trauma Physiological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the trauma 4

5 Traumatic memory Dual Representation Theory Recallable Memory (VAM) -story -timestamp -updateable -verbal Autobiographical Store (hippocampus) Event Emotional Memory (SAM) -no structure - in the present - fixed - sensory Fear Response (amygdala) after Chris Brewin et al Dissociation disruption in the usually integrated functions of consciousness, identity, memory or perception often related to a history of extreme interpersonal trauma (abuse/torture) May cause psychogenic amnesia NOT under the individual s control PTSD A : Exposure to a trauma (tightly defined) B : Persistent reexperiencing C : Persistent avoidance and numbing D : Persistent increased arousal E : Duration over 1 month F : Clinically significant distress or impairment Avoidance and Numbing THREE OF THE FOLLOWING: Efforts to avoid thoughts, feelings or conversations associated with the trauma Efforts to avoid activities, places or people that arouse recollections of the trauma Inability to recall an important aspect of the trauma Markedly diminished interest or participation in significant activities Feeling of detachment or estrangement from others Restricted range of affect (eg unable to have loving feelings) Sense of a foreshortened future (eg does not expect to have a career, marriage, children, or a normal life span) Avoidance & Sexual Torture Relationship between trauma experience and symptoms Most forms of torture: more intrusion (B) Sexual torture: more avoidance (C) Ramsay et al., 1993 van Velsen et al.,

6 PTSD Hyperarousal Symptoms A : Exposure to a trauma (tightly defined) B : Persistent reexperiencing C : Persistent avoidance and numbing D : Persistent increased arousal E : Duration over 1 month TWO OF THE FOLLOWING: Difficulty falling or staying asleep Irritability or outbursts of anger Difficulty concentrating Hypervigilance Exaggerated startle response F : Clinically significant distress or impairment Establish safety and trust Phased Model of Intervention Trauma focused therapy Reintegration Phase One Phase Two Phase Three Trust One of the main objectives of inflicting torture is the total control of another human being - therefore empowerment must be central to the therapy process [Tizon, 2001] Disclosure Examples include: Disclosure Culture and gender insensitivity Language barriers Low mood couldn t care PTSD and avoidance especially after a humiliating experience, associated with shame Problems with concentration (common in depression and PTSD, but also remember head injury) Dissociation 6

7 Sexual Violence and Disclosure PTSD, Shame and Disclosure women may not disclose sexual assault in their asylum interview (Burnett, 1999) men underreport sexual violence (Peel et al., 2000) cultural attitudes towards sexuality increased PTSD in refugees resettled in West PTSD / shame / disclosure (Fazel et al., 2005) (Andrews et al, 2000; Hook & Andrews, 2005) sexual torture / PTSD-avoidance shame? dissociation? (Van Velsen et al., 1996) Study Aim Participants To determine whether and how sexual violence impacts on asylum seekers disclosure of personal information during Home Office interviews. 27 refugees and asylum seekers with a history of sexual and non-sexual violence 11 male, 16 female, age arrival in UK between 1995 and 2003 wide variety of national and ethnic backgrounds Measures PTSD (PTSD Symptom Scale) Depression (Hopkins Symptom Checklist) Shame (Experience of Shame Scale) Dissociation (Peritraumatic Dissociative Experiences Questionnaire) Difficulty in disclosure rating Semi-Structured Interview Disclosure of personal sensitive information Reactions towards people in authority Situation- and context-specific factors Culture-specific issues Other issues and recommendations 7

8 Group Comparisons history of sexual violence higher : PTSD overall severity PTSD avoidance Shame Dissociation Difficulty in disclosure Correlations Difficulty in disclosure positively associated with higher levels of: PTSD overall severity PTSD avoidance Shame Depression Dissociation Home Office Disclosure Interview Data 20 out of 27 talked for the first time about their pre-migration trauma after entering the UK and most of those talked to Home Office officials Intrusive Experiences Dissociation When I talked about the past, what happened to me, the memories came, flashbacks. And then I found it difficult to remember anything that happened in my country. I tried to talk, but my mind kept wandering off and I kept thinking about the trauma and my family that I lost. Everything seemed unreal to me, I felt like I was dreaming. I found it hard to focus on the interview and answer questions 8

9 Shame Culture-Specific Issues 15 people : still undisclosed matters I wanted to keep things from my past private. I was scared that they would look at me badly and make me feel ashamed. I could not tell everything at the interview, but later on I was able to tell the court. They were nice at the court and made me feel more relaxed At home you are not allowed to talk to other men you are not related to, you are not allowed to look any men in the eyes. So how could I have looked him in the eyes and told him what happened to me it s a different culture Interpersonal Factors attitude of the interviewer : most frequently cited factor in facilitating disclosure (10 people) I wanted to explain properly, but they just stopped me.they ask you to make it short and give yes or no answers.you don t get a chance to say much or explain to them. Therefore I did not go into much detail. But that affected me later when I was asked why I did not tell them in the interview. Conclusions sexual violence/shame/ptsd-avoidance (van Velsen & Turner, 1996) those with histories of sexual violence are more likely to have difficulties disclosing to Immigration Officials non-disclosure should not be assumed to be due to fabrication on the part of the asylum claimant. Other factors may affect disclosure PTSD, Shame, Dissociation It was the first time in my life that I had to talk about what happened to me. I only told the interviewer about 10 per cent, I could not talk, it was too difficult. I felt so traumatised and ashamed Discrepancies 9

10 How good is memory for highly stressful experiences? US military personnel: young, fit, training Subjected to Stressful interrogation Assessed 24 hours later Only 66% were able to identify their interrogator Study : Memory 27 Kosovan and 16 Bosnians who were in the UK as programme refugees (they had not made an individual asylum application) were interviewed on two occasions. They were asked to recall a traumatic and a non traumatic event from their past. On both occasions, they were asked a series of standard questions about these events. Would they give the same answers each time? (No obvious motivation for deception...) Herlihy, Scragg & Turner (2002) Repeated Memory Task First interview free recall 15 questions central/peripheral rating Second interview prompt same 15 questions Detail questions (examples) who was with you? what were you wearing? what day of the week was it? Herlihy, Scragg & Turner (2002) Herlihy, Scragg & Turner (2002) Discrepant Memories I Discrepant Memories II Non-Traumatic Traumatic Peripheral Central Short Delay Long Delay High PTSD Low PTSD Herlihy, Scragg & Turner (2002) Herlihy, Scragg & Turner (2002) 10

11 More reasons Mood change Dissociation Intrusive memories Interpreting Taking care of YOURSELF Definition of concepts What affects us? vicarious traumatisation : an accumulation of memories of clients traumatic material that affects your perspective of the world Pearlman & Saakvitne,1995 burnout : a state of physical, emotional and mental exhaustion caused by long term involvement in emotionally demanding situations Pines and Aronson, 1988 secondary traumatic stress : PTSD-like symptoms horrific stories multiple exposure random nature of events human vulnerability raw intensity of client s reactions here and now quality sustained empathy re-activation of our own histories Impact on work over involvement blurring of boundaries detachment disbelief/minimisation of story forgetting appointments avoiding exploration judgemental, accusing, disbelieving labelling of client Impact on self specific symptoms and behaviours physical reactions changes in affect tolerance and disruptions in self soothing capacities changes in thinking impact on interpersonal relationships sense of meaning, identity, worldview and beliefs about self and others existential/ spiritual impact 11

12 What to do : Professional What to do : Personal peer support supervision and consultation diversity of professional practice training and skills development clear boundaries and limit setting professional connections (workshops, refugee forums) advocacy and political involvement recognise your limits!! realistic case load recognise reactions and articulate find ways to express and manage reactions take time to soothe and heal maintain a balance support and connection with others seek positive experiences outside work reflection and self awareness examine cynicism and maintain hope and joy personal psychotherapy Recommendations clinical experience impact of psychological difficulties on functioning research findings base crucial decisions on empirical research A Judicial comment In the case of country evidence, expert evidence can be evaluated against other material In contrast, there will be no similar breadth of evidence to assist in the evaluation of expert medical evidence Our aim is to challenge this assertion... Barnes (2004) References Herlihy, J., Gleeson, K. & Turner, S. (in press). A qualitative analysis of assumptions in judicial asylum determinations Herlihy, J., Scragg, P. & Turner, S. (2002). Discrepancies in Autobiographical Memories: Implications for the Assessment of Asylum Seekers: repeated interviews study. British Medical Journal, 324, Bogner, D., Herlihy, J. & Brewin, C. (2007). Impact of sexual violence on disclosure during Home Office interviews. British Journal of Psychiatry 191, Herlihy, J. and Turner, S.W. (2009). The Psychology of Seeking Protection. International Journal of Refugee Law 21(2),