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Culture, Medicine, and Psychiatry

, Volume 33, Issue 2, pp 219–265 | Cite as

Nightmares Among Cambodian Refugees: The Breaching of Concentric Ontological Security

  • D. E. HintonEmail author
  • A. L. Hinton
  • V. Pich
  • J. R. Loeum
  • M. H. Pollack
Special Section: Trauma and Dreams

Abstract

This article explores the nightmares of Cambodian refugees in a cultural context, and the role of nightmares in the trauma ontology of this population, including their role in generating post-traumatic stress disorder (PTSD). Among Cambodian refugees attending a psychiatric clinic, we found that having a nightmare was strongly associated with having PTSD (χ2 = 61.7, P < 0.001, odds ratio = 126); that nightmares caused much distress upon awakening, including panic attacks, fear of bodily dysfunction, flashbacks and difficulty returning to sleep; that nightmare content was frequently related to traumatic events; that nightmares resulted in a decrease in the sense of “concentric ontology security” (i.e., in an increased sense of physical and spiritual vulnerability in a culture that conceives of the self in terms of concentric, protective layers), including fears of being attacked by ghosts; and that nightmares frequently led to the performance of specific practices and rituals aiming to extrude and repel attacking forces and to create “protective layers.” Cases are presented to illustrate these findings. The Discussion considers some treatment implications of the study.

Keywords

Nightmares Post-traumatic stress disorder Refugees Cambodians Self 

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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • D. E. Hinton
    • 1
    Email author
  • A. L. Hinton
    • 2
  • V. Pich
    • 3
  • J. R. Loeum
    • 3
  • M. H. Pollack
    • 1
  1. 1.Massachusetts General Hospital, Harvard Medical SchoolBostonUSA
  2. 2.Anthropology DepartmentRutgers UniversityNewarkUSA
  3. 3.Arbour Counseling ServicesLowellUSA

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