Complex Cases of PTSD: Importance of Sociocultural Factors in the Sri Lankan Context

Abstract

Complex trauma that follow man-made and natural disasters has a psychosocial impact on not only the individual but also on the family, community, and society. Just as the mental health effects on the individual psyche can result in non-pathological distress as well as a variety of psychiatric disorders, massive and widespread trauma and loss can impact on family and social processes causing changes at the family, community, and societal levels. This qualitative study was done in postwar Northern Sri Lanka while actively involved in mental health programs among the Tamil community during 2009–2014. The methodology used case studies to inquire into the variety of factors complicating PTSD. This chapter reports on the sociocultural factors. It was found that sociocultural factors such as ostracization, social isolation, economical status, belief systems, and collective bereavement influenced the impact, manifestation, course, and recovery process of PTSD. Sociocultural factors helping in recovery were social support system, normalization in friendly environments, practice of routine coping strategies, and rituals, customs, and other traditional measures and opportunities for healthy, supportive expression of grief. It was evident that exposure to conflict, war, and disaster situations impact on fundamental family and community dynamics resulting in changes at a collective level. Relief, rehabilitation, and development programs to be effective will need to address sociocultural factors, particularly using integrated multilevel approaches.