Asylum seekers and refugees: their situation and treatment needs

On the background of the present situation for refugees in Europe the author describes the refugee experience., which includes the frequent traumatising background for many refugees, the many losses flight implies, the hazards of flight and arrival in a host-country and the exile experience. Exile is described as a profound identity transforming and disturbing process and the work of establishing a new home for oneself and for close ones are underlined. Extreme traumatisation sets off changes in personality functioning and in relations to others that need to be taken into consideration in the treatment and rehabilitation of refugees. The complex situation of refugees with problems relating to psychic and physical harm, low social status and poverty and the challenges of exile represent the context for psychoanalytic treatment. Principles of this treatment are demonstrated with a case presentation. The need for involvement with and work in complex transference and countertransference relations are underlined.