Profound psychological and emotional injuries may be the most enduring effects of war and violence, yet historically, they are the least addressed in terms of rebuilding a community or society, and preventing future violence within and between communities. Large-scale recovery efforts commonly focus on more visible needs such as food, shelter, clothing, physical health, security, and economic aid.

However, the effects of deep psychological trauma on individuals, their families, and ultimately their communities is typically overlooked, minimized, and seldomly truly resolved. This invariably leads to transgenerational trauma becoming imbedded as part of the psyche of a society that extends the wounds into future generations where it too often plays out in further violence and the creation of new victims. In this way the cycle of violence and the cycle of trauma directly contribute to each other.

The pervasive presence of such a large segment of traumatized members in all areas of these societies poses perhaps the most formidable barrier to recovery and peace. Without these urgently needed services it is expected the trauma of violent physical and emotional abuse, loss of loved ones and neighbors, loss of homes and community, and dramatic decline in basic daily life, will continue. It is imperative to not only the present but to the future that victims on all sides are assisted in healing and recovering from their tragic experiences. True healing and recovery can then better lead to lasting peace.

Whether in the Middle East, Europe, Caucuses, Balkans, Africa, or elsewhere, in modern times or the past, regardless of the original motivation of conflict, unresolved communal psychological wounds, often inherited from one generation to the other, are one of the most powerful fuels of war and violence. The chronicle of hostilities and conflict throughout our human story is heavily woven with narratives of revenge, retribution, and righting past wrongs, with often competing narratives on both sides of the same conflicts. No society or age is immune to these toxic dynamics, as is painfully evidenced by just the wars and bloodshed over the last century. Efforts at maintaining peace and avoiding war are seriously handicapped if they do not directly address such current and historical wounds to create the means for preventing future traumas by preventing unresolved communal wounds from bleeding into subsequent generations.

Treating large civilian populations, experiencing catastrophic psychological trauma pervasive at all levels of a society due to war and violence, poses unique challenges not typically focused on in the therapeutic literature or conventional clinical practice, where the historical application is with individuals or small groups. When the society is one where human services are seriously underdeveloped or absent, and where the integrity of the existing social support system itself is critically compromised by a catastrophic situation, this challenge can be overwhelming. Although needs assessments conducted in the region over the years by various international aid organizations have consistently identified this critical, pervasive, and relatively unmet need, and although NGO coordinating agencies and relief organizations confirm this as a present and growing condition, there has been far too little provided in the way of adequate direct treatment services or local training in trauma treatment.

This lack of action has been primarily due to the lack of workable models and methodologies in the field of mental health for undertaking such an immense, long-term task of treating at the large scale and societal level, and particularly where the local human service infrastructure is significantly lacking. What is required are concerted efforts at developing new models and methods oriented toward treating large populations in societies where trauma has become systemic and available resources are extremely limited, to both heal the current trauma and prevent it’s transfer into future generations where it can erupt at any given flashpoint within and between communities.

Local capacity building: These approaches must incorporate an integrated and multi-level flow of services and supports designed to respond to both immediate and long-term effects of trauma. A key feature is that the capacity to provide and quickly expand these services on an ongoing basis is designed to be instilled within the local community itself by tapping into the available skills and human resources within it. The deep symbolism of a community healing itself is vital to regaining the sense of empowerment, value, dignity, and balance with the world that is threatened and undermined by the trauma experience. It is noteworthy that these qualities within a community also support compassion and tolerance toward others that can help defuse impulses toward revenge and retribution.

It is imperative that any model also be sensitive and appropriate to the cultural context of both the trauma experience and treatment. Thus, in addition to adaptations of highly effective mental health treatment methods, it is important to enlist traditional healing aspects of the society, including its cultural and spiritual resources.