Then they come, one by one.
What really disturbs his sleep is that he is lying on full alert, the smallest sound makes his arms and legs twitch in readiness, adrenaline kickstarts his kidneys and his heart suddenly beat fast and hard, like it was a bird caught inside his chest. What really bothers his sleep at one in the morning, just when he begins to slumber, is being torn awake by fear, because he sees the images of the bomb on the block next door back home: the pieces of bodies everywhere, the blood that looks so fake compared to the movies, just lying there in sheeths and clumps coagulating everywhere, and he remembers the faces of some of the pieces lying there, and it´s those images he is trying to avoid looking at and sleep instead. But he can´t. So he lies awake. Because he never wants to see them again.
And sometimes, with peace, memories catch up.
A second refugee comes in together with a volunteer from the organisation helping them. His leg hurts. Why? A knife-stab. Right. When? When he was fleeing. In Italy. And sleeping problems. He is just entering the asylum process and is deeply worried about the outcome. Before this, life was uncertain, but now he can get a ”no”. I don´t ask anything more, I just begin to take his diagnosis in Chinese medicine and then to treat him.
I go and manipulate the needles to help the first refugee. He looks so young. Thin, skinny. That clarity in the face that sometimes comes with too much pain. He is already sitting half a sleep on his chair, a weak smile on his lips, as I turn up. He knows he will sleep tonight. Sleep, for real.
I walk over to the volunteer. She is also young, 23. She is part of that small group of Swedish people who actively work to improve society. I have a lot of compassion for those who invest back in society, for those who want to help out. It is us who know that when people stop doing that, the fall slowly begins, those first steps of the slow fall that leads to us becoming a country to flee from, instead of to.
She is tense, with dark circles under her eyes.
I know that if I open the window, the rain-scent of the city will come in, and the car-sounds from people having a safe existence and a pass-port in their drawers, one that can be renewed at the police office without being afraid to go through the doors.
To listen a few times too many to people telling you about traumas they have had, can give what is called tertiary PTSD.
If memories of traumatic events stay too long and begin to affect us every day, this is usually called posttraumatic stress disorder. If someone has this, symptoms include (but are not limited to) nightmares, flashbacks (quick or longer sequences of memory of the event, intruding during the day), and thoughts and ways of thinking that one can´t get out of, negative thoughts often linked to the trauma and what happened.
Some only get some of these, others get all of them. Some get milder versions, some get severe ones, so severe that they can no longer work.
The other one is called PDSD – Prolonged Duress Stress Disorder. This is where there has been not one big thing, but a long stretch of small traumas for a very long time, until things finally snap. PDSD is more common in social welfare work, for police, and people who live with violence or threat for a long time at home or in the workplace. Swedish psychiatry can usually recognize the first one, but is rarely trained to see the second.
In jobs like that – and within different kinds of aid-work – one needs to have a continual check on the stress levels in life and just gently take care of them, like keeping an eye on a garden or a beautiful flower-box outside the window. You need to look at them every now and then, water, add fertilizer, and check so that weeds are not spreading among the flowers.
PTSD can be treated and allowed to heal again. Western medicine most often uses psychopharmaceuticals, and, in best case, talk therapy together with CBT, Cognitive Behavioural Therapy. Sometimes people are unfortunately just put on psychopharmaceuticals and more or less permanently left to fend for themselves.
I withdraw the needles from the ear acupuncture and smile as I see how much more relaxed the young woman is. While she sits there and gently wakes up, I withdraw the needles from the man with the old stab wound. As he gets up, and tries the leg, it is a lot stronger, the hip doesn´t hurt anymore, nor does the knee. They both look relieved, happier, as they leave.