To mark the end of South Asian Heritage Month, Shabnam Berry-Khan, director of PsychWorks Associates, shares why the traumatic experiences of people coming to the UK in previous generations continue to impact today – and why, for that reason, a wholly bespoke approach to trauma within this community is needed from medico-legal professionals
“From empires such as the Mughal, the Duranni, the Vijayanagar and the British, from indentured labourers forced to travel to the Caribbean and East Asia, and other migrants who travelled by choice to Africa and beyond, to the journeys that families made to the UK with just £3 in their pockets, we have all been affected by the journeys of empire.” – SAHM website
This past month, from July 18 to August 17, has marked South Asian Heritage Month (SAHM). It is significant as an opportunity to celebrate the South Asian contributions to the UK and to recognise stories from these times, both positive and difficult.
This year, additionally, SAHM highlights the anniversaries of two significant and scarring events – the 75th anniversary of the partition of India into India, Pakistan and Bangladesh, and the 50th anniversary of the Ugandan expulsion of South Asians by Idi Amin.
SAHM has been marked by us at PsychWorks Associates and is a topic that is dear to my heart – not just because I’m a brown person whose parents were both refugees in the respective India and East Africa crises. But also because, as a psychologist, I know these experiences will be alive and active in South Asian clients that we see in some way, shape or form. Regardless of whether it has been a direct experience, and regardless of conscious awareness of it.
Shabnam Berry-Khan, director of Psychworks Associates
South Asian people make up the biggest minority group in the UK – currently there are around three million living here – but what is commonly known about our experience over the years? And how does and should that experience impact the work that you do with someone from the Indian subcontinent?
At this stage, you might be wondering “What crises?”, or perhaps “South Asians I know seem to be doing ok overall”, or maybe “Having lots of family members to rely on is a mixed bag when it comes to rehabilitation”.
First of all, let’s remind ourselves what we know about trauma and traumatic experiences:
- Trauma presents in so many different ways: anger, low mood, compliance and conformity, outbursts, disengagement, confusion, feeling unsafe with familiar and unfamiliar others.
- Trauma exists in the mind and body, so while we might understand the psychological effects, we also need to remember that the body also feels effects (presenting as increased pain, worsened chronic conditions, somatisation, etc).
- Traumatic experiences are intergenerational and are transmitted down the lineage, so the grandparents’ direct experience in 1947 can be experienced in some way in 2022 by the grandchild (who may be our client).
- One trauma can trigger other possibly unrelated traumas such as being bullied, ACEs, DV etc. and so what we observe in a client may actually be an accumulation of traumatic experiences from earlier in life.
Remembering these short, but effective facts, is important when working in the personal injury field.
Next, we can visit some defining facts about South Asian heritage:
- Up to 20 million people migrated to/from India in 1947, making it the largest forced migration and refugee crisis in living history. Two million people were thought to have lost their lives in interfaith conflict whilst communities ‘realigned’ according to religious divides.
My own eight-year-old dad became a refugee, moving from India to Pakistan. He found the most upsetting part was having multi-faith communities and neighbours suddenly turn into enemies overnight. It was a terrifying time: people feared for their lives enough to flee the place of their families, homes and livelihoods. Rebuilding a life elsewhere under such circumstances was not easy either, but what choice did he and others have?
Thousands of the displaced Indians went to East Africa to start afresh. However, ‘Africanisation‘ policies started in some of those countries during the 1960s following their own independence from Britain. The same South Asians who had come to seek refuge, 20 years earlier, once again became a persecuted group.
Many came to the UK. My mum was effectively one of the survivors of the East African persecutions, her family deciding to leave a few years before most of her community was forcibly or economically expelled. The sadness of leaving her home with whatever she could carry in such an uncertain times was masked by the relief of arriving with her family in tack. However, neither of her parents survived more than seven years after they settled in the UK, experiencing an increase in chronic health conditions like diabetes and heart disease. As a result I never met my Nani or Nana (maternal grandmother or grandfather).
For those who stayed behind in a newly carved-up Indian subcontinent, millions also had to start from scratch – despite being from the same original land. It became a hidden refugee experience which is not always recognised, but it was none the easier for it. My father was the only member of his family to emigrate from what was now Pakistan. However, his responsibility to his family remained strong, sending money back home, visiting when he could and feeling the connection, love and belonging that only ‘home’ can bring. He still talks about the Indian village where he grew up and where his mother was buried pre-Pakistan, with a sense of distress and comfort in equal measure.
- Coming to the UK was not the dream it was fantasied to be. It was a living nightmare for many as the hardship and struggle continued.
The British were largely unwelcoming and unhelpful towards those arriving as refugees leaving their lives behind. Housing was difficult to get, and many employers were reluctant to offer roles to brown-skinned folk who were suitably qualified and spoke English. Racism and prejudice were explicit and commonplace, resulting in the next generations – including mine – being told directly or indirectly “to keep your head down…not to do anything to draw negative attention…don’t rise to what is said about/to you or others…don’t think the people here like you”.
Such narratives naturally influence how communities form, how children are raised, how families function and how people end up living their lives. South Asians have consequently grown up differently, we behave differently and subsequently, people treat us differently. Not always consciously and not always maliciously, but we feel it. I don’t know how, but we just do. The impacts lie deeper than just the differences in skin colour – so being colour-blind, while a good start, is only scratching the surface.
- To understand the South Asian experience is to go beyond skin-deep
The plight of South Asians people in recent history as a ruled people for 200 years, who then turned into refugees in living history, and who then faced and can still face significant explicit and implicit racism while trying to survive is important to acknowledge and recognise.
The immediate response from generations since the 1940s might have been marked with the overwhelming sense of loss and grief, the stress and fear of starting over, the disbelief that such tragedy could happen followed by a sense of helplessness, as well as an overwhelming sense of injustice and anger that people can be allowed to treat others so disrespectfully and carelessly. The impact of this ongoing trauma on South Asians’ mental health is immense: affecting relationships, parenting, the ability to engage with others’ potential and vision of what is possible – every aspect of someone’s entire life.
And we also know how trauma can present and affect social interaction: wanting to stick to our own, limited trust, protective parenting, fighting for fairness/justice, sensitivity to injustice or disregard of cultural comforts.
We now also know that traumas of the past – whether directly experienced or carried through the generations – are carried in the body as well as the mind. It is no surprise, therefore, that South Asian people have health issues that are linked to trauma amongst other factors: high blood pressure, heart disease and diabetes are amongst the classic chronic conditions. Life expectancy is shorter compared to white peers, and due to the collectivistic lifestyle, death can be more widely felt by close family, friends and community members.
So what does this mean for personal injury work with South Asian clients?
An interesting paper that came out this year by Prajapati and Leibling, highlighting how South Asians feel about engaging with professional mental health services. Looking beyond the mental health setting and thinking about the service we provide South Asian clients and families, transferable recommendations include:
- Understanding that seeking help triggers powerlessness and threat, and increased anxiety can result in behaviour changes.
- Recognising that South Asian service users can feel disempowered and dehumanised when accessing health services.
- Knowing that family and friends often value the presence of family members for reassurance and support but noting that services did not always value family input, seeing it as a hindrance.
- Language is important to feeling as if a service hears them in the way they want to be heard, because sentiments can get lost in translation.
- Accepting that trust in the professional relationship can be enhanced when professionals look like them (representation) or can demonstrate at all times a sensitivity to the impact of cultural experiences on daily living.
Instead, understanding the traumatic intergenerational journeys of brown-skinned people in the context of a biased society is fundamental to offering a culturally sensitive service. Such a service would be marked with safety and inclusivity, allowing brown-skinned people to live an authentic life without bias – because we need to work hard in the right way for our South Asian clients, not the other way round.
If this topic interests you, have a listen to PsychWorks Associates’ Psychology of Case Management podcast episode on racism in personal injury work
