Post-traumatic stress disorder: a reaction to state-supported child abuse and neglect

The policy of apartheid not only fosters conditions conducive to child abuse and neglect, but is in itself abusive. Apartheid policies have led to civil unrest and high levels of violence in South Africa's black townships. Many youth are thus exposed to multiple trauma including witnessing death, being arrested, being beaten, being in exile, and being separated from family and friends. This had led many to develop Post Traumatic Stress Syndrome (PTSD) although this term is a misnomer in the South African context as traumatic stress is not historic but is current. Treatment programs have thus to be modified to accommodate the impossibility of guaranteeing even the physical safety of patients. They have also to be modified to accommodate the fact that most black youth are totally unfamiliar with the notion of the "talking cure." This paper describes a modified treatment program for PTSD which was developed in working with a group of 60 township refugees. Systematic follow up studies of its effectiveness were impossible as many of those treated have gone into hiding to escape the continuing violence in their communities, a violence facilitated by the ultimate guardian of the child, the State. However there are indications that the program was successful in providing immediate relief.