Exploring "Language of Suffering": Idioms of Distress Among Eritrean Refugees Living in Israel

In this paper, we explore idioms of distress among Eritrean refugees currently living in Israel, a refugee population that has experienced profound forms of violence and upheaval in their country of origin, yet largely overlooked in clinical research. A significant portion of Eritrean refugees have, over the past decade, sought asylum in Israel, and Eritrean refugees make up Israel's largest refugee population. To explore their unique idioms of distress, data collection methods included 200 hours of participant observation. It also involved in-depth interviews with Eritrean refugees (n = 26) and key informant interviews (n = 9) with people of Eritrean descent, who were not only active in the Eritrean community but also engaged in service provision for community members. Findings uncovered four groups of idioms of distress for our Eritrean sample including mind-head-related idioms (Bzuh mhasab, Ab aemroy selam ysen, Bzuh hasabat nab resey ymetseni, Hamam Resi), distress-related idioms (Chincket, Tsekti, and Tsulul), trauma-related idioms (Sineaemrawi Smbrat), and supernatural-related idioms (Buda and Tabib). Our findings reveal that Eritrean refugees possess distinct idiomatic expressions rooted in broader cultural frameworks and systems of knowledge. These idioms reference a range of both pathological and non-pathological states, with meanings that may vary based on factors such as education, gender, duration of stay in the host country, and context of use. We argue that clinicians need to take the time to listen to refugees' "language of suffering" and its cultural and contextual complexities in order to better understand their patients' distress and provide more culturally appropriate and effective care.