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Published online by Cambridge University Press: 17 April 2020
The process of migration has been described as a “trauma”, with psychic consequences conceptualized as post-traumatic stress disorder. As many clinical and extra-clinical variables are involved, there is a need for a better understanding.
A case report is described and discussed, under the joint perspective of three different approaches to human suffering, namely that of a neuro-rehabilitation physician, a psychiatrist and a social worker.
M. B. is a 36 year-old male, single and high school-educated, who migrated from Morocco to Italy in 2003. In 2006, he fell accidentally from a scaffolding at work, causing himself a traumatic brain injury with transient loss of consciousness, occipital fracture and bilateral frontal haematomas. He was taken in charge by Social Services. Over the following months, he developed multi-sensorial pseudohallucinations and hallucinosis, changes in character and behaviour, demoralisation, insomnia. M.B. was referred to psychiatry and to a neuro-rehabilitative outpatient service, where he was found to be suffering from severe dysexecutive syndrome, attention deficits and verbal working and long-term memory impairments. Integration of neuro-rehabilitative, psychiatric and social interventions was established to deal with M.B.’s complex needs.
In the experience of M.B., the biological head trauma pairs with the social trauma of migration and the psychological trauma of forced interruption in the migration parabola. The interrelated meanings of trauma - breaking up of a psycho-somatic balance with consequences on cognition, emotions, behaviour and social functioning - require a narrative and collaborative approach to care, addressing complex bio-psycho-social needs.
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