Syrian refugees pray, Friday prayers at the Wadi Khaled mosque on the Syrian-Lebanese border (Photo Si Mitchell)
Context & Experience:
Civilians continue to bear the brunt of the Syrian conflict marked by unparalleled suffering, destruction, and disregard for human life.
Nearly half of the population of Syria has been forced from their homes. Over 5.4 million people have fled the country since 2011, seeking safety in Lebanon, Turkey, Jordan, and beyond. Over 6 million more are displaced inside Syria and, as war continues, hope is fading fast. Many of those displaced persons have been displaced multiple times. Children and youth comprise more than half of those displaced, as well as half of those in need of humanitarian assistance. Among conflict-affected communities, life threatening needs continue to grow.
The level of trauma exposure and chronic stress is high among these populations, and is compounded by the pressure of unmet needs, social breakdown, and blatant discrimination in many host countries. Numerous interacting social, psychological, cultural, and personal biological factors influence whether individuals develop psychological difficulties or not, in response to hardship, and how they conceive of trauma. Psychological distress can take different forms beyond post-traumatic stress disorder but, in all cases, it can be very damaging. The combination of exposure to multiple extreme stressors and the effects of transgenerational transmission of trauma in contexts where the most recent experiences of violence happen within a long history of abuse and violent repression can be extremely damaging for the individuals concerned, and their communities.
Yet, mental health and psychosocial support remain among the least funded of all interventions in the region, so far. Experiences documented by the World Health Organizations and other agencies over the years have shown that mental health and psychosocial support are an essential part of recovery from conflict. At the individual level, the combination of trauma, anger, and despair makes young people more vulnerable to radicalization and recruitment into extremist groups. Many experiences in conflict environments have shown how blindness to the mental health and psychosocial needs of a group can also sabotage other interventions, in particular livelihood programs.
When asked about their self-care practices and what supports them most in their daily life, a fair number of Syrian refugees name Dhikr (also known as Zikr, meaning “remembrance”). The name refers to a devotional practice in Islam in which short phrases or prayers are repeatedly recited silently within the mind or aloud. It is counted on a set of prayer beads (or Misbaha), comparable to the rosary of Catholic tradition or Japa Mala of Hindu tradition. In some Sufi traditions, Dhikr involves chanting, repetitive movements of the head and body, or dancing.
Dhikr has a lot in common with forms of meditations that involve the repetition of mantras. The breath is also very present in some of the practices, as well as the repetitive movements of the body – all aspects that have been widely studied in different forms of Western meditation and yoga, and shown as having important impact on stress levels and PTSD symptoms, but very little in the context of Dhikr.
As a consequence, the tendency of outsiders has been to implement (although in limited scales) programs that involve Western forms of meditation and yoga, instead of looking at the local practices. Looking at local resources and applying a culturally embedded approach is, however, an important aspect of the ethical guidelines developed by the Inter-Agency Standing Committee (IASC) for any psychosocial support intervention.
Dhikr, as it involves the repetition of prayers and at times movements in a group, also has potential interesting effects in terms of intra-group synchrony.
 “IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings.” Geneva: Inter- Agency Standing Committee, 2007, p. 1; Beatrice Pouligny, Resilience, Trauma and Violence, World Bank SDV Flagship Societal Dynamics and Fragility, July 2010, p. 18.
 Yael Danieli, (ed), International Handbook of Multigenerational Legacies of Trauma, (New York: Springer, 1998); Derek Summerfield, “The Psychological Legacy of War and Atrocity: The Question of Longterm and Transgenerational Effects and the Need for a Broad View”, (1996) 184 Journal of Nervous Mental Disorders, pp. 375-377; Lykes, M. Brinton and Marcie Mersky, “Reparations and Mental Health: Psychosocial Interventions towards Healing, Human Agency, and Rethreading Social Realities”, in: Pablo De Grieff (ed), The Handbook of Reparations, (New York: Oxford University Press, 2006), pp. 589-622.
 Rebuilding Societies: Strategies for Resilience and Recovery in Times of Conflict. A Working Group Report of The Middle East Strategy Task Force. Atlantic Council / United States Institute of Peace (Washington DC, 2016), p. 17.
The Mind-Body Connection – The importance of the mind-body connection has been particularly highlighted in trauma healing processes. Within the different disciplines that study the brain, researchers have been exploring the interaction between contemplative practices (in particular mindfulness and other forms of meditation, yoga, and breathing techniques) the effect on memory, emotions, and chronic stress, with demonstrated effect, at times several months or even a year later. Recent studies have also found that interoception (consciousness awareness of sensations and functions of the body) activates complex neural structures involving the insula, somatomotor and cingulate cortices, and that interoception can be strengthened through contemplative practice. Among the effects studied are the different ways to increase the activation of the parasympathetic system in the body (rest and digest system), as it is chronically underactivated in individuals who suffer from trauma (in comparison to the sympathetic system, i.e. the fight or flight reaction). A few other studies have started to explore how contemplative practices might help relieve some of the traumatic symptoms, but they have not necessarily explored the role of spirituality beyond considering its function as a placebo. Further study is needed into the role of spirituality as an integral part of therapy and trauma healing. Although these effects can contribute to bring “peace” not only to the individual but to the individual’s interaction with others. (see White Paper)
Ritual and Predictability – Predictability is an essential feature of the brain. The brain constantly tries to predict the world and minimize cost; so in order to minimize the cost, and in order to save efforts (not having to encode new things all the time, as the brain takes more time and more energy to process something that is new), the healthy brain primarily bases its work on predictability, not reactivity. Therefore, emotions in the brain can be seen as a function of how predictable a situation is. Indeed, in theory, predictability is relaxing and stress free to the brain (reducing stress hormones such cortisol and epinephrine/norepinephrine).
The idea of predictability is a key characteristic of rituals, even though rituals might fall on a spectrum between predictability and spontaneity. The more predictable behaviors are in a collective setting, the more ritualized they become. The predictable structure and well-defined roles within a ritual allows the brain to relax, allowing the individuals to settle peacefully into themselves as well as the group dynamics. This sense of relaxation enables a feeling of safety, which can help the brain cope with stressful situations and also allow it to explore new perspectives and ideas, as well as expand some of their moral behaviors, beyond their group limits. (see White Paper)
Ritual and Safety – Safety is both a crucial component and a by-product of rituals. Ritualized activities can help build that symbolic safe space for individuals and groups. That sense of safety and trust in the process is important for the brain to be able to process things. Of course, each individual may approach and assess that sense of safety differently; but the hypothesis is that, by assessing different experiences, and looking for those elements comparatively, it might be possible to identify a number of components necessary to ensure that minimum safeness for individuals to engage and for a transformation to happen. (see White Paper)
1.1. Individual and/or collective rituals can regulate stress-related biological responses through explicit top-down control over limbic networks
1.2. Mind-body connections, particularly present in spiritual rituals, reinforce these effects and can act as an essential support to trauma healing processes in peacebuilding contexts
2.1. Group rituals help facilitate social bonding
3.1. Rituals provide predictability in terms of familiar forms and roles for the participants, providing a sense of relaxation
3.2. Rituals provide a sense of safety that can allow for the suspension of the fight/flight response and can ease the stigma around traumatic experiences
Similar experiences and practices in this database:
Dr. Marc Gopin share a simple, yet powerful experience of a spontaneous ritual that helped established a safe space for dialogue among Syrian refugees.