Mohammed was only the second of my clients to be detained during my 13 years working at Freedom from Torture (FFT), yet I feel that I have lived in the shadow of detention for all the 15 years that I have worked with people seeking asylum.
FFT is a UK-based human rights charity dedicated solely to the treatment and rehabilitation of survivors of torture who seek refuge here. We offer our services to around 1,000 survivors a year. Our psychological treatment aims not just to address the trauma of past experiences of torture and persecution but also to enable survivors to grieve multiple losses and adjust to life in the UK. This adjustment isn’t easy. The asylum process is fraught with delays, administrative errors and poor decision making. Survivors frequently live in poverty; they can face hostility from communities and reluctance from social care services to meet their multiple needs. Our therapeutic model aims both to address the trauma safely and to attend to the many practical challenges and difficulties of living in exile.
One of the most difficult issues our clients face is the threat of detention and subsequent deportation to the country from which they fled, or to the country they first reached before coming on to the UK, where they may have fewer rights and even less protection.
People seeking asylum are expected to report, or sign, at an immigration reporting centre or police station in their nearest town or city at frequencies determined by UK Visas and Immigration (UKVI). This is often when they are detained. The threat of detention and/or removal hangs over our clients from arrival and can last many years. It hangs over their therapist too. Managing this threat is a part of the day-to-day work of psychological therapists working with people seeking asylum.
Detention is not just about the experience of being imprisoned. For those seeking asylum it is also about what is likely to follow: namely, incarceration and the threat of further torture, possible death or persecution and oppression if they are returned to their country of origin. The right to rehabilitation for torture survivors is guaranteed by the UN Convention Against Torture, but the guarantee is illusory in many torturing states. Those with families face being forced to return to a country where their children may have nothing and may be at risk or unable to access the basic human needs of healthcare, education and housing. While they were in the UK their children will have settled at school and will have made friends and become part of their communities. Women, many of whom may have fled sexual violence, may face further abuse and exploitation and be vulnerable to further gender-based abuses such as honour killing, domestic abuse, female genital mutilation (FGM) or sexual exploitation.
According to Home Office statistics, 30,423 people entered detention in 2013. By the end of December that year 2796 people were in detention (not including the number of individuals held in prisons under immigration powers). Just 56 per cent of detainees were removed from the UK during 2013, while 36 per cent of detainees were either released on temporary admission or bailed. Some 199 had been in detention for between one and two years and 50 for two years or longer. The UK is the only country in the European Union without a time limit on immigration detention.1
The impact of detention
Sadly, detention has increased as the Government has taken an ever-harsher line on asylum seekers. UKVI has a policy against detention of torture survivors except in ‘very exceptional circumstances’, but this is routinely flouted and safeguards, including an alert system (known as ‘Rule 35’) intended to trigger release by detention centre doctors of those identified as potential torture survivors, are ineffective. These failings have been the subject of sustained criticism by parliamentary committees, including the Home Affairs Committee, the independent inspectorates for prisons and for borders and immigration, and even the UN Committee Against Torture.
The fear of detention affects and stifles recovery; detention itself can also be re-traumatising. The experience of being imprisoned and the conditions in the removal centre can trigger existing post-traumatic stress disorder (PTSD) symptoms, and detention can be a traumatic experience in its own right.
Alvine described how her nightmares became more frequent and violent in the immigration removal centre (IRC). Her flashbacks in detention were daily and she had only a few hours sleep at night, often waking up suddenly, thinking she was still in Cameroon. She described a sense of hopelessness and dread and her anxiety and panic attacks also increased. She felt that she was sinking into hopelessness during those months. Intrusive memories ‘ran like a TV film’ through her mind, she said, and she found herself planning suicide frequently, such was her fear of being returned to her country.
Freedom from Torture is well-versed on the procedures to follow when a client is detained. On the day we receive the phone call that a client has been detained, we contact their legal representative and arrange for their belongings to be stored safely (if they’re detained at a reporting centre, people are not allowed to collect their belongings). We also phone their friends and any social care agencies that are involved. We reassure the client that we will ring them daily throughout their detention.
One of the most isolating aspects of being alone in the UK is the feeling that anything can happen to you and no one will know. Our staying in contact is crucial to assisting a survivor to manage the isolation of detention. The daily telephone calls can become a lifeline; clients always tell us that the calls have been hugely significant in their ability to function day-to-day in a detention setting. Sometimes an FFT therapist will offer a full 50-minute weekly telephone session to help survivors manage the experience, to remind them of their resources and any tools learned during therapy, and to reassure and support them.
As in Imran’s case, for some clients the experience itself can be so re-traumatising that the therapist is unable to contain their acute distress and deterioration. Therapists can be left anxious and overwhelmed by their client’s distress and the damaging impact on a client with whom they may have worked for some time.
Imran had been progressing well in therapy prior to being detained. He was reporting reduced anxiety, a greater sense of safety, fewer nightmares and was more hopeful for his future. He was learning to manage the voices of his torturers, which had been overwhelming when he first started therapy. When he was detained and removal directions were set for him to be returned to his country, his mental health deteriorated rapidly. We rang him daily at the IRC; he was confused and disorientated and struggled to distinguish his cell at the IRC from the cave where the Taliban imprisoned him in Afghanistan. ‘They keep coming at night and they do bad things. Please get me out, they come at night and hurt me,’ he told us.
The two worlds melded for Imran. The noises of doors slamming, the smells of the urinals and the ‘smell of a frightened man in the dark’ placed him back in the cave, facing further brutality and possible death. Imran’s therapist found these phone calls deeply distressing; she felt powerless to help. She could feel that her therapeutic relationship with him was fading, and her ability to assist him was being undermined as he became more and more disorientated and unwell.
The role of the therapist
Mohammed came even closer to removal than Imran, whose flight was cancelled the day before he was due to be returned. Mohammed was actually being escorted towards the plane when his removal to Sri Lanka was terminated. A member of the FFT therapy team was speaking to him on his mobile as he walked to the plane, telling him that we were thinking of him and reassuring him not to give up hope. Mohammed described how the security officers from the Home Office had begun to taunt him – ‘We can hear you begging;’ ‘It’s too late for you now’ – as he was walked towards the flight. Then he heard a voice behind him asking him to step aside because his flight to Sri Lanka had been cancelled. His legal representative had successfully stopped his deportation.
Mohammed is a survivor of torture from Sri Lanka. He had been in the UK for a year when he was detained at a reporting centre and taken to an IRC. He spent six weeks at four different IRCs before he was finally released. Mohammed and I have been working together for the last year and he is only now beginning to recover from his experience of detention in the UK; it has been the focus of a significant proportion of our work.
As the Russian journalist Grossman wrote of the Nazi concentration camps: ‘There’s a despair that crushes you, another that attacks you suddenly, another that stifles you and won’t let you breathe. And then there’s a special kind that doesn’t do any of those things but somehow tears you to pieces from within – like a deep-sea creature brought suddenly up to the surface.’2
Our role as therapists is to normalise a client’s responses to being imprisoned and being denied basic human rights.3 It is as important as helping a survivor manage their fear of return. When Mohammed was detained I voiced my outrage at the injustice of the use of detention in the UK and the failure in his case of policies and safeguards meant to protect him: ‘One important principle of therapy includes solidarity, or expressing honest outrage at what has been done to this person in particular and to her community generally and by joining with her in the face of injury.’4
With Mohammed, our role was to keep his hope alive right up to the point of departure. We knew an injunction had been sought and that there was still a possibility that his deportation would be cancelled. If no legal proceedings were possible, our role would then have been to help Mohammed prepare for removal in the days/weeks leading up to his flight. We would also have had to say our goodbyes, to have the final telephone session – one of the worst possible enforced endings for therapeutic work.
‘It is a truism that work [with families who have experienced torture] is difficult; one can never achieve all that one might wish. Even when there is no clinical intervention, when no skill and no technique come to mind, there is still the person of the therapist who can be there for the client at the moments of deepest despair. To remain there and not run, deny, panic or hide in a professional role may be the most important thing the therapist can offer.’5
Mohammed, at the time of writing, has still not been granted protection as a refugee. His fresh claim has been refused by the UKVI and an application for judicial review against the refusal has also been turned down. He lives under constant threat of deportation. Required to report every fortnight, he has only one or two days after reporting when he feels a sense of relief and safety. Then his anxiety begins to build again towards his next reporting date.
Mohammed has helped me understand what it is about detention that so profoundly affected him. It began for him when he went to report. He was ‘appeal rights-exhausted’ but his legal representative at the time had made further submissions. So on the day he reported he considered himself relatively safe. His description of the moment when he knew something was terribly wrong is similar to the way he has talked about his arrest in Sri Lanka: the same sense of powerlessness and terror and the feeling that his life was at risk; the symptoms such as a racing heart, terror, shock and a feeling of dread.
He was moved frequently between IRCs, and this disorientated and distressed him. At a time of vulnerability he had to constantly adjust to a new and alien environment, with new rules and pressures, which reinforced his sense of lack of control over his life.
He described the room in which he was detained at one centre: ‘It is a small room and I felt so suffocated. When they put me there, the first question I asked was “When will you let me out?” There was no fresh air and just a small, blurred window that you could see nothing through, that opened upwards so you could not feel the air. You are supposed to be in these cells for three to seven days and are locked in for 23.5 hours a day. They let you out for up to an hour but how long you can exercise depends on who the officers are. In that room you go to the toilet, shower and eat with another person… in that one room. There are bunk beds and a table to eat on and a toilet with a curtain and so when your cellmate goes to the toilet you have to hold your nose. When you shower, water comes into the room and you have to mop it up…
‘I was there for three days and everything happened in that room, you see nothing outside that room – nothing. In Sri Lanka, the cells are bigger [with] lots of men and you are let out into the sun and you have the distraction of being able to talk to the other men… [at the UK IRC] I felt like I was suffocating. A man could go mad in there.’
Mohammed has an extremely close relationship with his mother, who remains in Sri Lanka. He rings her frequently; his father died when he was young; his brother was ‘disappeared’ four years before Mohammed was himself imprisoned and tortured. His mother, like many mothers of the disappeared in Sri Lanka, had worked hard to protect him and still waits for his brother’s return. Making those calls to his mother when he could no longer be strong and reassuring was painful for Mohammed.
Mohammed has talked often of his time in detention and, after a year, it is only now I think that he believes that he is recovering from it. He still feels under extreme threat and on the days he reports he packs a bag of the belongings and the key papers he will need if he is detained and swaps his Sim card to a phone that does not take photos, as only these are permitted in detention centres. On these days he is on standby, holding his breath until he walks back out of the door of the reporting centre.
In the early days following his release, I sometimes felt like I held my breath too. As a manager and an activist I find it hard to give space to my feelings as a therapist when clients are detained. My priority are the needs of the client and our staff, who work so hard to contain and support them. When I do allow myself what feels like this luxury, my overwhelming feeling is outrage and the same feeling of powerlessness that our clients describe. What clients need from us is hope, reassurance and a calm determination to do all that we can to help within our role. It was only when Mohammed was released that I realised how angry I was. It was such a relief to see him.
Some support organisations may expect a therapist to cease working with a client when they are detained. At FFT, our role is to contain and support our clients and stay alongside them where we can, even while they are detained.
We may need to liaise directly with the IRC’s medical team if the client is at risk of serious self-harm or there are concerns that their mental health is deteriorating as a result of being detained. We can also ask the client’s GP to write to the IRC medical team to inform them of any health concerns and of any prescribed medication. We can also refer a client to the visitors group local to the IRC, as these can be a vital support and can also provide advocacy and links to campaign groups.
Enabling your client to explore their experiences with you during and after release will often be crucial in helping them process what they witnessed and heard and its meaning for them. For many, detention will change their perception of the UK forever and bring an awareness that Mohammed says will never leave him – an awareness of who has power in society.
He told me: ‘I saw four suicide attempts when I was in those places and a lot of violence because it is a frightening and desperate place… I lost hope and you think of suicide because you can’t do anything to help yourself; you have no power to protect yourself.’
If a client is released, therapists at FFT often describe how the therapeutic relationship has deepened as a result of our ongoing input during detention. But with some clients rebuilding the relationship can take some time. Their sense of safety in the UK has been severely affected and they have yet more painful memories and feelings to process. Some may carry anger that their therapist could not protect them from detention, and most will be rightly angry and outraged at being detained and the conditions they witnessed.
As I’ve written elsewhere: ‘There can be consequences for the therapeutic relationship in acting to protect and advocate for a survivor of torture. Acting to protect may ensure your clients safety, but may leave a sense of indebtedness that in itself may be an obstacle in the therapeutic process, or it may strengthen and deepen the relationship.’6
Ensuring the client has an opportunity to explore this dynamic is crucial, although it may not always be necessary. Mohammed was simply grateful that we continued to be there for him throughout his experience, even while remaining deeply upset that a country for which he held such respect would disbelieve him and treat him like a criminal.
‘In Sri Lanka, prison is about physical torture, and the verbal abuse and that complete lack of respect. That verbal abuse and no respect, this is the same thing I saw in detention in the UK… you are imprisoned and have no rights and you are powerless,’ he says. ‘I am still shocked, I had not seen this sort of behaviour before in the UK and I will never forget it… you ask yourself, “Why am I in prison, I have not done anything?” It is the same.’
Jude Boyles is a BACP senior accredited counsellor with a diploma in psychodynamic theory and practice and a diploma in post-traumatic stress disorder. Jude qualified in 1994. She worked in a social services crisis service for 11 years and has worked for Freedom from Torture for 14 years, initially for two years as a psychological therapist at the London centre, before setting up and managing Freedom from Torture North West, where she is Centre Manager and a clinical supervisor.
Mohammed Shaez (not his real name) studied English in Sri Lanka at school and came to the UK as a young man for further English studies, where he qualified in ICT. Mohammed returned to Sri Lanka to support his family and manage the family business when his brother was ‘disappeared’. He now lives in the North West and attends a music group at Freedom from Torture, as well as weekly therapy. Mohammed’s long-term aim is to get work in the ICT field.
1. All Parliamentary Group on Refugees/All Party Parliamentary Group on Migration. The report of the inquiry into the use of immigration detention in the United Kingdom. London: All Parliamentary Group on Refugees/All Party Parliamentary Group on Migration; 2015. https://detentioninquiry.files.wordpress.com/2015/03/immigration-detention-inquiry-report.pdf
2. Grossman V (trans Chandler R). Life and fate. London: Vintage Books; 2006.
3. Proctor G, Cooper M, Sanders P, Malcolm B (eds). Politicizing the person-centred approach: an agenda for social change. Ross-on-Wye: PCCS Books; 2006.
4. Zerbe Enns C. Feminist theories and feminist psychotherapies: origins, themes and variations. Binghampton, NY: Harrington Park Press; 1997.
5. Jaffa T. Therapy with families who have experienced torture. In: Wilson JP, Raphael B. International handbook of traumatic stress syndromes. New York: Plenum Press; 1993 (pp715–723).
6. Boyles J. Not just naming the injustice: counselling asylum seekers and refugees. In: Proctor G, Cooper M, Sanders P, Malcolm B (eds). Politicizing the person-centred approach: an agenda for social change. Ross-on-Wye: PCCS Books; 2006 (pp156–166).