What Holistic Care for Refugees Looks Like

To view the refugee crisis from an attachment lens is to become aware of how forced migration trauma will shape child refugees’ relationships later as adults—even after rebuilding their lives over time. ILLUSTRATION BY MALTE MUELLER


Flee tells the story of Amin, a man who fled the war in Afghanistan as a child refugee. The docudrama is mostly an animation, with a conversation between Amin and the film director leading the narrative. In his own voice, Amin recounts the long, perilous journey for safety, and how as an adult today, he continues to experience disconnection from the people in his life—the kind of disconnection that results from the trauma of anti-refugee behavior and sentiment in global racism and police violence. What Amin went through is unimaginable for anyone, even more so for a child.

We live in a time when climate disasters, political violence, religious and social persecution, and imperialist wars worsen the international refugee crisis, and children are some of the most vulnerable in the tragedies of forced migration. UNICEF reports that “Children make up less than one third of the global population, but almost half among the world’s refugees in 2020. … The refugee population is much younger than the overall migrant population.” It recorded that almost 1 in 3 children who live outside their motherlands are child refugees, while the estimate for adults is less than 1 in 20. The UN Refugee Agency records an estimate of 35 million child refugees, most of whom are unaccompanied by an adult. These numbers show that as of 2020, 42% of displaced peoples from forced migrations are minors.

While physical safety from rescue and resettlement missions are necessary, the long-term effects of a child refugee’s mental and emotional health must also be taken into account, especially when the child’s earliest experiences are marked with not only suffering, but also separation from both their families and home countries. In Amin’s story, it is not a question of if but how his growth and current relationships are impacted by politically imposed distance from a sense of home and safety.

Attachment Theory

One theory that connects a child’s development to their earliest relationships and experiences is attachment theory. The theory posits that the attachment between caregiver and child or infant has a significant impact on the child’s later social formation and physiological development. John Bowlby, one of the creators of this theory, defines attachment as “a bonding process between infant and primary caregiver (usually the mother) that satisfies innate needs of the infant for physical contact, closeness, and safety,” which explains that the infant’s developing brain and body will depend on early nurturance or a lack thereof. In other words, a lot of who we are and how we relate to one another today are tremendously (although not entirely) determined by our earliest experiences. 

There are different kinds of attachment styles, and the following are simplified descriptions of each one.

Secure attachment: If the caregivers are consistently attuned to the child and demonstrate a warm and caring presence, the child is likely to develop a secure attachment. This means that as adults, they are more comfortable with intimacy and with taking risks. They will also likely be more attuned to their own loved ones, as well as their emotional needs. 

Anxious attachment: When the child experiences caregivers who are inconsistently present or are absent, the child will most likely develop an anxious attachment style. With an anxious attachment, the child grows into an adult who is perpetually preoccupied with the state of their relationships. They tend to worry about whether or not the people in their life, particularly their partners, will leave them. From there, they tend to cling to their loved ones, and they feel distressed whenever there is some level of separation from them, which comes from the fear of rejection or abandonment. 

Avoidant attachment: Caregivers were resentful toward the child and pushed them away. In more devastating cases, the caregiver even showed hostility (whether in violence or high degrees of contempt) toward the child or infant. This results in the child growing into an adult with indifference when it comes to closeness. They are likely to turn away whenever they experience intimacy, because as a child, closeness was not safe.

Attachment theory, just like any theory, has limitations. For one, attachment theory was conceptualized and developed by and for White people. Although one of the creators, Mary Ainsworth, built her findings on ethnographic research on Ugandan families, Black and Brown scholars have critiqued attachment theory, saying that it primarily focuses on and prioritizes the relational well-being of White American families and patients. (This also highlights how Black and Brown communities have historically been used as subjects of experimentation for scientific progress.) Secondly, attachment theory centers the nuclear family, particularly the relationship between parent or primary caregiver and child. In many non-White family structures, there is a more collectivized understanding and practice of raising a child, where extended family, neighbors, and family friends are involved in the child’s upbringing.

Attachment Theory and the Refugee Crisis

To view the refugee crisis from an attachment lens is to become aware of how forced migration trauma will shape child refugees’ relationships later as adults—even after rebuilding their lives over time. How does the sudden loss of contact with one’s family affect the experience of trust in later relationships? Will there be an aversion from intimacy or an anxiety to try to keep it? The theory helps prove that shelter does not always equate to safety, and that providing food, housing, clothing, etc. for refugee children is not enough to protect them. There are studies proving that the deprivation of relational care—human contact, even—can increase children’s mortality rates.

The intersection of attachment theory and forced migration trauma adds nuance to the idea of abandonment. Due to geopolitical strife and wars, abandonment is provoked by necessity more than by the caregiver’s choice. In attachment theory, the majority of clinical cases involve parents who willingly abandon their children and forfeit their responsibilities as caregivers, but for many refugee families, to separate means to increase their chances for survival, with the hope that all family members will reunite one day. 

It is possible to acknowledge attachment theory’s stark limitations while recognizing its role in helping to illuminate relational patterns and developmental factors caused by early life experiences. I would argue the theory is more illuminating than actionable; more validating than accountable. But attachment theory can be helpful in holistically supporting refugee children by using its evidence to improve refugee relief and resettlement. The theory confirms that we are all wired for connection (even as early as infancy), and that basic needs include emotional ones. It is imperative for refugee rescue and relief efforts to consider the need for emotional safety as much as physical security, especially for Black and Brown child refugees who are being targeted at alarming rates. We have witnessed these racial disparities in refugee communities today with Russia’s war on Ukraine, and how Africans and Afro-Caribbean refugees are harmed and deprived of the same rescue services and treatment as White refugees. Additionally, we see such disparities in how war, hyper-militarization, and apartheid in countries in the Global South receive less media attention and less compassion—making the genocidal military assaults on countries such as Palestine, Afghanistan, Somalia, and so forth seem more justifiable than the war in white European countries such as Ukraine. 

With attachment trauma, the past does not have to define a person’s life completely, and self-awareness and the recognition of relational care as a basic need may keep it from doing so. There is potential for having a new and different life from understanding the ongoing impact of early emotional wounds. This understanding is especially important for refugee rescue and resettlement efforts aiming to support and house children—those whose journeys of finding home and belonging do not end after finding physical refuge.

GABES TORRES is a psychotherapist, organizer, and artist. Her work focuses on anti-colonial approaches and practices within the mental health field. She also focuses on abolitionist organizing on a global scale. You can find most of her work on her official website, http://www.gabestorres.com, and social media platforms, including Instagram.

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