Consistent failure over the past few decades to reduce the high prevalence of stress-related disorders has motivated a search for alternative research strategies. Resilience refers to the phenomenon of many people maintaining mental health despite exposure to psychological or physical adversity. Instead of aiming to understand the pathophysiology of stress-related disorders, resilience research focuses on protective mechanisms that shield people against the development of such disorders and tries to exploit its insights to improve treatment and, in particular, disease prevention.

In a previous issue of Biological Psychiatry, we reported on the efficacy of repeated intranasal oxytocin administration early after emergency department admission in preventing posttraumatic stress disorder (PTSD) symptoms, assessed 1.5, 3, and 6 months posttrauma (1). In a randomized, placebocontrolled trial, we demonstrated beneficial effects in patients with high symptom levels before treatment onset (1,2).

Oudere patiënten met posttraumatische stressstoornis (PTSS) kunnen profiteren van kortdurende traumatherapie. Dat concludeert Jeannette Lely naar aanleiding van haar promotieonderzoek.
Ze onderzocht de behandeleffecten van twee psychotherapeutische behandelingen bij ouderen – één gericht op het verleden, de ander op het heden – en concludeerde dat een beduidende

Working with family conflicts can be a challenging task for counsellors. In a collectivist society, such as Afghanistan, where interactions between people of the opposite sex are highly regulated, counselling sessions with an individual involved in a family conflict may not be very effective unless conducted in a culturally sensitive manner. As asking for help from professionals may be considered to be ‘lunatic’, as well as a potential threat to the honour of the family, family counselling is not often easy to carry out and may actually pose risks to the client and to the counsellor.

This personal reflection on my daily interactions with an Afghan woman, Bibi Hawa, aims to describe how I witnessed her psychological distress, partly manifested as chest pain, and her resilience to this distress in a particular Afghan socio-cultural and political context. My reflections shed light on the importance of finding a space in which resilience can be built.

Drug addiction is a problem in many countries, affecting many lives, damaging the addicted individual and affecting their families and communities. In underdeveloped countries, such as Afghanistan, there are often no appropriate systems for rehabilitating drug addicted people. Most hospitals tend to use detoxification as the main treatment programme, and there remains a large gap between demand and treatment services. In this case study, the author discusses the possibilities for dealing with the various causes of substance abuse and recommends solutions.

This personal reflection examines the author’s experience while conducting qualitative research on the traumatic life events and coping among the female workers in Kabul University’s dormitory for female students. It also describes the experiences of one of the study’s participants, a woman who suffered from severe domestic violence and enacted various ways of active coping.

This short case history describes the counselling process with an adolescent girl in Afghanistan. It illustrates the lack of sexual education for children and adolescents in Afghan society and reaffirms that listening is the most important part of counselling. Listening includes showing that you believe the client, being careful with questions and giving the client the feeling that she does not have to justify herself.

Girls living in juvenile rehabilitation centres, especially as a consequence of escaping from home or sexual contact, can be difficult to engage in counselling sessions. Often, this can be related to the idea that help seeking from a psychologist or counsellor is equivalent to being labelled as ‘crazy’. Added to that is the belief that family secrets must stay at home, so girls feel uncomfortable speaking about their problems. As a result, counsellors’ attempts may lead to failure. This personal reflection shows the author’s first experiences working with clients.

In Afghanistan, most families strongly believe that their female members should stay at home concern themselves with housework. In general, women are anything but encouraged to get an education and/or have a professional career. This personal reflection shows that Afghani women, with support, can develop their competences and enjoy life.