This chapter describes several historic, illustrative cases of refugees who have survived torture and severe trauma. From a clinical perspective, these patients represent severe cruelty and evil inflicted on them. In addition to their clinical symptoms of prolonged posttraumatic stress disorder (PTSD) and depression, they raise the disturbing question regarding why evilness occurs. For most therapists, there was nothing in their education to prepare them for such disturbing human tragedy. At a philosophical or religious level, there is no adequate explanation or understanding for this personalized evil. As the events in Iraq demonstrate, no country, and perhaps no individual, is totally immune from committing atrocities. The author suggests honesty as well as empathy and professional commitment in caring for traumatized patients and offers suggestions for therapists to keep their sense of balance while performing their professional responsibilities.
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