Dr. Lin Piwowarczyk, co-founder of the Boston Center for Refugee Health and Human Rights, has been working with torture victims and refugees for over 30 years. Specializing in the mental health evaluation and treatment of refugees and survivors of torture, she is currently the principal investigator for an Office of Refugee Resettlement grant addressing the holistic treatment of torture survivors. She spoke to Sampan at length about her life, her work, and what we can all do to protect human rights in a time of danger and uncertainty.

Sampan: First, can you provide some biographical information? Where did you grow up, what were your interests, and how did you ultimately get into psychiatry?

Piwowarczyk: I grew up in an immigrant family whose origins are situated in Poland. Many of my early memories in New Bedford date to my family’s engagement with their community, their faith, and ethnic clubs which were the center of their social life. For over 20 years, my parents hosted a weekly radio program called “Polish Happy Time,” on WNBH-AM. I always found family activities, being out in nature and physical activities, especially hiking and kayaking, engaging. I actually attended medical school in Poland. After returning to the U.S., I first completed a residency in Primary Care at Carney Hospital. Exposed to the many psychosocial issues that often affected health led me to complete a residency in Psychiatry at (what was then called) Boston City Hospital.

Sampan: Your work focuses on refugees, asylum seekers, and torture survivors. How did you become interested in this work?

Piwowarczyk: I was fortunate to complete a fellowship in international psychiatry with the Harvard Program in Refugee Trauma, which focused on work with refugees from Cambodia and Vietnam. This program concluded with an internship in Geneva at the United Nations High Commissioner for Refugees. At its conclusion, I returned to Boston City Hospital to begin an international mental health program working first with African asylum seekers. Seeing how such traumatized individuals could continue to love notwithstanding what they had gone through inspired me to continue this as my life work and contribute to the establishment of the Boston Center for Refugee Health & Human Rights.

Sampan: Among your areas of expertise is the impact of torture. You wrote in a Boston Globe editorial in 2014 that “there can be no exceptions as it relates to torture or ill treatment, as to do so places us all in peril.” What are some of the effects torture has on victims? Further, how do it make all of us less safe?

Piwowarczyk: The act of torture is meant to terrorize communities and make them silent. It endangers us as it can be used to suppress opposing ideologies. This unique trauma can affect its victims psychologically, physically, socially, as well as existentially. Such trauma can affect our ability to trust as when mediated by states or even neighbors with complex humanitarian disasters, it represents extraordinary betrayal. Chronic pain can be a constant reminder as well as feelings of depression, anxiety and hopelessness. This is why programs that are holistic are needed to bring healing: primary care, mental health services (individual and group treatment), case management, career development services and English classes as needed in addition to subspecialty services.

Sampan: You are also one of the founders of the Boston Center for Refugee Health and Human Rights. In your experience, what health services are asylum seekers most in need of? What more can we be doing to improve the immigration process for asylum seekers?

Piwowarczyk: There is a tendency to see asylum seekers as nebulous group of thousands without truly seeing them as individuals who have experienced trauma in their countries of origin, in transit and even after coming to the United States. The immigration process is in need of greater staffing both in terms of immigration officers and immigration judges to address the extraordinary delays and the “last in, first out” policy which has exacerbated asylum wait times. There is a tendency to dehumanize individuals who fundamentally are seeking safety.

Sampan: As a practicing clinician, you have also presented on spirituality in clinical encounters. Why is spirituality important to consider, and as a clinician how do you handle differences in spiritual beliefs?

Piwowarczyk: Across many faith traditions, we recognize that spirituality is often a source of hope and often fortitude. At its core, trauma can challenge how we understand the world. Shaking this fundamental foundation can result in feelings of hopelessness and despair. Being grounded in one’s faith can provide a source of individualized support in addition to community support. Coming from collectivistic cultures, one’s faith community is often central to life’s activities and journey. Reconnecting with a community can contribute to the healing process as “one is seen”.

Sampan: We’re speaking on election day in the United States. What are some policies – on a local or national level – that you would like to see developed to address the issues you’ve worked on in your career?

By all accounts, it would appear that we may be entering a very challenging time. Meeting patients where they are at and being attuned to their concrete reality are critical. It becomes important to remind folks of the resilience that was required to survive trauma and to come to the United States. We had many immigration challenges after Sept. 11. Through working together as programs in collaboration with communities we were able to not only survive but to thrive. My hope is that the U.S. will continue to be a beacon and uphold its commitment to the UN Declaration of Human Rights Article 14 which speaks of the universal right of all people to seek and enjoy asylum from persecution.

Sampan: What can ordinary citizens like me do to support the work you and others are doing

Piwowarczyk: Please reach out to agencies and programs serving refugees and asylum seekers. Material and financial support can be very important and helpful. Consider volunteering with the many advocacy opportunities which are going to arise at this very time.