It is estimated that between 1975 and 1979 one to three million of the seven million Cambodian population died under the Pol Pot regime. Hundreds of thousands were executed. Many witnessed the executions of family members and friends. After the atrocities, many survivors developed symptoms of post-traumatic stress disorder (PTSD). The issues of shame and survivor guilt form an integral part of the Cambodian refugee PTSD experience. The cultural factors and the complexity of the symptomatology of PTSD with this population make treatment a special challenge for clinicians. This paper explores the issues of shame and survivor guilt in Cambodian people diagnosed with PTSD, along with the implications for culturally appropriate treatment with Cambodian refugees in the United States.
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