Dr Rangan ChatterjeeHealing Children in War Zones: Lessons in Hope & Humanity | Dr Alexandra Chen
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CHAPTERS
- 0:00 – 6:31
18 years on the front lines: what Dr Chen has witnessed in conflict zones
Dr Alexandra Chen describes working in conflict zones since 2008, including with children affected by war, displacement, sexual violence, and torture. She paints a picture of both visible devastation and “invisible wounds” like despair, fear, grief, and community fragmentation.
- •She has served in conflict zones since 2008 and worked across roughly 14–15 contexts, including early years with the UN
- •Children witness bombings, deaths, destroyed neighborhoods, and loss of home and identity
- •Beyond physical destruction, invisible impacts include despair, terror, anger, and extreme fear
- •Families face starvation, years living in tents, and dangerous attempts to flee
- •Severe psychological symptoms can include loss of touch with reality and psychosis after torture and intimidation
- 6:31 – 8:15
What healing can look like without physical safety: emotional safety, honesty, and accompaniment
Dr Chen explains that in war zones she cannot promise physical safety, so the work centers on emotional safety and trust. A core ethic is not overpromising; instead she offers presence, truthful framing, and steady accompaniment through the immediate moment.
- •Emotional safety starts with not overpromising or lying to comfort someone briefly
- •She names reality (“you are in danger”) while offering herself as a safe, non-harming person in that moment
- •Support often means sitting with crying, rage, and terror rather than trying to fix everything
- •Practical accompaniment can include helping families problem-solve survival needs (like food)
- •She teaches the importance of being able to say “I don’t know,” while staying with someone through uncertainty
- 8:15 – 11:46
Case story: Lara, a seven-year-old double amputee and the burden of survivor’s guilt
Dr Chen shares the story of Lara, a seven-year-old girl from Gaza who lost both legs in a bombing and watched her father die after protecting her. Therapy focuses on creating a confidential space for grief, addressing survivor’s guilt, and rebuilding a sense of contribution and identity after profound loss.
- •Lara survived a bombing that destroyed her home; her father shielded her but died while they were trapped
- •Her father’s last message pressured her to be brave and take care of the family, intensifying guilt
- •She feared crying and hid suffering from her mother to avoid “breaking” her
- •Therapy involved working through survivor’s guilt and finding ways she could still contribute at home
- •They also grieved the loss of her identity as a dancer and what that meant to her life
- 11:46 – 12:32
Family-centered trauma care: confidential individual work plus rebuilding relationships
Dr Chen explains that her team tries to support entire families, not only the identified child. Each family member can have their own therapist for confidentiality, and later the family may work together to repair relational fragmentation caused by war and displacement.
- •Parents often seek help for a child, but the parent is also carrying grief and stress
- •The approach encourages parents to participate in therapy rather than focusing only on the child
- •Different therapists for each family member support confidentiality and safety
- •Family sessions can address relational ruptures once members are ready
- •The model aims to “hold” the whole family system through crisis
- 12:32 – 16:06
When good intentions harm: ethics, trust, and the danger of overpromising in humanitarian work
Dr Chen shares lessons learned “the hard way” about how uninformed help can cause real damage and break trust. She gives an example from the Syria crisis where milk powder distribution without instructions and clean water led to babies getting sick, illustrating why community context is essential.
- •Good intentions can violate “do no harm” if community realities aren’t understood
- •An NGO distributed milk powder without readable instructions and without clean water access
- •Some mothers fed powder directly, and babies became sick
- •Mishandled aid can create humiliation, suspicion, and loss of trust
- •In therapy, overpromising can make people withdraw and feel unable to be fully themselves
- 16:06 – 20:35
Case story: a survivor of imprisonment and torture—and how documentation can be life-saving
Dr Chen describes working with a Syrian man who endured years of torture under the Assad regime and ISIS, and who lost his fiancée without ever finding her. He wanted to tell his story once; she learned that careful documentation and validation could protect him on his asylum journey and reduce repeated retraumatization.
- •He survived years in prison and torture, and carried grief and uncertainty about his missing fiancée
- •He insisted on telling his story once so he wouldn’t have to repeat it repeatedly
- •Dr Chen documented and validated his patient history, translated it, and coordinated verification
- •He later told her the document “saved my life” during asylum processes
- •The story shaped an ongoing practice: offering patients the option to document their history with consent
- 20:35 – 24:15
Why she chose this work: family refugee history and discovering therapeutic power through dance
Dr Chen recounts growing up in affluent Hong Kong, later learning all four grandparents were refugees, and encountering Palestinian refugee camps at 18. She began volunteering as a dance teacher and learned to use arts therapeutically, which changed her view of psychology and showed the potential for transformation after extreme trauma.
- •She grew up with limited exposure to poverty and war, later learning her grandparents had escaped war
- •At 18, she visited Palestine and was deeply affected by children who “didn’t smile”
- •She volunteered as a dance teacher in a refugee camp and learned arts could be used therapeutically
- •Seeing children who witnessed murders transformed her understanding of psychological healing
- •She emphasizes both movement/dance and psychological work as pathways to healing
- 24:15 – 31:11
Expressive therapies in war: power, limits, and the problem of “too much too soon”
Dr Chen explains how dance, music, art, and theater can help children express rage and grief when words aren’t available. She also cautions that large-scale programming can overwhelm children who aren’t ready, making timing and pacing crucial—especially with uncertain session counts and scarce resources.
- •Expressive therapies can help children release emotion and express what they can’t verbalize
- •Movement and group rhythm can support regulation and connection
- •Children may be carrying fear, anger, and enormous grief; approaches must fit their state
- •She warns that arts-based interventions can overwhelm if introduced too soon
- •War-zone therapy faces uncertainty: each session may be the last due to displacement or death
- 31:11 – 44:43
Healing for Gaza: the moment of conviction and building an online therapy “container”
Dr Chen describes the conversation with Lena that pushed her to act, and how her mother’s words reinforced the decision. She then explains Healing for Gaza as an emergency intervention delivering culturally resonant therapy via global teams of therapists and trained interpreters, housed within the Early Light Foundation.
- •Lena argued that even one child’s healing matters because each child is “the whole universe” to someone
- •Lena described how her child’s healing also reduced family conflict and guilt across the household
- •Dr Chen realized trained interpreters can enable therapy even when clinicians don’t speak Arabic
- •Healing for Gaza provides a structured “container” for online therapy with clinicians and interpreters
- •She shares its growth from a small start to a large team connecting patients, therapists, and interpreters across countries
- 44:43 – 54:48
When trauma frameworks assume safety: rethinking PTSD tools and pacing regulation in active war
Dr Chen explains that many Global North trauma models are built around PTSD and presume the person is now safe. In active war, protective responses like hypervigilance or dissociation may be necessary, and even common regulation tools (like humming or certain breathing exercises) can be inappropriate or triggering—so therapy must move slowly and follow the patient’s boundaries.
- •She says PTSD frameworks assume safety, which often isn’t present in war zones
- •Hypervigilance and dissociation can be adaptive survival mechanisms while danger continues
- •Some regulation tools can backfire: humming can resemble drones and trigger fear
- •Even breathing exercises can overwhelm dissociated or injured patients
- •The work emphasizes humility, avoiding one-size-fits-all protocols, and letting patients set the pace and boundaries
- 54:48 – 1:01:01
The hidden cost of “resilience”: what children taught her about the word and its health burden
A child challenges the repeated labeling of refugees as “resilient,” arguing it can comfort outsiders while ignoring the toll on bodies and families. Dr Chen expands on resilience as real but often unjust when demanded across a lifetime, linking it to cumulative load and the erosion of community capacities like hospitality under starvation.
- •A boy criticized foreigners praising “resilience” as a way to feel better without changing injustice
- •He described resilience as carrying a cost reflected in family health problems
- •Dr Chen describes resilience as meaningful but warns against oversimplification or celebration without action
- •She distinguishes short-term resilience from lifelong, multigenerational endurance under oppression
- •A patient feared starvation conditions would change who people are as a community by preventing care for neighbors
- 1:01:01 – 1:04:31
Guilt and connection: survivor’s guilt, privilege, and learning to carry responsibility without self-blame
Dr Chen discusses guilt as complex: it can be paralyzing, but also reflects love, connection, and shared responsibility. She returns to Lara’s story to show separating responsibility from guilt, and shares her grandmother’s message not to waste time feeling guilty for privilege but to use it to help others.
- •Guilt can reflect deep connection in cultures emphasizing interdependence
- •Some survivors insist guilt keeps them human and connected rather than “icing over”
- •Guilt can manifest in behaviors like struggling to eat when others are starving
- •With Lara, therapy aimed to separate responsibility from guilt and align with what her father would have wanted
- •Her grandmother urged using privilege to help rather than losing time to guilt
- 1:04:31 – 1:15:54
The emotional cost of helping: staying open-hearted through supervision, therapy, crying, and release
Dr Chen describes how the work has changed her and how she prevents cynicism and “hardening of the heart.” She outlines strict support structures for her team—mandatory therapy and supervision—and speaks candidly about crying as essential, plus practices she uses to ensure clinicians stay emotionally available.
- •She says the work requires holding both darkness and light without collapsing into despair
- •A mentor told her the task is to not let what she’s seen “darken your soul,” framing it as a choice
- •Her team requires clinicians to be in their own therapy and in regular supervision
- •She emphasizes crying as a necessary form of release and warns against emotional numbness
- •She sends numbed team members home to watch a sad film and return able to feel again
- 1:15:54 – 1:20:41
Why we disconnect from war—and creating an outlet for empathy to become action
Dr Chen argues people often turn away not only from horror but from helplessness: empathy without an outlet becomes demoralizing. She describes practical ways her team stays informed without becoming overwhelmed, including watching videos without sound and using written situational reports instead of constant graphic media exposure.
- •She says empathy combined with helplessness can be dehumanizing and causes avoidance
- •Healing for Gaza was partly designed to give people a constructive outlet for empathy
- •She recommends consuming distressing video content without sound to reduce bodily overwhelm
- •She notes sound is deeply tied to safety and can be especially triggering
- •Her team consolidates news into written situational reports so clinicians can stay informed without constant graphic viewing
- 1:20:41 – 1:33:58
Making a difference without carrying everything: courage, compassion, and signs of joy after devastation
Dr Chen and the host discuss how people can serve where they are best positioned, rather than trying to care about everything. In closing, she shares moments of unexpected joy and reconnection during field missions, emphasizing that rebuilding community and humanity can happen through creating spaces where people find each other again.
- •She argues no one can care about everything, but everyone can serve where they can best make a difference
- •She frames kindness and compassion as resistance to what violence is doing to humanity
- •She supports having difficult conversations because what is happening affects bodies and societies
- •On a mission, two separated groups overlapped and friends reunited after thinking each other were dead
- •She highlights men’s participation in therapy groups and the meaning of global solidarity for people in Gaza
