Post-conflict reconciliation led to societal healing, but worsened psychological health

A new study published in Science suggests reconciliation programs promote societal healing, but that these gains come at the cost of reduced psychological health, worsening depression, anxiety, and trauma.

"Our research suggests that talking about war atrocities can prove psychologically traumatic for people affected by war. Invoking war memories appears to re-open old war wounds," said Oeindrila Dube, assistant professor of politics and economics at New York University and one of the authors of the study. "At the same time, the reconciliation program we examined was also shown to improve social relations in communities divided by the war."

The program, which was designed and implemented by Fambul Tok ("Family Talk" in Krio), a Sierra Leonean NGO, brought victims face-to-face with perpetrators in community forums. Victims detailed war atrocities; perpetrators admitted to crimes and sought forgiveness for their actions; and no one was compensated financially or punished for participating. The forums in the study took place in 2011 and 2012, a decade after the country's civil war ended.

Researchers Jacobus Cilliers, of the McCourt School of Public Policy at Georgetown University, Dube of New York University, and Bilal Siddiqi, an economist at the World Bank's Development Research Group, worked with the research and policy nonprofit Innovations for Poverty Action (IPA) to conduct an independent, randomized evaluation of the program. The study took place across 200 villages, 100 of which were randomly chosen to be offered the reconciliation program. The research team tracked 2,383 people in both sets of villages, recording their attitudes towards former combatants, their mental health, and the strength of their social ties nine and 31 months after the program.

The results revealed that reconciliation had both positive and negative consequences. On the one hand, it promoted societal healing: forgiveness of former perpetrators increased substantially in program villages relative to control villages, as measured by an index of questions which gauged emotional and behavioral responses toward this group. Trust of former combatants also increased by 22.2 percent while trust of migrants (many of whom are perceived to be former combatants) increased by 6.7 percent. In addition, social network strength increased by 11 percent, as individuals formed more friendships and relied more on one another for advice and help.

Additionally, those living in program villages participated more in community groups such as Parent Teacher Associations and religious organizations, and contributed more resources toward public goods, including those used to build schools and health clinics.

On the other hand, these gains came at the cost of reduced psychological health: the program worsened depression, anxiety, and trauma. For example, the prevalence of clinical PTSD, or severe trauma, was 36 percent higher in program villages than in comparison villages, where the prevalence of clinical PTSD was 8 percent. Both positive and negative effects persisted for up to 31 months after the program ended.

"This study is the first of its kind, and provides valuable evidence about an approach used to heal war afflicted communities across the world," said Annie Duflo, executive director of Innovations for Poverty Action. "While more research should be conducted on this topic, this study suggests that policymakers may need to restructure reconciliation processes in ways that reduce their negative psychological costs, while retaining their positive societal benefits."

Additional Information:

• Sierra Leone experienced a devastating civil war from 1991 to 2002. More than 50,000 people were killed, thousands more were amputated, and over half the population was displaced. Much of the violence took place within communities, with members from the same villages taking up arms against each other.

• Following the conflict, the Sierra Leonean government and international community set up a national Truth and Reconciliation Commission, but the commission only had the capacity to cover a small fraction of the atrocities that happened during the war.

• Fambul Tok ("Family Talk" in Krio) was founded in 2007 to address the gap and facilitate local-level reconciliation in rural communities. It currently operates in five of 13 districts in Sierra Leone.

• Fambul Tok's reconciliation program has several features in common with truth and reconciliation processes around the world. It holds forums in which victims describe the violence they experienced and perpetrators seek forgiveness for their crimes. No one receives monetary compensation or is punished for participating. However, unlike national truth and reconciliation program, Fambul Tok's hold fits forums at the community level, in groups that include 10 villages on average.