Surviving Afghan trauma amid rigid immigration policies

This story is derived from my master's project at Columbia Journalism School

He shut his eyes tight as his fingers moved across the keys, rhythmically playing the fast-paced melodies on his piano. The piano is vital to Milad Yousufi’s future - he dreams of becoming a renowned pianist and music composer in the U.S.

Yousufi’s journey and struggles come to life through his compositions which are a reflection of his mixed feelings.

“Each eccentric section represents my life, for example, I may be calm now, happy tomorrow, or something happens and quickly I am drawn to grief,” he said.

Yousufi, 24, played as if he was mentally fading into a different place than the two-storey house in Brooklyn where his dark mahogany grand piano stood. The piano was a gift from his mentor at Mannes School of Music, Simone Dinnerstein. His fingers tapped on the piano’s black and white keys.

The keys, he said, resembled the colors of the chapters of his life in Afghanistan before he sought political asylum in the U.S. five years ago.

“It was already my third visit to the U.S. on a visitor’s visa and in order to survive I had to stay,” Yousufi said. “The support of my family and friends kept me grounded and convinced me to stay when I wanted to go back.”

Yousufi was among the 2% of Afghans from the nearly 70,000 refugees who entered the U.S. in 2015. He came from a war zone with over 2.5 million of the world’s refugees, the second-largest refugee population, according to the World Bank.

Escaping violence back home to pursue a music career in the U.S., Yousufi is among other asylum seekers in the U.S. that suffer from Post Traumatic Stress Disorder (PTSD) originally incurred in his home country but developed in different forms of stress during his resettlement process.

For example, family separation is one form of stress, according to Yousufi, which is common among Afghan asylees in the U.S. Yousufi’s mother and siblings currently live in India after his brother’s office in Afghanistan was attacked. Some armed men opened fire at Yousufi’s house as well.

He has not seen his mother, older brother, and younger sister for five years while he has been waiting for his asylum approval. It’s a common problem among the asylum and refugee community in the U.S., with family separations resulting from the 70% reduction in the refugee entry cap and the travel ban put in effect under the Donald Trump administration in 2017.

The cap was originally set at 110,000 under the Barack Obama administration and was later reduced to 30,000 under the Trump administration, according to a report by Migration Policy. The U.S. admitted around 15,000 refugees between October 2018 and April 2019.

Struggles in resettlement

Yousufi never planned to apply for asylum and intended to return home to his family and friends.

“There was a bombing in the airport the day I was supposed to go back to Afghanistan and my friends were telling me to stay there in the U.S. to survive. Some of those friends are no longer alive,” Yousufi said.

The decision to stay and apply for asylum included hurdles such as struggling to work to provide for his family in India. Yousufi found a job at a fast-food restaurant that required heavy lifting. The work made his muscles sore, affecting his performance as a pianist.

He also began to suffer from PTSD symptoms during his first year in New York. He recounted the heaviness he felt every day waking up in New York as if he was in “a hotel room on a short visit and set to return to Afghanistan the next day.”

Those psychological reactions are a normal response to a perceived harmful event or threat that affects the cognitive and neurological brain response, according to psychology professor Beth E. Meyerowitz who specializes in the psychosocial treatment of extreme trauma.

“It is not really mental health, we’re talking about a normal physical reaction of the body even when it is no longer in an unsafe situation,” Meyerowitz said.

The body goes through four categories when resettling from a dangerous situation, including intrusive thoughts that come in the form of nightmares and/or flashbacks of disturbing memories of violence or emotional unsettling, Meyerowitz said.

Fleeing Danger

A few months following his stay in the U.S, Yousufi met with an immigration attorney who helped him secure a four-year scholarship at Mannes School of Music in Manhattan. His professors connected him to a team of neurologists and psychologists to help counter his PTSD.

Carrying on where he left off his music career in Afghanistan, Yousufi began playing piano, composing music, and painting calligraphy again. These were artistic activities that were banned in Afghanistan under the Taliban who believed art and music defied religion.

The Taliban banned music when it took over Afghanistan’s capital Kabul in 1996. They would cut off the ears, tongues, and fingers of musicians, according to Yousufi. However, it didn’t stop from expressing himself artistically.

He grew up with famine and civil war under Taliban ruling, causing him to become depressed and anxious. He would draw sad faces that he showed to his parents as one form of expressing his feelings.

At around the same time, he discovered his love for the piano. He was inspired by his uncles who worked as musicians in Russia. Yousufi was 13 when he first had access to music, despite the ban. His school had a piano accessible for 50 students. Each student was allowed to practice for only 10 minutes per day.

Now, more than a decade later, sitting in a Brooklyn living room where he lives with his host family, Yousufi recounted his childhood and shared photos of himself when he was two-years-old with his father carrying him up in the sky.

“My mom sees a lot of my father in me and how I am just like him,” he said. Yousufi’s father was among the first to encourage him to pursue a music career.

But right after relocating to the U.S., Yousufi said his PTSD intensified and that music could no longer help him heal. The additional stress originated from being separated from his family and his long asylum process.

Coping under stress

Shortly after enrolling at Mannes School of Music in Manhattan, Yousufi decided to educate himself about PTSD and the symptoms he was experiencing. He volunteered at the International Rescue Committee (IRC), where he helped newly arriving refugees with emotional resettlement.

Yousufi would often play his music to refugees coming from conflict zones such as Iraq and Syria. He would reflect their culture and give voice to their pain through folk music.

“It was a fabulous day because it was the first time for some of them to listen to live music being played, and I could connect with them,” he said.

Yousufi is now pushing forward to build a stable life in the U.S. He has applied for his master’s degree in music composition at universities including Julliard, Yale, and Manhattan School of Music.

The universities he has applied to have waived the English language proficiency requirement - or TOEFL exam- after learning about a traumatic experience he had with the exam.

Shortly before Yousufi left Afghanistan, he and his friend were preparing to take the exam at the American University in Afghanistan. They both had exams on different dates. His friend died on the day of his exam in a terrorist attack- a shooting that leftover 40 people dead- at the university. He was carrying Yousufi’s TOEFL book at the time.

“When I take any tests, I am unable to use headphones because I imagine him sitting on the same table with my TOEFL book full of blood, and that creates a sense of PTSD for me,” he explained.

Yousufi is trying to put his traumatic years behind him, he is optimistic about his future in the U.S., although he still feels like he is “waking up every day in a hotel room.” He said he recalls the silence that prevailed on Kabul streets after being destroyed by bombs and shootings.

His symptoms continued to surface as he picked up his music career again amid the legal process of resettling as part of what psychologists call fight-or-flight response.

Changes in cognition and mood are another category, psychologist Meyerowitz said, in which a person would feel shame and guilt despite seeing their lives improve. Avoidance of certain smells, sounds, and situations and hypervigilance or being easily startled are the other two categories that are common among resettling refugees.

While professional psychological treatment is a necessity among extreme PTSD survivors, overcoming these categories could be achieved through basic steps. They include self-education about the symptoms experienced, claiming and controlling personal emotions, and gradually facing situations that are usually avoided, according to Meyerowitz.

The backfire of therapy with other Afghan asylees

Although such therapy process has proven to be somewhat effective with Yousufi, it backfired with F., a 53-year-old woman who lives in Sacramento, California. She doesn’t want to reveal her full name because she fears that it will affect her son’s asylum case to the U.S.

Coming from Parwan, a province located a few kilometers from Kabul in Afghanistan, F. also arrived in the U.S. on a visitor’s visa in 2015 before she applied for asylum. But unlike Yousufi, she was granted asylum in one year.

F. still gets startled from nightmares and flashbacks from her life back in Afghanistan. She worries most about her eldest son who is living undocumented in Malaysia. He moved there in 2015 to pursue a Bachelor of Arts degree, but his student visa expired last year. He can’t return to Afghanistan because it is unsafe and he can’t join his family in the U.S. because his asylum case is being processed by the American embassy in Malaysia.

“I could not sleep. I suffer from all different sorts of pain that are related to my life, even my stomach gets heavy and I have no appetite,” F. said.

Sometimes, F. would feel the pain in her arms and hands, despite seeing a psychotherapist during the first five months after resettling in California. Each session cost her $130 at a time when F. was unemployed and lacked transportation.

Therapy was an ineffective part of her resettlement, F. said, because even though she was able to get her husband and three other kids- two daughters and her younger son- to the U.S., she has not seen her oldest son, 25, for five years. “I am still struggling to bring my son. I cannot sleep because he’s at risk of deportation,” she said.

F’s son’s application for asylum has been in the expedited process since 2017. She blames the travel ban for her son not being granted asylum to this day.

F. has been using WhatsApp and Skype to connect with her son, but it’s not enough. Counseling no longer calms her, she explained.

“I always think about what will happen if he gets deported,” she said.

F. finds solace in her daughters’ educational success. One daughter has recently been admitted to the University of California Davis while the other is in high school.

F. hoped that she could provide this quality of life to her children in Afghanistan. She never anticipated that she would have to drop her two-decade career and leave her home country to provide a safe haven for her family.

Prior to F.’s plan to seek asylum, she worked in international development for 25 years at the United Nations in Afghanistan. There, she was verbally threatened because of her work with the UN and was asked to quit her job many times.

“Members of the Taliban would call anyone who works with non-Afghan or non-Muslim organizations a “Kafar” (an atheist or non-believer) and should be prosecuted,” she explained.

She never took the threats seriously until her younger son was brutally beaten one day on his way to his grandmother’s house. She later decided to leave Afghanistan and never return.

She was unable to identify the attackers, but F.s was sure the assault was relevant to her work in the UN. There were other incidents too - someone chased after her car as she drove to work and there was knocking on her front door.

Life in the U.S. is a “marathon”

For 27-year old S.Q, who also asked to be identified only by her initials, the journey of resettling in the U.S. is a “marathon” that highlights struggles that are different than coming from a war-torn country.

Working as a financial consultant in New York, S.Q first came to the U.S. in 2010 on a visitor’s visa when she received a scholarship from the Afghan Girls Financial Assistance Fund. It is designed to help young Afghans women with funding their college tuition fees.

S.Q studied finance at a university in Virginia where she was later employed as a consultant for four years. When she first arrived in the U.S., S.Q. did not have a high school diploma or skills, and couldn’t speak English

There were always reasons to give up and go back to Afghanistan with the lack of emotional support, S.Q. said. She worked hard to remind herself of her dreams and ambitions.

“When you and your family are affected by the Taliban and you grow in all this trouble [in Afghanistan], you become broken and you forget about your dreams because all you care about is being fed,” she said.

Going to school for the first time when she was 14-years-old in Afghanistan, S.Q. thought that living in the U.S. would be easy. She did facial threading at a salon when she was 19, her first job in the U.S.

“I thought the whole world was closed to me, threading was depressing,” she said.

She was disappointed, it wasn’t what she wanted to do, and she quit. She focused on her goal of landing a job in finance.

S.Q was an activist in Afghanistan and advocated for women’s rights in Afghanistan’s Herat and Kabul. She described her activism as “really risky.”

S.Q. continues to support Afghan women from the U.S., advocating for them and their independence. Adding that work, along with reading Persian literature and writing fictional stories, are some of her mental health recovery strategies.

Last year, she launched an NGO that provides an online one-year mentorship to women in Afghanistan. Participants are taught how to master skills in different job fields.

Advocacy as a coping mechanism

Advocacy has also helped F. to cope. She works as a victim advocate at LAO Family Community Development, an agency that resettled 772 Afghan refugees in Sacramento since it was launched in 2017. About 95% of the Afghans resettled suffer from some form of PTSD, according to Rawash Yar, a program coordinator at the agency.

The agency, which mostly deals with people coming on a Special Immigrant Visa (SIV), usually enrolls the asylees in a 90-day program that grants them guidance to employment, housing, and food stamps.

Their first year is usually the hardest in terms of employment, transportation, and most importantly, coping culturally. Yar said violence is somehow embedded in Afghan culture. For example, hitting children as a form of discipline is normalized, whereas in the U.S. parents could be arrested for such an act.

“The majority of the people we deal with are victims of violence in Afghanistan carried out by the guerilla groups like the Taliban and other radical militias and with certain behaviors that are accepted in their cultures, these behaviors are mostly illegal here such as them hitting their children in which Child Protective Services could be called for that,” Yar said.

Some of those parents were arrested and charged, according to Yar who added that Afghan asylees continue to suffer from a cultural stigma as they resettle here. Some of the girls at school were bullied for wearing headscarves (Hijab), she said.

Some of those seeking asylum have said they would rather go back to their war-zoned countries than in the U.S. because the resettlement process is so difficult, Yar said.

Past trauma resonates despite available resources in the U.S.

Adjusting to a new life in the U.S. is not the only stressful price paid for a safer life; some families carry their past trauma with them from home.

A New York-based civil society organization that is helping Afghan families cope with life in the city, Women for Afghan Women (WAW) reported that most of the cases they deal with are domestic violence victims that continue to experience this violence from their spouses even after coming to the U.S.

The organization specializes in providing English language courses and acts as a liaison with other resettlement agencies. It helps Afghan families reach out for social services including education and housing.

A case manager at WAW, Shgoofa Rahmani said that she dealt with 50 domestic violence and sexual assault cases—48 women and two men-- in 2019 alone.

“When you continue to deal with domestic violence, that is a lot of mental health problems,” she said. Most cases come into WAW in search of potential solutions, 90% of which have language barriers and in need of translators.

Most of the cases come either on SIV’s or as dependents on their spouse’s visa or legal status, according to Rahmani who dealt with only 10 undocumented Afghan immigrants during her four years of work with the organization.

Some Afghan women—namely those in arranged marriages-- become undocumented as a result of separating from their husbands following domestic violence incidents.

“Sometimes those incidents [domestic violence] were so bad, that one of their kids would call the police,” she said adding that those men come from a country where it is culturally acceptable for a man to be abusive. “This is how they lived all their lives and continue to live that way here too.”

These women can lose their sponsorship visa status once they are separated, Rahmani explained, and that is when WAW helps them apply for asylum. They connect them to immigration offices that offer pro bono work.

Many women choose not to report their abusive husbands to police, according to Rahmani, because of their financial dependency on their husbands. They can’t afford to have them in jail.

“Most of these women who come to seek our services have no skills or language that can be used in the U.S., they have at least five or six children or maybe three children that they can’t support on their own,” she said.

Out of the 48 women cases that Rahmani dealt with last year, only two women reported their abusive relationship to the police. The extent of the financial dependency and the severity of the abuse are factors that those Afghan women consider before deciding to go to the police.

“Some women were left homeless after reporting their husbands and claiming that they are not safe at their homes,” Rahmani said. “The New York City the shelter system is very hard to navigate especially if she is a Muslim woman and doesn’t speak English.”

Men too, have their own resettlement issues

“We have dealt with some Afghan men who worked as engineers and doctors back in their home country but came here to work in fast-food restaurants or as Uber drivers and “that alone is like trauma,” she said because their qualifications don’t match the same postings here in the U.S.

Rahmani is also a trauma survivor. She came to the U.S. 25 years ago as a dependent on her husband’s visa. She believes that there are some parts of the trauma that can never be treated.

“I am a child of war and I have been to therapy, coming to the U.S., but there are times that I will hear a little noise outside and actually think it is a bomb when I know it is not a bomb,” she said.

Building a new support system

Despite the hurdles that come along with fleeing a war zone and establishing a new life elsewhere, a lot of positive things began unfolding for Yousufi. Last summer, he reunited with his uncles and cousins from his father’s side of the family who had left Afghanistan about 40 years ago. They resettled in San Diego, California in the 1980s, when Afghanistan was under the Soviet Union occupation.

Yousufi’s uncles and cousins lost contact with his parents once they were in the U.S. Early in 2019, but one of his cousins came across one of Yousufi’s videos in which he was playing piano and tracked his name down on social media. After connecting on Facebook, they both met for the first time last summer in New York and for the second time in San Diego in November.

The reunion helped Yousufi focus on his aspirations and inspired him to share his goals with his cousin who works as a psychiatrist in San Diego and has recently helped Yousufi with his applications for his master’s degree in music composition.

This past February Yousufi also took to the stage at Mannes School of Music to play his one-hour graduation piano recital.

Yousufi played a mix of classical compositions and improvised a piece that he composed called “I Wander” that speaks of his life in Afghanistan and the U.S. A subtle mix of Cajón (box-shaped percussion instrument originally from Peru), bells, and piano managed to produce folk rhythmic beats that excited the full house and ended in a standing ovation.

“Some of the attendees came over after the recital to tell me I should only play my pieces next time instead of playing Bach and Mozart music,” Yousufi said recounting one of the after-recital comments.

But despite his progress, and all that he is doing to move on, Yousufi said he is “mentally still living in Afghanistan.”

“There is always an urge of wanting to go back home as if something is calling me there like the graveyards of my friends that I never got to see again or bid farewell,” he said.