Meet Dr. Damir Utrzan, former refugee helping others heal from the impacts of trauma
This was originally published for Hazelden Betty Ford’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
Damir S. Utrzan, PhD, was born in the former Yugoslavia and lived in Germany with his parents for about 10 years before being deported and applying for asylum in the United States. Since then, he has committed much of his time, energy and expertise to the treatment and protection of other asylum seekers and marginalized groups, including people with substance use disorders and mental health conditions. In his role as manager of mental health services at Hazelden Betty Ford in Center City, Minnesota, and adjunct assistant professor at the Hazelden Betty Ford Graduate School of Addiction Studies, Dr. Utrzan writes and speaks frequently about the trauma associated with fleeing from violence and armed conflict, or witnessing it, and the impacts on mental health and substance use. With the Russian invasion of Ukraine in February leading to tragic loss of life and millions of new refugees, we were grateful to check in with Dr. Utrzan and learn more about his personal story to help shed light on the far-reaching impact of the ongoing war in Eastern Europe on individual lives and families.
What challenges did you experience on your journey to the United States and then growing up in a new culture, and what was helpful to you along the way?
I came to the United States with my parents mid-2000, and we became naturalized citizens four or five years later. I don’t remember many details of being displaced. But the moment I received my passport is clear. The small hard-bound booklet embossed with the Great Seal of the United States, depicting an eagle holding a scroll that reads E Pluribus Unum (i.e., out of many, one), represented stability. It meant, without a shadow of a doubt, I would not have to look for another home again.
Today, all these years later, I can’t help but be affected by the tragic events unfolding in Ukraine — and around the world for that matter. While I am a U.S. citizen, I still identify as a refugee and connect to the experiences of others forced to flee home. Watching the news recently, I saw the escalating violence in Ukraine depicted through separation of families. Tears began streaming down my face. I was surprised. At the same time, I wasn’t.
My mother was a Bosnian Muslim and my father was an Orthodox Christian Serb. And, as the inter-ethnic Yugoslav wars escalated during my childhood, my father was required to join the Serbian military that controlled Bosanski Novi, the Bosnian city where we lived. Yes, it was incredibly complicated. And I remember waving goodbye to my dad while I sat on a tour bus that wasn’t actually on a tour. It was taking women, children and the elderly to safety — even as the Serbian military my father was now a part of sought to keep people from fleeing. As the bus passed through the countryside and eventually slowed down to stop at a military checkpoint, I watched an armed Serbian guard with a long beard enter the bus. He looked at all the passengers with distrust but never said a word. The handle of his automatic rifle hung over his right shoulder by a dark green strap and brushed against the headrest of my mother’s seat. I was not keenly aware of the situation at that age, but I was quiet. Years later, my mother shared her fear of me accidentally saying that we were fleeing.
Before the wars, when Yugoslavia was a relatively unified socialist country, my parents’ inter-ethnic marriage was no big deal. They never experienced prejudice or preferential treatment. But as tensions mounted, their marriage brought increased risks of persecution for my family, which became yet another stressor I had to grapple with as a child.
Thankfully, when I was in grad school later at Northwestern, my studies required that I experience seeing a therapist. That turned out to be a huge help, providing a forum to begin processing my traumatic experiences while simultaneously learning how to be a therapist myself. I continued with therapy beyond high school and also got involved with a lot of service work, which I think helped me heal and grow even more. Still does.
Reminders of the past are difficult to escape when they are also part of your identity. While it’s been many years since my family’s displacement, I definitely recognize a lot of what I’m seeing in the current situation overseas in Ukraine.
How is trauma connected to mental health and substance use disorders, and what are some helpful thoughts for people experiencing all of the above?
To stay on the refugee topic for a bit more, I think it’s worth mentioning that many countries have restrictive immigration policies — for a variety of reasons often debated. The resulting reality is that resettlement is often a long, arduous process that wears on families seeking safety and compounds their stress and the potential for mental health and substance use issues. Back in 1882, the Immigration Act barred “undesirables” from being admitted to the U.S. regardless of persecution. Such language isn’t in policy today but it does reflect some of the centuries-old challenges of countries needing to decide who to let in — and how — as well as the stressful challenge migrating people face wondering “who wants me.”
People driven from their homes are forced to confront the meaning in their lives throughout the resettlement process. This doesn’t change upon arrival. They continue experiencing individual and relational challenges despite being physically safe from persecution. Social isolation, identity uncertainty, and low self-esteem are common. Many struggle with culture shock and an inability to form trusting relationships. Understanding identity fragmentation after displacement and resettlement requires understanding refugee identity. People who abandon everything in fear of violence and persecution also abandon part of themselves. This includes their culture, language and traditions. They begin trying to integrate their past and present, which can lead to frustration and stress. This may be further compounded by an inability to secure employment immediately upon arrival or other pending processes. All of these factors exacerbate the risk for mental health and substance use disorders. At the same time, heightened stigma and fear of deportation prevent too many from seeking help.
I remember my father struggling with alcohol upon arriving to the United States. As a child, I couldn’t understand how good people could do seemingly bad things. I didn’t know back then the impact substances have on functioning or lack thereof, or that he was trying to alleviate intrusive symptoms consistent with trauma exposure. He’s been sober now and in recovery for more than a decade. That’s been another motivator for my work today, and if there’s one thought I always share with others experiencing mental health and substance use issues, it’s this: there is hope; healing and recovery are possible; and you deserve it.
What drew you to the fields of addiction treatment, mental health care and family therapy?
I was looking forward to some normalcy after arriving in Germany, which meant going to school. But my inability to cope with various mental health problems and lack of resources to help, left me unprepared for advanced studies. I accepted a recommendation to pursue vocational training from administrators, but it wasn’t what I wanted, and I felt defeated. This further fueled my desire to obtain an advanced education. I remained a somewhat mediocre student in the United States, which disappointed my parents, so I began taking my academic pursuits seriously. Luckily, despite unimpressive test scores, I was admitted to Rockford University, formerly Rockford College, after high school. I found my footing there and started to thrive and eventually was able to achieve my academic goals.
Part of me wants to say my career was planned. But therapy wasn’t really the plan. I was trained as a research scientist, disciplined about my approach to solving problems and always searching for as much certainty as possible. As I began to work more with people, though, I began to also see the necessity of faith, or hope, which isn’t always easy to measure or capture using the scientific method. Over time, I became more drawn to the universal humanity revealed in our behavioral health challenges, including those I experienced and witnessed as a child. Perhaps I had a goal I was unaware of until I realized it — to ease the suffering of families like mine so their cries for help would not be in vain.
In the end, I discovered my purpose, and I’m grateful. It’s a privilege being able to give back and empower others in ways I would have appreciated at earlier junctures in my life, and it’s tremendously rewarding.
How has your cultural background interwoven with your professional experience as an addiction treatment leader?
Once I made it to Germany, I learned to speak German and made a few friends. But other children bullied me in kindergarten because I wore clothing from the Red Cross. We had little financial resources and relied on government assistance. My father, who eventually was able to join us in Germany, was unauthorized to work, which relegated my mother to work long hours in a restaurant earning below minimum wage. I continued to be bullied by other children in elementary school and felt isolated. And the parents of the friends I did make were hesitant and afraid of asylum-seekers. At the time, my outward appearance rarely reflected my thoughts and feelings, and the hurt I felt. I bring that up because it’s a reality that is very important to treating and helping others who have co-occurring mental health and substance use disorders, and working with different cultural populations.
Today, all of my experiences fuel a commitment to help advance diversity, equity and inclusion at my workplace and in my industry, which is why I’m proud to serve on the DEI Committee of the National Association of Addiction Treatment Providers with others from throughout the country.
I have grown to feel comfortable being genuine and authentic in who I am, and comfortable with setbacks and uncertainty knowing I am not alone — that we all are unified by the human experience. And my wish is that everyone can come to find such comfort and peace.
What would you like more people to understand about recovery?
Recovery is complex. It’s not simple. We need to embrace the complexity and nuance of it. How personal it is. And the many paths to healing.
Recovery also has universal relevance. As humans, we all have to become more comfortable with uncertainty and hope — finding peace in taking next right steps even amid uncertainty. That’s spirituality to me — and it’s the essence of what we all need in order to get through the human experience in a healthy way. As a trained researcher who also works with humans every day, I want others to know and appreciate that medical science and the spirit of recovery are both very crucial to the help we provide to others.
Want to hear more from Dr. Utrzan? Listen to his interview with WCCO radio in Minneapolis.
