Category: Featured news

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Losing a Pregnancy Only to Lose One Again

00Fear, Featured news, Grief, Pregnancy, Resilience, Therapy, Trauma July, 17

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Anna R. was having an ultrasound, prepared to see her baby for the first time. When she asked the technician what the sex of the baby was, the tech quickly left the room. The physician then entered to tell Anna there was no heartbeat. This became the first of seven pregnancy losses that she would endure.

Recurrent pregnancy loss (RPL) is typically defined as three consecutive losses prior to 20 weeks from the last menstrual period.

Affecting 1-2% of women, the causes of RPL differ. Advancing maternal age is associated with elevated risks of miscarriages, particularly in women 45 or older. Paternal age can also be a variable, with environmental and genetic factors playing a role as well. The risk of miscarriages further increases with the number of previous miscarriages, reaching approximately 40% after three consecutive losses.

While these causes have been established within the medical community, doctors still struggle to predict what ultimately leads to a couple’s pregnancy loss. Even after numerous tests, Anna’s physicians never found anything wrong, making the loss that much harder to cope with.

After her eighth miscarriage, Tracey Beadle of County Durham, UK told The Northern Echo:

“I think I wanted for them to find something wrong, because that would mean something could either be fixed or give us a reason to stop trying for a baby. We did not know when to stop.”

Janet Jaffe, a clinical psychologist and co-author of the book “Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients”, told the American Psychological Association:

“A miscarriage is a traumatic loss, not only of the pregnancy, but of a woman’s sense of self and her hopes and dreams of the future. She has lost her ‘reproductive story’, and it needs to be grieved.”

This grief is unique, in that expectant mothers and fathers mourn a child that never came to be. As Kate Evans, a woman who had six miscarriages said in an article in the Independent:

“If there’s no body, how can I grieve? I feel as though I must be kidding myself, wallowing in a morass of grief over a person who never even lived. Every time my mind trips back to this death, this loss, it strikes on empty, because there’s nothing there to miss.”

While there is no physical body to grieve, the hopes and dreams for a future with the child are ultimately the elements missed the most.

This grief is further complicated by feelings of isolation. When a loved one dies, there is often comfort in collective mourning with other grief-stricken individuals. But grieving the loss of a pregnancy can be an isolating experience for parents, as others haven’t formed the same connection with the unborn child and may struggle to understand why the experience is so painful.

Outsiders may also lack empathy for the mother’s experiences and fault her for the outcome of the pregnancy. Anna explained that people unintentionally implied that she was to blame for her miscarriage through comments like, “Do the doctors know what’s wrong with you?” or “Maybe you weren’t taking good care of yourself.”

RPL has been shown to severely disrupt the parents’ mental health. According to astudy by psychiatrist Michael Craig and colleagues at the Institute of Psychiatry, King’s College London, of 81 women with recurrent miscarriages, 33% were classified as depressed, with 7.4% suffering from severe depression. And 21% of the women also had clinically significant anxiety, while some experienced heightened anger and guilt.

Research documenting fathers’ grieving processes showed that, unlike women, many men do not react with increased depressive symptoms, crying, or feeling the need to talk. But similar to women, a major source of grieving arises from relinquishing their hopes and expectations for their unborn child.

While physical treatments for RPL include surgeries, medications, genetic screening, and lifestyle changes, the emotional and psychological toll must also be addressed.

A report by the Practice Committee of the American Society for Reproductive Medicine indicates that psychological support in early pregnancy results in significant improvement of pregnancy outcomes. Psychotherapy can also help work out anxieties and fears from previous miscarriages.

According to Anna, therapy was what helped her through seven painful miscarriages:

“My therapist became my saving grace. I could comfortably tell her anything and everything—especially things I didn’t want to discuss with my husband, like thoughts of suicide. She was the voice of reason in my confused and isolated world.”

Individuals can find additional help through in-person support groups at local organizations, or through online sites, such as the Baby Center, which offer web-based clubs and blogs. Connecting with these groups allows individuals to interact with others experiencing the same grief, which may reduce feelings of isolation.

In the midst of hopelessness, people may feel safer bracing themselves for more heartache. But it is important to remember that, even after four consecutive losses, a patient has a greater than 60% to 65% chance of carrying the next pregnancy to term. In the meantime, seeking psychological support to work through the anxiety and grief may be beneficial.

–Eleenor Abraham, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Conversation Cards Help Therapists Dig Deeper

00Child Development, Education, Featured news, Parenting, Therapy, Trauma June, 17

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As a counselor, social worker, or therapist, how do you begin conversations with your clients? What are the best ways to break the ice and generate meaningful discussions? These are questions that Jane Evans, trauma, parenting and behaviour expert, found to be common among her colleagues in the field.

Evans is a therapist and member of NEYTCO, the National Early Years Trainers and Consultants Organization, located in the UK. She has spent over 20 years working with parents and children who experience difficulty in relationships.

In an interview with the Trauma and Mental Health Report, Evans explains:

“I find that many practitioners don’t entirely understand childhood trauma and they struggle to talk to parents about it.”

To facilitate more open dialogue, Evans created Fink Cards—a conversation tool that provides structure to therapy sessions and helps therapists and clients engage in meaningful discussions. The Cards list questions to help parents who have trouble communicating and forming a good relationship with their children. And the Cards help parents and families who have encountered trauma in the past.

Since Evans sees trauma as a major factor in difficult parent-child relationships, she directly addresses this issue with the Fink Cards. They ask questions like “what does the word trauma make you think about?” to open the door to therapy work. The Cards support the counselor in facilitating discussion, and assist clients.

Evans found, while working with families, that parents are not always aware of how their own actions, as well as their interactions with the child, may in fact perpetuate problem behaviours. She says:

“Most parents see the child as the problem; they’re always aiming to fix the child. However, these cards invite them on a different journey. Parents consider what has happened early in their own lives or in their child’s early years and how that impacts their child’s behaviour now.”

Questions like “who was in charge of discipline when you were a child?” and “who notices when you are worried or anxious?” help parents reflect on how their early experiences and current support systems shape their parenting practices, as well as any negative impact these may be having on the child. As parents consider how these events impact their parenting choices, the therapist is able to work with them to implement more effective methods of communication and alternative coping strategies.

Research has shown that conversation cards can help patients become more open about their feelings. In a study conducted by researchers at Stratheden Hospital in the UK, 6D cards were used to facilitate holistic, patient-led communication. 6D cards are a type of conversation card developed to help physicians and nurses ensure a meaningful consultation with female patients in a gynecology clinic. They contain six categories, or dimensions, of health, including healthcare, emotions, lifestyle, interpersonal relationships, symptoms, and life events. The purpose of these cards is to allow the patients to lead the conversation.

Another study, conducted by the Design Council of the UK and the Bolton Primary Care Trust, focused on creating stronger methods of communication and management for diabetic patients with the use of Agent Cards, which are similar to both the 6D and Fink Cards. Agent Card statements encourage patient-led conversations with practitioners. Results of the study showed that using the cards helped facilitate more open discussion.

With Evans’ Fink Cards, clients have the freedom to choose questions from four categories during sessions: the parent’s early childhood and upbringing; the parent’s relationship with his or her child; the parent and child’s worries and anxieties; and how early trauma may have affected the child.

“These cards are a way of having difficult conversations, but it’s not just me putting the questions to the patient and saying ‘you have a problem,’” Evans explains.

While the effectiveness of Fink Cards does require more research, they have already made their way into the marketplace, and look to be a promising resource in clinical settings. Sometimes building rapport or discussing sensitive topics with a client can be difficult, but Fink Cards may go a long way in helping therapists and clients ease into healthy conversations in an educational and comfortable way.

–Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Parent Mental Illness Casts Long Shadow on Children

00Anxiety, Child Development, Depression, Featured news, Parenting, Suicide, Trauma June, 17

Source: stefanos papachristou on flickr, Creative Commons

“My aunt woke me to say that my mom sent a text to the family priest in the middle of the night, asking for prayers after taking a bunch of pills.”

Diagnosed with clinical depression, Keith Reid-Cleveland’s mother had a long, painful history of suicide attempts, feeling unhappy and tired much of the time. Like many children, he felt helpless and didn’t understand depression, thinking her fatigue was from hard work, and that his mother just needed sleep.

As Reid-Cleveland grew up, he began to take notice of his mother’s mood, making it his responsibility to try to make her smile:

“At first, this just entailed telling her ‘I love you’ every time I saw her. Eventually, it morphed into me acting as sort of a motivational life coach/stand-up comic.”

After his mother’s first hospitalization:

“I did Desi Arnaz impressions to make her laugh…”

He also gave her emotional support:

“I sat down and unpacked what was bothering her step-by-step, until she realized it wasn’t as devastating as she’d thought.”

The Canadian Mental Health Association (CMHA) estimates that 8% of adults will experience major depression at some point in their lives. About 4000 Canadians die each year by suicide, making it the second leading cause of death for those between ages 15 and 34.

Parental suicide and hospitalization have a tremendous impact on children.

To better understand this traumatic experience, researchers Hanna Van Parys and Peter Rober, from the University of Leuven in Belgium, conducted interviews with children between ages 7 and 14 who had a parent hospitalized for major depression.

Many children showed sensitivity to the parent’s distress. Like Reid-Cleveland, some reported awareness of parental fatigue or lack of energy. Others picked up on mood changes, such as when the parent was feeling angry or sad. And some reported feeling guilty for being a burden.

Eleven-year-old Yellow expressed to his father: “If you would like me to be somewhere else sometimes, just tell me.”

Others sought ways to convey to their parents that they were not affected by their mental health, attempting to elevate mom’s or dad’s mood. Van Parys and Rober consider this behaviour common for children seeing a parent in distress. In their study, a child named Kamiel was asked whether he would like to solve problems for his mother, to which he responded: “Yes, sometimes, if that would be possible,” while hugging her closely.

When his mother was first hospitalized for a suicide attempt, Reid-Cleveland’s loved ones decided he shouldn’t see her. Recalling similar situations of parental hospitalization, child interviewees reported much distress and worry about the parent. Many felt alone, powerless, unable to help.

One girl expressed existential fear, stating: “Then I think about when you will die, everything will be different when you die.” Seeing a parent in the hospital forces the child to imagine life without them.

Research shows that children of parents who attempt suicide are at higher risk to do the same. And in a study conducted at the Aarhus University in Denmark, researchers found an increased long-term risk of suicide in children who experienced parental death in childhood, increasing suicide risk for up to 25 years following the traumatic experience.

Like Reid-Cleveland, many children living with parent mental illness feel isolated and helpless. Van Parys and Rober note that prevention programs focusing on family communication are beneficial to enhance family resilience, and to lessen the burden on the child.

– Khadija Bint-Misbah, Contributing Writer, The Trauma and Mental Health Report.
– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report.
 

This article was originally published on Psychology Today

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Denmark Declassifies Transgender as Mental Illness

00Bias, Featured news, Health, Identity, Sex, Sexual Orientation, Stress, Transgender June, 17

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In March 2016, North Carolina passed a law that bars transgender individuals from using public restrooms that match their gender identity, and prohibits cities from passing anti-discrimination laws that protect the rights of gay and transgender people. The bill has thrust North Carolina into the centre of a national debate over equality, privacy, and religious freedom in the wake of a 2015 U.S. Supreme Court ruling to legalize same-sex marriage.

For individuals who identify as transgender, this law has caused “emotional harm, mental anguish, distress, humiliation, and indignity,” according to U.S. Attorney General Loretta Lynch. These consequences are in addition to the emotional anguish and shame that transgender people frequently experience when their identity is classified as mental illness.

The World Health Organization (WHO) categorizes transgender individuals as having a “gender identity disorder” in their “Classification of Mental and Behavioural Disorders”.

But in Denmark, the issue is being addressed very differently.

Effective January 2017, transgender will no longer be considered mental illness in the country, and the term ‘transgender’ will no longer be listed as mental illness, making Denmark the first country in the world to remove the link between mental illness and individuals who identify with a gender other than the one they were born with.

Sexual orientation has always been a contentious topic, and homosexuality and other forms of expression of same-sex orientation are often stigmatized. According to Susan Cochran, a professor of epidemiology at UCLA, this stigma is worsened when sexual orientation is pathologized.

Research by psychologist Walter Bockting of the University of Minnesota Medical School found that transgender individuals often experience sanctioned prejudice, such as job discrimination, health discrimination, verbal aggression, and barriers to substance dependency services.

In 2014, the WHO acknowledged that linking transgender people to mental illness is harmful and pledged to remove the link from their next International Statistical Classification of Diseases and Related Health Problems (ICD)—but this version isn’t slated for release until 2017.

In response, social democrat health spokesman Flemming Møller Mortensen told The Local:

“The WHO is currently working on a new system for registering diagnoses. It has been working on it for a very, very long time. Now we’ve run out of patience, and want to send out a signal saying that if the system is not changed by October, then we in Denmark will go it alone.”

Mortensen also told Danish news agency Ritzau:

“At the moment, transgender is listed as a mental illness or behavioural problem. But that is incredibly stigmatizing and in no way reflects how we see transgender people in Denmark. It should be a neutral diagnosis.”

This is not the first transgender rights legislation that Denmark has passed. It was also the front-runner in enacting a law passed in 2014 designed to allow transgender adults to change their gender status without any legal or medical interventions. In many European countries, this is still not the case, and restrictive laws requiring sterilization and divorce are still in effect.

Amnesty International, a major player in LGBTQ human rights, has praised the Danish Parliament for their decision, which comes at a time when states in the U.S., such as North Carolina, are passing more restrictive and discriminatory legislation against transgender populations.

It is likely that the North Carolina ‘bathroom law’ will spark court cases for years to come, and a number of groups, including local LGBTQ organizations and celebrities, are boycotting the state. Even within the state, the University of North Carolina is refusing to enforce the bathroom portion of the law and, in fact, holds sensitivity orientation programs regarding LGBTQ students so that non-transgender populations will see their trans peers as equal and worthy of respect.

The entire question of transgender rights promises to be a hot-button issue with underlying mental-health implications in the coming years. But for now, Denmark is taking the first step to ensure the inclusion of transgender individuals by acknowledging them as normal human beings.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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When Discipline Worsens Performance in Competitive Sports

00Child Development, Coaching, Featured news, Parenting, Self-Control, Sport and Competition, Trauma May, 17

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On December 19, 2015, former National Hockey League (NHL) player Patrick O’Sullivan revealed shocking details of sports-related childhood abuse. In a blog article on The Players Tribune, he disclosed that his father began abusing him at 5 years old when he got his first pair of hockey skates.

At the age of 10, it worsened:

“It would start as soon as we got in the car, and sometimes right out in the parking lot.”

He reveals that his father would put out cigarettes on his skin, choke him, and throw objects at him. At times, he endured whippings with a jump rope or an electrical cord.

“As twisted and insane as it sounds, in his mind, the abuse was justified. It was all going to make me a better hockey player—and eventually get me to the NHL.”

The more goals Patrick scored, the more the abuse intensified.

Patrick’s father assumed that these harsh disciplinary practices would enhance his abilities and success, but experts say otherwise. The scars of childhood abuse have a lasting negative impact.

John O’Sullivan (no relation to Patrick), a former soccer player, coach, and founder of the Changing the Game Project, says this parenting behaviour burdens the child, hindering performance.

In an article on the Changing the Game Project website, John writes:

“If a child believes that a parent’s love is tied to the expectation of winning, and he does not win, he may believe that he is less loved or valued. This creates anxiety and inhibits performance.”

Childhood maltreatment leads to decreased mental and physical health, even decades after the abuse. Rutgers sociology professor Kristen Springer and colleagues reported that, in their population based survey, physical symptoms and illnesses, like hypertension and cardiac problems, were present in those who experienced childhood abuse years earlier. And childhood maltreatment is also associated with increased anxiety, anger, and depression—symptoms that can be heavily detrimental to an athlete’s performance.

Some studies also show that early childhood maltreatment, such as the abuse endured by Patrick, shape aspects of socio-emotional development in adolescence and adulthood. A study conducted by Pan Chen and colleagues at the University of Chicago supported the relationship between childhood abuse and aggressive behaviour in adulthood. The researchers note that early trauma may increase impulsive behaviour and lashing out in abuse survivors.

But some, like Patrick, seek help. He says in an interview with ESPN, “…I have put the money and time into my own health.”

He acknowledges that not everyone has the opportunity to find the help they need—especially as an athlete:

“Players don’t feel like they can say anything because it’s a huge red flag. You say you need to see a psychologist and you’ll get a call from your agent saying he spoke to the General Manager of the team and wants to know what your ‘problem’ is.”

In addition to how isolating the experience of abuse can be for professional athletes and adults, Patrick emphasizes how helpless and frightening it can be for a child. He describes his own feelings of disempowerment, at the age of ten: “I just tried to survive. Each morning, I’d wake up and think: Here we go again. Just get through it.”

It didn’t help that others turned a blind eye. Patrick says that parents and coaches would catch a glimpse of the abuse, but no one stepped in. Bystanders may feel hesitant to intervene, out of fear of being wrong. But he counters, “If you are wrong, that’s the absolute best case scenario.” He hopes his story will raise awareness about childhood abuse in young athletes.

As for parents, soccer coach John O’Sullivan says that empowerment may be key to promoting competitive success, instead of harsh discipline and criticism. “The best players play with freedom, they play without fear and they are not afraid of making errors, they can play up to their potential,” he says in an interview with Kids in The House.

He shares that “I love watching you play” are the best five words you can say to a child after a game. “Because when you tell your kids, after a game, that ‘I love watching you play’, what you do is you free them from the burden of being responsible for your happiness as a parent”.

–Khadija Bint Misbah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Slam Poetry Facilitates Sharing Stories of Mental Illness

00Anxiety, Creativity, Depression, Featured news, Health, Relationships, Self-Esteem, Social Life, Trauma May, 17

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Andrea Gibson is a spoken word artist and activist who writes with intense passion about mental illness, bullying, and social tragedy.

In her award-winning poem, The Madness Vase, Gibson speaks firsthand about the shame many feel from disclosing experiences of mental illness and suicide. In an interview with the Trauma and Mental Health Report, she explained, “The trauma said don’t write this poem; no one wants to hear you cry about the grief inside your bones.”

When asked why people use spoken word to share these sensitive and personal experiences, Gibson told the Report:

“I can say things within the context of a poem that I could never speak outside of a poem. There is a way in which a poem cares for its writer. Allows no interruption. It’s a sweetness, a generous sweetness. I think of a poem almost as a good parent who might say, ‘I’m going to hold you and have your back while you say this, and you have every right to say this.’ There is a safety in it. A holding we may not have had elsewhere in life.”

Gibson also speaks to the ways in which sharing poetry can build self-esteem and promote self-love in both speakers and audience members, and views her poetry as a form of therapy to treat anxiety and depression:

“Telling your story is healing. Telling your story to a receptive audience of listeners is even more healing. Being witness to people telling their stories is healing. There is so much pain in hiding, and spoken word is the opposite of hiding.”

Gibson’s ability to connect with her audience lies in her willingness to share her adversity battling panic attacks, anxiety, and depression. Narrating her journey with mental illness contributes to the authenticity of her poetry and resonates powerfully with viewers.

“I doubt that I would have an artistic life if I had not been pushed into it by my own flailing nervous system. Art is a shelter of sorts. At the same time, I have had shows where I was almost too panicked to speak. I had to keep saying to the audience, “I am feeling so much anxiety, I can barely get through this.” But I’m guessing in the long run even that is of some comfort to many people. To witness a panic attack on stage, and to watch art happen regardless.”

In addition to her work as a spoken word activist, Gibson created STAY HERE WITH ME in 2011, an online platform to share experiences of trauma, mental illness, of wanting to die, and of the different art forms that have prevented individuals from committing suicide. Gibson started this initiative with co-founder Kelsey Gibb, a mental-health professional and tour manager.

“Kelsey and I were on tour together while I was receiving a lot of letters from people who were struggling to want to stay alive and we wanted to create an online community that had larger reach of support. We wanted to create something that helped people want to stay.”

Gibson’s work highlights the healing power of story-telling. As an art-focused space, STAY HERE WITH ME encourages the use of art and poetry to heal, connect, and remind the audience they are not alone. Hundreds of individuals have shared personal stories through her website, finding acceptance and understanding through shared experiences.

Through poetry and mental health advocacy, Gibson is determined to build a community dedicated to helping people who have suicidal feelings.

“I want to remind individuals struggling with suicide to be sweet to the part of them that is in pain. To hold that part with gentleness and not to ask that pained part to go away sooner than it needs to. Sometimes simply letting ourselves hurt is what the hurt needs to move through us.”

–Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Police “Blue Wall of Silence”; Facilitates Domestic Assault

00Anger, Conformity, Domestic Violence, Featured news, Health, Relationships, Work April, 17

Source: Stefan Guido-Maria Krikl on flickr

In January 1999, Pierre Daviault, a 24-year veteran constable of the Aylmer Police Services in Quebec, was arrested on 10 criminal charges for allegedly assaulting and drugging three ex-girlfriends between 1984 and 1999. Daviault resigned from the police force a few days later, but he was only sentenced to three years’ probation, no jail time.

In their 2015 book Police Wife: The Secret Epidemic of Police Domestic Violence authors Susanna Hope (pseudonym) and Alex Roslin describe instances of police spousal abuse within the U.S. and Canada, reporting that at least 40 percent of U.S. police-officer families experience domestic violence, compared to 10 percent of families in the general population.

Some officers are speaking up. Lila C. (name changed), a Canadian corrections officer (CO), was interviewed by the Trauma and Mental Health Report to discuss the growing issue of spousal abuse in Canadian law enforcement. Lila’s former colleague, Stephanie (name changed), was a victim of abuse. Awareness of Stephanie’s predicament, and the inability to do anything about it, affected Lila’s mental health more than anything else on the job.

Lila explained:

“Steph and I bonded very quickly and we were very open with each other, which is normal when two COs work together so often. But she never actually told me about the abuse she was taking at home. I noticed bruises on her neck myself.”

Stephanie’s perpetrator was her husband—a long-time police officer of the Peel Regional Police in Ontario. He was a man Lila knew well, and considered a friend:

“At first I didn’t want to believe what I was seeing and I kept quiet for the first few hours of our shift that day. But eventually, I asked ‘what’s that on your neck, what’s going on?’ And then came the breakdown period and she told me everything.”

Upon opening up to Lila, Stephanie revealed that she was frequently abused by her husband at home, both physically and verbally.

“My first gut response was ‘you need to leave him and tell someone’. I mean, how could he continue to work in law enforcement, deal with these types of cases on the job, and then go home and abuse his wife off the job? But Steph wouldn’t do it—she wouldn’t leave him. She felt that she wouldn’t be able to have him arrested. If she called the police to report him, who would believe her?”

In Police Wife, authors Hope and Roslin argue that one factor perpetuating abuse is that many officers think they can get away with it.

Carleton professor George Rigakos explains in an interview with Hope and Roslin: “A major influence in the use of domestic violence is a lack of deterrence. If there is no sanction, then it’s obvious the offence goes on.”

Referred to as the “blue wall of silence”—an unwritten code to protect fellow officers from investigation—officers learn early on to cover for each other, to extend “professional courtesy.”

And when a woman works up the nerve to file a complaint, police and justice systems often continue to victimize her. She must take on a culture of fear and the blue wall of silence, while simultaneously facing allegations of being difficult, manipulative, and deceptive.

Lila explains:

“I mean, I saw her almost every day and it was a huge elephant in the room. We didn’t bring it up again. And though I didn’t see her husband often, when I did see him, it was weird. He had no idea that I knew—I just couldn’t be around him, knowing what he was doing. But there was no getting away from the constant reminder of this unspoken and undealt-with abuse.”

Knowing both the victim and the perpetrator, knowing that the abuse was not being addressed on a systemic level, and feeling powerless to do anything about it herself affected Lila’s mental health and enthusiasm about the work she was doing:

“About two months in, I started having panic attacks on my way to work and even during my shift. I vaguely remember nights where I had bad dreams. It’s weird, I wasn’t even the one being abused, but I felt unsafe. I knew that I couldn’t say anything, because it would probably make things worse. I feared for Steph’s life, but in some strange way, I also feared for my own.”

Many officers face ostracism, harassment, and the frightening prospect of not receiving support when they do not abide by the blue wall of silence. Believing she would not be taken seriously if she decided to come forward (because of her gender) only amplified Lila’s sense of powerlessness and anxiety.

“I know that the system is unjust towards women, and that makes this situation even more hopeless to confront.”

Stephanie eventually left the corrections facility where she and Lila worked, and they gradually lost touch. Lila doesn’t know if Stephanie is still with her husband, and looking back she partly wishes she had said something about it.

Hope and Roslin explain in Police Wife that we are often reluctant and afraid to intervene if we think a friend or family member may be in a violent or abusive relationship. They encourage bystanders to acknowledge the courage it takes to reach out.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Male Rape Victims Face Difficulty Finding Support

00Depression, Featured news, Post-Traumatic Stress Disorder, Suicide, Therapy, Trauma April, 17

Source: Fabrizio Lonzini on flickr, Creative Commons

In October 2015, Sweden opened the world’s first male rape center. It is the only known center that provides emergency medical care for men and boys who are victims of rape or sexual abuse. Although most rape centers don’t turn male victims away, there are no others that cater specifically to the physical and emotional needs of men who undergo such trauma.

The issue of male-on-male, and especially female-on-male rape and sexual abuse is largely unacknowledged in part because these forms of trauma are much less common than those involving a female victim. Statistics Canada reports that approximately 8% of sexual assaults involve a male victim.

In the 1980s, the word “rape” was removed from the Criminal Code of Canada and replaced by three different levels of sexual assault, specified by whether or not force or threats were involved and to what degree they were present. The problem with this approach is that “sexual assault” sounds like a lesser issue; it doesn’t carry the same weight as “rape”.

In October 2013, Kirk Makin wrote in an article for The Globe and Mail:

“Instead of the loaded word rape—with all its moral and social baggage—three levels of sexual assault were written into law, each level escalating in gravity. But getting rid of the legal term ‘rape’ didn’t stop it. In fact, many argue that it profoundly defanged the justice system and has resulted in lighter—not tougher—sentencing.”

Terminology may partly account for a lack of male rape centers, but so might the negative cultural view of a man being raped, particularly by a woman.

Popular culture and the media typically portray rape as involving penetration, which assumes only a male can perpetrate it. So, the common view is that men cannot be raped by women. For example, if a victim tells a friend he’s experienced unwanted sexual activity, the friend’s reaction is likely to be as congratulatory as horrified. And the victim is less likely to report the crime. An article on rape from Stanford University’s Encyclopedia of Philosophy even states in its premise the assumption that perpetrators are male and that victims are female, disregarding the issue of male rape altogether.

There is a common sentiment that men are always open to sexual advances and, therefore, automatically consent. This misconception can lead to situations where, if a man is intoxicated or otherwise unable to provide consent, he may subsequently be sexually assaulted. Contrary to stereotypes, the common view of “no means no” applies to both genders, and a lack of consent is just as significant as an expression of non-consent.

Another problem focuses on the male-on-male rape that occurs in prisons. Jokes about not “dropping the soap” are rampant in the media, giving the impression that, since these individuals are criminals, they should expect—indeed deserve—sexual assault.

And rape committed in prisons is not even included in national statistics, an omission that has the effect of failing to prevent abuse, as well as diminishing the issue. As a result, there is an insufficient allocation of resources for victims within the prison system. Victims require both emergency medical services, as well as counselling, to address the physical and emotional damage of sexual violence.

The opening of a male rape center in Sweden is a positive step, suggesting some progress toward support for male rape victims. But on a broader scale, the problem goes unacknowledged. Attitudes cannot change without a more systemic shift in how male rape is viewed and addressed.

–Andrei Nistor, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Lena Dunham's Representations of Mental Illness

00Anxiety, Asperger's Syndrome, Featured news, Health, Media, Obessive-Compulsive Disorder, OCD, Self-Esteem March, 17
Karolina Reis on Flickr

Source: Karolina Reis on Flickr

Media portrayals of mental illness are often controversial and have been criticized for inaccurate stereotypical depiction.

But more recently viewers have seen a notable shift towards more accurate representations. Writers, producers, and actors are using their own experiences to create more authentic characters and situations.

The controversial television series Girls on HBO leads the way.

Lena Dunham –actress, writer, director, and executive producer of Girls– stars as the show’s protagonist Hannah Horvath, who struggles with obsessive compulsive disorder (OCD). Through her character, Dunham conveys her own personal journey, enabling viewers to observe genuine symptoms of the illness.

Dunham was diagnosed with OCD around age 9. In an excerpt from her new book, she discusses the experience of intrusive thoughts:

“I am afraid of everything. The list of things that keep me up at night includes but is not limited to: appendicitis, typhoid, leprosy, unclean meat, foods I haven’t seen emerge from their packaging, foods my mother hasn’t tasted first so that if we die we die together, homeless people, headaches, rape, kidnapping, milk, the subway, sleep.”

As a public figure, Dunham feels a responsibility to discuss her disorder openly. She believes this approach helps people better relate to those who live with mental illness.

Researchers Joachim Kimmerle and Ulrike Cress explored this in an article published in the Journal of Community Psychology. Their study demonstrated that we can learn about mental illness from fictional shows when the information is accurately presented, highlighting how there can be many useful and creative ways to disseminate knowledge in mental health.

However, research by Nicole Mossing Caputo, a marketing and public relation specialist, and Donna Rouner, who has her PhD in mass communication, at Colorado State University found that when viewers don’t relate to the storyline or don’t form an emotional bond with a character, social stigmas tend to persist.

When a link to a storyline is successful or an emotional bond is formed, viewers become less critical and adopt the protagonists’ perspective and understand their struggle. Connections to narratives and characters like Hannah Horvath help battle misconceptions.

Another show, Parenthood, candidly explores the struggle of living with Asperger’s Syndrome (Autism Spectrum). Like Dunham, the show’s creator Jason Katims uses his own experience of raising a son with Asperger’s to connect with viewers on issues surrounding mental illness.

Dunham’s representation of OCD on television has increased public discussionaround mental health. It has increased the visibility of various mental-health communities and has helped pave the way for other shows to do the same.

In a Psychology Today article, Jeff Szymanski, Executive Director of the International OCD Foundation, speaks to this progress:

“Lena did a service not only to herself by letting the world ‘see’ what the struggle looks like, but to the entire OCD community at large by showing some of the pain, stigma, and struggle any person with mental health issues has to endure.”

And many are taking notice.

Shortly after Girls first aired, Allison Dotson—an OCD sufferer herself—wrote an articlefor the Huffington Post explaining how the depiction of Hannah on Girls has helped fight stereotypical portrayals of her disorder:

“As someone with OCD, I find it refreshing to see this often misunderstood illness portrayed in a realistic way on an acclaimed television show. Just as Hannah herself resists typical far-fetched sitcom stereotypes — she’s not model thin, she struggles with her finances and her career choices, and she often finds herself in believable awkward situations — her OCD symptoms are presented in a way that resists the low-hanging fruit of a kooky character most of us never encounter in our day-to-day routine.”

– Alyssa Carvajal, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Photography Documenting Mental Illness Draws Criticism

00Caregiving, Emotional Intelligence, Empathy, Featured news, Health, Relationships, Resilience March, 17

Source: ethermoon on flickr, Creative Commons

For the past six years, Melissa Spitz of St. Louis, Missouri has been using photography to illustrate her mother’s experience with mental illness, referring to it as a form of “documentary photography”.

The photographs taken of Melissa’s mother Deborah are shared on Melissa’s professional website and on her Instagram in a project she calls “You Have Nothing to Worry About.” They artfully depict Deborah’s lifelong struggle with bipolar disorder, schizophrenia, depression, dissociative identity disorder, and problem drinking.

In an interview with Time Magazine, Melissa explained that the series aims to provide an intimate look into the life of an individual suffering from mental illness. She told Dazed Digital:

“For me, mental illness has a face and a name—and that’s mum.”

Melissa first became aware of her mother’s mental-health problems when she was a child, and Deborah had to be institutionalized for “psychotic paranoia”. After years of anger and blame, Melissa picked up her camera as a way of confronting her mother’s disorder head-on.

The project became an emotional outlet for Melissa to facilitate healing. In an interview with Aint Bad Magazine, she explained:

“By turning the camera toward my mother and my relationship with her, I capture her behavior as an echo of my own emotional response. The images function like an ongoing conversation.”

Research published in the Journal of Public Health has shown that creative media can serve as powerful tools to help people express feelings of grief. Art therapy specifically can provide a means of expression, relieve emotional tension, and offer alternative perspectives.

Through her project, feelings of pain and hurt that Melissa held toward her mother were ameliorated, and she found herself feeling greater empathy, visually acknowledging her mother’s struggle with mental illness.

While the project is not without its merits, the provocative nature of the photographs—ranging from Deborah’s hospitalization to images of her unclothed and bruised—may elicit shock and discomfort in viewers.

Which raises the question: where do we draw the line between exploitation and freedom of expression in art depicting mental illness?

Laura Burke, a drama therapist from Nova Scotia, Canada, sees Melissa’s project as crossing an ethical line. Laura was diagnosed with schizophrenia in 2005, and has suffered from depression her entire life. She believes that people with mental illness are often spoken for, and this is a common trap in representing their lives through art.

In an interview with The Trauma and Mental Health Report, Laura commented on Melissa’s project:

“It appears sensitively done, but the line between exploitation and reverence is a tough one to walk. If the focus was more explicitly on Spitz’s perspectives of her mother, and not an objective account of how things happened, which is sometimes how a photo can appear, I might feel more comfortable with it.”

Another issue that can arise is the power differential between photographer and subject. Even when consent is provided, subjects who struggle with mental health issues are particularly vulnerable when someone else is formulating the vision and acting as “the voice” of the art piece.

Laura addressed this concern in her interview:

“I feel that focusing more on the family member’s experience, and less on the subject living with the mental illness would be a less exploitative choice.”

Melissa is aware of the criticism her project has garnered from audiences. In an interview with Time Magazine, Melissa said:

“I am fully aware that my mother thrives on being the center of attention and that, at times, our portrait sessions encourage her erratic behavior. My hope for the project is to show that these issues can happen to anyone, from any walk of life and that there is nothing to be ashamed about.”

Despite the criticism, art can be transformative for both the artist and the audience by exposing mental illness in its rawest form. Max Houghton, a Senior Lecturer in Photojournalism and Documentary Photography at the London College of Communication, appreciates what Melissa’s project can do, and how it can help break down stigma surrounding mental illness.

Houghton told BBC News:

“I think photojournalism is criticised when it looks at the miserable side of life and depressing issues. However, in the right hands, photography can be used as a tool to discover and tell important stories differently”.

Projects like Melissa’s You Have Nothing to Worry About often spark much needed discussion around mental illness and are important and necessary to address stigma. And yet, one is left wondering whether such depictions of the vulnerable may do more harm than good.

–Nonna Khakpour, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today