Category: Health

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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

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Staffing Shortage Underserves Long Term Care Residents

10Aging, Cognition, Dementia, Featured news, Health, Loneliness, Social Life February, 17

Source: Chris Marchant on flickr, Creative Commons

In the summer of 2014, I volunteered at a long-term care facility (LTC) in the Peel Region of Southern Ontario. Most of the residents who lived there were diagnosed with some form of cognitive impairment, primarily dementia. I saw first-hand the unfortunate reality of understaffing, and how it leads to deficits in patient care.

As the elderly population has grown, Ontario has seen a 22% increase in admission rates of LTC residents as of 2014. And the number of residents with cognitive impairments is especially high. According to the Ontario Long Term Care Association’s 2014 annual report, 62% of residents have Alzheimer’s disease or another form of dementia resulting from stroke, developmental disability, or traumatic brain injury.

Patients with cognitive impairments may have other mental health disorders as well. The Canadian Institute for Health Information (CIHI) indicates that 25.9% of residents in Ontario long-term care homes have shown symptoms of depression through 2013 and 2014.

In my time volunteering at the LTC, I noticed that residents often refrained from socializing because they were unable to take part in events due to memory deterioration, speech issues, and physical ailments such as paralysis or arthritis. Most residents required staff to transport them from one place to another and though they worked hard to support residents, there were simply not enough staff to supervise these daily activities.

Jane (name changed for anonymity), the Supervisor of Activation at an LTC in the Peel Region, spoke to the Trauma and Mental Health Report about this issue. Jane is responsible for organizing activities that motivate elderly residents to engage in social interaction and improve cognitive well-being.

Jane agreed that one of the biggest challenges for LTCs is staffing:

“Year by year, the case load of different residents is increasing, but with such little funding we do not have enough staff to support their needs. If residents aren’t participating in daily events and activities, their cognitive functioning is negatively impacted.”

A University of Ottawa study found that between the years 2000 and 2010, over 60% of residents with multiple cognitive deficits lacked stimulating therapeutic activities and social support. It showed that while residents received sufficient assistance with physical needs, such as feeding and changing, cognitive functioning continued to worsen in areas like memory and attention.

Jane also explained that despite research emphasizing the importance of activities that are engaging, staffing shortages make it difficult for these activities to be held in LTC homes:

“We need more activation staff for art therapy, music therapy and physiotherapy as these activities are beneficial to residents’ cognitive functioning. However, many activities are cancelled or postponed because of a lack of staff to facilitate the activities and monitor the residents. A few years ago, residents only needed one staff member or nurse for assistance, now they need two or more people. Sometimes, they’re left waiting for support.”

But perhaps the real issue here is funding. Adequate funds are necessary to increase the amount of staff within LTCs, so that residents can develop social relationships, participate in interactive activities, and improve their cognitive functioning and capabilities. Jane agrees:

“Funding hasn’t increased yet the resident conditions are changing and they require more care. The caseload is increasing, with little funding.”

Funding should also be allotted for appropriate staff training. LTC residents with cognitive impairments have a unique set of needs. According to the University of Ottawa study, residents require assistance in areas such as memory retention and engaging in regular social activities to help them interact and feel like recognized members of their community.

Making use of mental health first aid programs, such as the workshops offered atConestoga College and the Baycrest Health Sciences’ Geriatric Mental Health Serviceconference, can go a long way in improving the services staff provide.

As a past volunteer for an LTC home, I have seen the impact of limited support on residents’ lives. Greater funding and more staff to facilitate therapeutic activities are crucial to optimizing the care residents receive and to ensuring better cognitive functioning.

–Afifa Mahboob, 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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Lack of Regulation in Porn Industry Leaves Women Unprotected

00Career, Featured news, Health, Law and Crime, Pornography, Sex, Trauma January, 17

The documentary film ‘Hot Girls Wanted’, produced by Rashida Jones and released in the spring of 2015, follows several young women living in a North Miami Beach home as they attempt to enter the amateur pornography industry. Since its release, the film has sparked major discussion about the experiences of female performers and the porn industry itself.

There is very little research available on the impact on performers within this poorly regulated industry. In the U.S., the government turns a blind eye to many of the issues surrounding the production of pornography, unless it involves performers under the age of 18. And despite laws prohibiting the employment of performers under the legal age, there are still issues involving consent among newly legal women in the 18-21 age range.

During an AOL BUILD discussion led by Jones, Gail Dines, a professor of sociology and women’s studies at Wheelock College in Boston, emphasized the lack of understanding that some young women seem to have:

“I meet woman after woman who went into this industry, thinking they were going through consent. They’re young. They don’t know what they’re up against.”

Jones also interviews one of the film’s main performers Rachel Bernard, who has since left the industry, and who openly speaks about her experience working in amateur pornography. She addressed the concept of consent, and how it can become even more problematic on porn sets:

“When you walk in, your agent might’ve told you what you’ll be doing or they were general about it because they don’t want you to have an opinion whether you like it or not.”

In the AOL BUILD discussion, Bernard explained how it was common for her to enter onto a set without previously being told the details of her performance and, eventually, she would be pressured to perform acts she was not comfortable with. In one instance, she was told to say a highly demeaning line. When she refused, the director responded by saying, “Well, it’s part of the script, so you have to.”

A lack of agency in young people entering into any field of work is problematic. But working in pornography can open performers to elevated health risks and uncomfortable situations. During the AOL BUILD discussion, Bernard described how sex work was not comparable to most other lines of work because it required a higher degree of vulnerability:

“Every job does have points where it’s maybe uncomfortable but, when you go to a regular job, you’re not showing every single part of your body. The fact that I am out there and I am completely open. Every part of my body, soul, and mind is having to be in that position. It’s a little bit more than uncomfortable.”

Not only can pornography be uncomfortable, but due to the lack of regulation in the industry, the work can also have a negative impact on performers’ health. Condom use is reported to be very low in heterosexual adult films, with only 17% of performers using condoms. And performers in the study reported feeling pressured to work without condoms to remain employed.

The average age of performers entering the industry could explain a hesitance to speak up about rights on set.

For over 40 years, the average age of entry for female porn performers has been approximately 22. In an interview with VICE, Jones expressed the significance of the age of performers in influencing how they experience this line of work:

“When you’re 18 and you’re making choices for yourself, you’re not thinking about the eternal effects of footage online. You’re not thinking about the external and internal costs; the psychological, emotional, physiological, physical costs of having sex for a living. You’re thinking about the fame part. And so you may not be the best candidate to make a decision for yourself but you’re allowed to because you’re 18 and that’s all you need to be.”

So what do performers say about the development of regulations for this industry?

In February 2016, California officials in charge of workplace safety rejected a proposal requiring the use of condoms, dental dams, and goggles for porn actors on set. The decision was made after six hours of testimony from almost 100 performers and producers who strongly opposed the proposal.

Performers who spoke up in protest of the proposal worried that those particular regulations would either hurt the porn industry and their job security, or drive it underground, resulting in even more dangerous conditions.

In an interview with The Guardian, Ela Darling, a porn performer who spoke at the hearing, explained how those regulations would further limit performers’ rights:

“This law denies bodily autonomy to an already marginalized population, and it denies us our voice.”

In a statement made after the February decision, Erich Paul Leue, the executive director of the Free Speech Coalition, a trade association for the adult entertainment industry, discussed industry members’ interest in being involved in deciding industry regulations.

“We’re not opposed to regulation,” he said. “We’re opposed to this regulation.”

In terms of regulation, the aim should be to provide performers with the freedom to make their own decisions without fear of risking job security or safety. Individuals working in the industry should not be required to compromise health, safety, or wellbeing. And despite the current lack of understanding about the implications of working in porn, one thing is clear: Performers who wish to enter and remain in the industry should be able to do so without having to check their rights at the door.

–Abbi Sharvendiran, 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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Friends of Teens with Eating Disorders Unsure Where to Turn

00Adolescence, Anorexia Nervosa, Bulimia Nervosa, Eating Disorders, Featured news, Friends, Health, Social Life January, 17

Source: Darren Tunnicliff on Flickr, Creative Commons

During my last year of high school, I tried to help one of my closest friends, Rebecca (name changed), through an eating disorder.  I found myself in the difficult position of guarding her secret, yet somehow trying to get her through a mental illness.

So I was eager to see director Sanna Lenken’s, My Skinny Sister at the 2015 Rendezvous with Madness Film Festival in Toronto, a film that captures the pain of a family coping with one member’s eating disorder.

The story is narrated by a young girl, Stella, who discovers that her older sister and role model, Katja, is suffering from anorexia nervosa. Through their complicated relationship, the viewer feels the struggle of wanting to protect a friend or family member from harm, while respecting the right to come forward only when ready.

Stella’s confusion and anxiety resonated with me. Like her, I felt I had to keep my friend Rebecca’s eating disorder a secret, scared of repercussions should anyone find out.

Rebecca’s condition escalated during senior year. She began over-exercising and restricting her caloric intake. At first, the disorder was hardly noticeable. But over time her weight dropped, her face appeared gaunt, her bones protruded.

At seventeen, I felt ill-equipped to handle this. Like Stella, I wanted Rebecca to seek help, but I didn’t know how to arrange it without betraying her trust.

Trying to aid a family member or friend with an eating disorder is very hard. Without resources at school, with no one to turn to, I didn’t know how to begin the conversation. As I struggled to support Rebecca, it became obvious I had no tools to help. One week of anti-stigma instruction that focused on body image and speaking inclusively wasn’t nearly enough.

Many adolescents are vulnerable to personal and friendship crises like these. And some websites help educate teenagers, such as the Canadian Mental Health Association’s (CMHA) site or the National Eating Disorder Association’s (NEDA) site.

But mental health education in high school? Not so much.

That’s unfortunate. Research shows the benefits of educating teachers on mental illness. In a 2014 study published in the journal Child and Adolescent Mental Health, Yifeng Wei and Stan Kutcher at Dalhousie University found that training teachers through a mental health program led to significant development in their ability to identify individuals with mental illness. And their attitudes toward mental disorders improved as well. Teachers were better able to support students, and link them to services.

The Youth Action Committee of Children’s Mental Health Ontario, in 2012, designed a project to identify where schools were deficient in educating mental health issues. The study found a lack of training and education for students, with 39.5% of participants saying they only learned about mental health in one class. There was also a lack of access to resources, such as a designated safe space for students who wanted to discuss these issues in school.

In the end, there wasn’t much I could do to help my friend. Over time, Rebecca sought treatment independently—she got the help she needed.

But not everyone struggling with an eating disorder will seek help on their own. Better education and resources for people coping with mental illness, as well as for those who want to help, would go a long way in providing support.

–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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Trauma Documented Three Decades after Chernobyl Disaster

00Appetite, Depression, Environment, Featured news, Health, Stress, Trauma December, 16

Source: Surian Soosay on Flickr, Creative Commons

Chad Gracia’s award-winning 2015 documentary, The Russian Woodpecker, addresses the legacy of trauma caused by the Chernobyl nuclear disaster. The film documents the investigative journey of Fedor Alexandrovich, a Kiev based artist who shares his own experience as a survivor while exploring the disturbing question: Was the disaster at the Chernobyl power plant an ‘inside job’?

When a reactor at the power plant exploded on April 26th, 1986, the effects were catastrophic. As radiation levels rose, hundreds of thousands of people were evacuated from their homes in Ukraine, Belarus, and Russia.

Forced evacuation and relocation was traumatic for many who had no hope of returning home. In the most contaminated areas, entire villages were bulldozed and buried. Further, citizens were not notified of the risks they faced from radiation. Tamara Kovalchuk, who was employed by the Chernobyl power plant, tells Alexandrovich in the film:

“When the explosion happened, no one thought anything of it. They put on masks and we were surprised. Why wear a mask in such good weather?”

After the event, political authorities failed to implement policies to protect the health of their citizens. For example, the World Health Organization claims that:

“If people had stopped giving locally supplied contaminated milk to children for a few months following the accident, it is likely that most of the increase in radiation-induced thyroid cancer would not have resulted.”

Trauma is a recurrent theme of The Russian Woodpecker. Alexandrovich was four years old at the time of the disaster—he was evacuated from Kiev, Ukraine, separated from his parents, and sent to an orphanage. Reflecting on this experience, he says, “I thought I would be there forever. It’s quite a serious trauma for a child. And from that time I’ve felt strange…different.”

But this trauma is not unique to Alexandrovich—it extends to the hundreds of thousands of people who faced relocation, suffered from illness, and coped with deliberate misinformation from their government about health risks. To this day, those affected by the explosion continue to struggle, living in fear of long-lasting consequences such as birth defects and contaminated foods.

According to psychologist Lynn Barnett, trauma from the Chernobyl disaster is cumulative because it is “characterized by repeated adversity with no foreseeable end”. She describes radiation as an “unseen, unheard, unfelt and ‘un-smelt’ terror.” Its elusiveness, in conjunction with government deception following the event, has led to the spread of misinformation guided by unscientific explanations and recommendations for coping with radiation.

One such recommendation is that small doses of radiation are good for people of middle or old age. Others are that drinking red wine, or swabbing the throat with antiseptic iodine, can protect against radiation. But maybe false beliefs like these lessen the threat of the unknown by providing a sense of control.

Other research corroborates this notion. Anthropologist Richard Sosis at the University of Connecticut studied the effects of psalm recitation during the Second Palestinian Intifadain northern Israel. Among secular women, those who recited psalms to cope with violence experienced lower anxiety.

In relation to the Chernobyl disaster, Barnett wrote:

“The secrecy and lies that enshrouded the Chernobyl accident led to an almost total lack of knowledge about the facts, leading to the impossibility of any kind of personal control.” 

Perhaps Alexandrovich was seeking control over the chaos inflicted by the event when he decided to look into the politics surrounding the disaster.

His inquiry led him to interview Vladimir Komarov, head of the Chernobyl investigation committee. This committee was tasked with identifying the cause of the explosion. In the film, Komarov tells Alexandrovich that the last Soviet Head of Atomic Energy, Georgy Kopchinski, made phone calls to Chernobyl engineers demanding that they conduct experiments on an unstable nuclear reactor.

Kopchinski, who Alexandrovich also interviews, denies that he made these phone calls, despite the fact that they were reported by engineers at the time.

Like trauma that affects the individual, politically motivated trauma leaves people with a sense of vulnerability and fragility. In traumatic events, key values, beliefs, and attitudes are largely compromised, and individuals turn to external sources of authority, such as political figures, for answers.

But when political figures are complicit in the trauma, or fail to perform their leadership duties, basic trust in one’s society and culture is challenged, and the ability to cope is further hindered.

Alexandrovich’s theory that the Chernobyl disaster was politically motivated is provocative and incendiary. But is it true? According to Chernobyl historian Natalia Baranovskaya, “To prove this you need all the documents. But the documents are still classified.”

Secrecy around the events of the Chernobyl disaster persist, preventing those affected from understanding the cause of their suffering. For now, the truth remains elusive.

–Rebecca Abavi, 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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Remote Northwest Territories Lacking Mental Health Care

00Environment, Featured news, Health, Self-Harm, Suicide, Therapy, Trauma November, 16

Source: Gloria Williams on Flickr, Creative Commons

On April 26, 2015, 19-year-old Timothy Henderson, a resident of the North West Territories in Canada, was taken off life support after sustaining self-harm injuries, the culmination of a long battle with depression and other mental health issues.

Beginning in adolescence, Timothy struggled with symptoms of ADHD and Asperger’s syndrome (Autism spectrum). When he felt overwhelmed by his condition, he reached out for support, but felt dismissed, and began to lose hope that the help he needed would be available.

Shortly before his death, Timothy admitted himself to Stanton Territorial Hospital for the fifth time in a year, where he again disclosed details about a tendency to self-harm. He was released two days later, without adequate follow-up or a long-term care plan. Later that month, he sustained self-inflicted injuries that led to his death.

Timothy’s case is not uncommon in the Northwest Territories, a remote region of northern Canada. The NWT Mental Health Act states that a medical practitioner can only detain an individual for psychiatric assessment for a maximum of 48 hours. This time limitation often results in rushed and insufficient care—a result of a system that is understaffed and overworked.

The territory’s current Mental Health Act, introduced in June 1988, has been cited as a main cause of inadequate services for individuals suffering from mental illness. The act is out-of-date and has not been modernized with strategies to address the current mental health climate of the NWT.

In a report by the Alternative North Health Coalition, the mental wellbeing of residents in the NWT is shown to be much lower than that of the average Canadian, with a national rate of suicide three times greater than those living in the more populous south. Lack of access to staff, resources, and community-based treatments are all relevant aspects of the act that impede adequate treatment and prevention strategies.

Timothy’s mother, Connie Boraski, believes Timothy’s mental health began to worsen when he turned 17, and no longer qualified for the pediatric healthcare program. This transition resulted in lengthier waits for treatment and drastic changes in privacy laws that prevented Timothy’s parents from having access to information about their son’s treatment. Mental health legislation regarding the legal rights of family members and other caregivers is an aspect of the Mental Health Act that restricts parents, like Timothy’s, from intervening to support their children.

After being repeatedly dismissed, Timothy eventually stopped asking for help. Boraski explains:

“Timothy never wanted to be a burden to anyone. That was a real challenge for him, to ask for help.”

Deficiencies in the quality and quantity of staff and resources reflect the isolation and socioeconomic climate of the NWT. Due to the small and relatively isolated nature of the region, accessing facilities within the community can be difficult. Timothy had to travel between hospitals in the NWT and Alberta to obtain psychiatric help, which resulted in seeing a different doctor on each occasion. This kind of disjointed doctor-patient relationship makes it difficult to stay connected.

The public outrage following Timothy’s death eventually drove NWT Health Minister, Glen Abernethy, to open a review into Timothy’s case and bring changes to mental health legislation. In addition to other important components, the new act will include information on services such as Assertive Community Treatment (ACT), which will allow patients to have access to specialized treatment and supervision within remote communities of the NWT.

The revised act, if passed, is expected to come into effect sometime in 2016. Though implementation of a new mental health act is too late for Timothy Henderson, the hope is that a new mandate will provide the Northwest Territories with better preventative measures and resources for residents suffering with mental illness.

– 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

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Illustrating Mental Health with Cartoons

00Charisma, Creativity, Depression, Featured news, Health, Humor, Therapy November, 16

Source: Allie Brosh

From the darkness of despair, Gemma Correll and Allie Brosh have created deeply personal cartoons to illustrate their experiences with mental illness. Maintaining popular online blogs, they have recently published cartoon books revealing their innermost struggles and fears.

Through simple drawings, Correll and Brosh make it easy for audiences to grasp the intricate aspects of psychological disorders. The unique illustrations are designed to be informative, yet dark and humorous.

In her 2015 book, The Worrier’s Guide to Life, Correll portrays her experience with anxiety, including unwanted intrusions from unexpected guests and unwelcome phone calls that one would prefer to avoid. She labels them “Real Life Horror Movies.”

Another example of Correll’s sharp humour comes in the form of a red poster, shouting: “I can’t keep calm and carry on because I have an anxiety disorder.”

Though the images are vital to the message, the corresponding narratives are equally important. Correll explains her images only make sense in combination with the words. One poignant cartoon called “Visit Depression Land! It’s the crappiest place on earth,”depicts a “non” amusement park with commentary on all of the “non” amusing things you can do while visiting.

The comics are both painful and funny. One of Correll’s fans sums up the experience on Twitter: “I’m laughing but I’m also crying. But I’m also laughing.”

A common thread in the struggle with mental illness is the accompanying isolation; in these comics, readers see themselves and their situations, and perhaps realize that they are not alone in the experience. In an interview with NPR, Correll explains, “I think people are really glad to find somebody who’s had the same kind of experience. Anxiety and depression can make you feel quite isolated.”

This sentiment was echoed by Brosh in an online Reddit question and answer session:

“Depression is such an isolating experience, but there’s always a tiny amount of comfort from knowing that someone else has been out there too. I mean, I never thought that writing about my depression would circle back around and make me feel less isolated, but in a strange way, it has.”

Although depression can be difficult to explain, Brosh chronicles it with startling clarity in her blog Hyperbole and a Half:

“I spent months shut in my house. I couldn’t feel anything through the self-hatred. Trying to use willpower to overcome the apathetic sort of sadness that accompanies depression is like a person with no arms trying to punch themselves until their hands grow back.”

In another blog entry with an accompanying cartoon, Brosh captures how depression feels:

“You’re stuck in the boring, lonely, meaningless void without anything to distract you from how boring, lonely, and meaningless it is.”

Brosh painstakingly works to get the facial expressions and body stances of her characters just right, to depict the emotions she wants to convey. Visual cues give meaning where words fail.

Depression is often misunderstood by those who don’t suffer from it. Many think that giving advice and imposing optimism are the answers. Brosh illustrates this disconnect.

Psychologists and professors are taking note—sharing the blogs widely and using them as teaching tools.

Psychologist Jonathan Rottenberg of the University of South Florida devoted a post on Psychology Today to Brosh:

“I know of no better depiction of the guts of what it’s like to be severely depressed. If you’ve been severely depressed, or if you know someone who is and you want to know more about what they are experiencing, please read ‘Hyperbole and a Half.’ “

Psychotherapist, psychology student, and Reddit user ‘busterbrother’ also explains on Reddit how the cartoons made a difference in her practice and at school. One of her suicidal clients struggling with depression felt that no one understood. Using Brosh’s blog, the therapist could offer an account of someone facing similar difficulties. ‘Busterbrother’ also used the blog in a presentation to illustrate depression to others in her cohort, after which her professor began incorporating it into his own classes:

“The professor said that this blog is the best way that he has ever seen someone talk about depression to someone who has never experienced it.”

This idea is supported by research. In the International Journal of Humor Research, Yan Piaw Chua, a professor at the University of Malaya in Malaysia, demonstrated how this type of humour can enhance student comprehension and motivation to learn. And studies show that humour can improve wellbeing and reduce depression.

Researchers Shelley Crawford and Nerina Caltabiano at James Cook University in Australia developed a humour skills program that included a booklet with jokes and funny stories. They found that participants achieved heightened wellbeing, as well as decreased depression and anxiety, in comparison to groups that received treatment without humour or no treatment at all. Other studies have shown similar results.

As one reader put it: “…these comic strips make my day whenever I am feeling a little glum and need an instant pick-me-up.”

Being able to communicate feelings of depression and anxiety without being judged, and doing so creatively… what better way to combat demons?

–Lysianne Buie, 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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Fast Food Industry Demands ‘Emotional Labour’ from Employees

00Burnout, Depression, Emotion Regulation, Featured news, Health, Stress, Work October, 16

Source: Steffi Reichert on Flickr

Donna Abbott (name changed), a long-time employee at McDonald’s, does more than serve Happy Meals. She smiles politely and greets every single customer. It’s part of the job. She’s even expected to ask the customer about their day. That way, the customer can walk away feeling satisfied.

Emotional labour—strict emotional control and outward enthusiasm—may be a way of earning tips. But in some sectors, including North America’s growing low-wage service industry, emotional labour is a fundamental part of the job. Displaying concern for a customer’s needs, smiling, and making eye contact is critical to a customer’s perception of service quality.

Cheerful presence can be essential to profitability of service providers, particularly in the fast-food industry. But emotional labour may be doing more harm than good to employee emotional and mental wellbeing.

A recent research review by Alicia Grandey and colleagues at Penn State University examined the benefits and costs of emotional labour practices, including those used in fast-food services. According to the study, the self-control and regulation needed to convey a sense of artificial happiness for an extended period of time is taxing, depleting energy and resources that could be dedicated to other tasks.

In an interview with the Trauma and Mental Health Report, Donna said:

“The energy that I spend being overtly happy could be used elsewhere—I know that I’d be able to take orders faster and prepare meals quicker if I didn’t have to take that extra and, in my opinion, forced step to be emotionally friendly with customers that I don’t know.”

Emotional fatigue that detracts from the ability to do other work isn’t the only problem. Unless the employee is naturally a positive person, the act of suppressing true feelings and generating insincere ones leads to what psychologists call dissonance—a tense and uncomfortable state that can lead to high levels of stress, job dissatisfaction, and burnout.

“It’s just stressful and really frustrating,” says Donna. “It creates this push and pull within you that you really want to—but often can’t—resolve. And in trying to cope with these fake feelings, I’ve turned to things I’m not proud of and don’t admit to everyone.”

Donna reports excessive use of cigarettes and marijuana, particularly after a long and emotionally draining 10-hour shift; addictions that are not uncommon among employees in the fast-food industry. According to the Substance Abuse and Mental Health Services Association’s National Survey on Drug Use and Health, food service has the highest rate of drug use, with an estimated 17.4% of workers abusing substances.

Individuals vary in their ability to deal with inauthentic emotional expressions. This means that the effects of emotional labour on emotional and mental wellbeing do not apply to all fast-food employees. Some workers may be able to identify with the organization’s values of positive emotional communication, making them better prepared to express appropriate emotions. And people who are generally more cheerful and pleasant may be able to turn off negative emotions more easily than others.

Donna is one of the less cheerful employees:

“When I started working at McDonald’s I would say that I was happy, but still not at the level of putting a smile on randomly for just anyone. I’m not a naturally happy person. And after being there for a long time, I wouldn’t say that I’m the most pleasant employee. I’ve had my fair share of negative attitude and customer complaints, which make it very hard to pretend to be happy or care about the customer—especially since it’s not technically in my job description to do that.”

In their research, Grandey and colleagues note that there are some jobs where emotional labour may be a core requirement. Childcare workers or people who care for those who are mentally or physically ill are a common example. But, the dissonance that a fast-food employee feels is probably more than workers experience in other sectors, like care providers, who typically see the act of helping as part of their identity.

Emotional labour comes at an emotional cost. And employers who require emotional labour should do so in a supportive rather than controlling climate. By training employees to recognize mistreatment, offering down-time to help workers re-charge, and giving employees opportunities to engage in honest interaction, employers might find a positive attitude that comes about on its own.

–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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Semicolon Punctuates Mental Health Awareness

00Addiction, Featured news, Health, Resilience, Self-Harm, Suicide, Trauma September, 16

Source: Brittany Inskeep on Flickr

Sure, writers dismiss it. But the semicolon—the otherwise underwhelming punctuation mark—has had its share of fans like American physician and poet Lewis Thomas, who said the semicolon leaves “a pleasant little feeling of expectancy; there is more to come; read on; it will get clearer.”

Amy Bleuel echoed this sentiment when she founded Project Semicolon on April 16, 2013. This global non-profit movement is dedicated to providing support for those struggling with mental illness, suicide, addiction, and self-injury.

In a recent interview with the Trauma and Mental Health Report, Amy shared the meaning behind the semicolon:

“It represents continuance. Authors usually use the semicolon when they choose not to end the sentence. You are the author and the sentence is your life, and you’re choosing to continue.”

In 2003, Amy lost her father to suicide.

“I’m kind of continuing his story by telling it to raise awareness. It took 10 years for me to do it but I was able to use his story to bring hope to others and that was my inspiration.”

Since the project’s humble beginnings, the semicolon has evolved into something much bigger. After one of Amy’s blog posts went viral, many decided to get inked with the symbol. What’s more: they started sharing their stories online and creating awareness around mental illness.

But according to Amy, Project Semicolon was not intended to become a tattoo phenomenon:

“It was not meant at all to be a tattoo campaign. It was just picked up as that. I got a tattoo. People started getting a tattoo. It became something people apparently wanted to say.”

It also became something people were willing to stand behind. As a registered charity, Project Semicolon raises funds to help fight stigma and present hope and love to those in need. Dusk Till Dawn Ink, a tattoo shop in Calgary, even donates a portion of the proceeds from semicolon tattoos to the Canadian Mental Health Association.

But the semicolon isn’t the only mental health tattoo out there. Casidhe Gardiner, 20, has an eating disorder recovery symbol tattooed on the inside of her arm, alongside the words “take care.” To her, the tattoo serves as a reminder to look after herself and to avoid relapse:

“If I branded myself with a recovery symbol in a place that I could see all the time, it would remind me in a hard time when I’m spiraling down again that I’ve recovered. I’ve done all this hard work to get there. Why go through the negative parts of the disorder when I have all these amazing parts of recovery?”

What is it about mental health tattoos that help in the healing process?

According to Casidhe, the tattoo works as a conversation piece—sparking discussion when it might not happen otherwise. When asked about the role the semicolon tattoo plays in her healing process, Amy felt the concept was more opaque:

“You know I’m not really sure how that works. I have a lot of people say they look at the semicolon and it gives them inspiration. It’s a reminder that says you get to keep writing. Yeah it sucks sometimes but you get to keep going and choosing how you write that story.”

Supporters of the project have declared April 16th ‘National Semicolon Day.’ On this day, everyone is invited to post their semicolon tattoo on social media platforms like Twitter and Pinterest with the hashtag #ProjectSemicolon, raising awareness and celebrating the network of people who believe in moving forward despite their challenges.

On their website, the project states that they are not a helpline, nor are they trained mental health professionals. But what makes Project Semicolon special, according to Amy, is that it emphasizes the importance of community and non-judgmental support in recovery:

“These people need somebody who cares, who understands them. Not just people who say everything will get better. I wanna be open and honest about my own struggles, I don’t want them to think I’m a person who doesn’t struggle. I want people to be able to come up and say, ‘I struggle too.’ Why do we need to hide?”

A simple punctuation mark; a tattoo; a network of support. Perhaps by wearing a symbol that represents the struggles and victories of the human spirit, the invisible becomes visible. And visibility is important when striving for universal acceptance.

 “Stay strong; love endlessly; change lives.” The phrase appears on the mission statement on the project’s website. It was borne of a phrase close to Amy’s heart:

“I use the phrase “love endlessly” and I truly believe that it’s love that can save a life. And my father showed me that in the short time I had with him.”

–Marjan Khanjani, 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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“Ex-Gay” Conversion Therapy Movement Puts Lives at Risk

00Conformity, Featured news, Health, Sexual Orientation, Social Life, Stress, Therapy September, 16

Source: Photographee.eu/Shutterstock

There is a billboard in Richmond, Virginia hanging above the interstate with a picture of identical male twins and a caption that reads: “Identical Twins: One Gay, One Not. We believe twin research studies show nobody is born gay.”

Parents and Friends of Ex-Gays & Gays (PFOX), the organization that created the ad, promotes the view that being gay is a choice, not a genetic predisposition, despite extensive research showing the contrary.

The claims in the ad are not only false, but the men featured are not actually twins at all, or even brothers. According to the Huffington Post, the face of South African model, Kyle Roux, was superimposed onto two different bodies to give the illusion of twins. Roux was shocked to see his face on the ad, as he didn’t give permission for the image to be used. And…he is openly gay.

PFOX is part of the controversial Ex-Gay Movement, encouraging gay persons to refrain from same-sex relationships, eliminate homosexual tendencies, and develop heterosexual desires. Their view: Gay must be cured.

They consider sexual orientation a choice, and those who identify as gay are willingly choosing a deviant lifestyle. But this ideology results in family rejection and self-hatred among LGBTQ individuals, as well as intolerance and discrimination in the community.

Organizations promoting this view are often affiliated with religious institutions. PFOX believes gay people can renounce homosexuality through religious revelations or conversion therapy, also known as reparative therapy.

Sexual orientation conversion therapy became popular in the 1960s. According to the American Psychological Association report, Appropriate Therapeutic Responses to Sexual Orientation, different disciplines of psychology influenced practices of conversion therapy.

In response to such treatments, numerous mental health and psychological organizations publically announced that homosexuality is not a mental disorder and is not something that can or should be cured. In fact, the American Psychiatric Association’s Board of Trustees removed homosexuality from the Diagnostic and Statistical Manual of Mental Disorders, Second Edition (DSM II) in 1973. And in 2000, they further stated:

“The potential risks of reparative therapy are great, including depression, anxiety and self-destructive behavior, since therapist alignment with societal prejudices against homosexuality may reinforce self-hatred already experienced by the patient.”

The risks are even greater among gay youth. A 2009 study by Caitlin Ryan of San Francisco State University found that young adults who experience family rejection based on their sexual orientation are eight times more likely to attempt suicide and six times more likely to experience depression.

Despite these findings and professional opposition to conversion therapy by both the American Psychiatric and American Psychological Associations, many of these treatments continue to be used and promoted.

Michele Bachmann, a Republican former member of the U.S. House of Representatives, considers homosexuality a choice. Bachmann and her husband were found to be practicing conversion therapy at their Christian counseling clinic in Minnesota.

Conversion therapy is still legal in most U.S. states, though anti-conversion bills have been signed into law in California, New Jersey, and Washington DC. Campaigns such as the #BornPerfect movement are working toward expanding state bans into other areas.

While public attitudes and legislation are shifting toward respect for LGBTQ individuals, conversion therapy is still a common practice, compromising mental health, threatening lives, and undermining efforts of movements that stress tolerance and equality.

–Eleenor Abraham, 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