Category: Identity

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When the Expectation is for Parents to Hover

00Attachment, Attention, Child Development, Featured news, Identity, Parenting December, 16

Source: Dennis Skley on Flickr, Creative Commons

In September 2015, the Supreme Court of British Columbia, Canada, ruled that a mother, known only as ‘B.R.’, could no longer leave her eight-year old son home alone for two hours after school. As reported in a Vancouver Sun article by Brian Morton, this court decision implies that children under the age of ten cannot be left unsupervised under any circumstance.

The implications of this case reach far beyond B.R.’s personal story, and may have serious consequences, raising questions around babysitting, and even whether parents can leave children alone in the house to fetch something from the backyard or to have a conversation with the neighbours.

The ruling is seen by some as reflecting a shift toward helicopter parenting, where parents “hover”, rarely leaving children alone or allowing them to make their own decisions. This consistent interference may in fact hinder a child’s development.

Kathleen Vinson, a professor at Suffolk University, views parental hovering as preventing children from gaining a sense of independence and privacy, which in turn can impede a child’s ability to mature into a healthy, responsible adult later in life. In her research, Vinson found that:

“…the impact of having helicopter parents may have resulted in children’s under-involvement in decision-making; reduced ability to cope; and lack of experience with self-advocacy, self-reliance, or managing personal time.”

Vinson’s research highlights a helplessness and lack of control that many of these children feel. As they move through adolescence to enter university and an increasingly competitive job market, these young adults may find it difficult to juggle the stress brought on by sudden autonomy.

Similar views are expressed by Lenore Skenazy, author of the blog Free Range Kids.With tongue-in-cheek, this self-proclaimed “world’s worst mom” speaks out against tactics such as GPS-tracking one’s children. She supports the idea that it is normal for both parents and children to make mistakes. According to Skenazy, these experiences are an opportunity for a child to develop and mature:

Childhood is not a crime. Down time is not dangerous. In fact, it’s the fertile soil where creativity takes root. Do you wish you’d grown up with your mom tracking your every move? If not, don’t do it to your own kid.” 

But parents often believe they are doing the right thing. Over-attentiveness may come from a place of genuine concern, and the consequences of leaving one’s children unattended.

A Parents Magazine article explains that for many, even the smallest failure or accident can seem disastrous, especially if parental involvement could have prevented it.

And parental involvement is a crucial aspect of a child’s mental health and development. In their textbook, Home and School Relations, University of North Dakota professors Glenn Olsen and Mary Lou Fuller examine the impact of parental participation in children’s education. The authors found that children whose parents showed more interest and involvement in their growth tended to excel academically across multiple domains, including classroom performance and standardized testing—a trend that continued well into higher education.

Still, problems arise when parent involvement extends too far, leaving young adults helpless in trying to find their footing, impeding normal development and failing to foster independence.

For such competencies are necessary to cope with the trials and tribulations of adult life.

–Andrei Nestor, 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

Trauma Survivors at Risk for Future Abusive Relationships

Trauma Survivors at Risk for Future Abusive Relationships

10Child Development, Domestic Violence, Featured news, Identity, Post-Traumatic Stress Disorder, Relationships, Trauma January, 16

Source: David Dávila Vilanova/Flickr

In her 2012 TED talk on domestic violence, Leslie Morgan Steiner discusses what she calls “crazy love,” the irrational and often deadly tendency to be oblivious to the red flags that indicate you are sharing your life with an abusive partner.

After discussing the typical situations that often lead to an abusive relationship, Steiner states that by asking the  question, “Why doesn’t she just leave him?” we are blaming the victim for falling in love with someone who would go on to abuse them.

While Steiner was not a victim of childhood abuse, many women and men who find themselves in similar situations are.

Victims are never at fault; no one asks to be victimized by their relationship partner. But for those who do have a prior history of abuse and who might find themselves in repetitive abusive cycles, what ability do they have to become aware of their vulnerability to future abuse?  And more important, could such awareness be helpful to them?

When children witness or experience abuse, it can have a detrimental effect on their well being as an adult.  Their experiences have been linked to the development of depression, anxiety, substance abuse, as well as eating disorders later in life.  Early exposure can also place individuals at a higher risk of experiencing abusive relationships in the future.

Joanna Iwona Potkanska, a Toronto-based social worker and trauma-informed psychotherapist says, “We tend to remain in patterns that are familiar to us.   We often do not realize that the relationships we are in are abusive, especially if we grew up in dysfunctional families.”

Based on British psychiatrist John Bowlby’s original work on attachment, theorists view the attachment style one develops as a child as related to adult relational patterns.  Internal understanding of how relationships work derives from primary caregivers and is the basis of later interactions.

“It would be foolish to say that observing domestic abuse from a young age doesn’t have an impact on a person’s future relationships.  It contributes to the construction of a child’s belief system – on how a relationship should be and what it should look like,” says Whitney Wilson, a counselor for the Partner Assault Response program at the John Howard Society of Toronto.

Wilson considers exposure to early domestic abuse as altering one’s view of romantic relationships in many ways.  “It’s similar to having a parent that smokes; smoking becomes normalized and may influence your decision to smoke.  Or, you may dislike that your parent smokes and swear off it.  It really depends on your lived experience and how it affects the formation of your beliefs.”

According to Potkanska, when we experience interpersonal trauma, whether physical, emotional, sexual or spiritual, we often lose our sense of self.  The abuse becomes part of our story and is deeply internalized.

She says that when offenders are also caregivers, victims most often blame themselves.  “The idea that we are loved as we are being abused, or that we are being abused because we are loved(many perpetrators use this excuse to justify their actions) can become a template for the way we relate to the world and ourselves.”

So, if a woman grows up with a model of relationships that involved abuse, anger, and shame, will she believe that she deserves a different kind of relationship?  Or might she believe that a relationship based on support and love simply does not exist?

It depends…  The way people make sense of their early relationships, and the conclusions they draw from them, depend a good deal on what occurs in other important relationships in their lives.  And nowhere is this seen more clearly than in the area of counseling and psychotherapy.

By working with a therapist, individuals can learn to identify how they interpret experiences based on ‘old information’ and can learn to recognize the warning signs of an abusive relationship.

Potkanska says that “without learning how to set healthy boundaries, we allow others to harm us and we re-enact conscious or unconscious situations in an attempt to have either a different outcome, or to reinforce what we already believe about ourselves.”

Healthy attachments to other supportive family members and mentors can buffer the effects of childhood abuse.  For those not fortunate enough to experience positive relationships growing up, there are other ways to break the cycle.

The connection a survivor builds with their therapist is meant to act as a model for secure attachment.  This can then translate to the way the individual perceives themselves and how they interact with others.

Potkanska emphasizes safety and space within the therapeutic relationship, noting that “Simple actions like ensuring that adequate physical space exists between myself and my client shows that I respect their boundaries.”

A large part of the therapy process focuses on building an identity that is separate from the abuse.

“Romantic partners and relationships become a way to soothe and regulate, and so when clients are taught to self-soothe, they are less likely to look to their partner to provide what their perpetrator has failed to do. They eventually rely more on themselves and other resources, including healthy relationships, to meet their needs,” says Potkanska.

Even with therapy, breaking the cycle of abuse can be difficult.  Building an identity separate from abuse can take years of self-work, and often people cannot afford therapy or have limited access to resources.

And then there are the socio-political causes that force people to remain in abusive situations.  Potkanska points out, “Without adequate financial support, women and children are reliant on their perpetrators.  Our legal system does a poor job at protecting survivors of violence, even after they leave the abuser.”  Not only that, but it is usually after the victim has left that they are in the most danger.  Simply because, as Leslie Morgan Steiner states, “the abuser has nothing left to lose.”

So what do people who’ve experienced abuse as children, but go on to have normal and healthy relationships do so differently?

According to Wilson, “It’s really an active process for all of us, even those who were not abused.  Because we’ve allowed society to normalize things like verbal or emotional abuse you have to really know what a healthy relationship looks like and know that it’s hard work.”

Being in a healthy relationship is about giving yourself permission not to have to accept abuse.  And for many, that takes practice.  You have to first identify that you’re stuck in a cycle of violence, and then decide you have the right to break it.

– Jana Vigor, 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

Avatar Therapy Shows Promise For Voice Hearers

Avatar Therapy Shows Promise For Voice Hearers

00Depression, Featured news, Happiness, Health, Identity, Therapy October, 15

Source: Surian Soosay/Flickr

Auditory hallucinations are difficult to treat.  People show a wide range of response to antipsychotics.  And, the medications are associated with negative side effects. Psychological treatments like cognitive behavioral therapy (CBT) may help one cope with hearing voices, but they are usually not effective in quieting them or reducing their frequency.

An alternative method for voice hearers is a new computer–based approach called Avatar Therapy, developed at the University College London (UCL) by Emeritus Professor Julian Leff and his research team.

Avatar Therapy works as a collaborative process.  With the therapist, the patient constructs a digital representation of the face and voice that best suits one of their heard voices.  The therapist speaks as if they are one of the patient’s persecutors, and this speech is synced with the movement of the avatar’s lips, allowing for the patient to confront a simulation of their auditory hallucination in real time.

Patients have the opportunity to enter into a dialogue with their voices and learn how to gradually take control of the hallucinations.  By giving invisible and often menacing entities a face, these experiences can become easier to confront.  The therapeutic process allows for a safe space where the patient may practice  standing up to their voices in preparation for when they occur.

While research into Avatar therapy’s efficacy is limited to one pilot study, the results show promise.  After engaging 17 patients (who had not responded to medications) in up to seven 30 minute sessions of the therapy, patients experienced a significant reduction in the frequency and intensity of auditory hallucinations.

Also noteworthy is the abrupt cessation of voices in three of the patients who reported having experienced auditory hallucinations for 16, 13, and 3.5 years.  A follow up with these patients confirmed this cessation had continued three months after the pilot study. Patients also experienced a decrease in depression and suicidal thinking; encouraging results, since depression is often seen in cases of schizophrenia, and 1 in 10 of those diagnosed attempt suicide.

Patients were also given an MP3 recording of the conversations with their avatar from all the therapy sessions.  They were encouraged to listen to the recordings whenever they were feeling harassed by the voices.  This may have also contributed to their continued improvement.

Despite these preliminary results, Leff and his team caution that this approach may not be for everyone.  The study began with 26 patients, 9 of which dropped out.  The researchers attribute this drop out rate to the fear instilled in the patients by their voices and the threats uttered by them.

If this treatment is to have any effect, the patient must first be able to exercise a certain degree of tolerance over the voices, and be willing to manage the distress they produce. That said, another obstacle Leff and his colleagues face is working on ways to help patients develop stress management skills, so that more individuals may benefit from this approach.

The method may even open doors for further innovations in treatments for voice hearers, approaches that venture towards listening, understanding, and confronting one’s voices rather than suppressing them.

– Pavan Brar, 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

Grieving the Loss of a Child: The Five Stage Myth

Grieving the Loss of a Child: The Five Stage Myth

00Caregiving, Featured news, Grief, Identity, Memory, Parenting, Resilience, Trauma June, 15

Source: Bethan/Flickr

When we think of death, dying and grief, no one therapist has had the impact and staying power as that of Elisabeth Kübler-Ross. Her five stage model, presented in her classic, On Death and Dying, has been an influential voice on the topic for decades.

But in the last few years, work in the field has put the universality of that model in question. Some, such as Russell Friedman, therapist and director of the Grief Recovery Institute argue that with many kinds of loss people don’t grieve in five stages at all.

Originally intended to describe experiential stages of people facing their own impending death, mental health providers as well as school counsellors and educators seem to have generalized the Kübler-Ross model to a multitude of situations, some applicable, some not so much.

In a recent interview, The Trauma & Mental Health Report spoke with Katherine, who described her personal reactions throughout the first year after the loss of her son, Ben, who was killed in a car accident ten days shy of his twenty-first birthday. Like many coping with loss, her grief did not follow the patterns described by Kübler-Ross, it was much less predictable.

Katherine: I decided to see a social worker a few months after Ben died. We talked about grief after loss and the counsellor recited Elisabeth Kübler-Ross’s five stage grief model: denial, anger, bargaining, depression, and acceptance. This didn’t describe how I was feeling at all…

During the first few months after the accident, the only way I can describe how I was feeling is that there was no ‘feeling.’ It was as if my heart was ripped out and stomped on. There was nothing left, but a complete numbness.

According to clinical psychologists Jennifer Buckle and Stephen Fleming, co-authors of Parenting after the Death of a Child: A Practitioner’s Guide, this feeling of numbness described by Katherine, is often the first grieving experience reported by bereaved parents. Coupled with this sense of numbness, bereaved parents, especially mothers, feel vulnerable and unprotected in what is now considered to be an unfair world.

Eventually the numbness subsides and the unsettling and preoccupying images of the child’s death take over. Almost all bereaved parents make reference to traumatic memories. Even parents not present when their child died describe the trauma experienced as if they were physically there and directly involved.

Katherine: The nightmares just didn’t want to go away. I would have the same reoccurring dream. I would see a red traffic light and hear cars crashing, and then I would wake up in panic. It came to the point where I was anxious every night before bed; I knew what was coming, another nightmare or barely any sleep. I can’t recall having a peaceful sleep the first few months.

Katherine’s nightmares became less frequent over time, but still crept up on occasion. In Buckle and Fleming’s view, the impact of trauma can lessen for some over time; but for others, the images and violent memories may vividly persist.

Grieving parents also fight with recurring flashes of past memories they shared with their deceased child. After a child’s death, most parents feel as if a part of their life has been erased, this is a very frightening. To cope, some parents will resort to avoiding places they associate with the deceased child.

Katherine: It took me over a year to set foot in another hockey arena. Ben was coming home from hockey the night of the accident… just the idea of going into an arena was painful. All the memories… watching him learn how to skate, going to hockey practices, and going with the family to hockey tournaments. I was trying to avoid that pain.

Bereaved parents put a lot of energy into avoiding feelings, memories and places that remind them of the child. At times they also ruminate, thinking about what could or should have been.

Katherine: Sometimes I can’t help it, something will remind me of Ben, and I immediately think about what things would be like now if he was still around. It gets really hard at family get-togethers and around birthdays and holidays. Not having him there… a parent can never get used to that.

Psychology professor Susan Nolen-Hoecksema, on faculty at Yale University, reports that women tend to ruminate more if they were battling depression before their child’s death, in comparison to women who were not. Elderly bereaved parents also tend to ruminate more than younger bereaved parents. With more free time on their hands, there is occasion to think about what might have been.

So why do some parents have an easier time adjusting after the loss of a child, compared to others?

To move forward, grief counsellors tend to agree that parents need to experience their own pain, keep the deceased child’s memory alive, and accept the loss, a notion that aligns well with the Kübler-Ross “acceptance” stage. Parents who continue to avoid don’t adjust so well.

The ability to learn from bereavement helps parents take responsibility for creating a new purposeful life. Irvin Yalom, author of Existential Psychotherapy posits that when parents find it too painful to learn from their bereavement experience, they are unwilling to “feel true feelings guiltlessly.” For parents to adjust well, realising that it’s okay to be happy again is crucial.

The loss of a child is likely the most difficult thing a parent can endure. Perhaps it is fitting that a life experience so profound would turn out to be complex and hard to fit into predictable stages.

– Tessie Mastorakos, 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

A Contrast to Psychiatry: The ‘Hearing Voices’ Movement

A Contrast to Psychiatry: The ‘Hearing Voices’ Movement

00Conformity, Education, Featured news, Health, Identity, Psychiatry, Therapy May, 15

Source: Oiluj Samall Zeid / Flickr

The 1961 classic, The Myth of Mental Illness by Thomas Szasz, revolutionized the way we think about atypical mental phenomena.

And over the years, the diagnosis of schizophrenia has been criticized fervently, with some characterizing it as an umbrella term for separate psychological phenomena that vary in combination and severity from person to person.

Critics of the term have described the way experiences such as hearing voices are conceptualized and defined.  The International Hearing Voices Network (Intervoice) views hearing voices as a normal variation in human experience—albeit one of an unusual nature.

Representing a lesser known view within the field of mental health, the group encourages voice hearers to “accept that the voices are real, and to accept that the voices may have meaning (metaphoric or literal) based on one’s life experiences.”

In the interest of communicating different (and sometimes controversial) ideas in mental health, The Trauma & Mental Health Report recently spoke with a mental health nurse (who requested anonymity), whose current research examines voice-hearers’ narratives about their emotional experiences.  While not a member of Intervoice, the interviewee’s research represents an alternate approach to traditional psychiatry.

 Q:  Can you explain the structure and method of the narrative approach you are working on?

A:  Put at its most basic, I am following the method called ‘Dialogical Narrative Analysis’, outlined by Sociologist, Arthur Frank.  In my work, Dialogical Narrative Analysis examines the stories that voice-hearers have about their emotions and what those stories do for them.

Q:  How best do you think these experiences should be conceptualized if not as psychopathological?

A:  It would be best to ask those with the experience.  At the moment it seems as though they are greatly helped when they don’t dismiss their experiences as ‘illness’, but engage with them as meaningful.  Having seen the prolonged effects of both approaches over a number of years, I can say that it’s the voice-hearers and those with unshared beliefs [what we usually refer to as delusions] who clearly have the most to teach us.

Q:  Supporters of drug interventions often explain the use of pharmaceuticals for treatment as diminishing the occurrences of delusions or hallucination.  Can you comment on this way of thinking?

A:  It’s a normalizing practice; it seeks to return outliers to a normal.  I’m hardly the first to point out that what is considered normal is subject to extreme change.  This is how we get situations where persons and behaviours are rated as mad in one generation and acceptable in the next— like having a baby outside of marriage, or homosexuality.  This leads some in the Hearing Voices Movement to hope that what happened to the identity of being homosexual can happen to the identity of being a voice-hearer.

Q:  Does this point out a flaw in our cultural and scientific understanding of the meaning of ‘delusion’ and ‘hallucination’?

A:  The word ‘delusion’ is a judgment, and in the Hearing Voices Movement they tend to prefer the term ‘unshared belief’.  Many would agree that the problem with a ‘delusion’ is not so much in thinking, but in the interaction with humanity.  ‘Hallucination’ also implies a shared version of ‘real’ experiences which would be difficult to justify, a concept of normal which is utopian.

Many within the Hearing Voices Movement reject both terms.

Q:  Should therapeutic efforts end with the attempt to remove the occurrences of hallucinations or delusions?

A:  I think you can see now that I am not altogether in favour of ‘therapeutic efforts’.  Too often there is a lot of therapeutic effort, a lot of money, a lot of well-meaning people, and not very much thinking.  I am quite certain I would not like to be on the receiving end of ‘therapeutic efforts’.  I would like there to be justice and healing in communities.

Even if we were to know the complete neurological makeup of a voice-hearer’s brain, we would still lack true insight into the actual experience of hearing voices.  Understanding and accepting the lived experiences of these individuals is an indispensable tool for promoting coping and recovery.

It allows us to see the distressed individual not as some ‘gene-machine’ gone wrong, but a human who bears a certain relationship to himself and the world.

– Pavan Brar, 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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Ritual Abuse, Cults and Captivity

00Child Development, Diet, Environment, Fear, Featured news, Gratitude, Identity, Post-Traumatic Stress Disorder, Sleep, Therapy, Trauma February, 15

It is almost impossible to imagine the realities endured by victims of ritual abuse:  multiple abusers with systematic motives coordinated with the sole purpose of perpetrating and maintaining a cycle of abuse.  Cults and organizations such as David Koresh’s Branch Davidians use torture and sexual abuse to control their members and force them into compliance.

Behind The Abuse

The Ritual Abuse Task Force of the L.A. County Commission for Women defined ritual abuse as involving:

“…repeated abuse over an extended period of time.  The physical abuse is severe, sometimes including torture and killing.  The sexual abuse is usually painful, humiliating, intended as a means of gaining dominance over the victim.  The psychological abuse is devastating and involves the use of ritual indoctrination.  It includes mind control techniques which convey to the victim a profound terror of the cult members…most victims are in a state of terror, mind control and dissociation.”

According to psychologist Louis Cozolino of Pepperdine University, ritual abuse is characterized by a number of perpetrators of both sexes and the presence of many victims.  The abuse is often carried out in contexts where children are in groups, and within families or groups of families.

Often seen are mind-control techniques that involve combinations of extreme abuse and “brainwashing.”  For example, “psychic driving” is defined by psychologist Ellen Lacter (who runs www.endritualabuse.org) as taped messages that are played for hours non-stop, while the victim is in a state of consciousness altered by sleep deprivation, electro-shock, sensory deprivation, and inadequate nutrition.

Researcher Patricia Precin of the New York Institute of Technology, alongside Cozolino, report that many ritual abuse survivors suffer from PTSD.  Clinicians also see a high frequency of Dissociative Identity Disorder (DID) among such adolescent and adult patients.

And in an Australian study of workers at the Center against Sexual Assault (CASA) including psychiatrists, psychologists, and other clinicians, 70 percent of all counselors agreed with a single definition of ritual abuse and 85 percent agreed that ritual abuse was an indication of genuine trauma.  CASA workers were much more likely to believe their client’s ritual abuse and marginally more likely to identify ritual abuse cases than other therapists.

Cozolino references a vast amount of corroborating evidence for the existence of ritual abuse, such as police reports and therapeutic case studies.  In one of his papers he describes one such case:

“A five-year-old victim in the Country Walk case related that one of his abusers at his day-care setting had been killing birds.  This young boy spontaneously repeated the following well-rehearsed prayer to his startled father:

‘Devil, I love you.

Please take this bird with you

and take all the children up to hell with you.

You gave me grateful gifts.

God of Ghosts, please hate Jesus and kill Jesus because

He is the baddest, damnedest person in the whole world.

Amen.

We don’t love children because they are a gift of God.

We want the children to be hurt.’ ”

Although such accounts are well documented, not everyone believes ritual abuse exists. Bernard Gallagher from the Centre for Applied Childhood Studies at the University of Huddersfield considers ritual abuse a result of erroneous diagnosis made by agency workers:

“This includes pressuring children into making disclosures, the misinterpretation of children’s statements and an over-reliance upon preconceived ideas concerning the existence of ritual abuse.  This results in what psychologists and statisticians might refer to as ‘false positives, ” writes Gallagher.

After The Cult

Escaping the torment of a cult is perhaps the most difficult part for a survivor, but recovery and rehabilitation can be just as challenging.  Cozolino and colleague Ruth Shaffer interviewed survivors, focusing questions on recovery.  They reported that the majority considered participation in support groups a necessary adjunct to psychotherapy.

It may seem counterintuitive to treat ex-cult members as a group because their abuse took place in a group setting.  However certain precautions may be taken to make treatment effective.

For example, British researcher Nicole Durocher notes that organizers must take care not to construct a group that resembles a cult gathering in any way.  The support group has to be sensitive to the special needs of each ex-cult member and to the particular context of the cult from which they exited.

The professional in the group must differ from those in other support groups, acting as an advocate-mediator to observe the group, identifying conflicts, clarifying alternatives for resolution, and negotiating compromises.  These support groups occasionally have the professional co-lead the group with an ex-member acting as an observer, guide, and consultant.

One survivor of multi-generational ritual abuse who wishes to remain anonymous, has written a public letter to the Stop Mind Control and Ritual Abuse Today (S.M.A.R.T) organization, reflecting on his own struggle with PTSD.

“My PTSD often reminds me of what it is to be a soldier.  On the battlefield when every moment is life and death, a soldier will do many things and anything to survive.  When the soldier returns to a normal, non-war society he can’t understand why he did the things he did.”

He goes on to say that with the help of therapy, his shattered life and sense of self can be pieced together again:

“I cry, I sing, play guitar, listen to music, sleep normal hours instead of being awake all night, and more than anything else, I try to change who I was… into who I am.”

– Contributing Writer: Justin Garzon, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

Photo Credit: https://stocksnap.io/photo/YN5H0VTR6O/

This article was originally published on Psychology Today

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State of Emergency: Suicide in First Nations Communities

00Addiction, Anger, Depression, Education, Featured news, Grief, Health, Identity, Politics, Post-Traumatic Stress Disorder, Spirituality, Suicide, Trauma December, 14

On April 17th 2013, Chief Peter Moonias declared a state of emergency in the community of Neskantaga. Two suicides within days of each other are only the most recent in a string of sudden deaths that have ravaged the group. 

In the four months prior, seven people died, four of them from suicide, and twenty more made suicide attempts. In a community as small and remote as Neskantaga (the reserve is home to 300 people and is only accessible by plane), the residents are tight-knit. And the losses of their family members, friends and neighbours have left many struggling to cope.

Suicide is disturbingly common among some Inuit and First Nations groups, with the rate in some communities eleven times higher than the Canadian average. Overall, First Nations peoples have a suicide rate twice the norm in Canada, a statistic that has been stable for at least three decades.

Colonization of the Americas has had a profound effect on Indigenous populations. In the centuries since first contact, 90% of the American Indigenous population has been wiped out due to plagues, warfare, and forced relocations. The legacy of land seizures and residential schools still haunts these groups.

The immediate survivors of these incidents would undoubtedly be traumatized, but many of the people who have committed suicide in recent years were not personally exposed. How can trauma inflicted centuries ago have an impact on current suicide rates?

The answer lies in the concept of historical or collective trauma, which Maria Yellow Horse Brave Heart, Associate Professor at the University of New Mexico, defines as “cumulative emotional and psychological wounding over the lifespan, and across generations, emanating from massive group trauma experiences.”

Also known as generational grief, the trauma results from suffering profound losses in areas such as culture and identity, without resolution. Unresolved, deep seated emotions like sadness, anger and grief are passed on from generation to generation through parental practices, relations with others and culture-wide belief systems.

In everyday life, the trauma manifests itself through social problems like drug use, familial abuse and violence. These events can cause traumas of their own and result in depression and PTSD, both of which increase suicide attempts.

Young people are especially at risk. In the cohort of 15-24, the rate of completed suicides is five to seven times the national (Canadian) average, and suicide attempts are even more frequent 

Chris Moonias (no relation to Chief Peter Moonias), an emergency response worker in Neskantaga, told the CBC that since the end of 2012, “We average about ten suicide attempts per month, and at one time we surpassed thirty attempts in one month.”

In addition to unresolved grief, Cynthia Howard of Laurentian University identifies several factors that contribute to suicides in Aboriginal communities. These include: attendance at residential schools and abuse experiences there, forced assimilation, displacement, and adoptions. These experiences have left legitimate feelings of distrust towards dominant American and Canadian cultures and feelings of loss of culture.

Some people also feel strung between two cultures (dominant culture and their own band’s culture) while essentially belonging to neither. Feeling alienated and lacking a sense of belonging can leave many people depressed and feeling that their lives lack a sense of purpose.

Other issues such as low socioeconomic status and extreme poverty, along with low levels of education and lack of opportunity have lead to feelings of hopelessness and helplessness.

“Learned helplessness” occurs when a group or individual, usually after a series of disastrous events, believes they have no control over the outcome of any situation, and that perceived failures in the present will likely continue into the future. Without hope, people sometimes feel that living is worse than not living. This feeling is only exacerbated by a shared history of trauma and its consequences, and can culminate in suicide.

Unfortunately, many people suffering do not receive adequate help. Their families and friends are also left without professional support, continuing the cycle of unresolved grief.

Perhaps it is fitting that Chief Moonias of Neskantaga called a state of emergency. His community has reached a tipping point and must be healed in order to move forward. 

As of now, the federal Canadian government has offered some monetary and human aid, but unless we go beyond band-aid solutions, frequent suicides and their consequences will continue to haunt Neskantaga.

– Contributing Writer: Jennifer Parlee, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

 Photo Credit: https://www.flickr.com/photos/kittysfotos/6235090832/”>Kitty Terwolbeck</a

This article was originally published on Psychology Today

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LGBTQ Refugees Lack Mental Health Care

00Addiction, Depression, Education, Featured news, Gender, Health, Identity, Politics, Psychiatry, Psychopharmacology, Sexual Orientation, Stress, Suicide, Trauma November, 14

In 2012, the Canadian government introduced cuts to the Interim Federal Health Program (IFHP), which provides health coverage for immigrants seeking refuge in Canada. Coverage was scaled back for vision and dental care, as well as prescription medication. At the same time, the introduction of Bill C-31, the Protecting Canada’s Immigration System Act, left refugees with zero coverage for counselling and mental health services.

The bill affects all refugees and immigrants, but individuals seeking asylum based on persecution for sexual orientation or gender identity have been hit especially hard by these cuts.

LGBTQ refugees are affected by psychological trauma stemming from sexual torture and violence aimed at ‘curing’ their sexual identity. Often alienated from family, they are more likely to be fleeing their country of origin alone, at risk for depression, substance abuse, and suicide.

On arrival in Canada, refugees struggle with the claim process itself, which has been cited by asylum seekers and mental health workers as a major source of stress for newcomers. For LGBTQ individuals, the process is even harder, having to come out and defend their orientation after a lifetime spent hiding and denying their identity.

In 2013, six Canadian provinces introduced individual programs to supplement coverage. The Ontario Temporary Health Program (OTHP) came into effect on January 1, 2014, and provides refugees and immigrants short-term and urgent health coverage. But it still lacks provisions for mental health services.

Envisioning Global LGBT Human Rights, an organization and research project out of York University in Toronto, has been collecting data from focus groups with LGBTQ refugee claimants both pre- and post-hearing. A recent report by lawyer and project member Rohan Sanjnani explains how the refugee healthcare system has failed. LGBTQ asylum seekers are human beings deserving respect, dignity, and right to life under the Canadian Charter of Rights and Freedoms. Sanjnani argues that IFHP cuts are unconstitutional and that refugees have been relegated to a healthcare standard well below that of the average Canadian.

Arguments like these have brought legal challenges, encouraging courts and policy makers to consider LGBTQ rights within the framework of global human rights.

In July of this year, Bill C-31 was struck down in a federal court as unconstitutional, but the government filed an appeal on September 22. Only if the appeal fails could immigrant healthcare be reinstated to include many of the benefits removed in 2012.

Reversing the cuts to IFHP funding would not solve the problem entirely. LGBTQ asylum seekers face the challenge of finding service providers who can deal with their specific needs. The personal accounts collected by Envisioning tell a story of missed opportunity, limited access to essential services, and ultimate disappointment.

In the last two years, programs have sprung up to address these special needs. In Toronto -one of the preferred havens for LGBTQ refugees- some health providers now offer free mental health services to refugees who lack coverage. Centers like Rainbow Health Ontario and Supporting Our Youth have programs to help refugees come out, and to assist with isolation from friends and family back home, and with adjusting to a new life in Canada.

Still, the need for services greatly outnumbers providers; and accessibility issues persist.

Organizations like Envisioning try to create change through legal channels, but public opinion on LGBTQ healthcare access needs to be onside for real change to occur. Recent World Pride events held in Toronto were a step in the right direction. But specialized training of healthcare professionals and public education would go a long way in providing the LGBTQ community with the care they need.

– Contributing Writer: Sarah Hall, The Trauma and Mental Health Report 

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

Copyright Robert T. Muller

Photo Credit: https://www.flickr.com/photos/vhhammer/3238712773/

This article was originally published on Psychology Today