Category: Parenting

168623-173894

When You’re Gone: Deployment Effects On Parenting

00Anger, Attachment, Empathy, Featured news, Happiness, Marriage, Parenting, Post-Traumatic Stress Disorder, Stress January, 15

Deployment

“It’s hard, but I think it must be harder for my husband, being away for so long. He missed a lot of firsts when the girls were babies. Thankfully, between deployments he got to see with one, the things he missed with the other.”

Blair Johnson, mother of two, Mackenzie age 5, and Macey age 2, has experienced firsthand the hardships of having a spouse away on deployment, as her husband Nathan, an American marine, has spent half of their marriage overseas and in training.

Deployment, the movement of troops overseas for military action, is a reality for many families in the U.S. and Canada. The American military is deployed in more than 150 countries around the world, with the majority of troops in combat zones.

Deployed soldiers often face great emotional strain as they are forced to separate from their spouses and children. The separation, distance, and heartache make parenting in these families an enormous challenge. Children, who tend to be most sensitive to changes within the family, may react strongly.

“For me, it has been harder with my older daughter during Nathan’s most recent deployment. Since she is such a Daddy’s girl, she acted out a lot in trying to deal with her father being away. She would give me a hard time, almost like she thought I could control whether or not her Dad was home.”

Amy Drummet, a researcher at the University of Missouri explains that military families experience stress at three main junctions: relocation, separation, and reunion. As Blair recalls, separations bring on feelings of parental inadequacy and guilt. “It’s the feeling that I can’t give my girls everything they need when it’s just me; they miss their Dad and I can’t do anything to bring him home.”

To complicate matters, the return home can be just as problematic. “The last time he came back was different than the previous ones. It took a lot longer for everything to return to normal. Jumping back into the role of a full-time father was harder for him.”

One in every five soldiers returning home from Iraq or Afghanistan may suffer from posttraumatic stress disorder (PTSD). This prevalence makes it difficult for the returning parent to carry on normal parenting responsibilities. “When Nathan returned, he was very jumpy, angry, and agitated with every loud sound he heard. He would constantly reach for his gun even though he didn’t even have it once he returned home. He had to learn to let go of the defense mode he was used to.”

Coming home presents many obstacles the family must overcome in order to settle back into a normal and familiar way of living. Apart from the joy of having one’s partner return home, there is plenty of work that must be done to adapt to previous family roles.

“The girls hold a lot of anger towards me after he is home and it is heart breaking; they don’t want anything to do with me for the most part. Since I am the main disciplinarian the majority of the time, they see him as the good guy. They want to spend every moment with him when he is around, because they just miss him so much when he’s gone.”

“I have been blessed to have parents with whom we can stay during his deployments. For us, it helped a bit in filling the void of Daddy being gone. We take advantage of the time we can spend together, so all the family can be a part in their lives,” says Blair.

Military children are especially vulnerable during a deployment due to separation from their parent, a perceived sense of danger, and an increased sense of uncertainty. “I asked Mackenzie what she thought Daddy was doing when he is deployed and she said, ‘he is working…and fighting the bad guys.’”

Despite the difficulties, Blair insists that there are good aspects to deployment, “You have to make a choice to either let it affect you in a bad way or a good one. You can use that time to grow closer instead of growing distant. It is all a matter of choice. I believe something good can come from any situation, no matter how terrible it is. It makes you a stronger person and it helps you realize just how much you can handle.”

Deployment drastically affects family life. While it requires all family members to readjust, children, who are more prone to being agitated by their changing circumstances, may find it harder to cope. As parents battle their own issues and uncertainties, they may unintentionally miss signs that their children need them.

So deployment may have an effect on the attachment with not only the deployed parent, but also with the parent who stays behind. The confusion and uncertainty experienced by children should be treated with love and understanding, while maintaining their normal routine.

“Parents have their bad days, but it’s important to cry, let it all out, and then move on. Happiness is an everyday choice, and choosing it doesn’t mean you miss your spouse any less.”

– Contributing Writer: Noam Bin Noon, 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/dvids/3522556401/

This article was originally published on Psychology Today

166453-171245

Book Review: Becoming Trauma Informed

00Addiction, Anxiety, Child Development, Cognition, Empathy, Environment, Featured news, Health, Leadership, Parenting, Psychopharmacology, Race and Ethnicity, Stress, Therapy, Trauma, Treatment December, 14

Red, and your heart starts to race. Red, and your palms sweat. Red, and the sounds around you blur together. Imagine becoming emotionally aroused or distressed at the sight of simple stimuli, like the colour red, without knowing why.

Because triggers like this can take the form of harmless, everyday stimuli, trauma survivors are often unaware of them and the distress they cause in their lives. And clinicians who practice without the benefit of a trauma-informed lens are less able to help clients make the connection.

To address this and other concerns, researchers Nancy Poole and Lorraine Greaves in conjunction with the Centre for Addiction and Mental Health (CAMH) in Toronto recently published Becoming Trauma Informed, a book focused on the need for service providers working in the substance abuse and mental health fields to practice using a trauma informed lens.

Becoming Trauma Informed provides insight into the experiences, effects, and complexity of treating individuals who have a history of trauma. Without a clear understanding of the effect traumatic experiences have on development, it is challenging for practitioners to make important connections in diagnosis and treatment.

The authors describe how someone who self-harms may be diagnosed with bipolar disorder, possibly insufficiently treated with only medication and behaviour management. But using a trauma informed lens, the practitioner would more likely identify the self-harming patient as using a coping mechanism common to trauma survivors, giving rise to trauma informed care.

Such care involves helping survivors recognize their emotions as reactions to trauma. And helping clients discover the connection between their traumatic experiences and their emotional reactions can reduce feelings of distress. 

Throughout the text, the authors describe an array of treatment options, pointing to ways they can be put into practice; for example, motivational interviewing to provide guidance during sensitive conversations, cognitive behavioural therapy for trauma and psychosis, and body centred interventions to allow clients to make connections between the mind and body, an approach that has become increasingly popular in recent years. 

Importantly, the authors emphasize that a single approach to trauma-informed care is unrealistic and insufficient. While all treatments should include sensitivity, compassion, and a trusting relationship between therapist and client, specific groups require unique approaches. 

The authors devote chapters to specific groups, including men, women, parents and children involved with child welfare, those with developmental disabilities, and refugees. They outline different approaches necessary for trauma informed care in various contexts, such as when working in outpatient treatment settings, in the treatment of families, and when working with women on inpatient units, where treatment requires sensitivity to both the individual’s lived experiences and environment

A unique and compelling feature of this book is the focus on reducing risk of re-traumatization, an often neglected topic. Responding to the need for trauma survivors to feel safe, the authors outline how trauma informed care minimizes the use of restraints and seclusion (practices that can be re-traumatizing), and they offer ways to reduce the risk of re-traumatization by placing trauma survivors in less threatening situations, where they are less likely to feel dominated. This may involve matching female clients to female therapists or support groups comprised of only females. 

The numerous case studies help illustrate specific scenarios, challenges, and outcomes of trauma informed care and highlight the growing recognition of the link between substance abuse, mental illness and traumatic experiences.

While the text is theoretically grounded, the authors convey information in a way that is accessible to wider audiences. It provides critical information for those working in the field by underscoring the relationship between past experiences and current functioning.

Becoming Trauma Informed delivers a deeply informative look into the field of trauma therapy.

– Contributing Writer: Janany Jayanthikumar, 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/auntiep/4450279893/

This article was originally published on Psychology Today

164882-169627

U.S. Government Fails to Support Families of Hostage Victims

00Anger, Anxiety, Appetite, Ethics and Morality, Featured news, Parenting, Politics, Post-Traumatic Stress Disorder, Resilience, Sleep, Stress, Teamwork, Trauma November, 14

On August 19, 2014, a YouTube video of American journalist James Foley’s beheading was released by the terrorist organization ISIS (Islamic State in Iraq and Syria). Weeks later, two more videos were released, showing the execution of American journalist Steven Sotloff and British aid worker David Haines. Each victim was taken hostage years ago and ransom demands for their release were directed at their families in the months prior to their deaths.

But their families faced more than the pain of watching their loved ones die. The US government pressured relatives of hostages to do nothing to help.

According to Sotloff’s parents, a member of President Obama’s National Security Council threatened the family with criminal prosecution if they attempted to pay a ransom to ISIS for Sotloff’s release. A similar conversation was held with Foley’s family.

The US government emphasizes that they do not negotiate with terrorist organizations. But is threatening the families of hostages justifiable?

Families in hostage situations feel powerless, especially when information about their loved one is scarce. Government officials exacerbate this sense of powerlessness. Along with initial anxiety, feelings of isolation, loss of appetite, and trouble sleeping, families of hostage victims who are denied the ability to intervene are more likely to develop long-term conditions like Post-Traumatic Stress Disorder and Generalized Anxiety Disorder.

Furthermore, the US government may actually be stepping outside of its own legislation by forcing victims’ families into inaction.

According to an FBI report from April 2014 that discusses the protocol for helping families in overseas hostage situations, the ideal scenario is very different from what took place. The report states that a highly experienced operational psychologist should be put on the case to help the victim’s families by providing them with a sense of hope. 

“We [should] let them know there are people actively working to recover their family member and that we aren’t giving up”, says Carl Dickens, an operational psychologist with the FBI. In addition to emotional support, families should also be provided with temporary living accommodations and emergency expenses. 

When asked if they felt the US government gave them adequate support, the Sotloffs responded, “Not at all. We never really believed that the administration was doing anything to help us.”

The British government has also stood strong on their position to not pay ransom money to terrorist organizations. But the Haines family was never threatened. Despite their anger toward the law, friends and family of Haines did not experience the same pressure their American counterparts faced. “The government and foreign office did their best,” said Mike Haines, brother of the fallen aid worker, “we have complete satisfaction with what they did. We felt very much part of the team.”

The White House has denied all accounts of threatening the Sotloff and Foley families. Yet the Obama administration has become more attentive to families of the latest overseas hostages and the latest victim, Peter Kassig. The famiy of an unidentified female aid worker who is presently being held hostage by ISIS recently had personal meetings with Obama to discuss the situation.

This is an important step towards finding a balance between respecting victims of terrorists and protecting the public good. But in the meantime, where the government has failed, the families of victims are trying to help others like them. Foley’s parents are establishing an organization to aid families of overseas hostage victims through counselling and support. The James W. Foley Legacy Fund will help build a resource center for families of American hostages and foster a global dialogue on government policies in hostage crises.

– Contributing Writer: Alessandro Perri, 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/babasteve/4705515039/

This article was originally published on Psychology Today

163805-168551

Womb Wounds: Fetal Alcohol Spectrum Disorder

00ADHD, Alcohol, Child Development, Education, Empathy, Featured news, Guilt, Health, Neuroscience, Parenting, Pregnancy, Psychiatry, Stress, Trauma November, 14

“Fifteen years ago there were very few people who knew about FASD. If you were to go to court and say, ‘My son or daughter has FASD,’ a judge wouldn’t even know if it was a real thing.” – Jonathan Rudin, Justice Committee Co-Chair at the FASD Ontario Network of Expertise

Recently referred to as an “invisible condition” by the popular Canadian newspaper, The Globe And Mail, Fetal Alcohol Syndrome Disorder (FASD) often goes undiagnosed.

A supervisor at the Toronto Children’s Aid Society described to the Trauma & Mental Health Report the stream of FASD cases that have recently found their way into youth care and justice systems.

“You often don’t know a child has FASD because the mother is not around to confirm alcohol exposure during pregnancy. With one case, we suspected it, and did some digging. The grandparents of the child confirmed that the mother did consume alcohol during pregnancy. It was the grandparent’s report that changed everything. Nobody would have known.”

Characterized by growth deficiencies and central nervous system damage, FASD is an incurable condition. According to Ernest Abel, Professor of Obstetrics and Gynaecology at Wayne State University and Ronald Sokol, Professor of Paediatrics at the University of Colorado, FASD is the leading cause of mental retardation.

The Canadian Academy of Child and Adolescent Psychiatry explains that mothers often feel intense guilt and are typically blamed for damage to the child. For this reason, they are not always forthright about drinking habits. Stigma also plays a powerful role in motivating mothers to withhold information. And often, mothers consumed alcohol before they knew they were pregnant and are therefore unable to recall precise quantities and timing of drinks.

Adelaide Muswagon, a single mom, was featured in the Winnipeg Free Press in an article on FASD. “It took a lot of courage for me to get help. I know behind my back I was called an alcoholic and druggie. I can’t change what I have done; I already harmed my child. But I want expecting mothers to know my story, realize the consequences, and not make the same mistakes I did.”

The diagnosis of FASD is only given at birth for the most extreme cases. More often than not, symptoms are mild and fall within the normal range of development. For a firm diagnosis, confirmation of alcohol use during pregnancy is required. Because FASD can look like other medical, psychosocial and psychiatric conditions, children can be mistakenly labelled with Attention Deficit Hyperactivity Disorder (ADHD) or a behavioural disorder.

Fortunately, the behavioural symptoms associated with FASD are becoming better known. As we learn more about the hardships associated with the condition, mothers may question their decision to be vague or dishonest about drinking.

Liz Kulp, award winning author, advocate, and person living with FASD speaks candidly about her experiences in her book, The Best I Can Be: Living with Fetal Alcohol Syndrome-Effects.

“Finding out [why life was so hard for me] didn’t change how hard life is, but it did make me believe I was not a bad person. When I ask a question, it is because I don’t understand, not because I have not been listening, sometimes there is a blank space and I can’t get across it. I may look really normal and I work really hard to maintain. That is really stressful and sometimes I get frustrated. Sometimes the stress just builds up, especially when different people put different expectations on me all at the same time.”

For students, FASD manifests with attention problems and difficulties understanding instructions and rules. Common sense can be lacking, along with a tendency to take things literally. Learning issues lead to high drop-out rates. Youth with FASD often become involved in criminal justice systems, and many such individuals are overrepresented in prison populations. Jonathan Rudin, an Ontario lawyer and chair of the FASD Justice Committee says people with FASD are “usually not the mastermind behind the crime” but they are “easily convinced to take the rap.”

Catching the condition early in life and understanding its effects can help with education, parenting strategies, and legal provisions.

Moving through life without knowing why things are harder for you and why everyone else seems to be able to function with ease can be devastating. Sadly, people with undiagnosed FASD often grow up using alcohol to cope, possibly giving birth to a child with FASD.

Alleviating stigma around FASD by providing mothers with a non-judgemental space to speak about their drinking may help with diagnosis and treatment.

– Contributing Writer: Anjani Kapoor, 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

163216-167891

Fear of Ebola Leaves Orphaned Children Abandoned

00Anxiety, Child Development, Cognition, Deception, Diet, Fear, Featured news, Grief, Health, Parenting, Politics, Post-Traumatic Stress Disorder, Sleep, Stress, Teamwork, Trauma October, 14

13-year-old Jennette’s (name changed by UNICEF) grandmother died from Ebola. Shortly after attending the funeral, Jennette began to feel sick. When fever developed, she was taken to a local treatment center along with her mother and sister. All three family members tested positive for Ebola. Against all odds, they were successfully treated and released.

Jennette broke down in tears as she spoke about her experience as a victim of Ebola to Timothy La Rose, a Communication Specialist with UNICEF Guinea. Despite being healthy again, Jennette could not feel good about her recovery, now facing the stigma of being an ‘Ebola contact’.

“I cannot return home [to] my aunt who threatened me a lot when I was sick. So far she has never asked about my fate.”

The WHO (World Health Organization) estimates Ebola fatality rates between 25 and 90 percent. Passed on through contact with the bodily fluids of an infected person, symptoms are gruesome and can include internal and external bleeding. Currently, there are no approved vaccines, and the 2014 outbreaks in Guinea, Liberia, and Sierra Leone have created immense fear among those living in affected regions. Even in the United States, by October 2014 a handful of cases have quickly led to panic in some regions.

Jennette is only one of the many children facing the consequences of neglect due to the distrust surrounding Ebola survivors. UNICEF estimates that about 3,700 children have lost one or both parents to the current outbreak.

UNICEF’s regional director for West and Central Africa, Manuel Fontaine, said, “these children urgently need special attention and support; yet many of them feel unwanted and even abandoned.”

After surviving Ebola or losing a family member to the virus, these children are being shunned by surviving relatives due to fear of reinfection. “Orphans are usually taken in by a member of the extended family, but in some communities, the fear surrounding Ebola is becoming stronger than family ties,” Fontaine told CNN.

Orphans—some as young as two years old—are in the streets alone, lacking proper shelter, healthcare, and nutrition. Many of these children have undergone extreme trauma. Some have spent weeks in isolation wards without caregivers or proper mental healthcare. The New York Times reported a gut-wrenching scene:

In the next ward, a 4-year-old girl lay on the floor in urine, motionless, bleeding from her mouth, her eyes open. A corpse lay in the corner — a young woman, legs akimbo, who had died overnight. A small child stood on a cot watching as the team took the body away, stepping around a little boy lying immobile next to black buckets of vomit. They sprayed the body and the little girl on the floor with chlorine as they left.

Surviving children must also struggle with the grief of losing parents and siblings. “The hardest part of the job is telling parents their children have died or separating children from their parents,” Malcolm Hugo, a psychologist working in Sierra Leone, told the Guardian.

Many children are displaying symptoms of Post-Traumatic Stress Disorder, a condition that may develop after exposure to trauma. Intense grief, changes in eating and sleeping patterns, and extreme cognitive impairment are being reported in children who are most affected. Symptoms of depression and anxiety are also common.

The WHO reports that the most severely affected countries, Guinea, Sierra Leone, and Liberia lack resources to help those affected by the outbreak.

Many humanitarian aid agencies like Doctors Without Borders have sent physicians and healthcare workers to help in the treatment and containment of the disease. However, very little psychological or medical help is available for orphaned survivors. UNICEF has appealed for $200 million to provide emergency assistance to affected families but has only received a quarter of the amount so far.

Currently, the organization is looking at unique ways to provide emotional support. In Liberia, they are working with the government to train mental health and social workers. UNICEF will also be working with Ebola survivors who are now immune to the disease to provide support to children quarantined in health centres.

In a statement to Al Jazeera, Fontaine explained, “Ebola is turning a basic human reaction like comforting a sick child into a potential death sentence.” Further work needs to be done to abolish the harmful distrust surrounding Ebola survivors, and strengthen family and community support. Without this support, orphaned children face a harsh and unwarranted emotional toll, alone.

– Contributing Writer: Khadija Bint Misbah, 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

162693-167361

For Families Touched by Homicide, the Media Prolongs Pain

00Featured news, Grief, Health, Law and Crime, Media, Memory, Parenting, Resilience, Stress, Trauma October, 14

On January 1st, 2008, fourteen year old Stefanie Rengel was murdered a few meters outside of her Toronto home.

After receiving a mysterious phone call from someone she believed may have been a friend, Stefanie put on her shoes, told her younger brother that she would be right back, and ran out the door. She never returned.

Leading a normal life one day, and suddenly being thrust into the inevitable bureaucracy that follows a murder is excruciating for families affected by homicide.

The Trauma & Mental Health Report had the chance to speak with Stefanie’s mother, police officer Patricia Hung, who discusses how media involvement and court proceedings sometimes prolonged the healing after her teenage daughter’s murder. She also commented on support available for bereaved parents.

Patricia: Trying to get justice for Stefanie, in some ways… it kept her alive. It gave us something to focus on. I don’t know if that prolonged the grieving, but it certainly spread it out. When a child dies in a car accident, and there are no reporters or trial, you have no choice but to deal with it all right then. For us, we dealt with it a little at a time.

For families affected by homicide, the grief is drawn out. The media, bail hearings, preliminary trials, adjournments, mental health assessments, impact statements, perhaps a trial and hopefully a sentencing, all act as constant reminders of the tragedy. Prolonged investigations and legal processes have these families re-living the trauma of what happened to their loved ones.

Patricia: The day after Stefanie died the reporters were there –it was terrible– it felt like an attack, when all we wanted was privacy. They would come to our door at all hours of the day and night. They would go to my children’s schools and would piece together a false relationship between Stefanie and her killer.

Following a high profile murder case, reporters can unwittingly create chaos for families. The constant questioning, often well intentioned, can turn into intrusive and harmful reminders of the trauma.

Patricia: In the beginning, the press is really friendly to you because they want the gory details and all the juicy information. If you say one wrong word, they can turn on you [for a story]. The last thing grieving families need is to feel tried in the newspapers.

Unfortunately, most bereaved parents aren’t sure what it is they need right after their child’s death. They often feel as though no stranger is going to be able to help them and are unaware of how important it is to reach out for help.

Victim Crisis Assistance and Referral Services (VCARS) is a Canadian charitable service, with 48 sites in Ontario alone that provide immediate on-site assistance to victims affected by tragedy. Bereaved families can use victim services at any point during their recovery even if they initially decline assistance. Victim services offer a variety of support programs for long term assistance and can even help families deal with the media.

Patricia: Being a police officer and having to go through the legal system, I realized how scary it must be for other families who have absolutely no idea what to expect. So to those families who are feeling lost and overwhelmed, know that someone from victim services can be taking notes for you at the preliminary trial, someone can guide you while preparing for your impact statement, and can sit with you during trial.

One of the great difficulties at trial for bereaved parents is informing the judge or jury on how their child’s death affected their life. Impact statements can help determine the offender’s sentence, and parents feel the pressure; victim services help families write these. 

Patricia: Testifying and giving an impact statement was very difficult. I was trying to make sure that I wouldn’t mess it up. You’re so worried that if you say something wrong it could screw everything up. 

And adding to the heartache: 

Patricia: There are things that you don’t expect to happen that do. When I was at court, I went to the washroom and the accused’s mother was in there. It was just so hard. At the time, it wasn’t me against her. I actually felt quite sorry for her… it was a whirlwind of emotions.

Trial is very draining for families. Not only do they hear details of the child’s death, but also the accused is just feet away. Having external support such as VCARS ensures that bereaved families are aware of what steps they need to take and provides comfort at a time when family ties can become strained. 

Once a verdict is made, bereaved families still have much to deal with. Grieving the loss of a child never really ends. As time passes, families fill their lives with new memories and the moments of grief become more intermittent.

But of course, as parole hearings approach, families have to face the trauma of losing their child all over again.

– Contributing Writer: Tessie Mastorakos, 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

161190-165652

To Share or Not to Share (the Family Bed)

00Alcohol, Anxiety, Appetite, Attachment, Child Development, Empathy, Featured news, Health, Parenting, Sleep, Smoking October, 14

Some of the most common questions posed to parents of newborns, particularly by other parents, relate to sleeping patterns. Choices around sleep can be personal and sometimes controversial.

In western cultures, it is normal to put infants in different rooms. But in much of the rest of the world, the baby either sleeps with parents (bed-sharing) or in close proximity to the parent (co-sleeping).

These differing traditions often present a dilemma to parents in western societies who hear opposing points of view when seeking advice.

James McKenna, professor of anthropology at the University of Notre Dame considers that despite the dominant view (no bed-sharing), parents increasingly are opting for co-sleeping or bed-sharing. In fact, half of U.S. parents with infants bed-share with their children during at least part of the night.

This is especially true for breastfeeding mothers as co-sleeping can make night-time feeding easier to manage. It is thought by many that co-sleeping while breastfeeding results in the mother being more in-tune with the infant’s immediate hunger needs and as a result, the infant quickly learns that their needs can be satisfied. This contributes to the development of secure attachment

According to the American Academy of Pediatrics and Academy of Breastfeeding Medicine, mothers should sleep in close proximity to their baby not only to help facilitate breastfeeding but also to improve the survival rate of the developing infant. 

McKenna also indicates that from an anthropological viewpoint the proximity and sensory touch associated with bed-sharing induces positive behavioural and physiological changes in the infant. Studies have found long-term benefits of bed-sharing or co-sleeping. For example, children who bed-shared were found to have less anxiety and a higher level of comfort in social situations later on.

Traditional western medical views on bed-sharing tend to be rather negative. Based on the Joint Statement on Safe Sleep: Preventing Sudden Infant Deaths in Canada, the main reason cited is the threat of sudden infant death syndrome (SIDS).

The Joint statement defines SIDS as, “the sudden death of an infant less than one year of age, which remains unexplained after a thorough case investigation, including the performance of a complete autopsy, an examination of the death scene, and a review of the clinical history.”

Because it is difficult to distinguish specific causes of death that occurred during sleep, in many SIDS cases the cause may be cited as “unintentional suffocation due to overlaying,” which may be used to discourage bed-sharing.

Yet in many of the studies where infant deaths are discussed, parental smoking, alcohol consumption and unsafe sleeping practices are often major factors, as opposed to bed-sharing per se. Understanding preventative measures and safe sleeping practices can help reduce the incidence of SIDS.

Further, some research has found a strong link between breastfeeding and lowered risk of SIDS. Fern Hauck of the University of Virginia reviewed 18 studies that looked at the relationship between these two variables and found that babies exclusively breastfed had a 70% lower risk of SIDS, and the risk is lowered further the longer breastfeeding continues. Researchers attribute this lowered risk to infants being able to awaken more easily, reducing the risk of sudden death.

Daniel Flanders, pediatrician at North York General Hospital in Toronto, states that as a physician he follows the guidelines for the prevention of SIDS, but feels that strong recommendations against bed-sharing undermine parental choice on how to raise one’s child. He notes that in non-westernized communities bed-sharing is often a major part of the cultural practice of child rearing, and therefore his approach is to present the most relevant and up-to-date information available so the parent can make an informed decision.

There are several measures one can take to reduce the risks associated with bed-sharing. One of the most important things for the baby’s safe sleep is ensuring that the surface the infant sleeps on is firm, smooth and flat. Sheets should be tucked and never loose, whether the child sleeps with the parents, in a sidecar or in the crib.

If parents choose to bed-share there should be ample space for all, with both parents agreeing to the arrangement. The bed should not be shared with multiple children, especially if one or more are slightly older. Also, if the bed is raised off the floor there should be a mesh guardrail around the bed to prevent the baby from falling over. If the bed is against the wall, parents should ensure that there is no gap between the bed and the wall at all times.

Although bed-sharing is often discouraged by many in the medical community due to its association with an increased risk of SIDS, this does not mean that the practice is without benefit. Done safely, bed-sharing and co-sleeping offer unique opportunities for the development of closeness between parent and child.

Parents must choose the arrangement that works best for them and their families. For more information: Safe Sleeping Practices for Infants

– Contributing Writer: Saqina Abedi, 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

160567-164949

Acid Attacks: The New Gender Terrorism

00Dreaming, Ethics and Morality, Fear, Featured news, Gender, Law and Crime, Marriage, Parenting, Punishment, Resilience, Trauma September, 14

With her head bent down staring at the floor, saliva running down her chin, a woman is unable to lift her head or close her mouth. Acid has melted her skin.

An estimated 1500 people per year are victims of acid attacks; 80 percent of whom are female and 40 percent are under the age of 18. Although acid attacks are becoming increasingly common in countries such as India, Cambodia and Afghanistan, they occur more in Bangladesh than anywhere else in the world.

 About 60 cents a bottle, acid (hydrochloric, nitric or sulfuric) has become the weapon of choice against women in countries where their rights are still limited.

 In November 2012, the BBC reported a story about a 15-year old girl, attacked by her own parents because she turned her head to look at a boy passing on a motorcycle. Claiming that she “dishonoured her family,” the parents together beat her and then poured acid over her. After two days without being taken to a hospital, the young girl died of her injuries.

 Rarely resulting in death, the horror of the attacks is nevertheless striking. Within seconds, the acid melts skin, fat, muscle and sometimes bone. Women may be left blind, some with sealed nostrils, shriveled ears and damage to their airway from inhaling the fumes. In time, formed scar tissue tightens and pulls what is left on the face and neck, causing intense physical pain and discomfort.

 Why do the attacks occur? Most show a common theme: a woman stepping out of her subordinate gender role thereby causing dishonour to her husband or family. Choices many of us make without thinking, such as rejecting a marriage proposal or a sexual advance, are enough to instigate an attack.

The violent act is a threatening message not only to the victim, but to women in general, leaving many in a permanent state of fear.

 Victims are left permanently disfigured, socially isolated, and emotionally scarred. With the end results so extreme, some have called for punishment of death for those who inflict this on others. Yet in most cases, the perpetrator is left to carry on as if nothing happened. Laws have been passed with jail sentences as high as 14-years. But inefficiencies and corruption within the legal systems where these attacks occur mean that fewer than 10 percent of cases make it to court.

Many human rights agencies have advocated banning the sale of acid to decrease its availability. But for those who are motivated, acid can be found; many attackers are now using the inside contents of car batteries.

Sital Kalantry, the Cornell international human rights clinical director has called the phenomenon a form of “gender terrorism.” Unless women are able to step into a role of equality of rights and freedoms, the problem will persist.

Worldwide, many are taking action to raise awareness, provide treatment and ease pain. The 2012 Oscar award winning documentary Saving Face, tells the stories of Pakistani women who were victims of acid attacks, and follows them through their fight for justice, through their battle to get their lives back.

Featured in the film is British plastic surgeon Mohammad Jawad who has devoted countless hours to reconstructing the faces and bodies of women damaged by acid. He is one of many who have donated their time to try and heal these women.

The Acid Survivors Foundation, established in 1999, is a non-profit organization dedicated to helping women find a place again by connecting them with treatment and rehabilitation services offered by people such as Jawad.

Still, surgeons cannot repair everyone. For some already suffering from malnutrition, an acid attack can leave their skin almost fossilized, with scar tissue left to take over. For those who are able to undergo surgery, it can take over 20 procedures to restore basic functioning, a process unaffordable to many already living in poverty.

In addition to the physical damage, acid attacks inflict emotional damage and can destroy hopes and dreams. Uli Schmetzer, a Chicago Tribune foreign correspondent, told a story in 1999 of a 20-year old girl, Sufia, who became the victim of an acid attack meant for her sister who had turned down a marriage proposal. Having been accepted into university, Sufia had plans to become an agronomist; following the attack, she was likely to end up a beggar.

Often living as social pariahs following mutilation, these women are left with little hope. Seeing perpetrators get off without consequence, others are left to live in a state of fear that they will be next.

 – Contributing Writer: Crystal Slanzi, 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

159025-163284

Dr. Mom and Dad

00ADHD, Anxiety, Attention, Child Development, Depression, Environment, Featured news, Health, Intelligence, Leadership, Motivation, Parenting, Psychiatry, Psychopharmacology, Self-Control, Sleep September, 14

We live in a world of self-diagnosis. With access to online medical databases like WebMD and kidshealth.org, it is easy to type symptoms into Google, find a diagnosis and present findings to the family physician.

Self-diagnosis may seem harmless, but it can become problematic when we diagnose ourselves or our children with more complicated conditions, behavioral disorders like Attention Deficit Hyperactivity Disorder (ADHD).

The over-diagnosis of ADHD and the over-prescription of medications like Ritalin, Adderall, and Vyvanse (to name a few) have been longstanding problems in the health care community. Clinical psychologists Silvia Schneider, Jurgen Margraf, and Katrin Bruchmuller, on faculty at the University of Bochum and the University of Basel found that mental health workers such as psychiatrists tend to diagnose based on “a rule of thumb.” That is, children and adolescents -often males- are diagnosed with ADHD based on criteria such as “motoric restlessness, lack of concentration and impulsiveness,” rather than adhering to more comprehensive diagnostic criteria.

Parentsmotivation to get help for their child’s problems along with free access to online information may play a role in the over-diagnosis of ADHD.

A study by Anne Walsh, a professor of Nursing at Queensland University of Technology found that close to 43% of parents diagnosed and 33% treated their children’s health using online information. Of concern, 18% of parents actually altered their child’s professional health management to correspond with online information. Considering the questionable quality of some online health information, these numbers are worrisome.

Furthermore, as primary caregivers can sometimes be persuaded, it is possible that parental conviction of the child’s diagnosis may play a role in physician decisions to treat. With basic diagnostic criteria for ADHD readily available online, some parents may be quick to self-diagnose their “restless and impulsive child.”

“It sometimes happens that parents come to me convinced that their child has ADHD [based on their own research] and in many circumstances they are correct,” says Dan Flanders, a pediatrician practicing in Toronto, Canada.

 According to Flanders, there are certain traits that make a child more likely to be misdiagnosed with ADHD. “Children who have learning disabilities, hearing impairment, or visual impairment may be mistaken as having ADHD because it is harder for them to focus if they can’t see the blackboard, hear their teacher or if they simply cannot read their homework.”

Flanders adds that gifted children, children with anxiety or depression, and children with sleep disorders are commonly misdiagnosed with attention disorders. “Gifted children learn the class objectives after the first 10 minutes of a class whereas their classmates need the whole hour. For the remaining 50 minutes of class these children get bored, fidgety, distracted, and disruptive. The treatment for these children is to enrich their learning environment so that they are kept engaged by the additional school materials.”

Children with anxiety and depression can be misdiagnosed with ADHD because there may be an interference with a child’s ability to learn, focus, eat, sleep, and interact with others. For children with sleep disorders, “one of the most common presentations of sleep disorders is hyperactivity and an inability to focus during the day. Fix the sleep problem and the ADHD symptoms go away.”

It is, however, important to note that these disorders are not mutually exclusive of each other. “A child can have a learning disability, anxiety, and independent ADHD all at the same time.” 

While it is often beneficial for parents to consult online databases for background information, Flanders warns against relying solely on information found online because the information may not be up-to-date and cannot replace a thorough psychological assessment.

Why, then, do parents resort to this quick fix of information?

Walsh reported that parents use online health information for a range of reasons including feeling rushed and receiving limited general lifestyle guidance from their doctors.

Flanders points out that the doctor’s approach should always be to review the data honestly and objectively with parents and then openly present the treatment options available to them.

“The most important part of ADHD treatment is making sure of the diagnosis. There are so many children who are started on medication inappropriately. Throwing medication at the problem is not the answer unless the diagnosis is well established and the differential diagnoses have been exhausted.”

– Contributing Writer: Jana Vigour, 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