Category: Stress

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Pregnant Women Struggle with Managing Psychiatric Medication

00Child Development, Featured news, Health, Stress, Therapy, Trauma, Unclassified December, 17

It is often portrayed as a happy and exciting time but the experience of pregnancy can be mixed, with physical and mental complications dampening the experience.

In a recently released documentary, Moms and Meds, director Dina Fiasconaro addresses the challenges that she and other women with psychiatric disorders face during pregnancy.

Fiasconaro’s goal in making the documentary was to investigate women’s experiences with psychotropic drugs at this life stage. She became pregnant while on anti-anxiety medication and had difficulty obtaining clear information from healthcare professionals.

In an interview with the Trauma and Mental Health Report, Fiasconaro explained:

“I received very conflicting information on what medications were safe from my psychiatrist, therapist, and high-risk obstetrician. Even with non-psychiatric medication, I couldn’t get a clear answer, or from the pharmaceutical companies that manufactured them. No one wanted to say ‘that’s okay’ and be liable if something were to go awry.”

When she spoke to her maternal/fetal specialist, she was provided with a stack of research abstracts regarding the use of certain psychotropic medications during pregnancy. Although the information was helpful, it didn’t adequately inform her about the risks and benefits of medication use versus non-use.

One of the main questions Fiasconaro had was, should she continue using medication and risk harming her baby, or should she discontinue use and risk harming herself?

One of the women featured in Moms and Meds, Kelly Ford, contemplated suicide several times during pregnancy. When her feelings began to intensify, she admitted herself to a hospital. There, she was steered away from taking medication which led her to feel significant distress and an inability to cope with her declining mental health.

Elizabeth Fitelson, director of the Women’s Program at Columbia University, also featured in the documentary, believes there is a tendency for healthcare professionals to dismiss mental illness in pregnant women.

In the film, Fitelson said:

“If a pregnant woman falls and breaks her leg, for example, we don’t say, ‘Oh, we can’t give you anything for pain because there may be some potential risk for the baby.’ We say, ‘Of course we have to treat your pain. That’s excruciating. We’ll give you this. There are some risks, but the risks are low and, of course, we have to treat the pain. ‘”

This lack of validation for mental health issues was echoed by Fiasconaro when she visited her doctor:

“I was referred to a high-risk obstetrician by my therapist. Although I was given the proper advice, that high-risk doctor ended up being very insensitive to my mental illness. She told me that everybody’s anxious and brushed it off like it was a non-issue. I understand that in the larger context of what she does and who she treats, my anxiety probably seemed like a low priority in the face of other, seemingly more threatening, physical illnesses.”

The ambiguous information provided by health professionals is representative of a lack of research on the risks of using medication during pregnancy.

Mary Blehar and colleagues, at the National Institutes of Health (NIH), state in the Journal of Women and Health that data are lacking on the subject. In a review of clinical research on pregnant women, they found that data obtained over the last 30 years, about which medications are harmful and which can be used safely, are incomplete. These gaps are largely due to the majority of information being based on case reports of congenital abnormalities, which are rare and difficult to follow.

During her pregnancy, Fiasconaro was able to slowly stop taking her anxiety medication. But halting treatment is sometimes not an option for women who suffer from severe, debilitating psychiatric conditions such as bipolar disorder, major depression, or schizophrenia.

We also need to improve access to information on pharmacological and non-pharmacological treatment options, including psychotherapy for women with mental-health problems during pregnancy. Without adequate guidance, the management of psychiatric conditions can leave many feeling alone and overburdened. These women often feel stigmatized and neglected by healthcare professionals. The development of supportive and informative relationships is necessary to their wellbeing.

As Fiasconaro put it:

“I had to be pretty focused and tenacious in finding information and then making the most informed decision for myself. I’m grateful I was able to do so, but again, I know every woman might not be in that position, and it can be very scary and confusing.”

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

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

Copyright Robert T. Muller.

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Police Need Training to Deal With Mentally Ill Offenders

00Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Psychiatry, Psychopathy, Stress October, 17

Source: Free Images at Pixabay

On March 4, 2016, Devon LaFleur, a 30-year-old struggling with bipolar disorder, went missing. His father contacted law enforcement to notify police of his son’s mental illness and tendency towards violence. After learning that LaFleur had allegedly robbed a bank and was on the run, Toronto police tracked down and fatally shot the young man during a confrontation.

In many instances where mental illness is concerned, police officers respond too quickly with force. In an analysis conducted by The Washington Post, American officers shot 124 people who showed some sign of mental or emotional distress in 2015.

The Post explains that, for the majority of these crimes, the police were not called for reports of criminal activity. As in LaFleur’s case, police were contacted by “relatives, neighbors or other bystanders worried that a mentally fragile person was behaving erratically.”

An article by psychiatry professor Richard Lamb and colleagues at the University of Southern California reports that police officers are authorized to transport individuals with mental illness for psychiatric evaluation when there is reason to believe that they pose a danger or threat. But the researchers also state that this responsibility turns officers into ‘street-corner psychiatrists’ without giving them the training they need to make on-the-spot decisions about mentally ill offenders.

An article published in Criminal Justice Review by Teresa LaGrange shows that “higher educated police officers recognize a broader range of disorders” and they are more likely to “view the situation as requiring a professional intervention.”

However, LaGrange also recognizes that instead of teaching practical skills like learning how to identify individuals with mental-health conditions, many educational workshops only consist of general descriptions about psychological terms and concepts.

Police officers need to know how to handle individuals who display different types of mental illnesses. The Washington Post analysis states that the most extreme cases of mentally ill people causing a disturbance were schizophrenic individuals and those who displayed suicidal tendencies or had some form of post-traumatic stress disorder (PTSD).

In some states, crisis intervention team training (CIT) is being implemented to help officers identify mental illness and determine the best course of action.

CIT consists of a 40-hour training program for police forces that educates officers on mental-health issues and medications and teaches about mental-health services in the local community. CIT also teaches methods that help de-escalate heated situations by encouraging officers to allow vulnerable individuals to vent their frustrations—methods that could have been useful in LaFleur’s case to reduce the risk of violence from both the police and offender.

So far, this program has been considered effective by the police departments using it.

Major Sam Cochran of the Memphis police department, a retired officer and a coordinator of the CIT program, emphasizes that law enforcement should partner with local mental-health agencies: “If communities give attention only to law enforcement, you will fail as a training program. You cannot separate the two.”

Although the task of identifying mentally ill individuals can be daunting, these training programs are a step toward preventing injustices for individuals like LaFleur. Providing officers with appropriate training not only improves the ability to handle job stress but may also provide mentally ill offenders with a chance to receive treatment.

–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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Denmark Declassifies Transgender as Mental Illness

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

Source: Chey Rawhoof at flickr, Creative Commons

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

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

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

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

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

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

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

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

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

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

Mortensen also told Danish news agency Ritzau:

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

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

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

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

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

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

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

Copyright Robert T. Muller

This article was originally published on Psychology Today

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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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Death Penalty May Not Bring Peace to Victims’ Families

00Featured news, Forgiveness, Law and Crime, Memory, Punishment, Stress, Trauma October, 16
Source: Lesia Szyca – Trauma and Mental Health Report Artist

On May 15th 2015, a federal jury condemned Dzhokhar Tsarnaev to death for his role in killing four people and injuring hundreds in the Boston Marathon bombings in 2013. Before the verdict, Bill and Denise Richards—the parents of a nine-year old boy who was killed in the attack—asked that the government not seek the death penalty against Tsarnaev. In an open letter published in the Boston Globe, they explained:

“The continued pursuit of that punishment could bring years of appeals and prolong the most painful day of our lives.”

The death penalty is often touted as the only punishment that provides true justice and closure for a victim’s family and friends, also known as covictims. But this is rarely based on covictims’ actual sentiments.

Research by University of Minnesotta sociology-anthropology professor Scott Vollum and colleagues found ambivalence in covictims’ reactions to capital punishment. Their study showed that only 2.5% achieved true closure, and 20.1% said that the execution did not help them heal. Covictims in the study also expressed feelings of emptiness when the death penalty did not “bring back the victim.”

The long judicial process between conviction and execution, which can span many years in some cases, also prolongs grief and pain for covictims. Uncertainty prevails in the face of appeals, hearings, and trials, while increased publicity inherent in death-penalty cases exacerbates covictims’ suffering. Through media exposure, they repeatedly relive traumatic events.

Pain and anger, especially, are common in the wake of tragic loss and can be accompanied by an overwhelming desire for revenge. Some covictims in the Vollum study voiced that the death penalty was not harsh enough, while others communicated a wish to personally inflict harm on the condemned. In the majority of cases though, executions were not sufficient to satisfy these desires.

“More often than not, families of murder victims do not experience the relief they expected to feel at the execution,” states Lula Redmond, a Florida therapist who works with surviving family members. “Taking a life doesn’t fill that void, but it’s generally not until after the execution that families realize this.”

In a number of cases, covictims actually expressed sympathy for family members of the condemned, often empathizing with the experience of loss. “My heart really goes out to his family. I lost my daughter, and I know today is a terrible day for them as well,” statedone covictim.

A death sentence can polarize the two families, obstructing healing for both. Prison chaplain Caroll Pickett has witnessed how capital punishment inflicts trauma on loved ones of both the condemned and the victim, as well as prison employees and others in the judicial process, stating in his autobiography, “All the death penalty does is create another set of victims.”

Of course, findings like these beg the question, are other forms of punishment more conducive to healing? A 2012 Marquette University Law School study showed improved physical and psychological health for covictims, as well as greater satisfaction with the justice system, when life sentences were given, rather than capital punishment. The authors hypothesize that survivors “may prefer the finality of a life sentence and the obscurity into which the defendant will quickly fall, to the continued uncertainty and publicity of the death penalty.”

Would covictims move through the natural healing process more rapidly if they were not dependent on an execution to bring long-awaited peace? Perhaps the execution as an imagined endpoint for closure only leads to more grief in the meantime.

As one survivor expressed, “I get sick when death-penalty advocates self-righteously prescribe execution to treat the wounds we live with after homicide… Healing is a process, not an event.”

The realities of capital punishment may be poorly suited for healthy grieving and healing. The Richards family wrote, “We hope our two remaining children do not have to grow up with the lingering, painful reminder of what the defendant took from them, which years of appeals would undoubtedly bring.”

–Caitlin McNair, 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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“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

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CIA Torture Techniques Harm Interrogators As Well

00Anger, Empathy, Featured news, Intelligence, Post-Traumatic Stress Disorder, Stress, Trauma August, 16

Source: KamrenB Photography on flickr

In December of 2014, the U.S. Senate Intelligence Committee released a tell-all report about the Central Intelligence Agency’s (CIA) detainment and interrogation of suspected terrorists, concluding that the “enhanced interrogation techniques” used were far less effective and ethical than previously thought.

Under the supervision of medical staff, detainees were deprived of sleep for as long as a week, confined inside coffin-shaped boxes for several days, water-boarded multiple times a day, and even subjected to medically unnecessary “rectal feeding” or “rectal hydration” in an effort to assert “total control over the detainee.”

The report shows that, to obtain information, CIA officers intimidated detainees with threats to harm their families, which included, “threats to harm a detainee’s children, threats to sexually abuse the mother of a detainee, and threats to cut a detainee’s mother’s throat.” These individuals were also led to believe they would never be allowed to leave CIA custody alive.

According to Mark Costanzo, professor at Claremont McKenna College, torture used as an interrogation device can have severe, long-lasting effects on physical and mental health.

In the Senate report, one detainee, Abd al-Rahim al-Nashiri, was initially deemed compliant, cooperative, and truthful by some CIA interrogators. Yet after years of intense interrogations, he was diagnosed with anxiety and major depressive disorder and was later described as a “difficult and uncooperative detainee, who engaged in repeated belligerent acts, which included attempts to assault CIA personnel and efforts to damage items in his cell.”

Al-Nashiri accused CIA staff of “drugging or poisoning his food, and complained of bodily pain and insomnia.”

Yet the report failed to thoroughly investigate the long-term psychological consequences such techniques may inflict upon not only detainees, but interrogators as well.

CIA personnel involved in the interrogations also experienced psychological distress. Some even elected to be transferred out of the interrogation sites until the CIA stopped using torture as a form of interrogation.

Costanzo notes that research on the psychological consequences of partaking in torture is limited. Most studies have analyzed medical professionals who previously supervised torture to identify the psychological consequences.

In 1986, psychiatrist Robert Jay Lifton interviewed Nazi doctors who participated in human experimentation and mass killings. Lifton concluded that after years of exposure, many of the doctors experienced psychological damage similar in intensity to that of their victims. Anxiety, intrusive traumatic memories, and impaired cognitive and social functioning were all common consequences.

Costanzo believes that interrogators who use torture techniques may have similar experiences. In February 2007, Eric Fair, an American interrogator who was stationed at the Abu Ghraib prison in Iraq, confessed to participating in and overseeing the torture of Iraqi detainees. In his memoir, Consequences, Fair discusses how those events continue to haunt him—leading to martial problems, reoccurring night terrors and insomnia, substance abuse, and depression.

The U.S. public seems split on the issue of torture use, with many believing that enhanced interrogation techniques are warranted if they help prevent future terrorist attacks. Days after the Senate Intelligence Committee released the report, the Pew Research Center polled 1,000 Americans and discovered that 51% believed the CIA’s interrogation techniques were justified.

But according to Costanzo, many who survive torture reveal false information in order to appease the torturer and stop the pain. The Senate Intelligence Committee supported this finding when they discovered that none of the 39 detainees subjected to the enhanced interrogation techniques produced useful intelligence.

Senator Dianne Feinstein of California, head of the Senate Intelligence Committee, further argues that the CIA’s techniques are amoral:

“Such pressure, fear and expectation of further terrorist plots do not justify, temper or excuse improper actions taken by individuals or organizations in the name of national security.”

Feinstein is now proposing a bill to reform interrogation practices in the United States. The bill suggests the use of techniques designed by the High-Value Detainee Interrogation Group, which rely on building rapport and empathy as opposed to relying on physical and psychological pressure. This model has seen great success in both law enforcement and intelligence gathering in countries like Norway and the United Kingdom. Feinstein explains:

“It is my sincere and deep hope that through the release of these findings and conclusions, U.S. policy will never again allow for secretive indefinite detention and the use of coercive interrogations.”

–Alessandro Perri, 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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Exercising Your Way to PTSD Recovery

00Featured news, Health, Post-Traumatic Stress Disorder, Stress, Therapy, Trauma August, 16

Source: Wounded Warrior Regiment on Flickr

Recent headlines about suicide, domestic violence, and shootings have brought public awareness to the mental health strain that is placed on the men and women in our military.

Post-traumatic stress disorder (PTSD) can drastically alter the lives of sufferers and is particularly common in veterans. The condition has been documented in 8% of Canadian soldiers who served between 2001 and 2008 in Afghanistan.

Effects include flashbacks, high anxiety, personality changes, startle responses, mood swings, and disturbed sleep, with typical treatment involving antidepressants and psychotherapy.

In an effort to develop treatment options, many are looking to physical remedies such as intense exercise to help those suffering from PTSD. We know that those who exercise regularly are less likely to suffer from anxiety and depression. But research by Mathew Fetzner and Gordon Asmundson at the University of Regina found that two weeks of stationary biking can be helpful in reducing PTSD symptoms and improving mood.

Further, researchers at Loughborough University have reviewed multiple studies that looked at the impact of sport and physical activity on combat veterans diagnosed with PTSD. Their findings: physical activity enhances well-being in veterans by reducing symptoms and improving coping strategies.

Symptom reduction in these studies seems to occur through a renewed sense of determination and hope, increased quality of life, and the cultivation of positive self-identity. The researchers explain that participating in sports and physical activities helps combat veterans gain or regain a sense of achievement.

Exercise also increases respiratory sinus arrhythmia. This naturally occurring variation in heart rate is linked to higher levels of emotion-focused coping—an ability disrupted in those with PTSD.

Treatment adherence is often a problem for PTSD sufferers, given that formal therapy is not always appealing to them, Fetzner claims. Low dropout rates of therapies involving physical exercise make the intervention feasible.

But the positive effects of intensive exercise on PTSD may be suitable only for some combat veterans: those with the physical ability to participate.

According to Veterans Affairs in Canada, psychiatric conditions are the second-most common cause of disability among returning soldiers. Debilitating physical injuries, such as amputations, and traumatic brain and spinal chord injuries are more common. And in addition to PTSD, the two most common mental health problems among returning soldiers are substance abuse and depression. More than 80 percent of the time, combat veterans have more than one diagnosis.

While aerobic exercise significantly reduces depression symptoms and helps prevent the abuse of drugs, the high rates of physical impairment in returning soldiers complicates the optimistic picture of exercise’s benefits on PTSD.

Less physically demanding exercise may be an option. Recent research shows that yoga, for example, may help individuals with PTSD focus on the present, reduce rumination, and combat negative thinking patterns.

While strenuous physical exercise may only be helpful for some returning veterans, milder forms of exercise and physiotherapy may be a useful adjunct to traditional treatment for many others. In either case, it is important for researchers and clinicians alike to take note of alternative ways of treating PTSD in an effort to provide options to those affected with the debilitating disorder.

–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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Transgender Homeless Youth Victimized by Shelter System

00Bias, Featured news, Gender, Resilience, Sexual Orientation, Stress, Transgender, Trauma August, 16

Source: RAJVINOTH JOTHINEELAK on Flickr

At the age of three, Gale started to challenge gender norms, insisting on wearing dresses and tiaras; by age four, sobbing at his mirror image wearing pants. He began calling himself “a boy and a girl,” and later chose to identify with the female gender.

In 2010, Gale was found dead on an Austin Texas sidewalk, right outside a homeless shelter, having been denied housing. Shelter staff considered Gale’s male genitalia inconsistent with a female identity. She would have to stay with the other men. Unable to accept these terms, Gale decided to spend the night on the sidewalk, but froze to death.

A heartbreaking story; across the U.S. and Canada, it is hardly unique.

Every year, new names are added to the memorial list of transsexual people who have been killed due to transphobia. Founder of the Transgender Day of Remembrance, Gwendolyn Ann Smith explains, over the last decade at least one person has died every month due to anti-transgender hatred and violence.

Research conducted by the Canadian Observatory on Homelessness shows the reality transgender individuals face: elevated levels of daily stress resulting in missed school and work, addiction, self-harm, and chronic mental illnesses, which can lead to poverty and an inability to build a healthy, successful life.

The most vulnerable of the transgender community are its youth. Many are thrown out of their homes by parents unable to accept their gender identity. Many leave to escape daily abuse.

There is a much higher prevalence of homelessness among transgender youth as compared to other minorities.

In Canada, many transgender youth from rural areas leave unsafe home environments and come to Toronto in hopes of discovering freedom and acceptance in the city, even if it means spending a few days or weeks on the streets. But they are quickly exposed to the harsh reality of discrimination in the shelter system.

Housing discrimination is a significant concern for the transgender community. Most homeless shelters are segregated by sex. Shared shelters usually separate women and men by placing them on different floors.

Placement on the male or female floor is based on shelter staff perceptions of the youth, regardless of which gender the individual identifies with. This is problematic for those whose gender identity is not congruent with their biological sex.

Forcing transgender individuals into shelter housing with those who identify as the opposite gender falls under the definition of transphobia, the consequences on physical, mental, and emotional health are severe.

Research has shown that transgender youth are three times more likely to develop major depression, conduct disorder, and posttraumatic stress disorder. Transphobia can also lead to greater risk of developing substance abuse and self-harming tendencies.

A large study called TransPULSE investigated the current health conditions of transgender people in Canada. Results showed that, in Ontario, 77% of the transgender population had seriously considered suicide, while 45% had made an attempt to end their life. Transgender homeless youth in particular were found to be at greater risk for suicide, and LGBT homeless youth committing suicide at a rate 62% higher than heterosexual homeless youth. Based on the New York City model of the two LGBTQ shelters, the Ali Forney Center and the New Alternatives Centre, Toronto will soon be welcoming its first 54-bed shelter reserved for the gender-queer population, a promising achievement but not nearly enough.

There are many social and personal issues that accompany being young and transgender. While the personal trauma suffered by these individuals will only change with shifting views, it is up to us to provide safe spaces for this at-risk population.

– Sara Benceković, 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