Category: Stress

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Firefighters Fight Stress as First Responders

90Burnout, Featured news, Post-Traumatic Stress Disorder, Stress, Trauma, Work February, 18

We tend to think of firefighters saving lives as fires tear through homes or forest land. What many people don’t know is that firefighters are also first responders, arriving at crisis scenes even before paramedics or police officers.

Working in stressful and traumatic situations can take a toll on their mental health. Post Traumatic Stress Disorder (PTSD) and suicide rates are much higher in first responders than in most other professions. Canadian first responders experience twice the rate of PTSD compared to civilians.

Ongoing exposure to stress means that access to support is critical. But cultural and administrative barriers get in the way. Because firefighters are regarded as tough and invulnerable, many feel embarrassed to ask for help, and available programs can be difficult to navigate.

Brian (name changed for anonymity), a 30-year veteran of the fire service and a District Chief in Ontario, Canada has experienced the stressful effects of the job firsthand, and has witnessed the toll it takes on colleagues and family:

“You’re just supposed to deal with the effects of the job. The stigma is that, if you can’t handle it, you’re weak. This idea has been built into the profession.”

When Brian entered his new role as District Chief, he received very little training on how to support the well-being of those working under him. He received only a phone number to an Employee Assistance Program (EAP) to distribute to team members if they had an exceptionally stressful day. The call is left up to individual firefighters rather than to an outreach program that communicates to them directly.

Although Brian believes that firefighters can benefit from the EAP, he knows that stigma exists around making the call. So, the resource doesn’t get used.

“There have always been employee assistance programs. In all my thirty years, I’ve only seen the EAP used once or twice. For the program to work, the agency needs to call the firefighters, because firefighters don’t reach out.”

To fight this stigma, the province of Ontario has launched several initiatives, including a new radio and digital campaign created to raise awareness and reduce the hesitancy of first responders to seek support. A free online toolkit has also been developed that addresses how to cope with PTSD.

Social support is another essential component of first responders’ wellbeing. In a study published in the Journal of Occupational Health Psychology, Jasmine Huynh of Flinders University and colleagues found that support from family and friends was critical for protecting workers from burnout and for them to cope with the demands of frontline responsibilities.

Brian and his wife Sandra (name changed for anonymity) find support in each other and also through other firefighters and their families. Sandra explains that they often use humour to address the stress:

“When you go into the fire hall, there’s a lot of humour. I think we use humour to deal with the pressure, to keep going. That’s our coping mechanism. It’s also how we manage the stress as a family.”

While some programs exist to help firefighters work through their own issues, there is very little support for families of first responders. Having a loved one who is a firefighter can take a toll on the whole household.

In a study by social work professor Cheryl Regehr and a group of researchers at the University of Toronto, the authors explored how firefighters’ wives coped with the mental distress caused by their husbands’ emotionally taxing jobs. Wives handled partner stress by emotionally distancing themselves when necessary.

After thirty years, Sandra has learned to better read Brian’s emotional states, allowing her to recognize when he needs some space after a bad shift. She explains:

“If he comes home and is quiet, and not himself, I know that something is wrong. But I just let it go and let time pass, and then, eventually, I ask him about it. I can tell when it has been a rough shift. If he wants to be alone, I let him be.”

In an attempt to shield his children from the dangers of his job, Brian doesn’t discuss work much at home:

“When I was initially on the job, I talked to Sandra a lot about it, but when the kids came, I stopped. You don’t want to bring the experiences home; you don’t want the kids to worry. It’s bad enough that Sandra worries.”

Despite being proud of her husband, Sandra can’t help but feel constant fear in the back of her mind:

“I think about Brian’s safety all the time. The fear is always there. When he was first on the job, I tried not to think about it. I didn’t watch the news, and if I did, I prayed it wasn’t his fire truck at an emergency.”

To her relief, it has always been someone else’s fire truck. But that someone usually has a family at home, also worrying.

Brian and Sandra agree that more needs to be done to support frontline workers and families. At least initiatives like the media campaign and online toolkit serve as a starting point for an open dialogue surrounding the stigma of seeking help.

At the end of the day, Brian’s job is just that: a job. He says:

“People want to call us heroes. Most of the time, I don’t classify us as heroes. We do what we’re trained to do, and if we do it well, we all come home.”

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

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Parkinson’s Takes its Toll on Family Caregivers

00Caregiving, Family Dynamics, Featured news, Health, Neuroscience, Parenting, Stress January, 18
Source: Lesia Szyca, Trauma and Mental Health Report Artist, used with permission

Her hands and legs trembled, she could no longer drive. Cognitively, she declined. Her balance was affected, and she often fell. My grandmother Anna (name changed) had Parkinson’s Disease. It took over her life.

As a vibrant and independent woman, Anna had always been eager to help her family. Then, as the disease progressed, roles began to shift, and younger family members had to care for her.

Anna battled Parkinson’s Disease (PD) for more than 15 years. A degenerative neurocognitive condition, it is caused by a gradual loss of dopamine producing cells in the brain that worsens over time leading to tremors, cognitive impairment, and emotional changes.

To date, there is no cure, so a combination of medication and therapy is the only treatment. Anna battled this debilitating illness with no chance of recovery.

As she declined, so did her capacity to be self-sufficient. Her motor abilities drastically decreased, and her memory continued to diminish. She required supervision the majority of the day, and was unable to perform her favorite activities, such as baking, making crafts, sewing, and gardening.

Before Anna was admitted to a long-term facility in 2015, caring for her became a full-time job shared by my mother, my sisters, and grandfather. For my mother Charlotte (name changed), seeing her mother’s deterioration was particularly difficult. Unexpectedly shouldering the role of primary caregiver took a toll:

“At times on my own, I would go in the shower and cry. At other times too, the circumstances made me short and impatient with people. I would be intolerant and lose my temper due to the frustration.”

A study by Laurence Solberg and colleagues examined the emotional and mental health of adult children who are primary caregivers to ill parents. In administering a survey to identify stress levels, the researchers found that caregivers had heightened levels of negative feelings, such as anxiety, while caring for a parent. They found that being a caregiver of an elderly, sick parent adversely affected personal health. However, caregivers balancing the needs of an ill parent with those of their own children did not experience elevated stress compared to individuals without children.

But my own mother’s experience was different. She found it demanding to balance caring for an ill parent and caring for her own children.

“If you only have to balance an elderly parent and a job, it’s much easier than if you also have a family. With children, there’s additional responsibility. Anna required some priority, but I couldn’t lose focus on my children.”

When researchers Caroline Kenny and colleagues examined the experiences of family caregivers, many expressed distress over feeling unprepared for the role. My mother felt the same:

“We didn’t know how to properly care for Anna. We didn’t know how to lift her correctly, or how to deal with her frustration. On top of having the responsibility of caring for her, we had the added stress of not knowing how to handle her properly.”

And finding time for herself was not easy for my mother either. Solberg’s research supports this predicament: three quarters of caregivers reported decreased time for personal hobbies and interests. Charlotte said:

“I do think these responsibilities cause you to neglect your usual pastimes. I went from work to Anna’s home to my home. There wasn’t time for myself.”

In a study by Vasiliki Orgeta and colleagues, published in the International Psychogeriatrics Journal, the authors reported on the importance of social support for coping with the strain of becoming a caregiver.

For me, it was painful to see my grandmother’s decline alongside my own mother’s struggle to care for her. But consistent with Orgeta’s findings, I’ve found that relying on friends and family, and my social support system, has helped alleviate the anxiety of seeing my family in distress.

No one’s experience is the same; people cope in their own ways. For my mother, the situation has been heartbreaking:

“Seeing a person who is loving and vibrant, such a nurturing mother, become a person who is not nurturing anymore, not strong, whether emotionally or physically, is agonizing. It’s a part of life, but it’s hard to accept.”

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

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Medical Marijuana for PTSD?

80Addiction, Featured news, Post-Traumatic Stress Disorder, Stress, Therapy, Trauma December, 17

Source: Sinclair Terrasidius at flickr, Creative Commons

On October 1st, 2016, a Canadian medical marijuana company called Marijuana for Trauma opened a location in Edmonton, Alberta to treat PTSD in military veterans. It’s owned and operated by Fabian Henry, who uses marijuana to treat combat-related PTSD, resulting from his second tour of duty in Afghanistan. He claims that conventional medicine does not allow people struggling with PTSD to process their trauma, while marijuana does.

Although the use of medical marijuana for the treatment of physical and psychological disorders is controversial, medical marijuana is currently legal in Canada.

The Washington Post reports that therapeutic use of marijuana was banned in the U.S. in 1970, and marijuana is still categorized as an illicit drug despite its potential medicinal benefits. Given its controversial nature and association with stereotypes, cannabis research for treatment of mental disorders has been limited. But scientific interest is intensifying.

A recent study published in Molecular Psychiatry showed that treatment using particular compounds found in marijuana may benefit those with PTSD, and that “…plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms of PTSD.”

Research published in Science Daily also looked at symptom reduction in patients with PTSD. As a result of taking medical marijuana, participants reported a decrease in re-experiencing the trauma, less avoidance of situations that reminded them of the trauma, and a decline in hyper-arousal.

There is also anecdotal evidence. In an interview with the Trauma and Mental Health Report, Dianna Donnelly, a counselor and patient at the Canadian Cannabis Clinics, described her experience:

“I am a patient who legally uses cannabis for depression. The cannabis helps mute or lower my negative chatter, which allows for good thoughts and feelings to arise. One Veteran, a friend of mine, who recently started using marijuana instead of prescription medication for PTSD, said that with the cannabis, he can feel his emotions, and experience them properly and safely. Before, he just felt numb.”

Medical marijuana is not usually used on its own for the treatment of PTSD. Shelley Franklin, the Veteran Program Coordinator for the Canadian Cannabis Clinics, explained that:

“Medical cannabis is used in conjunction with other therapies. Peer support groups are a highly supported therapy for patients suffering an Operational Stress Injury [another term for PTSD]. Medical cannabis strains with the right CBD and THC [psychoactive chemicals in cannabis] levels are assisting veterans with chronic physical pain, as well anxiety and insomnia issues. I believe that medical cannabis will continue to work in conjunction with many other therapies.”

Conversely, former Canadian Member of Parliament Peter Stoffer believes that soldiers have too much access to medical marijuana. Although not opposed to the use of medical marijuana in certain cases, Stoffer believes that current legislation, which compensates veterans for up to 10 grams of cannabis per day, promotes overuse and could potentially lead to negative effects. In an interview with the CBC, Stoffer said:

“Ten grams a day is an awful lot of marijuana to give one person. It is an incredible amount. That’s simply not the way to go. You’re not helping that person at all. You’re not giving them any chance of recovery. All you’re really doing is masking the pain that they’re suffering.”

The research is still in its infancy and likely to explode in the near future, as the Canadian government prepares to remove restrictions on marijuana in 2017. This movement will make it much easier for researchers to study the effects cannabis has on psychological disorders and to form conclusions on its efficacy.

As for Fabian Henry and his cannabis dispensary Marijuana for Trauma, he continues to work with physicians to tailor the amounts dispensed to individuals and has no plans himself to stop using the drug.

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

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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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