Category: Stress

Taboo of Male Rape Keeps Victims Silent

Taboo of Male Rape Keeps Victims Silent

00Depression, Featured news, Friends, Gender, Post-Traumatic Stress Disorder, Sex, Stress June, 15

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“My name is Will, and I think rape is hilarious…when it happens to a dude,” begins the monologue in a recently posted video written and performed by actor, Andrew Bailey. In this powerful mostly-satirical piece, Bailey opens discussion about how male sexual assaults are brushed off. “A male can’t be raped because he must have wanted it.”

Rape can and does happen to men. Approximately 1 in 6 men have experienced some form of sexual abuse as children, and 1 in 33 American men are reportedly survivors of attempted or completed rape.

And these statistics are likely an under-representation. According toRAINN, an anti-sexual violence organization, about 60% of all sexual assaults are not reported to police.

Although women are more likely to be sexually assaulted, Western notion of masculinity and gender have made it difficult to view men as victims of abuse. Men are often expected to welcome sexual advances, not view them as unwanted, rendering them less able to identify a sexual assault when it occurs to them.

“Male survivors may be less likely to identify what happened to them as abuse or assault because of the general idea that men always want sex,” Jennifer Marsh, the vice president for Victim Services at RAINN told CNN.

A further challenge is the widely-held view that physical strength makes men incapable of being overpowered or assaulted. James Landrith, a sexual assault survivor, spoke to CNN: “We [men] are conditioned to believe that we cannot be victimized.”

But, a research study led by Janice Du Mont from the University of Toronto, reported that male victims are often drugged prior to assault. While the assailant is usually male, female aggressors who violently sexually abuse male victims are not uncommon.

After an assault, the victim often feels troubled by his inability to protect himself, questioning his masculinity, feeling that a sense of control has been taken from him. They may also feel ashamed about the incident, making them reluctant to speak out. In fact, 71% of adult sexual assault survivors hold the view that “nobody would believe me” as a reason for not reporting the incident.

Many report receiving little to no support from family and friends, as they often fear disclosing the abuse. In an interview with theDepartment of Justice Canada, a male sexual assault victim recounts, “no one knew about it, so I just felt very alone, and I didn’t communicate any of that.”

“All the guys would laugh at me about it,” Bailey says in his monologue. Uncomfortable disclosing the reality of the experience, Bailey’s character gives in to rape humour, to fit in with friends. “I was like ‘psych’, I totally did enjoy it; then they high-fived me and told me I was cool.” Indeed, it is not unusual for male victims to fear rejection and harassment from others. Many keep silent.

Victims also report a complex range of emotional difficulties: isolation, anger, sadness, shame, guilt, and fear. Post-traumatic stress disorder (PTSD), major depression and anxiety disorders are also common among victims.

Raising awareness and encouraging male survivors to reach out for support may be challenging, but education regarding sexual abuse and demystifying misconceptions surrounding rape is essential to help male survivors heal.

In research by the Department of Justice Canada, survivors suggested raising awareness through campaigns to better inform male survivors about available resources.

A recent UK initiative created a £500,000 fund for male victims of sexual abuse, bringing considerable public attention to the issue. The UK Ministry of Justice began an international social media campaign using the hash-tag #breakthesilence to end stigma and raise awareness.

Duncan Craig of Survivors Manchester, a survivor-led/survivor-run organization states, “In the future I would like to see both the government and society begin talking more openly about boys and men as victims and see us trying to make a positive change to pulling down those barriers that stop boys and men from speaking up.”

– Khadija Bint Misbah, 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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I Feel Your Pain: The Neuroscience of Empathy

00Empathy, Featured news, Neuroscience, Relationships, Stress April, 15

Source: Empathy Sand Sculpture/photopin

“I saw you doubling over and it felt like a shot right through me. I didn’t see any blood and there was nothing that scared me. Just you, in your misery, and a horrible sensation…I could feel your pain.”

This was my mother’s explanation for fainting while watching the doctor treating me in the operation room.

While fainting from another person’s pain may be uncommon, it brings into view an interesting aspect of human experience: the ability to relate to and feel the sensations of others.

Empathy is understanding and experiencing emotions from the perspective of another, a partial blurring of lines between self and other. We put ourselves in the shoes of others with the intention of understanding what they are going through, we employ empathy to make sense of their experiences.

Pain empathy takes the concept of empathy to the next level, describing physical sensations occurring to others. The concept has been portrayed in the form of sympathetic pregnancy, men reporting symptoms similar to those of their pregnant partners.

A subset of motor command neurons, mirror neurons are thought to be responsible for these sensations, firing in our brain when we perform an action, or when we observe someone else perform an action. These neurons can make you feel like you know what the other person is feeling. Witnessing someone getting hit by a ball, you feel a twinge of pain too.

Originally discovered in primates, mirror neurons have been used to explain how humans relate, interact, and even become attached.

Mirror neurons connect us to others. Neuroscientist Vilayanur Ramachandran, at the University of California, has described mirror neurons as dissolvers of physical barriers between people (he even nicknamed them Gandhi neurons), explaining that it is our skin receptors that prevent us from getting confused and thinking we are actually experiencing the action.

Though not entirely responsible for empathy, mirror neurons do help us detect when another person is angry, sad or happy, and allow us to feel what the person is feeling as if we were in their place.

Ramachandran suspects that mirror neuron research will lead to understanding purported mind reading abilities, which may in fact have an organic explanation, such as a strong empathic occurrence in which one’s emotional/physical sensations are experienced by the other.

Mirror neurons are important in learning and language acquisition. Through imitation, vicarious learning allows for the construction of culture and tradition.

When malfunctioning, mirror neurons may have a big impact. Individuals diagnosed with autism have difficulty with empathy. And as Ramachandran suggests, it is indeed mirror neuron dysfunction that is involved in autism.

The discovery of mirror neurons also helps us rethink other concepts, such as human evolution. Ramachandran says that mirror neurons are what make culture and civilization possible because they are involved in imitation and emulation. In other words, historically, to learn to do something, we have adopted another person’s point of view, and for that we’ve used mirror neurons.

Empathy allows for intimacy and closeness, and mirror neurons provide evidence that humans are biologically inclined to feel empathy for others. More than just an abstract concept, empathy seems rooted in our neurological makeup.

My mother fainted because she couldn’t endure my pain. Perhaps my suffering triggered great anxiety that her body was unable to manage. Or maybe she physically felt my pain.

Mirror neurons are the interface that joins science and humanities. The connection allows us to reconsider concepts like consciousness, the self, even the emergence of culture and civilization.

Indeed, it’s not surprising that Ramachandran compares the discovery of mirror neurons in psychology, to the discovery of DNA in biology.

– Contributing Writer: Noam Bin Noon, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

This article was originally published on Psychology Today

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Treatments Available to Long Term Abduction Victims

10Animal Behavior, Cognition, Depression, Dreaming, Family Dynamics, Featured news, Health, Parenting, Psychiatry, Psychoanalysis, Sleep, Stress, Therapy, Trauma April, 15

Source: artmajor24//Flickr

Between 2002 and 2004, 16-year-old Amanda Berry, 21-year-old Michelle Knight, and 14-year-old Georgina DeJesus were abducted from the streets of Cleveland, Ohio. They were lured into the home of Ariel Castro where they spent the next 11 years in captivity.

Often kept in restraints and locked rooms, the women regularly had their lives threatened to deter any plans of escape.  They were given little food or the opportunity to bathe. Sexual abuse led to Knight being impregnated several times, only to be beaten and starved in order to force miscarriage.  It wasn’t until May 2013 that the women were finally rescued and Castro arrested.

Other cases popularized by the media include that of Elizabeth Smart, held captive for 9 months, and Jaycee Dugard who was held captive for 18 years. These victims are now free, but living with the emotional aftermath.

In a 2000 study by the Department of Neurological and Psychiatric Sciences at the University of Padova, interviews with kidnap victims showed common after-effects of abduction including vivid flashbacks of the events, nightmares, and feelings of depression, all common symptoms of Post-Traumatic Stress Disorder.  Hypervigilance was also reported, where individuals anticipated danger and frequently felt guarded, leading to trouble sleeping, eating, and social withdrawal due to difficulty trusting others.

Mental health professors David A. Alexander and Susan Klein, from the Aberdeen Centre for Trauma Research in the UK also add that some victims end up “shutting off’ their emotions or denying that they even experienced a traumatic event, which may stem from a desire to avoid anything that reminds them of their trauma.

How does someone this traumatized even begin to recover?  Clinicians who work with these victims help them find opportunities to make their own decisions, to slowly understand that they are no longer powerless.

Clinical psychologist Rebecca Bailey, therapist to Jaycee Dugard, is the author of, “Safe Kids, Smart Parents: What Parents Need to Know to Keep Their Children Safe.” In an interview with the Trauma and Mental Health Report, Bailey explained: “Number one is helping victims find their voice.  When you’ve been kidnapped, so much of your world is about having choices made for you…From day one you have to give them choices for everything, Do you want a glass of milk, or do you want a glass of water? Things like that.”

Another important aspect to recovery is the role of the family.  It is through a strong connection with the family that the victim can feel safe, comforted, and empowered.  Bailey mentions “tribal meetings” with families soon after rescue to reunify both parties and create a support system. Through these family systems, further recovery is possible.

Specific therapeutic approaches for victim recovery really depend on the individual.  In some cases Cognitive Behavioural Therapy can be used, in other cases experiential therapy or a more psychodynamic approach can be implemented.  Common techniques used in therapy with kidnapping victims are role-playing, therapeutic pets, music, or even walking through the wilderness in an attempt to trigger underlying feelings that must be dealt with.

Often, different therapies are combined to see which works best for the individual. Bailey reminds, however, that client interaction with the therapist also has a large impact on recovery.

Bailey: The most important thing is for the therapist to be mindful, authentic, and purposeful. Counterproductive would be having a therapist who says very little.  This could almost reinjure [the victim] because they need a certain amount of modelling as well.

Modelling how to have an authentic healthy relationship—after the abusive one they had with their abductor—is crucial to helping the victim integrate aspects of normal everyday life.

Still, even with proper therapy and a strong support system, the trauma of being abducted and held captive for years is unlikely to be erased.  In the case of the young women in Cleveland, along with many others, the journey to recovery has been a challenging one, but one that has been described as worth taking:

“I may have been through hell and back, but I am strong enough to walk through hell with a smile on my face and my head held high,” says Michelle Knight in a YouTube video addressed to the public.  “I will not let the situation define who I am.  I will define the situation.”

– Contributing Writer: Anjali Wisnarama, 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

Slavery

Human Trafficking Remains Widespread Form of Slavery

00Bias, Featured news, Gender, Health, Law and Crime, Politics, Sex, Stress, Therapy, Trauma April, 15

Source: Bruno Casonato//Flickr

Despite being mostly illegal, slavery remains a global reality.  It is estimated that over 20.9 million people are currently enslaved and involuntarily trafficked within their own countries and across borders.

In an interview with Mark Lagon, Chair of International Relations and Security at Georgetown University’s foreign service program, former Ambassador, and Adjunct Senior Fellow for Human Rights at the Council on Foreign Relations, The Trauma & Mental Health Report learned about human trafficking and the traumatic experiences survivors encounter.

Q:  What is human trafficking?

A:  Human trafficking is a contemporary form of slavery – whether for sexual exploitation or forced labour.  It’s not a general form of exploitation that we sometimes see with globalization, but rather, an extreme version.

It involves appealing to someone who is desperate for a better life and looking for economic opportunities.  The work however, often onerous and violent, is very different from what was promised.  It’s important in terms of mental health and trauma to understand that while human trafficking often involves violence, especially for sexual exploitation, much of the control is psychological by the recruiter or trafficker.

Q:  Who is most vulnerable to becoming a victim of human trafficking?

A:  Those who are desperate for a new life and wooed into a situation that is exploitative are most vulnerable.  These groups are denied access to justice; they are not treated as human beings in full under the law, women or minorities – or in South Asia, those of a lower caste.  Migrants are also particularly vulnerable.  It’s not just undocumented workers around the world, but even some legal guest workers who are, through fraud, indebtedness, and having their papers seized, vulnerable to human trafficking.

Q:  How do gender stereotypes play a role in human trafficking?

A:  Females are particularly vulnerable to human trafficking.  Public attitude that “men have always bought women for sex and they always will” is based on gender stereotypes.  Society regularly tolerates women being turned into near commodities.

But women and girls are also victims of human trafficking for labour – in agriculture and domestic services.  In Kuwait, I met a woman who had been victimized as a domestic servant.  She showed me photographs of herself taken weeks earlier.  Her employers treated her any way they wanted.  In cases like these, women and migrant workers are seen as property.

Q:  What are some signs of people stuck in trafficking situations?

A:  There are some clear danger signs.  The one key sign is people who are intimidated and afraid.  Often, victims seem isolated.  Their boss, whether a pimp or supervisor, keeps them from having access to society.

Q:  What are some barriers to receiving help?

A:  Human trafficking victims often don’t identify themselves.  They are afraid that they will be treated as criminals.

Also, aspects of the trauma are not often discovered.  Someone might be rescued but the psychological hold that their trafficker has may not be fully appreciated.  They may flee the shelters and end up going back to their tormentor because of a kind of Stockholm syndrome or post-traumatic stress.  Survivors need mental health treatment, not just shelter and physical health treatment.

Q:  Much of humanitarian work is based on the notion of restoring survivors’ “human dignity,”  Can you elaborate?

A:  All human beings are of equal basic worth and there are places where people are not treated as human beings at all.  So, dignity is key.  Two things human dignity depends on are agency – someone’s ability to thrive and prosper in making choices, and social recognition – being treated like a human being.  Human trafficking is a classic example of agency and social recognition being crushed.

Q:  How can we empower survivors?

A:  Human trafficking victims are treated like slaves, but are very seldom in shackles or in chains.  Their tormentors convince them that they are unworthy or they have no ability to flee.  It is essential to restore survivors’ dignity, giving them the therapy and mental health treatment they need.

Q:  What can the general public do?

A:  They can understand that even a small amount of public funding from the government for human trafficking victims and mental health care goes a very long way to help people have their freedom.

Q:  Tell us about your upcoming co-edited book, “Human Dignity and the Future of Global Institutions”?

A:  It looks at how the proper goal for institutions like the UN and the International Criminal Court, is to fight for human dignity, and how well they serve that goal.

I’ve written a chapter on human trafficking, and the partnerships between governments, international organizations, non-profits, and businesses that attempted to combat this issue.  And I distinguish between those partnerships that are transformative in helping people reclaim their dignity and those that are doing little for this issue.

For more resources and information on fighting human trafficking, visit the Polaris Project.

– Contributing Writer: Khadija Bint-Misbah, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

Photo Credit: Bruno Casonato//Flickr

This article was originally published on Psychology Today

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Love Is War: Post Infidelity Stress Disorder

00Anger, Attention, Cognition, Dreaming, Empathy, Featured news, Health, Hormones, Infidelity, Memory, Post-Traumatic Stress Disorder, Relationships, Self-Esteem, Sex, Sleep, Stress, Trauma March, 15

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Blind-sided by the one you love, the one you married.

Learning about your spouse’s infidelity can be emotionally and physically devastating. The emotional damage is reflected in what some mental health professionals call Post-Infidelity Stress Disorder (PISD), for the stress and emotional turmoil experienced afterward.

Psychologist Dennis Ortman, author of Transcending Post-Infidelity Stress Disorder, describes the term as “not to suggest a new diagnostic category but to suggest a parallel with post-traumatic stress disorder, which has been well documented and researched.”

In Post-Traumatic Stress Disorder (PTSD), re-experiencing the trauma repeatedly is the first of three categories of symptoms described. The disorder is marked by flashbacks of war for veterans, nightmares of the accident for car wreck survivors, and painful memories of abuse for survivors of intra-familial trauma.

So too, in PISD husbands and wives will replay the painful realization of betrayal.  Even after the initial fall-out, people will have recurring thoughts of their partner with another.

Psychologist and certified sex therapist, Barry Bass, adds, “Like trauma victims, it is not unusual for betrayed spouses to replay in their minds previously assumed benign events,” those times when their spouse became defensive when asked a simple question, or the late nights at work, or the text messages from unnamed friends, all of these become viewed as possible deceitful acts.

The second category of symptoms for PTSD, avoidance and emotional numbing, is seen in PISD as well.  Rage or despair that comes after the initial shock of discovering the infidelity can be followed by a state of emotional hollowness.  Formerly pleasurable activities lose their appeal.  Those who were cheated on sometimes withdraw from friends and family and describe feelings of emptiness.

The last category of PTSD symptoms, hyper-vigilance and insomnia, can also arise for those dealing with infidelity.  Sleep patterns become erratic; and concentration becomes a challenge, affecting work performance and family life.

PISD can have physical consequences as well as emotional ones.  The stress of discovering infidelity can lead to what has been dubbed broken heart syndrome, also termed stress cardiomyopathy.  The American Heart Association describes symptoms such as sudden chest pain, leading to the sense that one is having a heart attack.  Physical or emotional stressors, such as a loved one passing or major surgery trigger a surge of stress hormones that temporarily affect the heart.  The condition typically reverses within a week.

Despite the stress, there is life after an affair.  Due to the symptomatic similarities, therapists are now beginning to use PTSD counseling techniques to help couples either stay together or move on.

Exposure and cognitive restructuring are techniques used when dealing with traumatic memories.  In exposure, spouses are asked to gradually imagine those heart-wrenching moments and to cope with them gradually, whereas cognitive restructuring substitutes irrational thoughts, feelings, and behaviours induced by the trauma, with adaptive ones.

Counselors use these “trauma focused” explorations with clients, sifting through the distressing memories and aversive feelings, to help build the client’s self-esteem and confidence in dealing with the betrayal or loss of the relationship.

Therapists are also working with their clients to help them understand the unique reasons that led to the infidelity.  Understanding why the affair occurred can help both people.

Along with help from family and friends, wounds can be bandaged and trust restored.  Infidelity trauma and the time and strength involved in recovery remind us that love, like war, can have its casualties.

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

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

Copyright Robert T. Muller

Photo Credit: Daquella Manera/Flickr

This article was originally published on Psychology Today

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When You’re Gone: Deployment Effects On Parenting

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

Deployment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

– Contributing Writer: Noam Bin Noon, The Trauma and Mental Health Report

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

 Copyright Robert T. Muller

 Photo Credit: https://www.flickr.com/photos/dvids/3522556401/

This article was originally published on Psychology Today

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Methadone Treatment May Prolong Addiction

00Addiction, Diet, Environment, Fear, Featured news, Health, Motivation, Psychopharmacology, Resilience, Sleep, Spirituality, Stress, Trauma January, 15

The conventional treatment for opioid dependence is to prescribe methadone.

Similar to morphine, methadone is a synthetic opioid sometimes referred to as a narcotic. It is useful at preventing opioid withdrawal, minimizing drug cravings, and is said to reduce the risk of HIV, Hepatitis C and other diseases associated with intravenous drug usage. Methadone is also cheap, and best of all legal.

Despite the advantages, methadone is highly addictive, and has many side effects such as dry mouth, fatigue, and weight gain.

Treatment involving methadone requires a weekly medical visit to renew the prescription, sometimes leading those who are addicted back to the very environment and people that they need to avoid to stay clean.

The Trauma & Mental Health Report recently spoke with Leslie (name changed for anonymity), a patient who has been receiving methadone maintenance treatment (MMT), who says, “Sometimes I wait all day to see the doctor. During that time, you can’t help but associate with other users, hear “drug talk”, or even see drugs being passed around. The methadone doctor doesn’t push counseling and is not there for support. I’m only going to get my prescription.”

Toward the end of treatment, methadone dose is slowly tapered to prevent withdrawal. But most users don’t wean off completely. Leslie says she didn’t have the motivation or tools to do so until she started seeing her drug addictions counselor:

“I’ve been trying to get off of methadone for 18 months now. It has helped with the withdrawal symptoms, and life is easier to manage since I’m not running the street 24/7 looking for my next fix. And I have more time to get my life on track. But, In order to ‘knock’ the addiction you need to figure out what your personal triggers are. My counselor has helped me with this. She also provides a safe place for me to go and discuss my problems and any issues I have with MMT.”

The greatest fear is relapse. Although part of the recovery process, relapse can have physical and emotional consequences. But it helps to identify personal triggers: cues that provoke drug-seeking behavior, the most common of which are stress, environmental factors such as certain people or places, and re-exposure to drugs.

The most important missing link in MMT is drug counseling. Meeting with a counselor is not mandated and patients seldom see one. Those who seek counseling benefit from help determining personal triggers, and preparing for potential relapse. A counselor may help create a healthy living plan that focuses on improving mental health with nutrition, exercise, sleep, building healthy relationships, and spiritual development.

Better family relationships also help with recovery. Including family members in treatment increases commitment to counseling and also helps family members understand what the person is going though.

Opioid addiction is more than physical dependence. Initial detox is a start. Methadone helps with the physical aspects of withdrawal, and helps users lead a more normal life. But without the help of a drug counselor, MMT isn’t enough.

Without counseling, social support, a drug free environment, and the desire to change, we lead the patient only part way there. And part way isn’t enough.

– Contributing Writer: Jenna Ulrich, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

Photo Credit: www.123rf.com/stock-photo/lonely_man.html

This article was originally published on Psychology Today

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Rape Chants Prevalent on University Campuses

00Education, Ethics and Morality, Featured news, Law and Crime, Social Life, Stress, Trauma January, 15

“Y-O-U-N-G, we like ‘em young, Y is for your sister, O is for oh so tight, U is for underage, N is for no consent, G is for go to jail.”

Frosh week: When nerves and expectations are high, and when first-year students are eager to meet new friends.

In September of 2013, university officials were outraged that some University of British Columbia (UBC) and St. Mary’s University (SMU) students glorified sexual assault by chanting a rape song during frosh week.

Chanting at frosh events is supposed to facilitate school-pride and community. Returning students organize frosh events to represent their schools with dignity. But like every year at UBC and SMU, frosh leaders continue to endorse sexist chants. The president of student council at St. Mary’s, who since resigned, said, “I never thought anything about it” since he heard the chant four years earlier. 

So do students who voluntarily take part in a rape chant actually endorse it? 

The desire to be part of a group can mean surrendering individuality. Social psychologists call this phenomenon deindividuation and it explains why rational individuals can become unruly in crowds. While group chanting is used as a social bonding technique during frosh –where fitting in and making friends is a priority– chanters may not realize they are legitimizing rape.

Historically, rape chanting has been associated with acceptance of violence against women says Otutubikey Izugbara, professor of medical anthropology at the University of Oyo, Nigeria. What’s concerning is that university campuses are unknowingly endorsing this mentality when young women ages 16 to 24 are four times more likely to be assaulted sexually than any other age group.

Political science professor Janni Aragon of The University of Victoria was not surprised by the frosh chants. “We live in a hyper-sexualized world where social justice activists, rape crisis workers, and academics working in women’s studies or other fields continually explain that rape culture thrives.” She explains that an atmosphere of rape culture can turn a rape chant into a “light-hearted moment,” one that underplays the severity of the ritual.

Both UBC and SMU administrators promised sensitivity training, counseling, and anti-rape education for students. Among them, Robert Helsley, dean of the UBC business school voiced concern for student safety and communicated his assurance that such inappropriate events would no longer occur. St. Mary’s appointed a panel to recommend sexual violence prevention on campus, including former politician Laurel Broten, who drafted Ontario’s sexual violence plan.

Education is part of the solution. Jessica Carlson, a psychology professor at Western New England College and Danielle Currier, a sociology and women’s studies professor at the College of William and Mary reported that students who participated in a rape education course were found to have changed attitudes about rape. Students were more likely to see rape as a negative event rather than a neutral or positive one.

But when Helen Lenskyj, professor of social justice at The University of Toronto showed that 60% of Canadian college-aged males would commit sexual assault if they knew they would not get caught, are preventive programs being introduced too late? 

In 2004, the Rand Corporation and Break the Cycle non-profit think tanks, questioned whether violence education programs are appropriately timed for university students. Their research shows that first sexual experiences often occur at a younger age, many of which are forced. High-school students are considered a high-risk group for unwanted sexual encounters.

Since then, rape education grants have increased for middle schools and high schools. Poco Smith, a professor of social work at Wayne State University and Sarah Welchans, a statistician from the U.S. Bureau of Justice Statistics studied rape education in high-school students. They found that using an education peer group to explain male responsibility in sexual assault (as opposed to victim blaming) led high-school students to perceive rape as an objectively harmful event.

Still, it is challenging to reach younger students because parental consent is often a requirement, and there are few knowledgeable counselors to teach abuse prevention. Sexual education in general also tends to focus on heterosexual abuse, labeling the male as the abuser and the female as the victim. There is considerably less research that focuses on abuse in sexually diverse groups.

For victims of sexual assault, there is a social and psychological cost. Male-privileging rape songs can isolate victims, and encourages a celebration of trauma.

When two different universities bordering Canada are singing the same song at frosh week, you might wonder if other universities across Canada are doing it too.

Universities worldwide ought to pay close attention. When I was in high school, I didn’t wonder whether the chant I participated in was wrong. My guess is there are a whole lot of unaware students out there. 

– Contributing Writer: Shira Yufe, The Trauma and Mental Health Report 

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

Copyright Robert T. Muller 

Photo Credit: Andrew Vaughan/The Canadian Press

This article was originally published on Psychology Today

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Book Review: Becoming Trauma Informed

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

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

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

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

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

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

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

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

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

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

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

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

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

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

– Contributing Writer: Janany Jayanthikumar, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

Photo Credit: https://www.flickr.com/photos/auntiep/4450279893/

This article was originally published on Psychology Today

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Video Games Rated A for Addictive

00Addiction, Depression, Diet, Featured news, Health, Neuroscience, Optimism, Psychopharmacology, Self-Control, Sex, Sleep, Stress, Treatment December, 14

Picture if you will, flashing screens, loud noises, focused faces and a crowd gathered to watch high stakes games; games that end only when you run out of money.

This is not a casino. Those faces are staring at flashing computer screens in an arcade and the high stakes match is actually a video game.

Scenes like this make it possible to view video gaming as an addiction. Like a gambler endlessly playing slots, the video gamer can spend hours on the vice of choice.

Those who consider gaming as addictive highlight similarities between models of addiction and the behaviour of those who can’t seem to stop playing video games, despite the consequences 

What does it mean to be addicted to a video game? Addiction used to be a term reserved for drug use defined by physical dependency, uncontrollable craving, and increased consumption due to tolerance. Advances in neuroscience show that these drugs tap into the reward system of the brain resulting in a large release of the neurotransmitter dopamine. This is a system normally activated when basic reinforcers are applied, like food or sex. Drugs just do it better.

Gaetano Di Chiara and Assunta Imperato, researchers at the Institute of Experimental Pharmacology and Toxicology at the University of Cagliani, Italy, found that drugs can cause a release of up to ten times the amount of dopamine normally found in the brain’s reward system. This has led to a shift in how addictions are viewed. Any physical substance or behaviour that can “hijack” this dopamine reward system may be viewed as addictive.

When can you be sure that the system has been hijacked? Steve Grant, chief clinical neuroscientist at the National Institute of Drug Abuse, says it happens when there “is continued engagement in self-destructive behaviour despite adverse consequences.”

Video games seem to hijack this reward system very efficiently. Certainly Nick Yee, author of the Daedelus Project, thinks so. He explains, “[Video Games] employ well-known behavioral conditioning principles from psychology that reinforce repetitive actions through an elaborate system of scheduled rewards. In effect, the game rewards players to perform increasingly tedious tasks and seduces the player to ‘play’ industriously.” Researchers in the UK found biological evidence that playing video games and achieving these rewards results in the release of dopamine.

This same release of the neurotransmitter occurs during activities considered healthy, such as exercise or work. Since dopamine release is not bad per se, it is not necessarily a problem that video games do the same thing.

In her book, Reality is Broken: Why Games Make Us Better and How They Can Change the World, Jane McGonigal writes, “A game is an opportunity to focus our energy, with relentless optimism, at something we’re good at (or getting better at) and enjoy. In other words, game-play is the direct emotional opposite of depression.” Playing games can be an easy way to relieve stress and get that satisfaction that comes with dopamine release.

But it is concerning when this search for the dopamine kick becomes preferable to real life, when playing video games replaces activities like socializing with friends and family, exercising, or sleep. Nutrition may begin to suffer as the gamer picks fast-food over proper meals. School-work and job performance suffer as gaming turns into an escape from life. It becomes troubling when video games are used as the main way of coping.

Psychologist Richard Wood says just that in his article Problems with the Concept of Video Game “Addiction”: Some Case Study Examples. “It seems that video games can be used as a means of escape…If people cannot deal with their problems, and choose instead to immerse themselves in a game, then surely their gaming behaviour is actually a symptom rather than the specific cause of their problem.”

Regardless, there are some unable to stop despite the consequences. In rare cases it has actually caused death, through neglect of a child or physical exhaustion. Excessive video game playing may represent a way of coping with underlying issues. But it becomes its own problem when the impulse to play just can’t be denied.

Psychiatrist Kimberly Young, Director of the Center for Internet Addiction Recovery argues that “[gaming addiction is] a clinical impulse control disorder, an addiction in the same sense as compulsive gambling.” Her centre is one of many that are now found in the United States, Canada, the United Kingdom, and China.

These clinics treat those with gaming problems using an addiction model. They use detox, 12-step programs, abstinence training, and other methods common to addiction centres.

Notably, many people play well within healthy limits, and engage in the activity for diverse reasons. Stress relief, a way to spend time online with friends, or the enjoyment of an interactive storyline are all common reasons for playing. Whatever the reason for starting, when you can’t stop you have a problem. 

We are often critical of labels in mental health, for good reason; they can be misused. On the other hand, a label can sometimes be helpful. If we call it an addiction, then we recognize it as a problem worth solving.

– Contributing Writer: Bradley Kushner, The Trauma and Mental Health Report 

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

Copyright Robert T. Muller

Photo Credit: Ben Andreas Harding

This article was originally published on Psychology Today