Category: Trauma

Rehabilitation Benefits Young Offenders

Rehabilitation Benefits Young Offenders

00Anger, Depression, Featured news, Health, Law and Crime, Punishment, Trauma September, 15

Source: Kim Silerio/Flickr

“We are seeing far too many young offenders entering the adult system who should be dealt with in the juvenile system,” says public defender, Gordon Weekes, in a short documentary published in April 2014, by Human Rights Watch.

With little support and a lack of rehabilitation resources available in adult facilities, young offenders prosecuted as adults are often faced with harsh protective and disciplinary measures like solitary confinement.

But, solitary confinement is just as common in juvenile correctional facilities. In 2013, an Ohio juvenile correctional facility placed a young boy in solitary confinement where he spent 1,964 hours in isolation. Referred to as K.R. in court documents, his longest period of seclusion was 19 consecutive days.

Although declining, in the 1980s through the mid-1990s, serious and violent juvenile crimes were on the rise, raising concerns about whether to subject young offenders to longer prison sentences and the same legal proceedings as adults. In 2011, Human Rights Watch (HRW) and the American Civil Liberties Union estimated that more than 95,000 youth were held in prisons, most of these facilities using solitary confinement.

A 2012 HRW report states that solitary confinement is often used to punish young people for misbehavior, to isolate children if dangerous, to separate children vulnerable to abuse from others, and for medical reasons (including suicidal ideation).

Yet, research shows that solitary confinement can cause serious psychological and developmental harm to children, and can have a detrimental effect on one’s ability to rehabilitate.

In the HRW report, adolescents indicated a range of mental health difficulties during their time in solitary confinement. Thoughts of suicide and self-harm were common. Several participants even described that their requests for mental health care were not taken seriously.

Kyle B., a participant of the HRW study recalled:

“The loneliness made me depressed and the depression caused me to be angry, leading to a desire to displace the agony by hurting others. I felt an inner pain not of this world… I allowed the pain that was inflicted upon [me] from my isolation placement to build up. And at the first opportunity of release (whether I was being released from isolation or receiving a cell-mate) I erupted like a volcano.”

According to researchers at the 2014 Advancing Science Serving Society annual meeting, prisoners kept in isolation lose touch with reality, and can develop identity disorders after spending long hours without social interaction. It can also be damaging to individuals with pre-existing mental illnesses or past childhood trauma.

Incarcerated adolescents who have been accused or found guilty of crimes can be extremely difficult to work with.  UN Special Rapporteur on torture, Juan E. Méndez, advises that “solitary confinement should be used only in very exceptional circumstances, for as short a time as possible.”

The US Supreme Court has consistently emphasized the importance of treating young people in the criminal justice system with special constitutional protections regarding punishment. Since solitary confinement is physically and mentally harmful to adolescents, many are calling for reform.

The HRW report suggests alternatives to solitary confinement to foster rehabilitation. They suggest increasing the number of trained supervised staff in facilities, like social workers and other mental health professionals. Providing adolescents with programs and activities in groups may help with development and rehabilitation. The HRW also emphasizes rewarding positive behaviours instead of punishing bad ones.

Research has also linked the role of education to improved behaviour and lower rates of delinquency among incarcerated youth.

Along with appropriate mental health care, education may improve rehabilitation efforts and assist youth in productive re-entry into their communities.

– 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

LGBTQ Refugees Lack Mental Healthcare

LGBTQ Refugees Lack Mental Healthcare

00Featured news, Health, Law and Crime, Loneliness, Sexual Orientation, Stress, Trauma September, 15

Source: William Murphy/Flickr

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

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

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

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

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

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

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

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

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

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

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

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

– Sarah Hall, 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

Cyberstalking yet to be taken as seriously as it should

Cyberstalking yet to be taken as seriously as it should

70Bullying, Fear, Featured news, Gender, Law and Crime, Post-Traumatic Stress Disorder, Trauma September, 15

Source: Surian Soosay/Flickr

If you were to Google search your name right now, what would come up?  Some are surprised by what they find.  The posting of personal information has made the internet the perfect medium for harassment and stalking.

Cyberstalking can take on a number of forms including blackmail, having online activities tracked, or sending threatening messages. Some cyberstalkers commit identity theft and proceed to terrorize victims in ways such as cancelling credit cards or using personal information to besmirch individuals.

Cyberstalking takes an emotional toll on victims, a feeling that Anna, a university student recently interviewed by The Trauma & Mental Health Report knows well.

Anna:  I would receive up to 10 emails from him a day.  He would send me photos of myself with vulgar and aggressive comments about me and my family, and he also made a MySpace page dedicated to me with offensive comments on them.  I was terrified to go onto any social networking site.

Anna’s cyberstalker even went as far as to email her university professors, demanding they provide information about her.

Anna:  I was constantly cancelling plans and commitments… I was afraid to leave my house.  It’s frightening not knowing where your stalker is when they’re contacting you.  For all you know they could be sitting in a car, on the same street where you live, messaging you from their cell phone.  I didn’t know if I was in real physical danger.  I worried about my safety all the time.

It is common for cyberstalkers to make threats of physical violence, and there have been cases where online stalking has crossed over to offline stalking.  For Anna, her fear resulted in anxiety, nightmares, and insomnia.

Also common is for work or academic performance to deteriorate and interpersonal relationships to crumble from distrust, leaving these victims with a lack of social support.

The fear associated with cyberstalking can be so traumatic for some that desperate measures are taken. A study of cyberstalked university students performed by PhD candidate, Nancy Felicity Hensler-McGinnis of the University of Maryland showed that many reported withdrawal from courses or transferring schools to feel safer.  Popular cases like that of Kristen Pratt demonstrate that some victims will even change their appearance.

Calling the police seemed like Anna’s best solution, but the initial response she received was not helpful.

Anna:  I was told to try to track his IP address on my own because the police IT department might not be able to do it.  I was told to tell him to stop (as if I hadn’t already done that) and to make myself anonymous on the internet, which is not only difficult but nearly impossible in our technology driven professional world.  I was treated as if my situation wasn’t serious or detrimental to my well-being.

Anna’s predicament was not unusual.  Cyberstalking is often not taken seriously.  This is reflected in the lack of cyberstalking legislation in Canada.  Sections of the criminal code focus specifically on face-to-face stalking and although some cyberstalking behaviours are included, there are gaps.

When school teacher Lee David Clayworth’s cyberstalker harmed his reputation by posting inappropriate content under his name, authorities could do little, since his cyberstalker was not in Canada.  Canadian arrest warrants were not effective; jurisdictional obstacles, like difference in internet service providers, leave victims helpless.

U.S. state laws regarding cyberstalking vary, but according to the Working to Halt Online Abuse (WHOA) organization, many of these only protect victims 18 and under. Alabama, New Mexico, Hawaii, and Indiana have no formal cyberstalking laws. While some legislation addresses cyber harassment, this is defined as having no credible threat to victims.

Lack of internet regulation leaves victims to track down cyberstalkers on their own.  Asking individuals to erase their identities online is unrealistic.  Online communication continues to grow and law enforcement is having a hard time keeping up.

In both Canada and the US, some bills have been proposed.

Anna’s advice to victims is not to let fear control their lives:  People who harass you online want you to feel isolated and powerless.  If you are not in any immediate danger it is important to realize that by living in fear, you are actually giving them exactly what they want.  Do everything in your power to get them to stop; speak up about your experience and make their behaviour public.

Anna also stresses the importance of a support system. Talking to friends, family, or a counsellor may help victims deal with the trauma and realize they are not alone.

Clinical psychologist Seth Meyers mentions the importance of warning friends and family of a potential stalker as well. This could protect loved ones if there is risk of physical danger, and keeps victims from socially isolating themselves.

Until authorities take action, the Canadian Clearhousing on Cyberstalking suggests that victims report harassment to their internet service provider which can possibly take such measures as blocking the cyberstalker’s IP address from contacting them. Victims can also find support from organizations such as WHOA or CyberAngels which can help gather information to build a criminal case against the cyberstalker.

As communication continues online, personal information ends up on the internet. It is time that lawmakers realize the dangers and enact legislation to keep users safe.

– By Anjali Wisnarama, Contributing Writer, The Trauma & Mental Health Report 

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

Copyright Robert T. Muller

This article was originally published on Psychology Today

Media Fail to Respect Crime Victims

Media Fail to Respect Crime Victims

00Ethics and Morality, Featured news, Law and Crime, Media, Post-Traumatic Stress Disorder, Trauma August, 15

Source: Kurt Bauschardt/Flickr

Pickton, Gein, Dahmer, Bundy. Few of us forget these names; names belonging to four infamous serial killers who shocked the world.

But the names Andrea Joesbury, Bernice Worden, Steven Tuomi, and Lisa Yates belong to the killers’ victims.  All were tortured, raped, and killed.

Unlike their murderers, they were not awarded Wikipedia pages.  They do not have Hollywood-made biographies.  And they do not have a place in the minds and memories of the public.

With so much news vying for attention, the need to sensationalize stories has grown, making the media complicit in the way we think of and remember heinous acts.  We read “Gunman Kills Six” instead of “How Poverty and Desperation Breed Crime.”

The need to shift media attention away from criminals is more than just a matter of principle.  While most suicides go unpublicized because psychologists have discovered that media coverage breeds imitation, the same findings have been shown to apply to the reporting of violent offenses. Yet media coverage of such crimes is still extensive enough to inspire new killers on a regular basis, giving the incentive of fame and profit from publicity.

In the U.S., the Son of Sam Law was passed following a 1977 murder trial, where it was ruled that any proceeds garnered by criminals for publicizing their crimes would be seized and turned over to victims.  A recent amendment has extended this legislation to not-criminally-responsible rulings as well.  Yet with crimes and the publicity they earn transcending borders and regulations, this is increasingly difficult to enforce.

The last few years have seen “popular” criminals earning fame and fortune through grisly deeds.  In 2007 in Japan, a man murdered Lindsay Ann Hawker, an English teacher, avoiding capture for several years.  His story became a hot topic for media speculators, earning him quasi-celebrity status.  Other killers who were acquitted on technicalities or due to legal loopholes also went on to turn profits from books, TV appearances, and years of controversial media exposure.

At times, the media create the very controversy they exploit.  This is especially true of crime reporting, where the focus is slanted to include graphic details of events and frightening images of suspected criminals.  The longer a manhunt or trial continues, the more attention the media are able to gain from what would otherwise be a single story.  It is this persistent coverage that creates a painful, damaging atmosphere for victims.

Psychologists agree that being re-traumatized by overwhelming life experiences can lead to difficulty with recovery.  Symptoms of Post Traumatic Stress Disorder (PTSD) can become aggravated when survivors are repeatedly reminded of painful private events in an exposing public context.  As a result, experts recommend that families and victims recovering from crime avoid contact with the media by minimizing their viewing of the news until they regain a sense of personal safety and stability.

Unfortunately, advice like that can be next to impossible to follow when a single Google search can return millions of hits for killers’ names.  When TV stations spend years showing photos of terrorists and their attacks.  And when headlines across the globe follow murderers who drag out court cases for years by slowly admitting to more crimes.

At the same time, the media can turn on the victims themselves. Reporters often hound victims of high-profile crimes, starting out benevolently, but becoming doggedly persistent if ignored.  Yet there is no formal protection from either the harassment of reporters or the reports themselves.

Legislation exists to curb the reporting of suicides.  But there is none to oversee the press when it comes to publicizing crimes or dealing with criminals and victims.

Organizations like Fairness & Accuracy in Reporting are doing their best to stop sensationalistic journalism.  But until a fundamental change occurs in legislation or the public’s appetite for detail, victims will continue to be victimized further by the media.

– Nick Zabara, 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

Trauma Workers At Risk for Compassion Fatigue

Trauma Workers At Risk for Compassion Fatigue

00Burnout, Empathy, Featured news, Health, Resilience, Self-Help, Trauma, Work July, 15

Source: Brian Walker/Flickr

The expectation of unending compassion for others is unrealistic. For trauma workers, hearing devastating stories can take its toll. This can be seen in detrimental effects to physical and emotional health; that is, a specific type of burnout called compassion fatigue.

The Trauma & Mental Health Report recently spoke with compassion fatigue specialist and director of Compassion Fatigue Solutions in Kingston, Ontario, Françoise Mathieu, to discuss the symptoms of the condition and how trauma workers can protect themselves from it.

Q: What is compassion fatigue?

A: It is a gradual shift and decline in an individual’s ability to feel empathy and compassion towards others. It is not an illness or disorder. Often, the term compassion fatigue is used interchangeably with vicarious trauma or secondary traumatic stress (STS), but there is a distinction.

STS refers to a traumatic, stressful experience without direct exposure to the trauma. STS results from hearing traumatic stories, like hearing witness testimonies or stories of torture. Over time, those stories can shift your view of the world to a tainted and jaded one, to the point where you lose the ability to experience joy. For example, people who work with victims of sexual trauma may have a hard time trusting babysitters or coaches. Vicarious trauma is the result of the accumulation of several STS experiences.

Q: Who is susceptible to compassion fatigue, vicarious trauma, and STS?

A: Helping professionals are the most susceptible. This typically includes physicians, nurses, mental health care workers, allied health professionals, therapists, clergy, law enforcement, teachers, long term care workers, and personal support workers.

The public can also start internalizing trauma from continuous exposure to graphic images portrayed by the media. Overexposure of the September 11th, 2001 terrorist attacks created a heightened sense of danger and paranoia. The difference is that the relationship helping professionals form with their clients is very unique: You become deeply vulnerable. When you’re opening your heart and listening to someone’s pain, it can be very intense.

Q: Are there any signs and symptoms of compassion fatigue?

A: A major warning sign is workaholism. Many helping professionals are so dedicated to their jobs that they don’t have a balance between their work and home lives. The more caring you are, the more vulnerable you are. We call it a “normal consequence” of doing a good job. Helping professionals may experience a decline in empathy, reduced collegiality, dreading client appointments, and belittling their stories.

Or, someone might be doing a great job at work, but they have nothing left to give at home. Warning signs are irritability, social isolation, emotional and physical exhaustion, or self-medicating with drugs, alcohol, or even excessive shopping.

Q: What can protect trauma workers?

A: With increased budget cuts, many trauma workers do not have adequate training, so Trauma Informed Training can be highly protective. Richard Harrison and Marvin Westwood, researchers from the University of British Columbia (UBC), studied experienced trauma therapists and found that those who connected spiritually or creatively with something outside their work and felt supported by their families and communities managed well with the stress of their jobs.

Establishing a deep therapeutic alliance characterized by a meaningful relationship with clients, based on presence and heartfelt concern, also provided professional satisfaction.

Q: What can a person with compassion fatigue do to alleviate symptoms?

A: We can’t prevent compassion fatigue, but there are strategies and tools for professionals to be able to feel grounded, present in the moment, and well trained. Ask yourself these questions:

–Do I work somewhere where I have control? Control over your schedule can reduce compassion fatigue. Small changes can make a big difference.

–Do I have a debriefing process that might relieve some of the emotional strain?

–Do I have access to supportive people whom I can consult with, when I hear difficult stories?

–Am I trained in trauma-related concepts, so that I have a better understanding of the side effects?

–Do I have a transition ritual, a way to leave work behind and transition into my home life? (e.g., yoga, exercise)

Last, research shows that the most effective strategy is Mindfulness-Based Stress Reduction, which recommends relaxation techniques to reduce stress and improve self-compassion.

Mathieu adds that even if you have your own past history of trauma, it doesn’t mean that you shouldn’t be a helping professional. In this case, it’s important to identify your triggers, ensure you have a support system, and that your caseload doesn’t remind you of your personal trauma.

Mathieu cautions the trauma worker to “pay equal attention to the needs of your client, and yourself.”

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

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

Copyright Robert T. Muller

This article was originally published on Psychology Today

Grieving the Loss of a Child: The Five Stage Myth

Grieving the Loss of a Child: The Five Stage Myth

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

Source: Bethan/Flickr

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

– Tessie Mastorakos, Contributing Writer, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

This article was originally published on Psychology Today

When a Parent is Incarcerated

When a Parent is Incarcerated

00Behaviorism, Child Development, Featured news, Law and Crime, Parenting, Trauma May, 15

Source: Restless Mind / Flickr

The wildly popular television drama Breaking Bad followed the evolution of a high school chemistry teacher and father turned drug kingpin.  The series came to an explosive end in the Fall of 2013; shows like this often end when the protagonist-criminal’s story ends.

But from a mental health standpoint, just as this occurs new stories begin, particularly for the family.

When parents are arrested or convicted their children face many challenges, one of the most important being the disruption of parent-child attachment.  Research shows that parent-child attachment directly affects cognitive and behavioural development in children, and this disruption can lead to social and behavioural problems later in life.

When a parent goes to prison, young children often develop emotional responses such as sadness, fear and guilt as a reaction to the parent’s incarceration.

These emotional reactions can turn into severe behavioural problems, triggering conflicts between the child and others.  Many children of incarcerated parents develop feelings of anger and aggression, leading to failed friendships in school.  Some may also become depressed and anxious, bringing academic and social challenges.

The child’s attachment to caregivers is important in the development of what psychologists call social cognition (the study of how our thoughts and perceptions of others affect how we think, feel and interact in our everyday life).  Our earliest thoughts about others are learned through our parents.  Children raised without a sufficient parent-child interaction may lose this important experience.  The child may have a difficult time socially, often when they approach adolescence.

The media tend to overlook children of criminals.  In 2005, it was estimated that more than 2.3 million children in the U.S. had a parent in prison.  How can children in this position be helped?

A two-step process, adapted by education professor Glen Palm of St. Cloud State University and the Inside-Out Connections Project, was developed to decrease these children’s odds of developing negative behaviours.

Step 1: Understanding and Awareness

When a parent is incarcerated, the child’s remaining caregivers often don’t know if or how they should explain the parent’s absence to the child.  Once a child understands the situation, they are more likely to adapt to the changes in their life in a positive way.

Clinical psychologist Deonisha Thigpen’s book When a Parent Goes to Prison helps explain incarceration to a younger audience.  It defines what breaking the law is, presents easy-to-understand definitions regarding the justice system, and even provides support to children by explaining that they are not the only one who is experiencing this situation.

And popular children’s television shows like Sesame Street have developed episodes for children with incarcerated parents.  They provide a visual explanation that helps to explain incarceration and how children can eventually explain it to their peers.

Step 2: Visiting the Incarcerated Parent

Once a child understands incarceration and what it means for them, they may be able to visit their parent in prison.  Prison visitations are often portrayed on television and in film, but reality often differs.

Visitors may have to wait an extended period of time before seeing an inmate, which can be challenging when visiting with young children.  Sometimes families of inmates wait for hours, to discover the visiting request has been denied.  When a visit is granted, most correctional facilities have large visiting rooms shared between many inmates and visitors, limiting close parent-child interaction.

A more viable prison visitation program for nurturing a parent-child bond is filial play therapy.  It is only an option for inmates who are not sex offenders and who have not committed any serious violations at their institution.  Once accepted into the program, they are taught how to create a safe and open environment with their child.  Then they meet with their child for one hour a week in a private setting, utilizing these new skills.

Play therapist, Garry Landreth, of the University of North Texas, believes that filial play therapy improves a child’s self-worth and self-esteem, despite the parent’s incarceration.  After a 10-week study, Landreth found that the children began to see themselves as more capable and valuable individuals.

Of course it’s fair to expect convicted criminals to pay for their crimes.  But no child should have to suffer for their parent’s mistakes by being left to grow up on their own.

And when those we incarcerate leave children behind, we’d be wise to consider the kind of future we want for the next generation.  Perhaps a future that gives a shot at something better…for their sake, and for ours.

– Alessandro Perri, 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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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

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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

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Forgetting PTSD: How Genes Affect Memory

00Fear, Featured news, Genetics, Memory, Neuroscience, Post-Traumatic Stress Disorder, Therapy, Trauma April, 15

Source: Jared Rodriguez // Flickr

Memory can be a double edged sword. It holds our identities, our relationships, our histories. But when memory holds our most unspeakable stories, it can become a painful burden.

Sufferers of PTSD live with this reality. Many cannot forget. Recent studies have found that a gene, called tet1, plays a central role in forgetting such traumatic experiences.

Massachusetts Institute of Technology researcher, Andrii Rudenko, found that when people with normal levels of this gene experience a traumatic event, the triggers to traumatic responses become extinct over time. For example, if you were bitten by a dog after walking past a neighbour’s house, you may be reluctant to walk by that same house again. And if you continued to walk past the house and nothing happened, eventually the association with being bitten and walking past that house would become extinct –you would no longer fear walking past the house. However, people with PTSD do not form these new associations, and would continue to fear walking past the neighbour’s house.

Currently, one of the most effective treatments for PTSD is exposure therapy, where patients learn new associations by being exposed to the triggers of PTSD in safe environments. This can include practicing driving on a driving simulator for someone who is afraid to drive due to a motor vehicle accident. Over time, patients begin to learn that driving is not as dangerous as they came to believe.

The tet1 gene aids in the expression of genes in the brain that help people form new memories and cover up old ones. However, when a person has low levels of this gene, old and traumatic memories are not masked.

In Rudenko’s study, mice were conditioned to fear a particular cage using electric shocks. When the electric shock was taken away and the mice were placed in the cage, the mice with normal levels of the tet1 gene lost their fear of the cage, while the mice with low levels of the tet1 gene continued to fear as before.

A process called DNA methylation blocks the expression of the promoter genes that are responsible for forming new memories. The methylation process is lowered by tet1 and other tet proteins in areas of the brain that are important for forming memories, including the hippocampus and the cortex.

Simply put, the more tet proteins, the more expression of promoter genes and memories formed. Conversely, even though low levels of the tet1 gene make learning new things difficult, it has been hypothesized that fear responses are so strong that tet2 and tet3 proteins can compensate for the demethylation processes of tet1 proteins. Therefore, memories are formed during strong responses to fear or traumatic events, but with a lack of tet1 proteins, new memories are not formed to replace the old memories, and chronic PTSD is the result.

Li-Huei Tsai, director of MIT’s Picower Institute for Learning and Memory, told MIT news that “if there is a way to significantly boost the expression of these genes, then extinction learning is going to be much more active.” That is, if we can find a way to boost the expression of the tet1 gene, then people’s traumatic memories will be covered up by new memories quicker.

Memory extinction, prefrontal lobotomies, and other psychosurgeries have been a topic of popular film and literature. It’s not surprising that questions on how these findings may be applied to PTSD treatment have raised eyebrows.

According to Tsai, “What happens during memory extinction is not erasure of the original memory.” Instead, new memories and associations can be formed and old ones forgotten. In the case of the mice, the mice with the higher levels of the tet1 gene begin to learn that the cage is safe, and forget that it was once dangerous. In Rudneko’s view, “association with safety is rebuilt.”

Manipulating tet1 proteins in the brain and combining exposure therapy may bring new PTSD treatment possibilities. This method might even be used to assess a person’s genetic predisposition to PTSD. One imagines a possible screening tool for applicants to jobs with exposure to highly stressful events, like police officers.

This research is still in its infancy. Yet it shows promise for those who, despite their best efforts, can’t find a way to forget.

– Contributing Writer: Andrew McColl, The Trauma and Mental Health Report

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

Copyright Robert T. Muller

Photo Credit:Jared Rodriguez // Flickr

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