Category: Featured news

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The Hidden Struggles of Animal Rescue Workers

00Animal Behavior, Depression, Featured news, Resilience, Suicide, Trauma September, 19

Source: 12019 at Pixabay, Creative Commons

During the civil war in Syria, veterinary surgeon Amir Khalil from the charity organization Four Paws International, travelled to Aleppo to rescue surviving zoo animals. Before the war began, the zoo was home to around 300 animals, yet by July 2017 only 13 remained. After months of intense negotiations with the Syrian and Turkish governments, local factions and warlords, and two dangerous rescue missions later, Khalil managed to save all 13 animals. Prior to this rescue, Khalil had rescued animals from conflict zones in Libya, Gaza and Iraq. 

When tragedy strikes, most people think about the potential harm done to human lives. However, many care deeply about animals and are willing to put their lives at risk to save them. In fact, during Hurricane Katrina, of those who did not evacuate their homes, 44% did so because they did not want to abandon their pets.  

Research has even shown that there are some circumstances in which people chose to save pets over humans. One study showed that 40% of people chose to save their own pet over a foreign tourist. Another study showed that when presented with a fictional news story, people cared more about crimes involving dogs and children than adults. A possible reason for this surprising finding was likely due to the vulnerable nature of animals. In fact Khalil felt compelled to rescue many animals in the past simply because the zoo animals were dependent on humans. In an interview with The Telegraph, he explained: 

“Humans have the option to escape, but animals caged in a zoo don’t have this option. It was humans who brought animals to these places. They cannot speak, they have no political agenda, but they are messengers from the darkness, they bring hope.”

Other animal rescue workers express similar sentiments. Darren Grandel, Deputy Chief of the investigations department at the Ontario Society for the Prevention of Cruelty to Animals, explained in an interview with the Trauma and Mental Health Report (TMHR) that the most difficult part of his enforcement work is witnessing innocents being harmed: 

“The animals, all the time, are the innocents. It’s not that they’ve chosen to engage in a type of activity that can harm them. The humans have done it to them. So a lot of the time you’re seeing innocent animals being harmed, sometimes in very horrific ways, in ways that you couldn’t imagine someone hurting another living thing. It can be very, very traumatic.”

When working on rescuing  animals such as in the wake of a natural disaster, a similar type of trauma can be experienced.  In a TMHR interview, Miranda Spindel, a veterinarian with 19 years of experience, including a decade with the American Society for the Prevention of Cruelty to Animals explained:

“On deployment, you are typically away from home and often working in conditions that are less than ideal. Sometimes, there are animal owners as well as animals involved, who may have experienced very stressful and emotionally challenging situations and require skilled and compassionate care, too. Often the work is physically as well as mentally challenging.”

Animal rescue work, though important, severely affects the mental health of these individuals. Humanitarian aid workers and first responders report high rates of depression, anxiety and PTSD. Animal rescue workers occupy similar roles, rescuing and proving aid to animals in distress and likely experience similar mental health problems. And, according to a study in the American Journal of Preventative Medicine, those in protective service occupations, including animal control workers, have the highest rate of suicide, at 5.3 per million workers. 

Veterinarians and others individuals who work with animals also experience high rates of compassion fatigue. Compassion fatigue, also known as vicarious traumatization, refers to stress symptoms that result from providing care and empathy to humans or animals in distress. 

Janice Hannah, Campaign Manager of the International Fund for Animal Welfare’s Northern Dog Project described one such experience in a TMHR interview:

“I remember visiting a rural shelter. The dogs were literally stuck in a poop filled fence, cold, wet and hungry. That was the end of shelter work for me – I had been to so many similar shelters around the world and am reminded of the sadness felt in those situations. Though those feelings dissipate over time, it never goes fully away. You end up building up more and more sadness and discomfort around all the animals that you see but can’t make a tangible difference about the circumstance. 

There are some programs in place, such as support groups and internal services within organizations to help animal rescue workers recover from trauma. Yet, more needs to be done to better help individuals who have dedicated their lives to helping animals. Increased peer support and open communication without fear of stigma are required to better help individuals with mental health problems. Spindel emphasizes that preventative measures are equally important:  

“Whether or not workers are suffering from mental health issues, the circumstances are generally enough, in my opinion, that mental health services and resources should be made available as a matter of routine. Trained support during the deployment – or even before – not just debriefing afterward – seems critical to building resiliency for this type of work.”

From enforcement officers to veterinarians, many different professionals work selflessly to rescue innocent animals from harm. With greater support services, these individuals will be better able to cope with the stresses of their job, enabling them to better help animals in need.  

-Roselyn Gishen, 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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In Post-Secondary School and Homeless

00Depression, Education, Featured news, Loneliness, Productivity, Sleep August, 19

Source: liborius at Flickr, some rights reserved

Under the concrete, ivy-covered walls of many universities lies a disturbing phenomenon; homelessness. Many find it incomprehensible that homelessness would exist in these spaces, but  it does. A study by Michael Sulkowski shows that student homelessness is growing at an “unprecedented rate,” with 1 million affected. Rising tuition costs, coupled with a higher cost of living, makes it unlikely that student homelessness will be resolved any time soon. 

In an interview with The Trauma and Mental Health Report, Maya (name changed for anonymity), a fourth-year psychology major, explained what it was like living as a homeless university student:

“I would search for empty lecture halls to sleep in. I would adjust my sleep schedule by sleeping during the daytime and remaining awake at night, because it was much safer to do so.”

“I would carry my bags with me, which contained all of my belongings. Classmates and friends would ask me why I was always carrying my stuff around, but I was hesitant to tell them that I was homeless. I was afraid and ashamed of my living situation and did not want anyone to know. I was afraid that people would judge me and believe that I was to blame for my homelessness,”

When at school, Maya said that it was hard to focus on her studies and practice self-care, as her homelessness took top priority:

“I would try to do everything in my power to not bring attention to myself. I would not ask questions in class, and I would avoid making friends with other classmates. I felt sub-human and inferior. I found myself deteriorating both physically and mentally. My hair began to turn grey and greasy, my skin was pale, and my mental health was in shambles. I was so focused on my homelessness that my grades also began to suffer.”

Eventually, things got a little better for Maya, as she found a temporary place to stay:

“One of my friends was a student executive for a women’s advocacy club on-campus, and she told me that I could use the office to sleep. It was a relief because I was given food, menstrual pads and tampons, as well as a place to sleep. It really helped me to get back on my feet.”

Why does homelessness among university students seem to be an invisible issue? Stephen Gaetz, director of the Canadian Observatory on Homelessness and Professor at York University explained this issue in an interview with CBC News Toronto: 

“The hidden homeless is a much different population compared to the homeless population that is seen in emergency shelters. Student homelessness is often overlooked because they pull all-nighters in school, take showers in the gym, and sleep on the couches.”

According to Sulkowski’s study, youth homelessness receives less economic resources compared to adult homelessness. Youth who experience homelessness encounter several barriers to their academic success and well-being, leaving them vulnerable. One barrier that Maya had to overcome was difficulty accessing on-campus resources:

“When I tried to access counselling services, the first thing they asked me was my address. I did not have one, so I used my mother’s address instead. Something as simple as an address was a large issue for me, which isn’t something that we think about too often.”

“But even when I tried getting help for my living situation, I was given the run-around. I would call one service, and they would refer me to another one. I honestly felt like no one cared and wanted to help me, so I stopped asking for help.”

And Maya’s story is not unique. Recently, one student at the University of Alberta shared his experience with homelessness, explaining that he “slept in parks or near malls” and would find himself “frequently accessing the university food bank.” Despite the number of anecdotes regarding student homelessness, there is no national approximation for the number of post-secondary students facing homelessness in Canada, and university-specific data are not currently available.

I asked Maya what she believed post-secondary institutions should do to address the growing issue of student homelessness, given her own experience:

“Firstly, I think that campuses should have services that allow students who are homeless to access these resources without having to provide sensitive personal information. Secondly, having a kitchen on-campus stocked with food so students can prepare their own meals. Oftentimes the food that is provided by the school’s food bank is not accessible because you need a fridge or stove in order to eat it.”

Student homelessness is a problem that goes unseen. For many who experience it, they resist speaking out for fear of being shamed by their circumstances and ridiculed by others. 

-Zeinab Mohamed, 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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When a subway passenger dies by suicide, workers suffer too

00Featured news, Health, Post-Traumatic Stress Disorder, Suicide, Trauma, Work August, 19

Source: Lily Banse at Unsplash, Creative Commons

In an article in a Canadian daily, The Globe and Mail, Oliver Moore reported that during 2016, 21 suicide attempts occurred on Toronto’s subway system. In fact, a study published by the Journal of Urban Health considers suicide on subway platforms to be a public health issue.

Subway delays by attempted suicide not only affect passengers, the victims and their families, but drivers as well. Subway workers and drivers who have witnessed a suicide have been reported to have Post-Traumatic Stress Disorder (PTSD). Research suggests that those exposed to human-generated traumatic events have a greater chance of developing PTSD.   In an interview with Vice Magazine, psychologist Wilfried Echterhoff discussed the long-lasting psychological trauma workers face when confronted with a death on the worksite:

“Some people have never been confronted with death before…To suddenly be confronted with it in such a violent way can lead to PTSD or a serious depression.”

In an interview with the Trauma and Mental Health Report, Robert (name changed), a retired subway worker with over 30 years of experience, described an incident he faced while working: 

“One Saturday afternoon maybe around 11:00 a.m. or 12:00 p.m., I witnessed a lady jump off the subway platform. I needed to go upstairs and tell my supervisor and my supervisor told me that my face was all white. They kicked everyone out and only the police and ambulance were allowed to come in.” 

Nik Douglas, a train driver who worked for the Northallerton subway station in the UK, noted in an interview with The Independent:   

“When I was on my own I’d burst into tears for no reason, I found sleep hard and I’d have flashbacks during the night and day. I could be in a room full of people with a really good party atmosphere but feel alone and isolated. That’s one of the biggest things I remember, feeling alone… It changed my life instantly from who I was to what I have become. Some people aren’t affected, but two years after it happened I’m still not the same person.”

In deciding what was best for his mental health, Nik took six months off work to deal with his PTSD. Recent studies suggest that in Canada, 6.5% of subway workers have been absent from work due to witnessing suicides while working. Last November, this rate was at its highest with 7.44% of employees absent. Some employees are unable to return to work altogether and opt to receive compensation from their employers.

Nik experienced intrusive distress and feelings of isolation. Kevin, a 39-year-old subway driver expressed his feeling of being responsible for the suicide of a man:

“When he looked at me and our eyes met, time just stood still. It felt like driving your car over railroad tracks, that rumbling feeling you get … I realized then that I just killed somebody.”  

In his years of working at the subway, Robert explained the brief protocol subway workers go through once they have witnessed a suicide:

“The subway drivers have to talk to the police after that happens. They always have to stay and give a statement. Then they’re taken off duty for that day. Then they get sent home or to counselling. It depends on what the driver wants to do. It just started recently in the last five or six years.  The company asks if the drivers want to speak to someone.”

Effective suicide preventions have been created to decrease the suicide rate in subway stations and increase safety. Subway stations in Tokyo have implemented glass doors that open for passengers to board the subway only once it has arrived in the station. Other preventions put in place are blue lights and mirrors set up to discourage suicide attempts. In London and Paris, these forms of preventions have been effective too. 

In addition, intervention programs, including the Gatekeeper Program, exist for those who are feeling suicidal.  However, interventions put in place for subway workers who experience suicides are rare. Most workers deal with the effect of these experiences on their own. In Robert’s words:

“If something is going to happen, it’s going to happen.  There’s nothing you can do. They don’t tell you this can happen or that can happen.  They won’t tell you what can happen when you sign up for this job.  They don’t tell you that workers deal with this.  They don’t train you how to deal with it.  They won’t ever tell you what to expect even when training people.”

Social support is argued to be one of the most powerful factors in recovering from PTSD and is known to decrease risk for depression, foster resilience, and reduce stress in those who have experienced traumatic events.  Mindfulness-based stress reduction therapy has shown to reduce stress and increase recovery in those with PTSD.  

Lucia Chiara Limanni, 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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Universities Can Do Better To Help with Mental Illness

00Anxiety, Attention, Emotion Regulation, Featured news, Social Life, Stress August, 19

Source: Filip Bunkens at Unsplash

A good friend of mine, Jessica (name changed), was diagnosed with social anxiety disorder in September of 2017, the same year she enrolled in university. And, as is the case with many other mental illnesses, her anxiety took over her life.  

Post-secondary students all over the world face mental illnesses that affect their schooling.  Research done at the University of Alberta suggests that half of the student population felt “overwhelming anxiety” within the past 12 months of attending university. In an interview with the Trauma and Mental Health Report, Jessica shares her experience dealing with anxiety at school as a “feeling of constant worrying that goes away only when she leaves class”.  

After taking some time to review her current situation, Jessica dropped out of school. Psychologist Martin Antony, professor at Ryerson University in Toronto, and author of the Shyness and Social Anxiety Workbook discussed the impairment those with anxiety-related disorders can experience:  

  “It is not uncommon for people with especially high levels of anxiety to drop out of school completely or take a leave of absence from school.”

Despite this fact, there has been little research on the relationship between anxiety and quitting school. One study found that out of 201 individuals with anxiety disorders, 49% dropped out of school, with 24% of dropouts attributing their decision to their anxiety. These students often struggle with going back to school and completing their degrees. The main hindrance Jessica faces is the delay in receiving her degree:

“The art program has specialized studio classes where they teach pottery, photography, sculpting, painting, stone carving, things like that. I don’t know how long it’s going to delay my schooling.”

Without being physically present in these classes, Jessica fails to complete her degree requirements.  Inevitably, this puts her behind in finishing her typical four-year degree.

The Anxiety and Depression Association of America suggests that accommodations can help alleviate anxiety experience at school. In the U.S., students have the right under the Individuals with Disabilities Education Act (IDEA) to request accommodations such as writing in alternative exam rooms, or receiving longer time for exams.  

However, these accommodations are quite general, and may do more harm than good. Clinical psychologist, Anu Asnaani, at the Center for the Treatment and Study of Anxiety and assistant professor at the University of Pennsylvania explains the importance of meeting the needs of each student. As anxiety and depression based disorders require specialty interventions, Asnaani believes that school administered accommodations will not treat them.

Similarly, Martin Antony agrees that accommodations recommended by schools may help maintain anxiety rather than help students overcome it:

“One of the most powerful ways of overcoming a fear of being around others is to practice being around others. However, accommodations may run counter to this idea by isolating students. Accommodations such as these may help people to feel more comfortable in the short term, but they may also interfere with overcoming fear in the long term.”

Jessica recalls her experience with the counselling and disability service at her university as unhelpful. She received accommodations of lecture notes, a seat with an empty chair on each side of her, the ability to sit close to the back of the room, and alternative exam testing. Yet, none of these accommodations helped reduce her anxiety.

Regarding counselling, disability, and student wellness centers across all post-secondary institutions, Asnaani recommends: 

“If the techniques and therapy that the counselling centers at school administer are not working for the students, then being able to make a referral to community partners is important.  Other resources that students can look at for help or finding a suitable therapist are the Association for Behavioral and Cognitive Therapies and Anxiety and Depression Association of America.” 

Inevitably, Jessica enrolled in online classes to slowly continue working towards the completion of her degree. However, this isn’t always a solution, especially for individuals in hands-on programs, such as art. For Jessica, the online classes helped eliminate her anxiety.  She is now able to work on her course work in the comfort of her own home. 

Anxiety therapies often teach their patients how to be their own therapist. When asked about mechanisms students learn in therapy, Asnaani and Antony agree that exposing yourself to the feared situation over time and cognitive-behavioural therapies can help reduce anxiety in students.  

For Jessica, the experience has been life changing.  She often wishes that she had received more support from her school and offers this piece of advice to others in similar situations:

“Take things step by step, you and your well-being are the most important. It’s okay to take time for yourself and there is no rush to finish school. There are other routes to take if you are unable to attend classes, such as taking online classes like I’ve been doing. You are not alone in this situation and there are always people to talk to and resources available to you, whether at the school or even online.”

Fortunately, for Jessica, online classes enabled her to complete some of her first-year elective courses. Unfortunately, there is still a lack of adequate tailored accommodations for post-secondary students experiencing mental disorders preventing them from gaining the education they need for their future careers.

– Lucia Chiara Limanni, 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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What Happens After Children Are Freed From Captivity?

00Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

The 13 Turpin children were held captive in their house, where they were limited to only one meal a day and one shower a year. Twelve of the children were subject to extreme physical abuse, and one suffered from sexual abuse. The eldest child, who was 29 years old, weighed only 82 pounds.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath. 

Research on children held captive is sparse, however, there are some studies of other high-profile cases where children suffered extreme deprivation. A well-known one is Genie, a child who was isolated in a small bedroom where she was strapped to a toilet seat during the day, or trapped in a crib with wire covering. She received absolutely no stimulation and was only fed infant food. 

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude Julien, a psychotherapist from France who herself was subjected to captivity by her parents, now treats patients who are victims of trauma. In an interview with The Trauma and Mental Health Report, Maude describes her experiences growing up.

“For about 15 years, I practically never went out. I never went to school; my mother was my home-school teacher. My father wanted to create a superhuman, uncorrupted by this world,” Maude said. “I had to undergo a ‘training of the mind’ in order to become this ‘superhuman.’ He wanted me to believe that the world outside was terrible.”

Maude described the effects of severe trauma caused and explained her recovery process.

“I had to learn the simplest, most basic social conventions like speaking to strangers or finding my way around. Above all, I had to learn how to talk, because my long periods of forced silence had made me almost mute,” Maude said.

“Even though I was learning all this, I was still imprisoned behind the ‘gates’ of conditioning. I could still hear in my head, day and night, the tick-tock of my father timing everything,” she said.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than ten years to overcome the consequences of her imprisonment.

Maude explains how reading, and connecting with animals and other people helped her cope with trauma. She attributes her ability to get out of the house to her music teacher and describes her second husband’s parents as an instrumental part in helping her mature.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it and live with a heavy feeling of shame and guilt. 

“It’s usually shame that prevents victims from seeking help,” Maude said. “They have also a feeling of isolation, because a predator like my father, makes the victim believe that he alone can love and protect them.”

Children reported in these high-profile cases may feel guilty for having “betrayed” their parents, yet may also feel relief for having escaped. She describes living with this duality as being very “painful.”

“They will have to free themselves from the ‘psychological leash’ imposed by their predator,” Maude said. “They will have to learn how to trust certain people, and they will have to learn how to recognize other predators and stay away from them. Most of all, they have to learn how to trust themselves.”

—Amanda Piccirilli, 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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After Children Are Freed From Captivity

00Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

The 13 Turpin children were held captive in their house, where they were limited to only one meal a day and one shower a year. Twelve of the children were subject to extreme physical abuse, and one suffered from sexual abuse. The eldest child, who was 29 years old, weighed only 82 pounds.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath. 

Research on children held captive is sparse, however, there are some studies of other high-profile cases where children suffered extreme deprivation. A well-known one is Genie, a child who was isolated in a small bedroom where she was strapped to a toilet seat during the day, or trapped in a crib with wire covering. She received absolutely no stimulation and was only fed infant food. 

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak, but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude Julien, a psychotherapist from France who herself was subjected to captivity by her parents, now treats patients who are victims of trauma. In an interview with The Trauma and Mental Health Report, Maude describes her experiences growing up.

“For about 15 years, I practically never went out. I never went to school; my mother was my home-school teacher. My father wanted to create a superhuman, uncorrupted by this world,” Maude said. “I had to undergo a ‘training of the mind’ in order to become this ‘superhuman.’ He wanted me to believe that the world outside was terrible.”

Maude described the effects severe trauma caused and explained her recovery process.

“I had to learn the simplest, most basic social conventions like speaking to strangers or finding my way around. Above all, I had to learn how to talk, because my long periods of forced silence had made me almost mute,” Maude said.

“Even though I was learning all this, I was still imprisoned behind the ‘gates’ of conditioning. I could still hear in my head, day and night, the tick-tock of my father timing everything,” she said.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than 10 years to overcome the consequences of her imprisonment.

Maude explains how reading, and connecting with animals and other people helped her cope with trauma. She attributes her ability to get out of the house to her music teacher and describes her second husband’s parents as an instrumental part in helping her mature.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it, and live with a heavy feeling of shame and guilt. 

“It’s usually shame that prevents victims from seeking help,” Maude said. “They have also a feeling of isolation, because a predator like my father, makes the victim believe that he alone can love and protect them.”

Children reported in these high-profile cases may feel guilty for having “betrayed” their parents, yet may also feel relief for having escaped. She describes living with this duality as being very “painful.”

“They will have to free themselves from the ‘psychological leash’ imposed by their predator,” Maude said. “They will have to learn how to trust certain people, and they will have to learn how to recognize other predators and stay away from them. Most of all, they have to learn how to trust themselves.”

—Amanda Piccirilli, 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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When Bipolar Disorder Brings Marital Distress

00Bipolar Disorder, Depression, Featured news, Marriage, Stress, Suicide July, 19

Source: Cristina Jiménez Ledesma at Flickr, some rights reserved

In a busy urban community church, Reverend John Tahir, a parish minister, enjoys many moments helping and advising members of his congregation. One of his more meaningful responsibilities is counselling young couples, providing marriage education to them with the hopes of preparing them for this new chapter in their lives. The importance of this task is not lost on Tahir, as he knows far too well that significant issues such as money, boundaries, and lack of communication to name a few, can result in marital challenges. The reality is that marriage can be a rather difficult journey. 

Dr. Gary Chapman’s book, The Five Love Languages, examines marital discord resulting from a lack of effective communication. The premise is that every person enters a marriage with their own definition of what love means. As a result of these inevitable differences, people have distinctive love languages. According to Chapman, problems in marriage arise primarily because people often expect their spouse to demonstrate love in a way that is compatible with their own love language.  

It is not hard to imagine that living with a spouse struggling with a mental health disorder only adds to the complexities of marriage. The divorce rate varies among mental health disabilities because each condition presents its own unique challenges. For example, those who have phobias and obsessive compulsive disorders have a much lower divorce rate than affective disorders such as bipolar disorder and depression. Though there are four different types, bipolar disorder is characterized by drastic mood shifts with either manic or depressive episodes. Those with this affective disorder can experience high, elated, and energized moods while experiencing hopeless and depressive ones at other times. It is interesting to note that the divorce rate of those with bipolar disorder is very high—approximately double the rate of the general population.

In an interview with the Trauma and Mental Health Report, Brian (name changed for anonymity) shares his experience of having bipolar disorder: 

“It’s been hell struggling with suicidal thoughts every day. I’ve lost a sense of joy and optimism.  I find it difficult to complete even regular daily activities.”

Brian’s struggles have taken a great toll on Christina, his wife. Spouses of individuals with bipolar disorder, like Christina, may be at increased risk of stigma, stress, depression, psychiatric symptoms and a decreased quality of life:

“My life revolves around my husband. I’ve taken on a lot of additional responsibilities and it has affected my physical and mental wellbeing.” 

Christina recalls being late for a recent meeting because she was afraid that her husband was going to kill himself: 

“I didn’t feel comfortable leaving him at home that day. I had my mother-in-law come over so that I could attend my meeting.”

The relational interaction between spouses, where one is a patient and the other a caregiver, can contribute to additional marital challenges. Research suggests that neither patients with bipolar disorder, nor their spouses were accurate in describing each other’s experiences and concerns when it came to the impact of the disorder on their lives. These differing perspectives can lead to marital difficulties because each partner’s thoughts and feelings are misunderstood and challenged. The issue speaks to a lack of effective communication, which Chapman believes can contribute to the breakdown of the relationship.  

Brian and Christina both emphasized certain themes that were important to themselves while neglecting other aspects that were important to the other. When asked to reflect on a specific experience related to Brian’s psychiatric treatment, the couple highlights different concerns:

Christina: “I feel frustrated and helpless due to the lack of support and guidance from medical professionals. I have to constantly fight for Brian to receive proper treatment.”

Brian: “I have first-hand experience as a patient. When I’m in the hospital, I feel like I lose my identity as an individual. I am treated as just one among many other patients with a mental illness.”   

Lack of effective communication appears to be a common theme in all marital problems, which becomes further impaired when coping with the difficult challenges associated with bipolar disorder.  

In his book, Chapman asks:

“Could it be that deep inside hurting couples exists an invisible ‘emotional love tank’ with its gauge on empty?…If we could find a way to fill it, could the marriage be reborn? With a full tank, would couples be able to create an emotional climate where it is possible to discuss differences and resolve conflicts? Could that tank be the key that makes marriage work?

—Young Cho, 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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Caring for a Loved One with Alzheimer’s Brings Benefits

00Aging, Burnout, Caregiving, Featured news, Health, Memory June, 19

Source: Edwin & Kelly Tofslie at Flickr, Creative Commons

“I’m always in the present. I have to be one step ahead of David. Things go missing all the time in this house—the remote, mail and even the utensils. I’m down to a handful of forks! It would be simple if I could just lock the door to store some important items, but he doesn’t like that.”

Mary (name changed for anonymity) is the primary caregiver for David, her husband of 50 years who is in the final stages of Alzheimer’s disease. For Mary, ‘being in the present’ refers to her constant worry about even the most mundane elements of life that many take for granted. 

Recent estimates show that over 5 million Americans are living with Alzheimer’s—a number expected to rise to as high as 16 million by 2050. Currently more than 15 million Americans function as primary caregivers and provide essential, albeit unpaid care for people with Alzheimer’s and other dementia-related illnesses, taking on responsibilities such as bathing, grooming, dressing, feeding, and providing additional daily living assistance. At times, caregivers may even have to manage unexpected and unprovoked acts of violence, paranoia, and inappropriate sexual behaviours.  Mary understands this reality all too well. In an interview with the Trauma and Mental Health Report she confirms this additional stress:

“I take David everywhere I go. I’m always scared that he will do something unpredictable, embarrassing and grossly inappropriate.”

This demanding and overwhelming role can take an emotional toll, putting caregivers at risk of becoming socially isolated, exhausted, and suffering from burnout. It is clear that there are drawbacks to being a primary caregiver and Mary has experienced many of them, such as loneliness, guilt, embarrassment, frustration, and even verbal and physical abuse. Mary and many individuals in similar circumstances, continue to do so at the expense of their own wellbeing.

But a growing body of research shows that despite challenges, there are positive aspects associated with providing such care for another person. Studies report that some experience an enhanced sense of meaning in their lives, while others feel a sense of empowerment as they learn how to navigate the health and social systems related to the illness. Caregivers have also been found to frequently reminisce on happy memories, enjoy pleasurable activities, and develop a deeper appreciation for time spent with their loved ones.

When reflecting on their life and their current situation, many of the positive benefits of caregiving resonate with Mary:

“Throughout our marriage, we lived separate lives. At times, I resented David because he would often leave me to go play golf.  I felt a distance between us. Now our situation has forced me to spend time with him and in some ways, I’m getting what I longed for. I’ve become closer to family members who have assisted me with David’s care for which I am so grateful. You truly learn who is there for you.”

In addition to gaining a deeper appreciation for her family, Mary acknowledges that she has also grown substantially as an individual:

“I have become more patient and have learned to effectively de-escalate situations. I am confident I can handle a lot more than I could before.”

Speaking with her, it is evident that Mary has come to appreciate the little things in life:

“Despite our daily struggles, there are precious moments; moments when I see glimpses into his soul. Some days when I pick him up from the nursing home, he is eagerly waiting for me by the window. I’m sure he thinks that I’m solely his caregiver. But, I can see his vulnerability and I know that he needs me.”

Many factors appear to influence caregiver resilience: the intensity and context of the provided care, socio-demographics such as age, gender, education, the availability of social and community resources, and the caregiver’s psychological attributes. Though Mary fully acknowledges the struggles and stresses that come with her role caring for David, she remains resilient. And no matter how difficult her situation may get, she stays focused on the gifts this experience has brought her. 

-Young Cho, 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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Coping Through the Lens of a Camera

00Attention, Career, Ethics and Morality, Featured news, Media, Trauma, Work May, 19

Source: American Documentary, Inc at Flickr, Creative Commons

Documentaries tell compelling stories. But while we become captivated by moments on screen, we forget there is someone behind the camera, watching events unfold in real-time. Cameraperson, a recently released documentary by Kirsten Johnson, portrays her experiences filming documentaries, and it includes footage captured while traveling and filming.

Johnson has travelled the world – from the United States, to South America, to Europe – filming documentaries on topics such as America’s hunger problem or a notorious FBI burglary. She worked on Citizen Four, a documentary about a former CIA agent leaking government information. Sometimes, the stories are about traumatic historical events such as the Rwandan Genocide and the Bosnian War. She has visited the sites of mass killings and heard the stories of people who have survived tragedies. 

I had the opportunity to speak with Johnson, and learn about her experiences. Born in Seattle, she was always curious about the world and wanted to travel. She describes herself as a “visual person.” And as the daughter of a psychiatrist, she always wondered about the unique experiences of others. Her personal background, along with an interest in political inequalities, led her to pursue a career in documentary filmmaking.

In an interview with the Trauma and Mental Health Report, Johnson explains why she followed this path:

“As a doc filmmaker you’re trying to help reveal a human rights injustice, or a problem that people haven’t looked at or paid attention to, and you know people don’t want to hear it. People don’t want to watch a film about rape in Bosnia. Then the question is, how do you find a way for people to look at things they don’t want to look at?”

I asked Johnson about one of her first jobs filming documentaries:

“I filmed over 200 interviews with holocaust survivors, it was one of the first experiences I had in filmmaking and being deeply interested in how people tell the stories of their trauma. I got interested in the stories themselves, and how people remember them because some people remember different aspects. What I found surprising was that over half the people I interviewed had never talked to anyone about it before—this was the first time they had ever talked about it. There was just a curiosity in me, how could it be that somebody experienced something so devastating and never spoke of it?”

Many filmmakers have likely had similar experiences, so I was curious if Johnson had ever shared her experiences with other people in the industry:

“As camera people, we work so much we rarely get the chance to talk together. I have always talked a great deal with the people who I film with as they’re listening and I’m watching. We process our experience together. Or the translators, those are the kinds of people I’ve had deep conversations about things we were witnessing together.”

Johnson described some of the unspeakable events she had witnessed, and how she copes with the trauma while still doing her work:

“There’s often an aesthetic pleasure even though you may be filming a terrible moment—somehow, the light, the fabric, their skin, what they are wearing, helps you as the camera person cope with the things you are taking in. That’s what I realized when I was looking back at my own footage. It’s this active creative process you’re involved with when you’re trying to organize it and see it differently and search for the beauty in it.”

She described one such experience with a Bosnian family:

“We were filming about how rape was a weapon during the Bosnian war and listening to horrible stories about people who had to leave their homes. Being with one of the few families who had returned to their home—it was beautiful to witness that.”

When asked about the particularly overwhelming and painful moments she is confronted with during film shoots, Johnson incorporates practical and simple strategies to maintain “psychological equilibrium”. 

“ I try to sleep enough, eat with relish, laugh a lot and move in all kinds of ways. I read what others have written, talk to friends, see a therapist who has known me for years, watch movies and play with my kids. If I have been traveling too much, I stay home and if I have stayed somewhere too long, I go somewhere new and the world surprises me one more time.” 

The importance of telling stories is integral to documentaries. Filmmaking is about more than just reporting on tragedies, it’s about giving people a voice. Yet, more often than not, we don’t think about the person behind the camera, who witnesses trauma in order to share stories with the world.

-Amanda Piccirelli, 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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When Doctors Are At-Risk for Suicide

00Burnout, Depression, Embarrassment, Emotion Regulation, Featured news, Health, Suicide May, 19

Source: Feature: skeeze at Pixabay, Creative Commons

They had known each other well enough in the early days of medical school, when they were students studying well into the night. After graduation, they went their separate ways, each assuming the other was doing well.

“I wanted you to hear it from me,” a colleague sadly said on the phone. Dr. Ranjana Srivastava nearly fell to the pavement when she was told that her long-time friend and colleague—a clinician, wife, and devoted mother—had died by suicide.

Unfortunately, this is not the first that time Dr. Srivastava had to face the suicide of a colleague. In a piece she wrote for The Guardian, Srivastava explains:

“Forced smiles and tough hides abound in the workplace, where always being ‘fine’ is a badge of honour. This is why it can be so difficult to distinguish doctors who will indeed be fine from those who need help.”

Research shows a higher rate of mental health problems among physicians. A 2013 report estimates over 25% of doctors in Australia having at least a minor psychiatric disorder, with 10% reporting suicidal thoughts in the past year. A survey of 2000 U.S. physicians showed that roughly half believed they met criteria for a mental illness in the past, but had not sought treatment. And in Canada, recent research estimates over 26% of Canadian doctors suffer professionally due to poor mental health, with 20% of them reporting they had been depressed in the last 12 months. Overall, roughly 30% of physicians worldwide have depression or symptoms of it, according to an extensive review published in the Journal of the American Medical Association (JAMA).

Why is this the case? The answer isn’t all that clear, but according to physician and social worker Katharine Gold and colleagues, stigma is to blame. Their research looked at survey responses of over 2000 female physicians, and it showed that stigma attached to mental illness is greater among medical trainees and physicians than in the general population. According to one respondent:

“I have been discriminated against in a department after disclosing my history of well-treated depression to my department chief.”

And this is not an isolated incident. Studies show that 50% of doctors are less likely to work with a colleague who has a history of depression or anxiety disorder, with four in ten admitting to thinking less of such a colleague. And throughout the years, healthcare organizations have favoured a punitive approach when addressing the issue of physician mental illness, rather than a supportive one. So disclosing mental health issues by a medical doctor can pose a real threat to licensing, career, and reputation, leading to reluctance to seek help.

In an interview with the Trauma & Mental Health Report, medical student Jamie Katuna explains the predicament physicians face:

“Getting care could mean problems for doctors. If they seek help for mental health issues and if someone decides they are ‘unstable’ and shouldn’t be seeing patients, that physician is out of a job and would have a really hard time finding another one. So instead, doctors suffer in silence.”

When deteriorating mental health makes it difficult to work, many physicians ignore their symptoms and continue to work anyway, often self-medicating with drugs or alcohol to avoid the perceived embarrassment of having a psychological disorder.

Steps are being taken to bring awareness. Many universities and medical organizations are starting conversations about physician wellness and stigma reduction. Physicians and medical students who have lived through suicide attempts, depression, and other mental health issues are standing up for themselves and each other. Likewise, organizations such as the American Foundation for Suicide Prevention and the American Medical Association have recommended reforming medical licensing questions to make it clear that physicians may get help without fear of negative consequences. Despite the growing support, Thomas Schwenk of the University of Nevada School of Medicine noted that change isn’t happening fast enough:

“A lot of [conversations about mental health stigma are] very difficult and very slow to happen, and unfortunately tragic incidents like the two suicides in Quebec and other suicides across the country are still occurring because it’s taking time to change that culture.”

There are some resources available. In Canada, organizations like Physician Health Program and the Canadian Medical Association provide a range of direct services for physicians and medical students at risk of, or suffering from, substance use, psychiatric disorders, or occupational stress. The interventions offered can include awareness workshops, referral to treatment, and monitoring, all while maintaining confidentiality. Also, online resources such as ePhysicianHealth and Combating Stigma are available.

Most solutions exist at a personal or program level, but the problems are pervasive and affect the entire structure of healthcare education. According to Katuna:

“The culture of medicine should undergo amazing and radical transformations. We need to redesign how we implement medical education.”

Systematic problems require systematic solutions and until then, medical professionals remain at risk.

— Ilia Azari, 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