Category: Featured news

Robert T Muller - Toronto Psychologist

Mental-Health Stigma All Too Common in Iran

70Depression, Featured news, Health, Psychopathy, Stress, Trauma March, 18

Source: PakPolaris at Deviant Art, Creative Commons

A Minor Leap Down, an Iranian film featured at international film festivals in Berlin and Toronto, illustrates the struggle of a 30-year-old Iranian woman named Nahal, whose deteriorating mental health is undermined by her family.

When Nahal is told she’s had a miscarriage, instead of seeking support from her family—who have, in the past, refused to recognize her struggle with depression—she keeps the news to herself, leading to desperation.

Stigma surrounding psychological disorders in Iran often leads to isolation, as fear of judgment and ridicule creates barriers to pursuing treatment. Some reports show that 26.5 percent of Iranian women and 20.8 percent of Iranian men have mental-health difficulties.

In an interview with the Trauma and Mental Health Report (translated, Farsi to English), Hamed Rajabi, director of A Minor Leap Down, explains:

“This social system is only concerned with how people work and perform, and when that performance is lowered, their behavior is instantly condemned.”

Research by Ahmad Ali Noorbala and colleagues from Tehran University of Medical Sciences shows women in Iran have a greater incidence of mental disorders than women in Western cultures. One contributing factor may be that women in Iran are often confined to the home, leading to isolation and poor domestic conditions.

After the loss of her unborn child, Nahal spirals into deep depression, deciding not to remove dead fetal tissue from her womb. When she tries to address the issue with her mother and husband, she’s turned away.

Familial relationships and reputation are important aspects of Iranian culture. Mental illness in a family member is viewed as a familial flaw.

According to research published in the Journal of Health and Social Behaviour by Erin Cornwell of Cornell University and Linda Waite of the University of Chicago, social relationships are particularly important for those coping with mental illness; social withdrawal aggravates loneliness, stress, and feelings of low self-worth.

Nahal’s silence about her mental illness also relates to a worry that she’ll be forced to resume antidepressant medication, which she took prior to pregnancy. Medications like these are seen as first-line treatment in Iran.

In A Minor Leap Down, filmmaker Rajabi addresses the over-prescription of psychotropic medication in Iran, explaining:

“Depression signifies that a part of our lives hurt—and taking pills won’t solve anything until we distinguish which part of our life is causing the problem.”

Although recognition of mental-health problems in Iran has arguably increased over the past few years, considerable stigma still exists.

Awareness can translate to an enhanced understanding of the complexity of mental-health problems in a culture that holds rigid attitudes about mental health and illness.

–Nonna Khakpour, 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

Robert T Muller - Toronto Psychologist

Workplace Alcohol Tests: Where Do We Draw the Line?

40Addiction, Alcoholism, Career, Featured news, Health, Law and Crime, Work February, 18

Source: Bousure at flickr, Creative Commons

Keeping our personal and professional lives separate is something many of us strive for. But, as Johnene Canfield recently discovered, we only have so much control over this process. In the spring of 2015, Canfield was fired from her six-figure position as a Minnesota Lottery official after a DUI conviction and a stint in rehab for alcohol abuse. The following October, she filed a lawsuit to reclaim her job.

Canfield’s former employers say the reason they dismissed her was to ensure the safety of other employees and clients, as well as to preserve employee productivity at the Minnesota Lottery. But these reasons reveal how problem drinkers are viewed as incapable of workplace competence.

According to Linda Horrocks, a former health care aide at Flin Flon’s Northern Lights Manor, a long-term care home for seniors, “Employers often act based on what they think they know about addiction and alcohol addicts”—but not necessarily on the reality of living with addiction. Horrocks, like Canfield, was fired for alcohol addiction.

She was eventually re-hired by the Northern Regional Health Authority, the health-governing body in northern Manitoba that oversees employment at Northern Lights Manor. But her employer required her to sign an agreement to abstain from drinking on and off the job, and to undergo random drug and alcohol testing.

In an interview with the Trauma and Mental Health Report, Horrocks said:

“I didn’t object to the testing, but I didn’t want to commit to never drink again on my own time. My union even advised me against signing this agreement, because I would just be setting myself up for failure—I hadn’t gone through treatment yet. And so, I was fired again.”

Horrocks maintains that the employers’ offer to help her abstain from alcohol completely was based on misconceptions about alcoholism and treatment.

“The managers knew a little bit about alcoholism, as family and acquaintances had gone through treatment. They just decided that the counselling that I was going through with Addictions Foundation of Manitoba was not enough because it is a harm-reduction program, not a direct path to complete abstinence.”

Horrocks understands why some may think that abstinence is the only way:

“After all, if you’re a recovering alcoholic, alcohol is deemed ‘your enemy.’”

Proponents for abstinence-based treatments argue that periods of abstinence can repair brain and central nervous system functions that were impaired. Having problem drinkers self-moderate alcohol intake has had variable success in the past. For some, the temptation of having “just one drink” can be a precursor to relapse. And for them, total abstinence may be a better approach.

But Horrocks explains, abstinence may not be the best approach for everyone. The harm reduction model accepts that some use of mind-altering substances is inevitable, and that a minimal level of drug use is normal. This approach also recognizes research showing experimental and controlled use to be the norm for most individuals who try any substance with abuse potential.

Harm reduction seeks to reduce the more immediate and tangible harms of substance use rather than embrace a vague, abstract goal, such as a substance-free society. During intervention talk sessions, therapists explore and attempt to modify drinking patterns or behaviours with the client. The clinicians support autonomous decision-making and independent goal setting related to drinking.

Evidence published in the Canadian Medical Association Journal shows that these programs aim to reduce the short- and long-term harm to substance users and improve the health and functioning of these individuals. There are also benefits to the entire community through reduced crime and public disorder, in addition to the benefits that accrue from the inclusion into mainstream life of those previously marginalized.

Benjamin Henwood and colleagues from the University of Southern California also show that those who work on the front-line of severe mental illness and addiction prefer the harm-reduction approach to complete abstinence. Yet few employers have taken this approach into account when deciding the fate of employees with proven substance abuse problems outside of the workplace.

Horrocks’s and Canfield’s experience begs the question, where do we draw the line? How much say do employers have over their employees’ personal lives? It may just be that employers need to better respect the privacy of workers, so long as workplace productivity is not affected. And if employers maintain substance abuse policies that bleed over into the personal lives of staff, consideration of a harm-reduction approach is key.

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

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

Copyright Robert T. Muller. 

This article was originally published on Psychology Today

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Stigma Surrounds HIV-Positive Children in China

00Bias, Featured news, Health, Law and Crime, Trauma February, 18

Source: quaerion at DeviantArt, Creative Commons

In 2014, a young boy (pseudonym ‘Kunkun’ for anonymity) was banished from his village in Sichuan, China after being diagnosed with AIDS. The villagers did not understand the disease, so feared for their safety. In a CNN article, resident He Jialing expressed his concerns for his daughter who went to school with Kunkun at the time:

“My daughter is around his age, and goes to a boarding school now. What happens if she gets bitten while playing with him here at home? That boy is too dangerous.”

There are roughly 740,000 active cases of HIV in China. Misinformation and intense stigma surrounding HIV and AIDS often result in tragic consequences for HIV-positive children. For example, infected children are frequently banned from their schools and abandoned by their loved ones.

Xu Wenqing, an HIV/AIDS specialist with UNICEF China, revealed to The World Post that HIV-positive children are often segregated from their peers in school:

“If their HIV status has been disclosed, it’s very common that parents of other children complain to the school and force the school to separate their children from HIV positive children.”

But a boarding school in China called the Green Harbor Red-Ribbon School was created in 2006 to house roughly 30 HIV-positive children between the ages of 6 and 19. The school is a refuge for those who have been ostracized by their communities because of their illness. Other organizations are intervening as well.

At an orphanage run by the non-government Fuyang AIDS Orphan Salvation Association, children receive food, housing, education, and the necessary medications to control the virus. The director, Zhang Ying, explained to Reuters that psychological improvements are seen in the children under their care:

“Our children have a healthier state of mind now. When I first started to get to know these children, they had low self-esteem and were afraid of being discriminated against by others. After these few years, by staging different kinds of activities for them, the children no longer feel inferior and are more confident about themselves.”

Although a source of refuge for children, boarding schools and orphanages are not a long-term solution. They cannot cope with the sheer number of children who have HIV. In the case of Green Harbor, the haven can only protect children to age 19, at which point they are expected to leave. Unfortunately, the stigma faced by HIV-positive adults is also problematic.

In 2010, a court in China ruled against a man who said that he was wrongfully denied a job after his prospective employer discovered he was HIV-positive. The judge’s ruling contradicted an earlier law that was meant to protect infected individuals from being discriminated against by employers. The law stated:

“No institution or individual shall discriminate against people living with HIV, AIDS patients and their relatives.”

Even with legal protection, those with HIV are still regularly banned from schools and jobs, perpetuating the ignorance and fear surrounding a positive status. And, although medical treatment of AIDS is becoming increasingly accessible in China, a 2009 United Nations report stated many infected people do not seek treatment due to lack of knowledge or to concern that their status will be exposed.

Lack of consistent medical care, or lack of any treatment for that matter, presents huge risks to those with HIV. Without medication, HIV can develop into AIDS and cause death. Nonadherence to medication can lead to the development of drug-resistant strains of HIV that may lower quality of life, since patients may require stronger medications with more serious side effects. All the more reason to reduce the stigma associated with positive-HIV status, and to support treatment for those battling the virus.

In an effort to combat these problems, China’s first lady Peng Liyuan appeared in public advertisements holding hands and playing with HIV-positive children at the Red-Ribbon School. Plus, in 2010, a law limiting HIV-positive individuals’ entrance into and movement within China was lifted, but more needs to be done.

People with HIV in China are still ostracized, and laws meant to protect them from discrimination are circumvented. Until awareness and access to disease education improve, cases of people being denied schooling and jobs due to HIV status are likely to continue. Furthermore, children who do not live in a protected environment or who are too old for an orphanage will be left fending for themselves.

–Abbiramy Sharvendiran, Contributing Writer, The Trauma and Mental Health Report. 

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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A Brain Stimulation Device May Power Healing

00Cognition, Cognitive Stimulation Therapy, Environment, Featured news, Health, Neuroscience February, 18

Source: UCI Research at flickr, Creative Commons

Promising new treatments for neurological disorders are aimed at transforming disease management through neuroplasticity—the brain’s ability to alter its structure and function to adapt to changes in the environment. Leading-edge research is investigating how technological solutions can enhance neuroplasticity, boosting recovery from neurological damage.

In September 2016, Helius Medical Technologies announced positive results for its pilot study using a brain stimulation device to treat pediatric Cerebral Palsy (CP). CP affects muscle control due to injury or malformation of the brain. For the study, some participants received standard physiotherapy, while others received standard physiotherapy along with 20 minutes of brain stimulation with Helius’s experimental device.

Those who received brain stimulation showed improvements in muscle spasms and gross lower limb motor function, over those who did not. And, there were improvements in quality of life, social status, and cognitive function. One explanation is that the brain stimulation device heightens the brain’s natural ability to heal, producing enhanced benefits from physiotherapy.

This new method of brain stimulation is termed cranial nerve non-invasive neuromodulation (CN-NINM). A successful feasibility study was done for the treatment of Multiple Sclerosis (MS), and studies are underway for Parkinson’s disease, brain injury, and stroke. Participants are reporting improvements in mental health and wellbeing, such as greater mental clarity and increased energy. And benefits may extend to other neurological conditions as well.

The brain stimulation device used in these studies comes from decades of work by researchers at the University of Wisconsin-Madison, in the Tactile Communication and Neurorehabilitation Laboratory (TCN Lab). The team named the device the Portable Neuromodulation Stimulator (PoNS). The PoNS consists of a small array of electrodes that transfer an electrical current to the patient’s tongue, activating areas of the brainstem and cerebellum. Researchers theorize that this activation induces a sequence of activity that spreads through the brain.

In his book, The Brain’s Way of Healing, researcher and psychiatrist Norman Doidge explains how brain stimulation enhances neuroplastic healing. Doidge says an underlying cause of symptoms in neurological disorders is a dysregulation of electrical activity in the brain. He explains the sequence of activity caused by the PoNS may help the brain balance the electrical activity in its networks of brain cells. Balancing promotes rest and relaxation of these cells, allowing further stimulation alongside appropriate rehabilitative therapy. Stimulation reactivates dormant or dysregulated brain cells, and reintegrates them into functioning networks. Taken together, these changes make an ideal state for neuroplastic healing to take place.

Doidge shares a story about Broadway singer Ron Husmann’s remarkable recovery, which Doidge attributes to neuroplastic healing. Multiple Sclerosis led Ron to lose control of his bladder, mobility, and singing voice. Devastated by the loss of his voice and feeling he had nothing to lose, Ron travelled to the TCN Lab. He spent two weeks in intensive speech therapy, accompanied by brain stimulation with the PoNS device. By the end of his stay, Ron was singing and dancing again.

Brain stimulation and modulation are not new. They are central to established, FDA-approved treatments, such as deep brain stimulation (DBS), for neurological disorders. But, an important difference between the PoNS device and deep brain stimulation is that DBS is a highly invasive treatment. It involves the insertion of an electrode into the patient’s brain, and introduces several possible risks, including infections and strokes. And so, DBS is only used as a last resort. But the PoNS is non-invasive and presents few risks. Plus, the effects of the PoNS appear to continue even after the stimulation ends, whereas the benefits of DBS tend to end when stimulation is turned off.

Reported side effects for treatment by the PoNS, though, include increased salivation, mild headaches, and jaw pain. To reduce side effects, researchers teach participants swallowing and relaxation techniques that manage saliva and tension in the jaw.

Although early evidence for the PoNS device is impressive, skeptics point out that the number of participants used in the studies is small, which reduces confidence in reported outcomes. And although the team at the TCN Lab has shown that the PoNS increases activity in key brain areas, theories on how, precisely, it contributes to healing are still unclear.

Still, the PoNS shows promise as an addition to rehabilitation programs, and as a way of promoting physical and mental health. This technology is one to watch.

–Stefano Costa, Contributing Writer, The Trauma and Mental Health Report.

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

Robert T Muller - Toronto Psychologist

Firefighters Fight Stress as First Responders

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

Robert T Muller - Toronto Psychologist

Models Face Routine Exploitation, Mental Health Problems

130Body Image, Career, Eating Disorders, Featured news, Health, Post-Traumatic Stress Disorder January, 18

Source: Richard George Davis, used with permission

Former model Nikki Dubose has graced the covers of fashion magazines from Maxim to Vogue to Vanity Fair. She’s modeled in Barcelona, Paris, London, and Tel Aviv, and has walked the runway for numerous fashion designers.

Despite the glamorous lifestyle, Dubose is also a sexual assault survivor, and has struggled with eating disorders and mental-health issues. The story is a common one for many in the modeling industry. In an article for the Huffington Post, Dubose describes her experience:

“There were regular pressures to sleep with the director of my agency, constant ‘model dinners’ he organized that involved the owner of the agency, the director and his friends, and select models. This led to [my] being drugged and raped. [I was] raped by a photographer at a lunch that was organized by the director of my agency. Later, when I confronted the director, I was shot down.”

A recent report from The Model Alliance shows that nearly thirty percent of models report being sexually harassed, while twenty-eight percent have been pressured into sex with someone in the industry. Most of the models surveyed said they never told anyone—over two-thirds of those who did report the harassment to their agents were essentially ignored.

In a 2014 Flare Magazine exposé, model Misty Fox also revealed being mistreated by a photographer. Fox said he took photos of her without consent as she was using the bathroom:

“He went to the next cubicle, leaned over like a kid in primary school and took my picture.”

When she asked for the film:

“He just sneered, ‘What are you going to do, tell your daddy?’”

When Fox reported this incident to her agent, the reply was:

“‘Honey, it’s [name redacted]; he’s a really big deal. You’re lucky to be there. Get some good shots. Gotta go.”

Stories of photographers preying on young models are commonplace, and there are few consequences. In an interview with the Trauma and Mental Health Report, Dubose said:

Education and legislation are critical here—talking about sexual abuse in workshops so that models can develop safety plans, know what organizations to reach out to, and who to call if something happens. Prevention is key. Plus, predators need to be held accountable. Adopting regulations is also important to change the way the industry currently runs.”

Recently, Dubose worked alongside California State assembly-member Marc Levine on Bill AB 2539, which addressed the need for “workplace protections and health standards in the modeling industry.” This proposal was based on the current French law that prohibits using models with a Body Mass Index (BMI) of 18 or lower. Disappointingly, the bill was not passed by the California state legislature. Dubose said:

“The government continues not to take the necessary measures to ensure the safety of models in an industry that puts them at risk.”

People often associate modeling with a luxurious lifestyle, but working in the industry can have an impact on mental health. Studies in the past decade have shown that models run a higher risk of developing psychological disorders and report lower life satisfaction compared to other occupations. The Model Alliance reports that sixty-eight percent of models surveyed suffer from anorexia, depression, or a combination of both.

Dubose recognizes how common mental health issues are in her industry. Her memoir “Washed Away: From Darkness to Light” recounts the painful struggles and abuses she suffered as a young, aspiring model. Success often comes at a great cost, with young hopefuls developing an array of dangerous disorders and unhealthy coping mechanisms in the pursuit of fame. She explains:

“Models are often forced into doing things that they don’t want to do, such as losing weight for jobs or sleeping with photographers and other people in the business, and are often victims of wage theft. Most of these girls and boys are minors. It is not acceptable for them to be subjected to abuse, rape, financial theft, and so on.”

A movement for change is emerging in response to these problems. Dubose and many others like her are fighting to create a future where young models perform their jobs in a safe environment without worrying about sexual and financial exploitation, eating disorders, and mental-health issues. Dubose concludes:

“It’s only a matter of time before we see major, positive change. I’m confident.”

–Ty LeBlanc, Contributing Writer, The Trauma and Mental Health Report. 

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Parkinson's Takes its Toll on Family Caregivers

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

This article was originally published on Psychology Today

Robert T Muller - Toronto Psychologist

Parkinson’s Takes its Toll on Family Caregivers

20Caregiving, Family Dynamics, Featured news, Health, Neuroscience, Parenting, Stress January, 18
Source: Lesia Szyca, Trauma and Mental Health Report Artist, used with permission

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Rape Victims’ Reactions Misunderstood by Law Enforcement

40Depression, Featured news, Law and Crime, Neuroscience, Post-Traumatic Stress Disorder, Trauma January, 18

Source: Richard George Davis, used with permission

In 2008, 18-year-old Marie reported being raped at knifepoint in her apartment. Confronted by the police with allegations that she was lying, she conceded under pressure that the rape may have been a dream. Then, after being aggressively interrogated about her story, she finally admitted to making it up. She was subsequently charged with false reporting.

The report, however, was not false. In June 2012, Marc O’Leary pleaded guilty to 28 counts of rape and was sentenced to 327½ years in prison, including 28½ years for the rape of Marie.

Rape is unlike most other criminal offences. The credibility of the victim is often on trial as much as the guilt of the assailant, despite the fact that false rape accusations are rare (only an estimated 2-8% of cases are fabricated).

Sergeant Gregg Rinta, a sex crimes supervisor at the Snohomish County Sheriff’s Office in Washington, deemed that what happened to Marie was “nothing short of the victim being coerced into admitting that she had lied about the rape.” Rinta recounted in an external report of the department’s handling of the case how Marie was subjected to “bullying and hounding”, as well as threats of jail time and withdrawal of housing assistance.

Steve Rider, the commander of Marie’s criminal investigation, considers her case a failure. In an interview conducted by ProPublica and The Marshall Project, he explained:

“Knowing that she went through that brutal attack—and then we told her she lied? That’s awful. We all got into this job to help people, not to hurt them”

The seed of doubt was planted when the police received a phone call from Marie’s former foster mother Peggy and another foster mother, Shannon. One of their biggest issues was that Marie was calm while describing the attack, rather than upset.  Shannon stated:

“She called and said, ‘I’ve been raped. there was just no emotion. It was like she was telling me that she’d made a sandwich.”

Peggy remembers:

“I felt like she was telling me the script of a Law & Order story. She seemed so detached and removed emotionally.”

Hearing these accounts from those closest to Marie led the police to distrust her story, and the situation unfolded from there. In rape cases, a judgment of legitimacy often focuses on the victim’s reaction during and following the event instead of on the assailant’s behaviour.

Clinical psychologist Dr. Rebecca Campbell spoke about the neurobiology of sexual assault in a talk to the National Institute of Justice. She explained that victims are flooded with high levels of opiates during a rape—chemicals in the body intended to block physical and emotional pain, but which can also dull the victims’ feelings:

“The affect that a victim might be communicating during the assault and afterward may be very flat, incredibly monotone—like seeing no emotional reaction, which can seem counterintuitive to both the victim and other people.”

This misperception contributes to sexual assault cases not going to trial. Of rape cases that are reported, 84% are never referred to prosecutors or charged; 7% are charged but later dropped; 7% get a plea bargain; 1% are acquitted; and only 1% are ever convicted.

Dr. Campbell identifies part of this problem as the police misunderstanding victims’ reactions as they recount their trauma. Based on this confusion, police officers make assumptions about the legitimacy of what they hear and often discourage victims from seeking justice. Officers may even secondarily victimize them.

Secondary victimization is defined by Dr. Campbell as “the attitudes, beliefs and behaviors of social system personnel that victims experience as victim blaming and insensitive. It exacerbates their trauma, and it makes them feel like what they’re experiencing is a second rape.”

On average, 90% of victims are subject to at least one secondary victimization in their first encounter with the justice system. Victimization includes discouraging victims from pursuing the case, telling them it’s not serious enough, and asking about their appearance or any actions that may have provoked the assault.

These incidents have a profound effect on victims, as conveyed by Dr. Campbell, with many reporting feeling depressed, blamed, and violated. In fact, 80% feel unwilling to seek further help. As a result, many rape victims withdraw their complaint. To make matters worse, only 68% of rape cases are reported in the first place.

Sharing information on the neurobiology of trauma could be a powerful tool in educating police officers who don’t understand victims’ reactions. Evidence of the neurobiological changes that lead to flat affect or what appear to be huge emotional swings after an assault may help police better serve this population.

Furthermore, normalizing a range of reactions from rape victims, rather than accepting preconceived notions, may lead to a safer and more effective environment for reporting sexual assault. Knowledge about trauma can also serve to inform public discourse about sexual assault, as well as help victims to see their own reactions with compassion.

–Caitlin McNair, Contributing Writer, The Trauma and Mental Health Report.

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

cm-_-feature-1-_let-me-go-wv2-800x675-470x260-1.jpg

Rape Victims' Reactions Misunderstood by Law Enforcement

00Depression, Featured news, Law and Crime, Neuroscience, Post-Traumatic Stress Disorder, Trauma January, 18

Source: Richard George Davis, used with permission

In 2008, 18-year-old Marie reported being raped at knifepoint in her apartment. Confronted by the police with allegations that she was lying, she conceded under pressure that the rape may have been a dream. Then, after being aggressively interrogated about her story, she finally admitted to making it up. She was subsequently charged with false reporting.

The report, however, was not false. In June 2012, Marc O’Leary pleaded guilty to 28 counts of rape and was sentenced to 327½ years in prison, including 28½ years for the rape of Marie.

Rape is unlike most other criminal offenses. The credibility of the victim is often on trial as much as the guilt of the assailant, despite the fact that false rape accusations are rare (only an estimated 2 to 8 percent of cases are fabricated).

Sergeant Gregg Rinta, a sex crimes supervisor at the Snohomish County Sheriff’s Office in Washington, deemed that what happened to Marie was “nothing short of the victim being coerced into admitting that she had lied about the rape.” Rinta recounted in an external report of the department’s handling of the case how Marie was subjected to “bullying and hounding,” as well as threats of jail time and withdrawal of housing assistance.

Steve Rider, the commander of Marie’s criminal investigation, considers her case a failure. In an interview conducted by ProPublica and The Marshall Project, he explained:

“Knowing that she went through that brutal attack—and then we told her she lied? That’s awful. We all got into this job to help people, not to hurt them.”

The seed of doubt was planted when the police received a phone call from Marie’s former foster mother Peggy and another foster mother, Shannon. One of their biggest issues was that Marie was calm while describing the attack, rather than upset. Shannon stated:

“She called and said, ‘I’ve been raped.’ there was just no emotion. It was like she was telling me that she’d made a sandwich.”

Peggy remembers:

“I felt like she was telling me the script of a Law & Order story. She seemed so detached and removed emotionally.”

Hearing these accounts from those closest to Marie led the police to distrust her story, and the situation unfolded from there. In rape cases, a judgment of legitimacy often focuses on the victim’s reaction during and following the event instead of on the assailant’s behaviour.

Clinical psychologist Dr. Rebecca Campbell spoke about the neurobiology of sexual assault in a talk to the National Institute of Justice. She explained that victims are flooded with high levels of opiates during a rape—chemicals in the body intended to block physical and emotional pain, but which can also dull the victims’ feelings:

“The affect that a victim might be communicating during the assault and afterward may be very flat, incredibly monotone—like seeing no emotional reaction, which can seem counterintuitive to both the victim and other people.”

This misperception contributes to sexual assault cases not going to trial. Of rape cases that are reported, 84 percent are never referred to prosecutors or charged; 7 percent are charged but later dropped; 7 percent get a plea bargain; 1 percent are acquitted; and only 1 percent are ever convicted.

Dr. Campbell identifies part of this problem is the police misunderstanding victims’ reactions as they recount their trauma. Based on this confusion, police officers make assumptions about the legitimacy of what they hear and often discourage victims from seeking justice. Officers may even secondarily victimize them.

Secondary victimization is defined by Dr. Campbell as “the attitudes, beliefs, and behaviors of social system personnel that victims experience as victim blaming and insensitive. It exacerbates their trauma, and it makes them feel like what they’re experiencing is a second rape.”

On average, 90 percent of victims are subject to at least one secondary victimization in their first encounter with the justice system. Victimization includes discouraging victims from pursuing the case, telling them it’s not serious enough, and asking about their appearance or any actions that may have provoked the assault.

These incidents have a profound effect on victims, as conveyed by Dr. Campbell, with many report feeling depressed, blamed, and violated. In fact, 80 percent feel unwilling to seek further help. As a result, many rape victims withdraw their complaint. To make matters worse, only 68 percent of rape cases are reported in the first place.

Sharing information on the neurobiology of trauma could be a powerful tool in educating police officers who don’t understand victims’ reactions. Evidence of the neurobiological changes that lead to flat affect or what appear to be huge emotional swings after an assault may help police better serve this population.

Furthermore, normalizing a range of reactions from rape victims, rather than accepting preconceived notions, may lead to a safer and more effective environment for reporting sexual assault. Knowledge about trauma can also serve to inform public discourse about sexual assault, as well as help victims to see their own reactions with compassion.

–Caitlin McNair, Contributing Writer, The Trauma and Mental Health Report.

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today