Category: Grief

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Man to Monster

00Ethics and Morality, Featured news, Grief, Parenting, Pornography, Trauma November, 18

Man to Monster

Source: intographics at pixabay, Creative Commons

Anatomy of Violence, a film directed by Deepa Mehta, takes viewers on an emotional journey, illustrating how we create perpetrators of violence against women.

Mehta made the film after hearing about the gang rape of Jyoti Singh in Delhi, India. The BBC news reported that an off-duty driver took his bus for a joyride with five friends. When Jyoti boarded the bus, believing it was on-duty public transportation, the men raped her and beat her with iron bars. She died of the injuries.

According to the BBC, a rape victim cannot be publicly named under Indian law to protect the family from shame. In defiance, Jyoti’s mother Asha Singh stated in a public gathering after the attack:

“I say this in front of you all that her name was Jyoti Singh.”

The significance of her actions cannot be overstated. Jyoti’s mother said she had no shame in being known as the mother of a rape victim—it was the perpetrators who should feel shame.

Jyoti’s death sparked outrage across India, and brought public attention to the false belief that women are to blame when assaulted. Although media coverage focused on the victim, filmmaker Mehta decided to analyse what led the men to do what they did.

In an interview with The Reel, Mehta explains:

“I was in Delhi when this horrific incident [the rape of Jyoti] took place, and since then, I have been curious about what made or turned these men into brutal animals.”

Mehta thinks the rapists were not born monsters, but became that way. In the film, she explores factors contributing to their violent behaviour. She also humanizes the men by portraying their day-to-day lives, similar to the lives of other Indian men. They worked, they cooked, they had families.

This approach was highlighted when she spoke to the CBC about the film:

“I really wanted to humanize [the rapists]. [It] doesn’t excuse what they did, but it helps start a conversation about why these things happen.”

Early in the film, Vikas, one of the perpetrators, is shown hiding under the bed when his uncle enters his room and sexually assaults him. By age eight, Vikas is homeless.

Another character Dinesh grew up in a family where women were treated badly. He always received what he wanted, while his sisters were forced to take care of him and do household chores. In one scene, Dinesh’s sister is reading a book. Dinesh yells that he wants the book. His sister is then threatened by their father with violence if she denies her brother’s request.

Researchers at Georgia State University found similar themes in the backgrounds of men who were self-confessed rapists. The researchers analysed an “ask a rapist” thread on Reddit that posed the question: “Reddit’s had a few threads about sexual assault victims, but are there any redditors from the other side of the story? What were your motivations? Do you regret it?”

Someone responded with:

“I was an extremely isolated youth who came from a broken home, and my escape was the Internet… Most of the material [internet pornography] was very sexually aggressive towards women.”

Much like the characters in the film, this individual sees his environment as contributing to his violent behavior.

The responses to the Reddit thread also showed themes of: blaming the victim or their biology, expressing hostility toward women, and objectifying women. More than one motivation was typically found to underlie a single rapist’s actions.

-Anika Rak, 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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Talking about Death May Prevent End-Of-Life Suffering

80Anxiety, Decision-Making, Featured news, Grief, Health, Psychopathy December, 17
Source: Marica Villeneuve, Trauma and Mental Health Report artist, used with permission

Death comes unexpectedly. As City University of New York professor Massimo Pigliuccionce said, “You can evade taxes. But so far, you can’t evade death.” Just what is it, though, that we are trying to evade?

“We don’t know how or when we will die – even as we are actually dying,” wrote Joan Halifax, medical anthropologist and Zen teacher. “Death, in all its aspects, is a mystery.”

But we can talk. In conversation, we are able to clarify our wishes for end-of-life care, express our fear of the unknown, and grieve the loss of a loved one.

The “Death Café”, or “café mortel”, is a movement in which strangers meet to talk about death over tea and cake. The first “café mortel” was hosted in 2004 by Swiss sociologist and anthropologist Bernard Crettaz. In 2011, the movement migrated to the UK and took on the name “Death Café”. Their website states:

“Our aim is to increase awareness of death to help people make the most of their (finite) lives.”

In an article for Aeon magazine, freelance essayist Clare Davies described the kinds of topics explored at Death Café:

“The guests take turns to voice their thoughts and feelings across a wide range of subjects. How does it feel to lose a parent? What is existence? What matters most to us in life? The point is to talk. What is death like? What exactly are we afraid of? To what degree do our ideas on death influence how we live?”

But death isn’t an easy topic… even some doctors avoid it.

A 2015 study led by Vyjeyanthi Periyakoli at the Stanford University School of Medicine found that 86% of 1040 doctors said that they find it “very challenging” to talk to patients about death.

Yet, conversations that explore patient values are essential to end-of-life care. Many prefer to forgo aggressive treatments that are unlikely to prolong life, or improve its quality. Conversations ensure that patients are protected from unwanted treatments and excessive rescue measures that may lead to distress.

End-of-life distress can take many forms. Medications and surgeries often leave the body frail and vulnerable to other illnesses, or dependent on a ventilator or intravenous nutrition.

In a 2010 New Yorker article entitled “Letting Go”, medical doctor and public health researcher Atul Gawande wrote:

“Spending one’s final days in an intensive care unit because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place.”

End-of-life decisions can be stressful for both the patient and doctor. But talking about them does help.

In the New Yorker article, Gawande describes a 2008 Coping with Cancer study in which only one third of patients reported talking with their doctors about goals for end-of-life care, even though they were, on average, four months from death. Those who did have end-of-life conversations were significantly less likely to undergo cardiopulmonary resuscitation, be put on a ventilator, or end up in an intensive care unit. Gawande wrote:

“These patients suffered less, were physically more capable, and were better able, for a longer period, to interact with others. In other words, people who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation, and to spare their family anguish.”

Audrey Pellicano hosts the New York Death Café, and works as a grief counsellor. She told the New York Times:

“Death and grief are topics avoided at all costs in our society. If we talk about them, maybe we won’t fear them as much.”

This sentiment is echoed by palliative care specialist Susan Block, who was interviewed by Gawande for the New Yorker article. Regarding end-of-life conversations, she said:

“A large part of the task is helping people negotiate the overwhelming anxiety—anxiety about death, anxiety about suffering, anxiety about loved ones, anxiety about finances.”

Fear surrounding life’s end is immense and varied. But death comes regardless. Perhaps what is needed is an ideological shift, supported by movements like the Death Café, which provides opportunities for people to discuss death from a safe distance. By facing death, a greater appreciation of life’s preciousness may emerge, clarifying what we want most from both living and dying.

–Rebecca Abavi, Contributing Writer, The Trauma and Mental Health Report.

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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Talking About Death May Prevent End-Of-Life Suffering

00Anxiety, Decision-Making, Featured news, Grief, Health, Psychopathy December, 17
Source: Marica Villeneuve, Trauma and Mental Health Report artist, used with permission

Death comes unexpectedly. As City University of New York professor Massimo Pigliuccionce said, “You can evade taxes. But so far, you can’t evade death.” Just what is it, though, that we are trying to evade?

“We don’t know how or when we will die – even as we are actually dying,” wrote Joan Halifax, medical anthropologist and Zen teacher. “Death, in all its aspects, is a mystery.”

But we can talk. In conversation, we are able to clarify our wishes for end-of-life care, express our fear of the unknown, and grieve the loss of a loved one.

The “Death Café”, or “café mortel”, is a movement in which strangers meet to talk about death over tea and cake. The first “café mortel” was hosted in 2004 by Swiss sociologist and anthropologist Bernard Crettaz. In 2011, the movement migrated to the UK and took on the name “Death Café”. Their website states:

“Our aim is to increase awareness of death to help people make the most of their (finite) lives.”

In an article for Aeon, freelance essayist Clare Davies described the kinds of topics explored at Death Café:

“The guests take turns to voice their thoughts and feelings across a wide range of subjects. How does it feel to lose a parent? What is existence? What matters most to us in life? The point is to talk. What is death like? What exactly are we afraid of? To what degree do our ideas on death influence how we live?”

But death isn’t an easy topic… even some doctors avoid it.

A 2015 study led by Vyjeyanthi Periyakoli at the Stanford University School of Medicine found that 86 percent of 1040 doctors said that they find it “very challenging” to talk to patients about death.

Yet, conversations that explore patient values are essential to end-of-life care. Many prefer to forgo aggressive treatments that are unlikely to prolong life, or improve its quality. Conversations ensure that patients are protected from unwanted treatments and excessive rescue measures that may lead to distress.

End-of-life distress can take many forms. Medications and surgeries often leave the body frail and vulnerable to other illnesses, or dependent on a ventilator or intravenous nutrition.

In a 2010 New Yorker article entitled “Letting Go”, medical doctor and public health researcher Atul Gawande wrote:

“Spending one’s final days in an intensive care unit because of terminal illness is for most people a kind of failure. You lie on a ventilator, your every organ shutting down, your mind teetering on delirium and permanently beyond realizing that you will never leave this borrowed, fluorescent place.”

End-of-life decisions can be stressful for both the patient and doctor. But talking about them does help.

In the New Yorker article, Gawande describes a 2008 Coping with Cancer study in which only one-third of patients reported talking with their doctors about goals for end-of-life care, even though they were, on average, four months from death. Those who did have end-of-life conversations were significantly less likely to undergo cardiopulmonary resuscitation, be put on a ventilator, or end up in an intensive care unit. Gawande wrote:

“These patients suffered less, were physically more capable, and were better able, for a longer period, to interact with others. In other words, people who had substantive discussions with their doctor about their end-of-life preferences were far more likely to die at peace and in control of their situation, and to spare their family anguish.”

Audrey Pellicano hosts the New York Death Café, and works as a grief counsellor. She told the New York Times:

“Death and grief are topics avoided at all costs in our society. If we talk about them, maybe we won’t fear them as much.”

This sentiment is echoed by palliative care specialist Susan Block, who was interviewed by Gawande for the New Yorker article. Regarding end-of-life conversations, she said:

“A large part of the task is helping people negotiate the overwhelming anxiety—anxiety about death, anxiety about suffering, anxiety about loved ones, anxiety about finances.”

Fear surrounding life’s end is immense and varied. But death comes regardless. Perhaps what is needed is an ideological shift, supported by movements like the Death Café, which provides opportunities for people to discuss death from a safe distance. By facing death, a greater appreciation of life’s preciousness may emerge, clarifying what we want most from both living and dying.

–Rebecca Abavi, Contributing Writer, The Trauma and Mental Health Report.

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

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When a Sibling Dies by Suicide

00Depression, Family Dynamics, Featured news, Grief, Health, Suicide October, 17

Source: Clair Graubner and Clair Graubner at flicker, Creative Commons

“As far back as I can remember, Michael was always good at being silly. He could make me laugh harder than anyone. He was very creative, and always had a good ear for music.”

In an interview with the Trauma and Mental Health Report, Samantha (names changed for anonymity) shared her experiences living through the suicide of her older brother, Michael, when she was sixteen years old.

Michael’s battle with mental illness began as a teen. He struggled with low self-esteem and clinical depression, and consequently self-medicated.

“After my parentsdivorce, his mental health took a turn for the worse. He was always getting stoned and was generally depressed… After he took LSD with his friend, he was never the same. He was in a psychotic, suicidal state from the drug, so my parents took him to a mental hospital one night… He stayed in the hospital for a week, and was moved to a rehab facility to learn coping skills to become less dependent on marijuana. He was in an extremely dark place during his stay there, and came home in September to start school. He committed suicide on October 15, 2007.”

Samantha’s experience is not uncommon. Suicide is the second leading cause of death for young people aged 15 to 34. And according to a report published by the National Institute of Mental Health, depression and substance abuse (often in combination with other mental disorders) are common risk factors for suicide.

“Words could never express how I felt when I found out. I fell to the ground in absolute hysterics. It’s such an out-of-body memory for me… to go from having an older brother and having visions of our future together, to then in a second having all of that taken away from you.”

Samantha also experienced dissociative thoughts after her brother’s suicide.

“I remember thinking that maybe we were being ‘punk’d’, and that this was all part of a twisted social experiment to show the devastating effects suicide has on a family. That probably lasted a year or so in order to protect my brain from feeling too deeply and to help me focus on other things, like getting into college.”

Samantha began using marijuana and alcohol regularly to numb feelings of anger and loss. Her transition to college was challenging—she had difficulty balancing school work with partying, and often felt isolated.

“I felt like I couldn’t relate to most of my peers, and was extremely lonely. I was always getting high by myself, and reflecting on the past. While all of this was going on, my dad got remarried and had a baby during my freshman year of college. It was really hard for me to watch him start a new family while I was still grieving the loss of our old family.”

Samantha’s decision to self-medicate to deal with her unresolved grief is common among adolescents who lack strong social support.

“I think about Michael every day… but finally I have the relationships and living environment to really dig deep and process what I’ve been through. Yoga and meditation have also played a huge part in my healing process, as well as hula hoop dancing.”

In fact, yoga and meditation can help the healing process. Research by psychology professor Stefan Hofmann and colleagues at Boston University describes the benefits of mindfulness meditation for anxiety and mood symptoms. In their meta-analysis of 39 research studies, individuals who practiced mindfulness meditation experienced reduced anxiety, grief, and depressive symptoms.

Everyone grieves in their own way, and moving on doesn’t have to mean leaving the loved one’s memory behind. As for Samantha: “Michael continues to live on with all of those who knew him.”

–Lauren Goldberg, 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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When a Sibling Dies by Suicide

00Depression, Family Dynamics, Featured news, Grief, Health, Suicide October, 17

Source: Clair Graubner and Clair Graubner at flicker, Creative Commons

“As far back as I can remember, Michael was always good at being silly. He could make me laugh harder than anyone. He was very creative, and always had a good ear for music.”

In an interview with the Trauma and Mental Health Report, Samantha (names changed for anonymity) shared her experience living through the suicide of her older brother, Michael, when she was 16-years-old.

Michael’s battle with mental illness began as a teen. He struggled with low self-esteem and clinical depression and, consequently, self-medicated.

“After my parentsdivorce, his mental health took a turn for the worse. He was always getting stoned and was generally depressed… After he took LSD with his friend, he was never the same. He was in a psychotic, suicidal state from the drug, so my parents took him to a mental hospital one night… He stayed in the hospital for a week, and was moved to a rehab facility to learn coping skills to become less dependent on marijuana. He was in an extremely dark place during his stay there, and came home in September to start school. He committed suicide on October 15, 2007.”

Samantha’s experience is not uncommon. Suicide is the second leading cause of death for young people aged 15 to 34. And, according to a report published by the National Institute of Mental Health, depression and substance abuse (often in combination with other mental disorders) are common risk factors for suicide.

“Words could never express how I felt when I found out. I fell to the ground in absolute hysterics. It’s such an out-of-body memory for me… to go from having an older brother and having visions of our future together, to then in a second having all of that taken away from you.”

Samantha also experienced dissociative thoughts after her brother’s suicide.

“I remember thinking that maybe we were being ‘punk’d’, and that this was all part of a twisted social experiment to show the devastating effects suicide has on a family. That probably lasted a year or so in order to protect my brain from feeling too deeply and to help me focus on other things, like getting into college.”

Samantha began using marijuana and alcohol regularly to numb feelings of anger and loss. Her transition to college was challenging—she had difficulty balancing school work with partying, and often felt isolated.

“I felt like I couldn’t relate to most of my peers, and was extremely lonely. I was always getting high by myself, and reflecting on the past. While all of this was going on, my dad got remarried and had a baby during my freshman year of college. It was really hard for me to watch him start a new family while I was still grieving the loss of our old family.”

Samantha’s decision to self-medicate to deal with her unresolved grief is common among adolescents who lack strong social support.

“I think about Michael every day… but finally I have the relationships and living environment to really dig deep and process what I’ve been through. Yoga and meditation have also played a huge part in my healing process, as well as hula hoop dancing.”

In fact, yoga and meditation can help the healing process. Research by psychology professor Stefan Hofmann and colleagues at Boston University describes the benefits of mindfulness meditation for anxiety and mood symptoms. In their meta-analysis of 39 research studies, individuals who practiced mindfulness meditation experienced reduced anxiety, grief, and depressive symptoms.

Everyone grieves in their own way, and moving on doesn’t have to mean leaving the loved one’s memory behind. As for Samantha: “Michael continues to live on with all of those who knew him.”

–Lauren Goldberg, 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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Wearing Cancer Survival Like a Badge of Honor

00Featured news, Grief, Health, Positive Psychology, Relationships, Resilience October, 17

Source: eKBS at DeviantArt, Creative Commons

“I have stage 3 cancer; my friend has stage 1—which is like a pimple.”

On her personal blog, Debbie Woodbury, a woman diagnosed with Stage 0 cancer, references this comment by a fellow cancer patient. While she considers the comment hurtful, she is not particularly surprised.

Cancer prognoses vary, and there is large variation in survival between types and degrees of illness. Some are fortunate to survive without the sickening effects of chemotherapy, the fear of losing hair, or surgeries that leave patients bedridden for weeks. But people may also minimize their cancer journey, or be made to view their experiences as ‘lesser’.

Woodbury explains:

“Without a tumor and with a Stage 0 cancer diagnosis, I started this journey not even sure I was qualified to call myself a cancer patient.”

Similarly, Lesley Miller writes of her husband:

“I bought him a bold yellow shirt that said ‘survivor’ across the front. ‘Survivor,’ in his mind, is nothing to tell the world about. He didn’t do anything to claim survivor status; his body just had a treatable cancer that happened to respond to drugs.”

Just like that, degrees of illness become a competition, belittle personal struggles, and create segregation among patients and those in remission.

In January 2015, cancer survivor Cindy Finch posted an article in the Huffington Post entitled “The 6 Injustices of Cancer.” The article received a great deal of backlash for suggesting that certain cancer patients “get off really easy”. She claimed:

“I’ve heard it a hundred times, ‘I’m a cancer survivor, too.’ ‘Oh, really? What type of cancer did you have and what was your treatment?’ ‘Oh, I had thyroid cancer and had to take a radioactive pill for 30 days. Then I was all better.’”

Finch talks about individuals with ‘worse’ diagnoses:

“These folks represent the worst among us. If you’re not one of these folks, perhaps you should be quiet and sit down, and let someone else tell their war story.”

As if some cancer patients just aren’t macho enough. Attitudes like these have negative consequences on patient mental health.

Cancer patients often report feelings of guilt for surviving the illness. Survivor guilt is common among people who have gone through traumatic experiences, such as war, accidents, natural disasters, and interpersonal abuse. For Woodbury, not suffering enough throughout her cancer experience elicited guilt feelings.

Some individuals also consider themselves less deserving. Ann Silberman, a breast cancer survivor, writes in her personal blog:

“It was my belief that others deserved to live more than I did. Better people than me are now gone; people who were funnier, who were kinder, who had more to give.”

And then, of course, there are expectations people have of cancer patients: The image of the strong, inspirational individual, filled with gratitude for a second chance at life.

Silberman continues:

“I am still trudging along, bitching about how cold I am and slamming pain meds for my aches and pains.”

According to Crystal Park and colleagues at the University of Connecticut at Storrs, living through cancer results in the development of new identities that can define people for the rest of their lives. For those still in active treatment, the identity of patient or victim can develop, carrying the connotation of severe suffering inflicted on them. But for those who have survived such adversity, the most common identity was survivor, which carries the connotation of cure.

As cancer becomes an engrained aspect of an individual’s identity, it may be natural for those who suffered greatly to take pride in how much they overcame, indeed to try to silence others who have not experienced the same level of adversity.

But Woodbury takes umbrage at this view, noting:

“The truth is that cancer is not a competition and, just as I am enough, so is my cancer. I certainly did go through less than someone else might have gone through. Thank God for that. For that I should be grateful, not made to feel, by myself or anyone else, that I am guilty of not suffering enough to qualify in the cancer games.”

– Eleenor Abraham, 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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Wearing Cancer Survival Like a Badge of Honor

00Featured news, Grief, Health, Positive Psychology, Relationships, Resilience October, 17

Source: eKBS at DeviantArt, Creative Commons

“I have stage 3 cancer; my friend has stage 1—which is like a pimple.”

On her personal blog, Debbie Woodbury, a woman diagnosed with stage 0 cancer, references this comment by a fellow cancer patient. While she considers the comment hurtful, she is not particularly surprised.

Cancer prognoses vary, and there is a large variation in survival between types and degrees of illness. Some are fortunate to survive without the sickening effects of chemotherapy, the fear of losing hair, or surgeries that leave patients bedridden for weeks. But people may also minimize their cancer journey, or are made to view their experiences as ‘lesser’.

Woodbury explains:

“Without a tumor and with a stage 0 cancer diagnosis, I started this journey not even sure I was qualified to call myself a cancer patient.”

Similarly, Lesley Miller writes of her husband:

“I bought him a bold yellow shirt that said ‘survivor’ across the front. ‘Survivor,’ in his mind, is nothing to tell the world about. He didn’t do anything to claim survivor status; his body just had a treatable cancer that happened to respond to drugs.”

Just like that, degrees of illness become a competition, belittle personal struggles, and create segregation among patients and those in remission.

In January 2015, cancer survivor Cindy Finch posted an article in the Huffington Post entitled “The 6 Injustices of Cancer.” The article received a great deal of backlash for suggesting that certain cancer patients “get off really easy.” She claimed:

“I’ve heard it a hundred times, ‘I’m a cancer survivor, too.’ ‘Oh, really? What type of cancer did you have and what was your treatment?’ ‘Oh, I had thyroid cancer and had to take a radioactive pill for 30 days. Then I was all better.’”

Finch talks about individuals with ‘worse’ diagnoses:

“These folks represent the worst among us. If you’re not one of these folks, perhaps you should be quiet and sit down, and let someone else tell their war story.”

As if some cancer patients just aren’t macho enough. Attitudes like these have negative consequences on patient mental health.

Cancer patients often report feelings of guilt for surviving the illness. Survivor guilt is common among people who have gone through traumatic experiences, such as war, accidents, natural disasters, and interpersonal abuse. For Woodbury, not suffering enough throughout her cancer experience elicited guilt feelings.

Some individuals also consider themselves less deserving. Ann Silberman, a breast cancer survivor, writes on her personal blog:

“It was my belief that others deserved to live more than I did. Better people than me are now gone; people who were funnier, who were kinder, who had more to give.”

And then, of course, there are expectations people have of cancer patients: The image of the strong, inspirational individual, filled with gratitude for a second chance at life.

Silberman continues:

“I am still trudging along, bitching about how cold I am and slamming pain meds for my aches and pains.”

According to Crystal Park and colleagues at the University of Connecticut at Storrs, living through cancer results in the development of new identities that can define people for the rest of their lives. For those still in active treatment, the identity of patient or victim can develop, carrying the connotation of severe suffering inflicted on them. But for those who have survived such adversity, the most common identity was survivor, which carries the connotation of cure.

As cancer becomes an ingrained aspect of an individual’s identity, it may be natural for those who suffered greatly to take pride in how much they overcame, indeed to try to silence others who have not experienced the same level of adversity.

But Woodbury takes umbrage at this view, noting:

“The truth is that cancer is not a competition and, just as I am enough, so is my cancer. I certainly did go through less than someone else might have gone through. Thank God for that. For that, I should be grateful, not made to feel, by myself or anyone else, that I am guilty of not suffering enough to qualify in the cancer games.”

–Eleenor Abraham, 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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Losing a Pregnancy Only to Lose One Again

00Fear, Featured news, Grief, Pregnancy, Resilience, Therapy, Trauma July, 17

Source: margimadness, Deviant Art

Anna R. was having an ultrasound, prepared to see her baby for the first time. When she asked the technician what the sex of the baby was, the tech quickly left the room. The physician then entered to tell Anna there was no heartbeat. This became the first of seven pregnancy losses that she would endure.

Recurrent pregnancy loss (RPL) is typically defined as three consecutive losses prior to 20 weeks from the last menstrual period.

Affecting 1-2% of women, the causes of RPL differ. Advancing maternal age is associated with elevated risks of miscarriages, particularly in women 45 or older. Paternal age can also be a variable, with environmental and genetic factors playing a role as well. The risk of miscarriages further increases with the number of previous miscarriages, reaching approximately 40% after three consecutive losses.

While these causes have been established within the medical community, doctors still struggle to predict what ultimately leads to a couple’s pregnancy loss. Even after numerous tests, Anna’s physicians never found anything wrong, making the loss that much harder to cope with.

After her eighth miscarriage, Tracey Beadle of County Durham, UK told The Northern Echo:

“I think I wanted for them to find something wrong, because that would mean something could either be fixed or give us a reason to stop trying for a baby. We did not know when to stop.”

Janet Jaffe, a clinical psychologist and co-author of the book “Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients”, told the American Psychological Association:

“A miscarriage is a traumatic loss, not only of the pregnancy, but of a woman’s sense of self and her hopes and dreams of the future. She has lost her ‘reproductive story’, and it needs to be grieved.”

This grief is unique, in that expectant mothers and fathers mourn a child that never came to be. As Kate Evans, a woman who had six miscarriages said in an article in the Independent:

“If there’s no body, how can I grieve? I feel as though I must be kidding myself, wallowing in a morass of grief over a person who never even lived. Every time my mind trips back to this death, this loss, it strikes on empty, because there’s nothing there to miss.”

While there is no physical body to grieve, the hopes and dreams for a future with the child are ultimately the elements missed the most.

This grief is further complicated by feelings of isolation. When a loved one dies, there is often comfort in collective mourning with other grief-stricken individuals. But grieving the loss of a pregnancy can be an isolating experience for parents, as others haven’t formed the same connection with the unborn child and may struggle to understand why the experience is so painful.

Outsiders may also lack empathy for the mother’s experiences and fault her for the outcome of the pregnancy. Anna explained that people unintentionally implied that she was to blame for her miscarriage through comments like, “Do the doctors know what’s wrong with you?” or “Maybe you weren’t taking good care of yourself.”

RPL has been shown to severely disrupt the parents’ mental health. According to astudy by psychiatrist Michael Craig and colleagues at the Institute of Psychiatry, King’s College London, of 81 women with recurrent miscarriages, 33% were classified as depressed, with 7.4% suffering from severe depression. And 21% of the women also had clinically significant anxiety, while some experienced heightened anger and guilt.

Research documenting fathers’ grieving processes showed that, unlike women, many men do not react with increased depressive symptoms, crying, or feeling the need to talk. But similar to women, a major source of grieving arises from relinquishing their hopes and expectations for their unborn child.

While physical treatments for RPL include surgeries, medications, genetic screening, and lifestyle changes, the emotional and psychological toll must also be addressed.

A report by the Practice Committee of the American Society for Reproductive Medicine indicates that psychological support in early pregnancy results in significant improvement of pregnancy outcomes. Psychotherapy can also help work out anxieties and fears from previous miscarriages.

According to Anna, therapy was what helped her through seven painful miscarriages:

“My therapist became my saving grace. I could comfortably tell her anything and everything—especially things I didn’t want to discuss with my husband, like thoughts of suicide. She was the voice of reason in my confused and isolated world.”

Individuals can find additional help through in-person support groups at local organizations, or through online sites, such as the Baby Center, which offer web-based clubs and blogs. Connecting with these groups allows individuals to interact with others experiencing the same grief, which may reduce feelings of isolation.

In the midst of hopelessness, people may feel safer bracing themselves for more heartache. But it is important to remember that, even after four consecutive losses, a patient has a greater than 60% to 65% chance of carrying the next pregnancy to term. In the meantime, seeking psychological support to work through the anxiety and grief may be beneficial.

–Eleenor Abraham, 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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Losing a Pregnancy Only to Lose One Again

00Fear, Featured news, Grief, Pregnancy, Resilience, Therapy, Trauma July, 17

Source: margimadness, Deviant Art

Anna R. was having an ultrasound, prepared to see her baby for the first time. When she asked the technician what the sex of the baby was, the tech quickly left the room. The physician then entered to tell Anna there was no heartbeat. This became the first of seven pregnancy losses that she would endure.

Recurrent pregnancy loss (RPL) is typically defined as three consecutive losses prior to 20 weeks from the last menstrual period.

Affecting 1-2% of women, the causes of RPL differ. Advancing maternal age is associated with elevated risks of miscarriages, particularly in women 45 or older. Paternal age can also be a variable, with environmental and genetic factors playing a role as well. The risk of miscarriages further increases with the number of previous miscarriages, reaching approximately 40% after three consecutive losses.

While these causes have been established within the medical community, doctors still struggle to predict what ultimately leads to a couple’s pregnancy loss. Even after numerous tests, Anna’s physicians never found anything wrong, making the loss that much harder to cope with.

After her eighth miscarriage, Tracey Beadle of County Durham, UK told The Northern Echo:

“I think I wanted for them to find something wrong, because that would mean something could either be fixed or give us a reason to stop trying for a baby. We did not know when to stop.”

Janet Jaffe, a clinical psychologist and co-author of the book “Reproductive Trauma: Psychotherapy with Infertility and Pregnancy Loss Clients”, told the American Psychological Association:

“A miscarriage is a traumatic loss, not only of the pregnancy, but of a woman’s sense of self and her hopes and dreams of the future. She has lost her ‘reproductive story’, and it needs to be grieved.”

This grief is unique, in that expectant mothers and fathers mourn a child that never came to be. As Kate Evans, a woman who had six miscarriages said in an article in the Independent:

“If there’s no body, how can I grieve? I feel as though I must be kidding myself, wallowing in a morass of grief over a person who never even lived. Every time my mind trips back to this death, this loss, it strikes on empty, because there’s nothing there to miss.”

While there is no physical body to grieve, the hopes and dreams for a future with the child are ultimately the elements missed the most.

This grief is further complicated by feelings of isolation. When a loved one dies, there is often comfort in collective mourning with other grief-stricken individuals. But grieving the loss of a pregnancy can be an isolating experience for parents, as others haven’t formed the same connection with the unborn child and may struggle to understand why the experience is so painful.

Outsiders may also lack empathy for the mother’s experiences and fault her for the outcome of the pregnancy. Anna explained that people unintentionally implied that she was to blame for her miscarriage through comments like, “Do the doctors know what’s wrong with you?” or “Maybe you weren’t taking good care of yourself.”

RPL has been shown to severely disrupt the parents’ mental health. According to astudy by psychiatrist Michael Craig and colleagues at the Institute of Psychiatry, King’s College London, of 81 women with recurrent miscarriages, 33% were classified as depressed, with 7.4% suffering from severe depression. And 21% of the women also had clinically significant anxiety, while some experienced heightened anger and guilt.

Research documenting fathers’ grieving processes showed that, unlike women, many men do not react with increased depressive symptoms, crying, or feeling the need to talk. But similar to women, a major source of grieving arises from relinquishing their hopes and expectations for their unborn child.

While physical treatments for RPL include surgeries, medications, genetic screening, and lifestyle changes, the emotional and psychological toll must also be addressed.

A report by the Practice Committee of the American Society for Reproductive Medicine indicates that psychological support in early pregnancy results in significant improvement of pregnancy outcomes. Psychotherapy can also help work out anxieties and fears from previous miscarriages.

According to Anna, therapy was what helped her through seven painful miscarriages:

“My therapist became my saving grace. I could comfortably tell her anything and everything—especially things I didn’t want to discuss with my husband, like thoughts of suicide. She was the voice of reason in my confused and isolated world.”

Individuals can find additional help through in-person support groups at local organizations, or through online sites, such as the Baby Center, which offer web-based clubs and blogs. Connecting with these groups allows individuals to interact with others experiencing the same grief, which may reduce feelings of isolation.

In the midst of hopelessness, people may feel safer bracing themselves for more heartache. But it is important to remember that, even after four consecutive losses, a patient has a greater than 60% to 65% chance of carrying the next pregnancy to term. In the meantime, seeking psychological support to work through the anxiety and grief may be beneficial.

–Eleenor Abraham, 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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Teaching Children about Trauma: The “River Speaks” Series

00Child Development, Emotion Regulation, Family Dynamics, Featured news, Grief, Therapy, Trauma March, 16

Source: Freaktography on Flickr

In her latest series of children’s books, River Speaks, author Sandy Stream conveys the emotional turmoil that children and families go through when dealing with trauma.

Children who have undergone loss, abuse, and other traumatic experiences are often unable to fully understand or express their feelings. Their inability to verbalize the emotional impact the crisis had on them makes it difficult for therapists to determine how to best help them heal.

Although research has shown children’s literature to be a helpful tool in therapy, its use is still not particularly common.

The stories found in Stream’s books are meant to help therapists provide relatable experiences for children to help them come to terms with their own trauma. They revolve around a baby bird, Sparky, who is snatched away from his family. In dealing with his captivity, escape, and eventual return, Sparky and his family learn to articulate the complex feelings they experience.

Sparky does return home, but the series does not employ the conventional happily-ever-after ending. Instead, the stories address the turmoil felt by everyone both during his captivity and after his return.

The seven books in this series, Sparky Can Fly, Sparky’s Mama, Tweets and Hurricanes, Feathers, Flex, Roots, and The River, all feature a different main character, retelling the narrative from the perspective of the victim, the parents, the siblings, and the therapist. Each book also deals with different emotional themes, including grief, loss, isolation, and acceptance.

Many of the communication strategies seen in River Speaks can be linked to Jean Piaget’s work on child development. According to Piaget, healthy coping and a sense of self cannot exist without establishing trusting relationships during childhood. Trauma can interrupt this process, and the River Speaks series is intended to restart and re-establish healthy connections.

Research, including that of psychiatrist Bessel van der Kolk, professor at Boston University, shows that children must understand the emotions caused by trauma. This research emphasizes that therapists should teach children to regulate emotional distress, with the first step being acknowledgment of the distress’ severity.

Stream’s metaphorical approach helps children grasp the complex concepts that make the healing process. Comparing Sparky’s inability to express anger and grief to “hurricanes” and “tweets” helps make the abstract more tangible.

This strategy allows the River Speaks stories to personify complex psychological issues such as emotional defense mechanisms like denial, fear of abandonment, and Stockholm syndrome, making her books well-suited to children as young as three or four years of age.

Stream’s stories are accompanied by illustrations from Yoko Matsuoka. The colourful drawings were designed to keep the oftentimes-dark subject matter child-friendly, and work well in conjunction with Stream’s metaphorical portrayals of emotions and trauma.

Such illustrations are a common tool in dealing with childhood trauma. The use of visual art to depict emotional reactions has been found to benefit children during the normal grieving process. A paper by Cynthia O’Flynn at North Central University explains that art therapy can be especially beneficial for children suffering from serious traumatic grief.

The article cites numerous other studies reporting that art allows children to bypass the language and vocabulary needed to explain their grief or loss, making self-expression much easier. The children are able to perceive greater control over their emotions and feel safe while reflecting upon their experiences.

Alexa S. Rabin of Alliant International University reinforced these findings in 2012, stating that art is an exercise which allows children to assert themselves and their boundaries. Rabin explained that such therapy significantly decreases acute stress symptoms, noting that the purpose of trauma treatment is to help children find a way to cope.

Stream’s books bridge the two sets of findings—using both art and language to reach out to children and better their self-expression across both media. A therapist using Stream’s books would be more flexible in tailoring the therapeutic style to the child’s age and individual needs.

Feedback from psychologists such as Jacqueline A. Carlton and fellow author Cheryl Eckl, applaud Stream’s attempt at tackling such difficult subject matter. And while research would be needed to gauge the helpfulness of her specific stories, existing research suggests that her books may ease therapy for both clinicians and children.

– Olivia Jon, 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