Category: Post-Traumatic Stress Disorder

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Unforeseen Stress When a Child Receives a Transplant

00Featured news, Guilt, Health, Post-Traumatic Stress Disorder, Stress, Trauma April, 18

Source: debowscyfoto at pixabay, Creative Commons

On April 13, 2016, Bill and Lindsay Brent received the phone call they were desperate for. Their youngest child Nathan would get the liver transplant he urgently needed. Within hours, the family from Barrie, Ontario was heading to The Hospital for Sick Children in Toronto.

By 8:00 the next morning, Nathan’s life-saving surgery was underway. Twelve hours after surgery began, the Brents’ feisty toddler emerged from surgery sedated, but holding his own, and began his road to recovery.

Twenty months earlier, Nathan was diagnosed with Alagille Syndrome, a genetic disorder affecting his liver, and severe enough that his only hope for survival was a liver transplant. But as the months passed, the situation began to look bleak. Nathan’s rare AB negative blood type greatly decreased his chances of finding a donor match.

Complicating matters further, Nathan was ineligible for the program; he required a liver from a deceased donor rather than from someone who was living. In his case, a pediatric donor would increase the odds of success, meaning that another child would have to die for Nathan to live.

And yet, despite insurmountable odds, thanks to the decision of one family, a liver was donated and Nathan survived.

Raelynn Maloney, a clinical psychologist and co-author of the book Caring for Donor Families: Before, During and After, says that the donor waiting period can be extremely stressful for families.

“Many traumas can occur during the ‘waiting period’; seeing a loved one suffer from illness without a clear outcome in sight, financial stress as families juggle care demands with work schedules, and, of course, the fear of running out of time.”

For the Brents, though, the psychological impact of their son’s traumatic journey started to surface only after the transplant was completed. Bill explains:

“Even though you are devastated when you receive the news that your child has a life-threatening illness, your need to remain focused on the outcome and to stay positive takes over. What has been shocking is the magnitude of post-transplant emotions that we’ve had to face. You’ve received a miracle, and yet, somehow, you are gripped with guilt and sorrow for the donor’s family, and an anxiety about the future that is so strong, it hinders your ability to feel good about life.”

For the couple, while they shared the same concerns for Nathan, their struggles with anxiety manifested in different ways. While Lindsay tended to ruminate and panic about the risks to Nathan post-transplant, such as illness, injury, and organ rejection, Bill reported an increase in social anxiety and was gripped with survivor’s guilt and depression. He says:

“It is very difficult for me to accept that my son needed someone to die for him to live. The donor family is in our thoughts constantly, and words cannot describe how thankful we are to them. They are our heroes.”

Maloney explains that recipient families can have a delayed reaction to the distress they experience while their loved one is on the donor list, and they are often unprepared for the rush of emotions that come after transplant.

While remaining focused on a solution, recipient families often do not allow themselves the space to grieve setbacks as they occur. Rather, they strive to maintain hopefulness while supressing the pain of the situation.

Maloney emphasizes that it may only be during recovery, when these families finally have a chance to process what they have gone through, that the traumatic grief hits.

The Brents recognized that, post-transplant, there was much more time to reflect on the enormity of what they had been through. Although grateful for Nathan’s outcome and the support of their family and friends, the Brents still faced ongoing emotional issues, all while trying to build normalcy back into their lives. Lindsay explains:

“Since Nathan has received his new liver, we no longer have access to the transplant support team that was available to us before the surgery. The medical team has moved on, the social support from the families at the hospital has been less frequent since we have returned home. In a way, Bill and I feel like we’ve lost family members, people that up until the transplant were a part of our innermost circle. In some ways, we feel left to navigate this post-transplant terrain on our own.”

Maloney acknowledges that there is an illusion held by the public that, after a transplant, all is well and life returns to normal. In reality, this is a time when transplant recipients and their families may need even more support as they try to reconcile the trauma of the illness with a hopeful and optimistic view of the future.

Now at home, Nathan continues to improve. Bill and Lindsay look forward to the time when this difficult journey will be surpassed by many happier, hopeful moments.

–Kimberley Moore, 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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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

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

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

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Medical Marijuana for PTSD?

00Addiction, Featured news, Post-Traumatic Stress Disorder, Stress, Therapy, Trauma December, 17

Source: Sinclair Terrasidius at flickr, Creative Commons

On October 1, 2016, a Canadian medical marijuana company called Marijuana for Trauma opened a location in Edmonton, Alberta to treat PTSD in military veterans. It’s owned and operated by Fabian Henry, who uses marijuana to treat combat-related PTSD, resulting from his second tour of duty in Afghanistan. He claims that conventional medicine does not allow people struggling with PTSD to process their trauma, while marijuana does.

Although the use of medical marijuana for the treatment of physical and psychological disorders is controversial, medical marijuana is currently legal in Canada.

The Washington Post reported that therapeutic use of marijuana was banned in the U.S. in 1970, and marijuana is still categorized as an illicit drug despite its potential medicinal benefits. Given its controversial nature and association with stereotypes, cannabis research for treatment of mental disorders has been limited. But scientific interest is intensifying.

A recent study published in Molecular Psychiatry showed that treatment using particular compounds found in marijuana may benefit those with PTSD, and that “plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms of PTSD.”

Research published on Science Daily also looked at symptom reduction in patients with PTSD. As a result of taking medical marijuana, participants reported a decrease in re-experiencing the trauma, less avoidance of situations that reminded them of the trauma, and a decline in hyper-arousal.

There is also anecdotal evidence. In an interview with the Trauma and Mental Health Report, Dianna Donnelly, a counselor and patient at the Canadian Cannabis Clinics, described her experience:

“I am a patient who legally uses cannabis for depression. The cannabis helps mute or lower my negative chatter, which allows for good thoughts and feelings to arise. One Veteran, a friend of mine, who recently started using marijuana instead of prescription medication for PTSD, said that with the cannabis, he can feel his emotions, and experience them properly and safely. Before, he just felt numb.”

Medical marijuana is not usually used on its own for the treatment of PTSD. Shelley Franklin, the Veteran Program Coordinator for the Canadian Cannabis Clinics, explained:

“Medical cannabis is used in conjunction with other therapies. Peer support groups are a highly supported therapy for patients suffering an Operational Stress Injury [another term for PTSD]. Medical cannabis strains with the right CBD and THC [psychoactive chemicals in cannabis] levels are assisting veterans with chronic physical pain, as well anxiety and insomnia issues. I believe that medical cannabis will continue to work in conjunction with many other therapies.”

Conversely, former Canadian Member of Parliament Peter Stoffer believes that soldiers have too much access to medical marijuana. Although not opposed to the use of medical marijuana in certain cases, Stoffer believes that current legislation, which compensates veterans for up to 10 grams of cannabis per day, promotes overuse and could potentially lead to negative effects. In an interview with the CBC, Stoffer said:

“Ten grams a day is an awful lot of marijuana to give one person. It is an incredible amount. That’s simply not the way to go. You’re not helping that person at all. You’re not giving them any chance of recovery. All you’re really doing is masking the pain that they’re suffering.”

The research is still in its infancy and likely to explode in the near future, as the Canadian government prepares to remove restrictions on marijuana in 2017. This movement will make it much easier for researchers to study the effects cannabis has on psychological disorders and to form conclusions on its efficacy.

As for Fabian Henry and his cannabis dispensary Marijuana for Trauma, he continues to work with physicians to tailor the amounts dispensed to individuals and has no plans himself to stop using the drug.

This article was originally published on Psychology Today

an-_-article-2-_-feature-1-_-cropped-470x260.jpg

Medical Marijuana for PTSD?

80Addiction, Featured news, Post-Traumatic Stress Disorder, Stress, Therapy, Trauma December, 17

Source: Sinclair Terrasidius at flickr, Creative Commons

On October 1st, 2016, a Canadian medical marijuana company called Marijuana for Trauma opened a location in Edmonton, Alberta to treat PTSD in military veterans. It’s owned and operated by Fabian Henry, who uses marijuana to treat combat-related PTSD, resulting from his second tour of duty in Afghanistan. He claims that conventional medicine does not allow people struggling with PTSD to process their trauma, while marijuana does.

Although the use of medical marijuana for the treatment of physical and psychological disorders is controversial, medical marijuana is currently legal in Canada.

The Washington Post reports that therapeutic use of marijuana was banned in the U.S. in 1970, and marijuana is still categorized as an illicit drug despite its potential medicinal benefits. Given its controversial nature and association with stereotypes, cannabis research for treatment of mental disorders has been limited. But scientific interest is intensifying.

A recent study published in Molecular Psychiatry showed that treatment using particular compounds found in marijuana may benefit those with PTSD, and that “…plant-derived cannabinoids [psychoactive chemicals] such as marijuana may possess some benefits in individuals with PTSD by helping relieve haunting nightmares and other symptoms of PTSD.”

Research published in Science Daily also looked at symptom reduction in patients with PTSD. As a result of taking medical marijuana, participants reported a decrease in re-experiencing the trauma, less avoidance of situations that reminded them of the trauma, and a decline in hyper-arousal.

There is also anecdotal evidence. In an interview with the Trauma and Mental Health Report, Dianna Donnelly, a counselor and patient at the Canadian Cannabis Clinics, described her experience:

“I am a patient who legally uses cannabis for depression. The cannabis helps mute or lower my negative chatter, which allows for good thoughts and feelings to arise. One Veteran, a friend of mine, who recently started using marijuana instead of prescription medication for PTSD, said that with the cannabis, he can feel his emotions, and experience them properly and safely. Before, he just felt numb.”

Medical marijuana is not usually used on its own for the treatment of PTSD. Shelley Franklin, the Veteran Program Coordinator for the Canadian Cannabis Clinics, explained that:

“Medical cannabis is used in conjunction with other therapies. Peer support groups are a highly supported therapy for patients suffering an Operational Stress Injury [another term for PTSD]. Medical cannabis strains with the right CBD and THC [psychoactive chemicals in cannabis] levels are assisting veterans with chronic physical pain, as well anxiety and insomnia issues. I believe that medical cannabis will continue to work in conjunction with many other therapies.”

Conversely, former Canadian Member of Parliament Peter Stoffer believes that soldiers have too much access to medical marijuana. Although not opposed to the use of medical marijuana in certain cases, Stoffer believes that current legislation, which compensates veterans for up to 10 grams of cannabis per day, promotes overuse and could potentially lead to negative effects. In an interview with the CBC, Stoffer said:

“Ten grams a day is an awful lot of marijuana to give one person. It is an incredible amount. That’s simply not the way to go. You’re not helping that person at all. You’re not giving them any chance of recovery. All you’re really doing is masking the pain that they’re suffering.”

The research is still in its infancy and likely to explode in the near future, as the Canadian government prepares to remove restrictions on marijuana in 2017. This movement will make it much easier for researchers to study the effects cannabis has on psychological disorders and to form conclusions on its efficacy.

As for Fabian Henry and his cannabis dispensary Marijuana for Trauma, he continues to work with physicians to tailor the amounts dispensed to individuals and has no plans himself to stop using the drug.

–Andrei Nistor, 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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Police Need Training to Deal With Mentally Ill Offenders

00Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Psychiatry, Psychopathy, Stress October, 17

Source: Free Images at Pixabay

On March 4, 2016, Devon LaFleur, a 30-year-old struggling with bipolar disorder, went missing. His father contacted law enforcement to notify police of his son’s mental illness and tendency towards violence. After learning that LaFleur had allegedly robbed a bank and was on the run, Toronto police tracked down and fatally shot the young man during a confrontation.

In many instances where mental illness is concerned, police officers respond too quickly with force. In an analysis conducted by The Washington Post, American officers shot 124 people who showed some sign of mental or emotional distress in 2015.

The Post explains that, for the majority of these crimes, the police were not called for reports of criminal activity. As in LaFleur’s case, police were contacted by “relatives, neighbors or other bystanders worried that a mentally fragile person was behaving erratically.”

An article by psychiatry professor Richard Lamb and colleagues at the University of Southern California reports that police officers are authorized to transport individuals with mental illness for psychiatric evaluation when there is reason to believe that they pose a danger or threat. But the researchers also state that this responsibility turns officers into ‘street-corner psychiatrists’ without giving them the training they need to make on-the-spot decisions about mentally ill offenders.

An article published in Criminal Justice Review by Teresa LaGrange shows that “higher educated police officers recognize a broader range of disorders” and they are more likely to “view the situation as requiring a professional intervention.”

However, LaGrange also recognizes that instead of teaching practical skills like learning how to identify individuals with mental-health conditions, many educational workshops only consist of general descriptions about psychological terms and concepts.

Police officers need to know how to handle individuals who display different types of mental illnesses. The Washington Post analysis states that the most extreme cases of mentally ill people causing a disturbance were schizophrenic individuals and those who displayed suicidal tendencies or had some form of post-traumatic stress disorder (PTSD).

In some states, crisis intervention team training (CIT) is being implemented to help officers identify mental illness and determine the best course of action.

CIT consists of a 40-hour training program for police forces that educates officers on mental-health issues and medications and teaches about mental-health services in the local community. CIT also teaches methods that help de-escalate heated situations by encouraging officers to allow vulnerable individuals to vent their frustrations—methods that could have been useful in LaFleur’s case to reduce the risk of violence from both the police and offender.

So far, this program has been considered effective by the police departments using it.

Major Sam Cochran of the Memphis police department, a retired officer and a coordinator of the CIT program, emphasizes that law enforcement should partner with local mental-health agencies: “If communities give attention only to law enforcement, you will fail as a training program. You cannot separate the two.”

Although the task of identifying mentally ill individuals can be daunting, these training programs are a step toward preventing injustices for individuals like LaFleur. Providing officers with appropriate training not only improves the ability to handle job stress but may also provide mentally ill offenders with a chance to receive treatment.

–Afifa Mahboob, 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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Trauma Exposure Linked to PTSD in 911 Dispatchers

00Featured news, Health, Post-Traumatic Stress Disorder, Therapy, Trauma, Work September, 17

Source: Public Domain at flickr

In February 2016, Gail—a 911 dispatcher with Toronto Paramedic Services—found herself in tears at work. She had just received a call about Wallace Passos, a three-year-old boy from Toronto, who fell from a 17-story apartment building to his death.

At age 57, Gail has been working as an Emergency Medical Dispatcher for 15 years. Taking calls from around the city, she dispatches the closest ambulance. All dispatchers are expected to work 12-hour shifts, at times with only one colleague on duty.

This past year, Gail’s job became especially difficult for her when she was diagnosed with Post Traumatic Stress Disorder (PTSD). Gail recently spoke with the Trauma and Mental Health Report to discuss the experience that led to the diagnosis:

“I’m still haunted by the sounds of the family crying on the phone after the three-year-old fell off the building. I imagine the boy in pain, and it’s just awful.”

Gail is not the first emergency dispatcher to experience PTSD symptoms. A study conducted by researchers at Northern Illinois University described how 911 dispatchers are exposed to duty-related trauma, which is defined as an indirect exposure to someone else’s traumatic experience. Duty-related trauma puts dispatchers at risk for developing PTSD. Participants in the study reported experiencing fear, helplessness, and horror in reaction to various calls they received.

Along with the stress of being on the receiving end of difficult calls, emergency dispatchers also deal with the pressure and demand of following protocol, despite variability in situations.

Toronto Paramedic Services follows specific protocols set by The National Academy of Dispatch. The system was developed at Salt Lake City, Utah in 1988 and incorporates a set of 33 protocols for those answering 911 emergency phone calls. On a call, everyone is treated equally and is asked the same basic investigative questions. These questions are then used to give priority to life-threatening situations and provide guidance to first responders like firefighters, paramedics, and police officers on the scene.

While the protocols can be useful for guiding dispatchers through stressful situations, in other circumstances, they can cause pain and discomfort when a dispatcher can tell that a situation is hopeless. Dispatchers are not trained to deal with each unique case differently; they are expected to follow through with the routine questions regardless of circumstances.

In the case of Wallace Passos, Gail had to give instructions for CPR despite knowing that the child was already dead.

“It’s not just that the little boy died, but I feel that I traumatized the people that were trying to help him because I was required, in my position as a dispatcher, to tell them what to do to try and save him. And I knew from their description that he was dead. But we have to follow the procedure; we have to try.”

This predicament is further compounded by the blame placed on dispatchers for negative outcomes. Gail explains:

“People curse us and call us names just because we’re doing our jobs.”

Before her diagnosis, Gail often found herself crying at work without reason; she would take a call regarding a minor injury and become emotional. Her supervisor eventually gave her permission to take a leave of absence.

Over the past few months she has had disruptive sleep, nightmares, headaches, and unexplainable muscle spasms:

“I am hyper-vigilant, especially when I hear sirens. And it doesn’t have to be an ambulance; it could be a police car or fire truck. I hear the sirens and I start tensing up and looking all around me.”

Gail has been on a year-long search for proper psychological support for her PTSD. Unfortunately, there are few mental health benefits offered to dispatchers. Gail sought help from doctors, counselors, and social workers, most of whom referred her to other mental healthcare workers without providing much support.

But there is reason to be optimistic. The Ontario government passed legislation in February 2016 for better mental health support and benefits for first responders with PTSD, including 911 dispatchers.

“It made me sad that no one was stepping up and taking care of us. I want my peers to understand what it’s like to have PTSD after doing this job because I felt so alone when it happened to me. But this new legislation is huge. I think it’s very important because it’s raising awareness around this concern.”

–Afifa Mahboob, Contributing Writer

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today

feature-_-af5-470x260-fe5510d0d275a89fd87a25acc8b8aee46014c652

Trauma Exposure Linked to PTSD in 911 Dispatchers

00Featured news, Health, Post-Traumatic Stress Disorder, Therapy, Trauma, Work September, 17

Source: Public Domain at flickr

In February 2016, Gail—a 911 dispatcher with Toronto Paramedic Services—found herself in tears at work. She had just received a call about Wallace Passos, a three-year-old boy from Toronto, who fell from a 17-story apartment building to his death.

At age 57, Gail has been working as an Emergency Medical Dispatcher for 15 years. Taking calls from around the city, she dispatches the closest ambulance. All dispatchers are expected to work 12-hour shifts, at times with only one colleague on duty.

This past year, Gail’s job became especially difficult for her when she was diagnosed with Post Traumatic Stress Disorder (PTSD). Gail recently spoke with the Trauma and Mental Health Report to discuss the experience that led to the diagnosis:

“I’m still haunted by the sounds of the family crying on the phone after the three-year-old fell off the building. I imagine the boy in pain, and it’s just awful.”

Gail is not the first emergency dispatcher to experience PTSD symptoms. A study conducted by researchers at Northern Illinois University described how 911 dispatchers are exposed to duty-related trauma, which is defined as an indirect exposure to someone else’s traumatic experience. Duty-related trauma puts dispatchers at risk for developing PTSD. Participants in the study reported experiencing fear, helplessness, and horror in reaction to various calls they received.

Along with the stress of being on the receiving end of difficult calls, emergency dispatchers also deal with the pressure and demand of following protocol, despite variability in situations.

Toronto Paramedic Services follows specific protocols set by The National Academy of Dispatch. The system was developed at Salt Lake City, Utah in 1988 and incorporates a set of 33 protocols for those answering 911 emergency phone calls. On a call, everyone is treated equally and is asked the same basic investigative questions. These questions are then used to give priority to life-threatening situations and provide guidance to first responders like firefighters, paramedics, and police officers on the scene.

While the protocols can be useful for guiding dispatchers through stressful situations, in other circumstances, they can cause pain and discomfort when a dispatcher can tell that a situation is hopeless. Dispatchers are not trained to deal with each unique case differently; they are expected to follow through with the routine questions regardless of circumstances.

In the case of Wallace Passos, Gail had to give instructions for CPR despite knowing that the child was already dead.

“It’s not just that the little boy died, but I feel that I traumatized the people that were trying to help him because I was required, in my position as a dispatcher, to tell them what to do to try and save him. And I knew from their description that he was dead. But we have to follow the procedure; we have to try.”

This predicament is further compounded by the blame placed on dispatchers for negative outcomes. Gail explains:

“People curse us and call us names just because we’re doing our jobs.”

Before her diagnosis, Gail often found herself crying at work without reason; she would take a call regarding a minor injury and become emotional. Her supervisor eventually gave her permission to take a leave of absence.

Over the past few months she has had disruptive sleep, nightmares, headaches, and unexplainable muscle spasms:

“I am hyper-vigilant, especially when I hear sirens. And it doesn’t have to be an ambulance; it could be a police car or fire truck. I hear the sirens and I start tensing up and looking all around me.”

Gail has been on a year-long search for proper psychological support for her PTSD. Unfortunately, there are few mental health benefits offered to dispatchers. Gail sought help from doctors, counselors, and social workers, most of whom referred her to other mental healthcare workers without providing much support.

But there is reason to be optimistic. The Ontario government passed legislation in February 2016 for better mental health support and benefits for first responders with PTSD, including 911 dispatchers.

“It made me sad that no one was stepping up and taking care of us. I want my peers to understand what it’s like to have PTSD after doing this job because I felt so alone when it happened to me. But this new legislation is huge. I think it’s very important because it’s raising awareness around this concern.”

–Afifa Mahboob, Contributing Writer

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

Copyright Robert T. Muller.

This article was originally published on Psychology Today