Trauma | Psychotherapy Toronto - Toronto Psychologist

Coping Through the Lens of a Camera

May 31, 201900Attention, Career, Ethics and Morality, Featured news, Media, Trauma, Work May, 19

Source: American Documentary, Inc at Flickr, Creative Commons

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

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

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

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

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

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

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

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

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

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

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

She described one such experience with a Bosnian family:

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

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

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

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

-Amanda Piccirelli, Contributing Writer, The Trauma and Mental Health Report

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

-Copyright Robert T. Muller

This article was originally published on Psychology Today

Jurors Are Left Traumatized by Some Court Cases

April 19, 201900Decision-Making, Dopamine, Empathy, Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Stress, Trauma April, 19

Source: Marica Villeneuve, Trauma and Mental Health Report artist, used with permission

On November 7, 2016, the Ministry of the Attorney General of Ontario reached a settlement with a juror diagnosed with vicarious post-traumatic stress disorder. The juror served on the trial of eight-year-old Tori Stafford’s killer.

The woman, who cannot be named due to a publication ban protecting the identity of jurors in this case, received the diagnosis months after performing her civic duty. Four years ago, she was one of 12 jurors in the trial of Michael Rafferty, the man charged and convicted of kidnapping, sexually assaulting, and murdering Stafford.

While sitting on the jury during the two-month trial, the woman visited scenes of rape, saw photographic evidence of the crime, and heard eyewitness testimony from Rafferty’s girlfriend and accomplice, Terri-Lynne McClintic.

In a submission to the Ontario Court of Appeal, the juror said that, almost immediately after the trial, she lashed out at her children, suffered from depression, had flashbacks to disturbing pieces of evidence, and experienced short-term memory loss and difficulties with concentration.

Over the course of a criminal trial, jurors are often exposed to disturbing graphic evidence. And while jury members are instructed to remain unbiased and evenhanded, the process can take a toll on their mental health.

Beyond the traumatizing effects of graphic evidence, the weight of the task itself can be harmful to jurors’ wellbeing. The high-stakes decision that members have been tasked with, which includes determining the fate of someone’s life, can be psychologically taxing. This pattern of stress and anxiety is frequently observed in other high-pressure jobs that involve exposure to traumatic information and heavy responsibilities, such as social work.

Patrick Baillie, a psychologist with Alberta Health Services, and former Chair of the Mental Health Commission of Canada, says that jury members are often not mentally prepared to sit through a criminal trial:

“These are twelve citizens who don’t typically have any involvement with the system, which is why we want them to serve as jurors, being given this extraordinary task with not a whole lot of mental support.”

In addition to the responsibility of remaining impartial, jurors are not allowed to share any details related to their deliberations. To protect the integrity of the trial, members are prohibited from discussing their personal views on the evidence, witnesses, or trial process, to ensure confidential information cannot be related back to discussions that took place in the jury room. Baillie explains:

“It is illegal to disclose the deliberation of a jury to anybody. So, [you] can’t tell a spouse and family and friends… people in [your] usual support system and the mental health professionals that [you] may want to come in contact with down the road. We need to make sure that jurors are not identified and to make sure the process is pure as it can be.”

Under these circumstances, jury members are left to process the psychological and emotional effects of the trial on their own.

Barbara Legate, the lawyer representing the juror from Stafford’s case, argues:

“We ask jurors to sit through days, weeks, and sometimes months of testimony and sometimes that testimony is very, very difficult, and we ask them to keep it to themselves, not discuss it with people outside.”

Until recently, Ontario judges were responsible for deciding whether jurors should be offered counseling at the end of a trial. Jurors would then either be connected with counselors provided by the Ministry of the Attorney General or would pursue counseling on their own.

Starting in January 2017, however, Ontario initiates a new program to provide free and accessible counseling services to anyone serving on a jury. The Ontario Attorney General Yasir Naqvi says the Juror Support Program will be available for anyone serving in a criminal or civil trial, or an inquest.

Jurors will be provided with information on the program at the beginning of a trial, and then again as it finishes. They will call a designated phone number, speak to a specialist who does an assessment, and have counseling made available to them. A third party will provide and cover the costs of the counseling services, but the government still determines who that third party will be. Naqui says:

“Jurors in difficult trials do face evidence that could be quite horrific, and we’ve heard those stories. It’s only appropriate that we provide appropriate services.”

-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

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

-Copyright Robert T. Muller

This article was originally published on Psychology Today

When Male Rape Victims Are Accountable for Child Support

February 21, 201900Adolescence, Caregiving, Featured news, Law and Crime, Sex, Trauma February, 19

Source: Steve Halama at Unsplash, Creative Commons

When Shane Seyer was 12, he was sexually exploited by his 16-year-old babysitter Colleen Hermesmann. She became pregnant with Seyer’s child in 1989 and was charged with statutory rape shortly afterward. Instead of being convicted of rape, Hermesmann was declared a juvenile offender under the non-sexual offense of “contributing to child misconduct.” Seyer was subsequently court-ordered to pay child support.

In 1993, at the age of 15, Seyer appealed this decision to the Kansas Supreme Court, arguing he should not be liable for these payments. He maintained that his babysitter (Hermesmann) took advantage of him sexually when he was too young to give consent.

The Kansas Supreme Court ruled against him. The judgment stated that, because Seyer initially consented to the sexual encounters and never told his parents what was happening, he was responsible for supporting the child.

This court case set a precedent for male rape victims to make child-support payments. The financial needs of the children outweigh the court’s interest in deterring sexual crimes against male minors, even if statutory rape is the cause of conception.

More recently, in 2014, Nick Olivas of Arizona was forced to pay over $15,000 in back-payments to a woman who had sex with him when he was 14. She was 20 years old at the time. Commenting on the Olivas case and others like it, Mel Feit, director of the New York-based advocacy group the National Center for Men, told the Arizona Republic newspaper:

“To hold him unresponsible for the sex act, and to then turn around and say we’re going to hold him responsible for the child that resulted from that act is off-the-charts ridiculous… it makes no sense.”

Peter Pollard, co-founder of 1in6, an organization designed to help male assault survivors, explained in an interview with the Good Men Project why we downplay the severity of male sexual assault:

“We’re all raised in a culture that says boys are always supposed to initiate and enjoy a sexual experience and males are never supposed to see themselves or be seen as victims. The easiest default is to blame the victim, to say ‘he wanted it,’ ‘he must have chosen that.’”

These attitudes toward male sexual assault are apparent even in the way these men are treated during their court cases.

In 1996, the court heard the case of County of San Luis Obispo v. Nathaniel J in which a 34-year-old woman became pregnant after sexually exploiting a 15-year-old boy. He was also forced to pay child support, and then Deputy Attorney General Mary Roth alleged:

“I guess he thought he was a man then. Now, he prefers to be considered a child.”

Some professionals, such as Mary Koss from the University of Arizona who published the first national rape study in 1987, even argued that men and boys cannot be raped by women. In a radio interview, Koss stated:

“How would [a man being raped by a woman] happen… how would that happen by force or threat of force or when the victim is unable to consent? How does that happen? I would call it ‘unwanted contact.’”

Research indicates, however, that men can be stimulated and achieve an erection in times of fear and terror, despite not being aroused. Studies range from cases where men report arousal during assault, to scientific experiments that find men have erections under many non-sexual circumstances, including when they are unconscious.

In her research, Myriam Denov, a professor at McGill University who holds the Canada Research Chair in Youth, Gender and Armed Conflict, asserted:

“The professional assumption that sexual abuse by women is less harmful than similar abuse by men has potentially dangerous implications for [male] victims of sexual abuse. If professionals fail to recognize sexual abuse by women as potentially serious and harmful, child protection plans will not be made.”

She goes on to say that, as a result, the experiences of male victims who come forward to disclose sexual abuse by women may be trivialized. These misconceptions can lead to delayed referral to social services, or failure to provide victims with the care and support they require.

Until the idea that women cannot rape men and other rape myths are dispelled, cases where victims are misunderstood and mistreated, and even made to pay child support to their former abusers, are likely to continue.

– Ty LeBlanc, 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

What Can A Lizard Tell Us About Mental Health?

December 13, 201800Animal Behavior, Child Development, Epigenetics, Evolutionary Psychology, Featured news, Genetics, Health, Parenting, Stress, Trauma December, 18

Source: Hayke Tjemmes at flickr, Creative Commons

A new study on lizards has found that, when exposed to stress, their responses can be passed down genetically. Scientists now believe there may be more to the process of heritability than once thought. This process is called “Transgenerational Stress Inheritance.”

As recently as 2011, most research did not examine the possibility that parental stress could affect sperm or egg cells. Since genes are transferred to offspring through these cells, anything that modifies them can have an impact on genetic expression in children. The idea that parents’ experiences prior to pregnancy can change gene expression and, therefore, affect offspring behaviour, is novel.

In the lizard study, researchers from Pennsylvania State University exposed young lizards to fire ants (a natural stressor) and compared stress levels to unexposed lizards. Interestingly, contact with the stressor did not affect the lizards’ behaviour later in life. But, their offspring had stronger stress reactions than offspring of lizards who had not been subjected to the ants.

Lead researcher Gail McCormick told PsyPost:

“Our work reveals that the stress experienced by an individual’s parents or ancestors may overshadow the stress that an individual faces within its lifetime. In this study, offspring of lizards from high-stress sites were more responsive to stress as adults, regardless of exposure to stress during their own lifetime.”

These findings suggest that, although early life stress may not manifest later in adulthood, the effects may be passed down to offspring, even if offspring are not directly exposed to the stressor.

A similar study involved researchers conditioning mice to associate the smell of cherries with a mild electric current. When the fragrance permeated the air, the mice were given a small electric shock. And so, the mice began to fear the scent even when the shock wasn’t administered. Even more fascinating was that offspring of these mice, as well as their offspring, experienced fear in the presence of the odor. The fear reaction occurred even though the later generations didn’t experience the conditioning process.

Of course, the question these studies pose is whether there is a similar effect in humans.

As recently reported in the Guardian newspaper, researchers from New York’s Mount Sinai School of Medicine compared the genes of direct descendants of Jews who were “interned in a Nazi concentration camp, witnessed or experienced torture or who had had to hide during the second world war” to the offspring of Jews living outside of Europe who were unharmed. The children of parents who experienced WWII trauma showed genetic changes and a greater risk of stress disorders. These were not present in the other children. The Guardian article stated:

“[The] new finding is [a] clear example in humans of the theory of epigenetic inheritance: the idea that environmental factors can affect the genes of your children.”

In other research, psychologist Margaret Keyes from the University of Minnesota and colleagues examined twins to determine if the behaviour of biological parents could affect offspring who were not raised by them. The study found that children of parents who smoked were more likely to be smokers, even if those children weren’t raised by the parents, and as such, did not have parental smoking behavior modeled to them. Scientists are still questioning, though, whether it’s parental behavior directly affecting these genes or a genetic predisposition to smoking being passed down for generations.

On the whole, these studies make the case that genetic changes can happen a lot faster than previously thought, within a few generations or even one generation. And, as reported in Science magazine, people can see evolution in real time:

“Now, thanks to the genomic revolution, researchers can actually track the population-level genetic shifts that mark evolution in action—and they’re doing this in humans. [Studies] show how our genomes have changed over centuries or decades…”

Research in this field is still new and is subject to several caveats. Perhaps the most important one is the complexity of human beings and their environments. Indeed, there may be too many variables that factor into the human experience for researchers to arrive at definitive conclusions.

But, these studies do suggest that individuals may be affected by the stress felt by ancestors in before them. Further research is required to determine whether these findings are the result of transgenerational stress inheritance or an external factor that has yet to be considered.

– 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

Man to Monster

November 29, 201800Ethics 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

Prison Executioners Face Job-Related Trauma

October 12, 201800Decision-Making, Empathy, Featured news, Guilt, Law and Crime, Trauma October, 18

When an order of execution is issued by the courts in the United States, the prison warden or superintendent is responsible for the sentence being carried out—often by Corrections Officers (CO) who are unaware they will be tasked with killing a prisoner.

Complicating matters, human connections are frequently formed between guards and prisoners. According to Jerry Givens, who administered the death penalty in Virginia to 62 inmates over 25 years, COs may spend more time with death-row prisoners than with friends or family, and can develop empathy towards these inmates.

With potential bonds between death-row guards and prisoners in mind, a separate team of officers frequently conducts the actual execution. COs directly involved with the prisoners are often given smaller roles, such as walking the prisoners to the execution spot, or putting a hood over their head. This approach aims to reduce the emotionally damaging effects of executions on those in close contact with the inmates.

Authorities also try to disperse feelings of responsibility for the killing by having multiple guards involved in the execution process. With lethal injection, the method of execution used in most States, three COs are assigned to turn a key switch that releases the lethal drug into the prisoner. Only one “live” switch dispenses the fatal chemical. The CO initiating the procedure that ultimately kills the prisoner is not known.

Despite such measures, guards can feel mentally tortured by their participation in executions, both before and after.

As illustrated in Into the Abyss, a documentary detailing the death sentence of convicted killer Michael Perry, many execution guards experience post-traumatic stress disorder (PTSD). One guard explained his acute symptoms at the outset of his descent into PTSD. He began crying and shaking uncontrollably when “the eyes of all the inmates he had executed began flashing before him.” Another developed nightmares, cold sweats, and sleeplessness.

Other guards, like Givens, have reported depression, inability to sustain relationships, and changes in personality. According to Rachel MacNair, author of Perpetration-Induced Traumatic Stress: The Psychological Consequences of Killing:

“The inner lives of guards who execute become like those of battlefield veterans who suppress memories from themselves and others.”

In 2007, two South Carolina COs who developed obsessive compulsive behaviour, nightmares, and other emotional disturbances filed civil lawsuits, claiming that their conditions resulted from performing executions. The COs alleged that they were coerced into carrying out executions and were not given any debriefing or counseling to help them deal with the emotional effects.

For some guards who need psychological treatment, it is simply not available. Other times, guards do not use available psychological help for fear of bei

Source: Feature: Fumigraphik at flickr, Creative Commons

ng labelled ‘weak’ by their colleagues. Additionally, guards may not have the opportunity to talk about their involvement in executions with members of their families. Givens explained:

“When I accepted the job, I never told my wife or kids or anybody. I didn’t want them to go through anything I had to go through. If I told someone, they would tell someone. It would have been like a snowball and gotten bigger and bigger and everyone would know exactly what I was doing.”

This secrecy protects guards from having to explain or defend their actions. But it also prevents them from obtaining help to lessen the ill-effects of the associated trauma. Lack of disclosure precludes obtaining support.

The unacknowledged stress experienced by guards on execution teams risks dangerous mental-health consequences. As Givens, who now campaigns to end the death penalty, put it:

“It’s not an easy task to do. If I had known what I had to go through as an executioner, I wouldn’t have done it. You can’t tell me I can take the life of people and go home and be normal.”

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

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

This article was originally published on Psychology Today

Using Art to Heal from Sexual Assault

September 27, 201800Anger, Creativity, Featured news, Relationships, Self-Control, Therapy, Trauma September, 18

Source: Safi, Frizz kid,used with permission

Frizz Kid (Hana Shafi), a writer and visual artist based in Toronto, Canada, deals with themes of feminism, sexual violence, and self-care. Shafi first came to prominence through social media after the high-profile Jian Ghomeshi sexual assault trial in Toronto. Prominent radio personality Ghomeshi was charged with, but subsequently acquitted of, multiple counts of sexual violence.

Ghomeshi’s victims were essentially blamed for the assaults, and their stories were discounted as inconsistent or false. Following the trial, numerous artists and activists joined together under the hashtag #WeBelieveSurvivors—Shafi among them. And her craft was deeply affected and altered by the outcome of the trial.

In an interview with the Trauma and Mental Health Report, Shafi discussed the impact on her art:

“The period after the trial was really difficult. The constant media coverage of what happened to these women and the ultimate lack of justice was hurtful, particularly to survivors of sexual assault. A compassionate perspective was missing. The trial turned into an attack on their characters instead of focusing on the wrong that was done to them.”

In reaction, Shafi began her most well-known work: her Positive Affirmation Series. Shafi combined drawn images with words to assert comforting phrases, such as “healing is not linear,” “it’s natural to have emotional baggage,” and “you are worthy of love.”

According to Shafi:

“The series has been a way for me to express solidarity with victims of sexual assault. I never expected the art to get as big a reception as it has.”

Her art serves several purposes. She creates it to cope, as well as to help others:

“All my pieces have a purpose for me as much as for others. I find it personally healing to create, but I also want to help others and create a community of people around art where we can heal together, be angry together, be sad together, and create together.”

To engage more closely with her audience, Shafi recently collaborated with Ryerson University as their artist-in-residence. There, she conducted free workshops on making zines, which are short, self-published magazines made by photocopying and binding artwork, poetry, or other writing.

Participants were invited to answer the following:

“Have you ever thought about what you would say to the person who sexually assaulted you? What would you want your peers to know? What would you like to remind yourself?”

These works were compiled for an art installation, titled “Lost Words.” In an Instagram post, Shafi explained:

“Through these questions, we can communicate the lost words; all the things that have been left unsaid but need to be heard.”

When speaking with the Trauma and Mental Health Report, she added:

“I really wanted there to be a platform for people impacted by sexual violence to speak about their experiences. To say the things they never had an opportunity to say, or felt they couldn’t say. I wanted people to get the sense that they could say whatever they wanted in that space and that they would be safe doing so. This is them talking back. I think having an outlet like this is critical for the healing process.”

Shafi also stressed the important role that participant anonymity played in “Lost Words:”

“There’s safety in anonymity. People are not super understanding about this subject matter; there needs to be anonymity.”

Some may be familiar with the therapeutic practice of writing a letter to a person who has hurt them, then destroying the letter. These so-called “hot letters” are used as a form of emotional catharsis.

Similar ideas were explored by Shafi in this exhibit. “Lost Words,” however, dealt with having private and painful thoughts read by the public. These works were exhibited in conjunction with the Sexual Assault Roadshow, a travelling art gallery that aims to change the public’s perception of survivors of sexual assault. This decision to exhibit to the general public was tactical. Shafi explained:

“I think through viewing the works, they begin to understand; they get a small glimpse into the reality of a survivor; they see the injustice, trauma, and frustration.”

Survivors of sexual assault benefit from the exhibit too, Shafi argued:

“They express what they’ve always wanted to say but never had the platform for. It may have been unsafe for them to say things before, but they are now excited that their work will be seen—that they can speak in a public setting while remaining anonymous.”

The reception to the exhibit was overwhelmingly positive, with many reaching out to Shafi to express their gratitude. Others, Shafi said, were genuinely surprised by the exhibit, which she suspected was a reality check for them.

Shafi stressed that she is not giving survivors a voice because they have their own voice.

“I think what I’m doing is giving them a space to feel heard and validated. Giving them art that emphasizes their experience, highlights their issues, and provides a compassionate space.”

– “Fernanda de la Mora, 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

What if Your Father Were a Pedophile?

August 30, 201800Embarrassment, Family Dynamics, Featured news, Psychiatry, Punishment, Relationships, Trauma August, 18

Source: Feature: enki22 at flickr, Creative Commons

“Between You and Me,” a documentary by director Chase Joynt, examines what it feels like to discover a family member has done a terrible thing. In this short film, Chase accompanies his friend Rebekah Skoor as they travel to visit Rebekah’s father, Michael, a convicted pedophile.

Michael Skoor, a pastor and family man, was convicted of repeatedly molesting an 11-year old boy. After contemplating suicide, he confessed the abuse to a psychiatrist, who reported him. Michael turned himself in, pled guilty, and was sentenced to 29 years in prison. For many, the story ends there, but for Rebekah and her family, the story just begins.

After her father’s revelations, Rebekah and her family faced social ostracism and stigmatization from their community. And, they felt their own feelings of shame. These repercussions often fall on families of sex offenders. “It was a really scary time,” Rebekah recounts to Chase in the film, as they prepare to travel to see her dad in prison.

A study by Professors Jill Levenson and Richard Tewksbury reported on data from family members of sex offenders. These families experienced financial hardship, housing displacement, and psychological distress. They also met with social repercussions, such as ridicule and teasing, as a result of their loved one’s actions.

In addition to feeling humiliation and shame, family members feared for their personal safety. Of all participants studied, 44% reported they had been threatened or harassed by a neighbor. Children of offenders suffered from depression and anxiety due to being bullied at school by both teachers and fellow students.

The public’s animosity toward these families may have its roots in the belief that family members know about the relative’s crimes, and could have intervened to stop them. It’s not uncommon for some members of law enforcement, the media, and the helping professions, to voice such assumptions, which may influence public opinion.

In an opinion piece by psychologist Seth Myers, he portrays the wife of disgraced football coach Jerry Sandusky as a guilty party to her husband’s crimes, even though she was never charged for any part in the assaults. And, Myers had never clinically assessed Sandusky’s wife. The assumption of guilt-by-association is a dubious claim to make, and may be at the heart of stigma faced by family members of sex offenders.

In an interview with the Toronto Star, psychiatrist Paul Fedoroff refers to the family members of sex offenders as “secondary victims.” These people are often abandoned and left reeling in the aftermath of the crime.

Families must also deal with their own personal feelings and internal conflicts. In the Toronto Star article, Scott Woodside, of the Sexual Behaviours Clinic at the Centre for Addiction and Mental Health (CAMH) in Toronto, explained that children of sexually abusive fathers “don’t like that their father did this to them but they love their father… and do not want their father to be taken away because no one will replace him.” The same can apply when parents abuse outsiders.

While acknowledging the seriousness of the crimes committed by these sexual predators, their families are confronted with the difficult task of trying to reconcile their good memories with the knowledge of the terrible act the relative committed. They are caught in the middle.

And to them, the offense is hard to integrate. In a deleted scene from “Between You And Me,” Rebekah explains her difficulty in trying to convey this dichotomy to others when speaking about her father:

“I feel called to give the back story of the 21 years of awesomeness that was in my life. Not perfection, but good intentional fathering. Before I land this heinous offense on people… I want them to be able to hold with me my dichotomy, that he is in some part hero and in some part this fallen man.”

Rebekah wants to illustrate both sides of her father, the man she knew, and the crimes he committed. Recognizing these two seemingly incompatible aspects leaves Rebekah feeling she is caught between loving her father and condemning his actions. Rebekah’s recollection of his sentencing illustrates the issue well.

“It felt very divided… the people with the ribbons who were there for the [victim] and the people without ribbons who were there for my dad. I really felt this profound sense of, ‘I also want a ribbon. I’m not pro sexual violence. I’m not endorsing my father’s actions.’”

She does not approve of what he did. And yet, “The terrible things don’t undo the love.”

– Stefano Costa, 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

Unforeseen Stress When a Child Receives a Transplant

April 26, 201800Featured 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. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

Inadequate Training Increases Risk of Compassion Fatigue

March 15, 201870Burnout, Caregiving, Featured news, Health, Stress, Trauma, Work March, 18

Source: Pennsylvania National Guard at flickr, Creative Commons

Every afternoon, personal support worker Susan (name changed) struggled with administering medication to a particular elderly patient in the dementia ward where she worked. On one such occasion, fed up with the patient’s behaviour, Susan became so frustrated that she mumbled a profanity, reached over, and pinched the patient’s arm. With a sharp cry of pain, the patient quickly accepted the medication and Susan was able to move on.

Stories of malpractice or poor patient care like this are not as uncommon as one might imagine. Evident from media reports of negligence in hospital settings, such cases can ignite an outcry in the community and prompt questions about individuals’ suitability for caretaking roles. How could someone with a career revolving around caring for others lack empathy?

Grace, an Ontario care worker who witnessed Susan’s behavior firsthand, believes the demanding nature of the job took a physical and mental toll on her co-worker. Having worked for eight years at a residential center for dementia patients, Grace knows from experience just how mentally exhausting the work can be. In an interview with the Trauma and Mental Health Report, Grace explained:

“There’s so much to take care of with these particular patients. When it’s dinnertime, you have to make sure to clean the patient, take them to the dining room, prepare the area for them, feed them, etc. But the next thing you know, they may have soiled themselves or vomited and you have yet another thing to clean when you already have so much to do… There are times when you need to take dirty clothing or dishes from them and they refuse to give them to you or just start yelling at you.”

When faced with the same situation on a daily basis, Grace explains that it’s hard not to become exasperated:

“It can get annoying and even angering at times. It’s hard to control… I didn’t hear much from Susan when I first started working here, but then she began yelling at the patients. I do believe it’s because the stress finally got to her.”

Mental health professionals support Grace’s theory. Overworked employees who are plagued by such feelings of frustration are showing signs of Compassion Fatigue (CF).

Francoise Mathieu, CF specialist and founder of Compassion Fatigue Solutions in Kingston, Ontario, describes the condition on her organization’s website as a gradual emotional and physical exhaustion of helping professionals. While CF is sometimes used interchangeably with Vicarious Trauma (VT), there is a difference between the two. VT is a secondary form of post-traumatic stress disorder, where a worker becomes preoccupied with a specific event or patient problem. On the other hand, CF is an overall decline in the ability to empathize with others.

The American Institute of Stress also differentiates CF from ‘burnout’. With CF, the constant pressure to show compassion toward patients may wear on mental energy stores, leading workers to become emotionally blunted to people and events. Burnout is less dependent on this loss of compassion.

CF is not limited to mental health professionals. It has been shown to affect teachers, social workers, police officers, prison guards, and even lawyers who work with trauma victims. In Grace’s words:

“At first, the stories you hear and the things you see involving the patients really do follow you home. They used to make me feel depressed. Over time, that sensitivity does lessen. After being exposed to this type of thing day after day, you start to lose those feelings.”

According to CF expert Francois Mathieu, once workers begin to experience this emotional exhaustion, they may be prone to moodiness, irritability, difficulty concentrating, intrusive thoughts, feelings of hopelessness, and apathy in both workplace and personal relationships. Fran McHolm, Director of Continuing Education at the Nurses Christian Fellowship has written about how CF can lead to a decrease in general employee happiness, workplace satisfaction, and quality of patient care.

CF is not a rare condition. Results from a 2012 dissertation study by Shannon Abraham-Cook at Seton Hall University show that, out of 111 urban public school teachers in Newark, New Jersey, 90% were at high-risk for CF. In 2010, Crystal Hooper and colleagues from the AnMed Health Medical Center in South Carolina also found that 86% of emergency department nurses exhibited moderate to high levels of CF.

While CF is common in many workplaces, help for employees who are experiencing symptoms, is not readily available. In an interview with the Trauma and Mental Health Report, Isabella, an assistant teacher working with special needs children at a Toronto daycare, describes her experience:

“When we began training, the instructors only talked about how to care for the children and how to work with the different age groups. Management didn’t provide us with anything else. The only thing we can do when feeling overly stressed is go for a break.”

Grace adds that her center for dementia patients fails to directly address employee needs:

“Recently, they added cameras everywhere to prevent poor patient care, but it’s made things worse. Now we are forced to seem especially compassionate and the littlest mistake can lead to a suspension. The management doesn’t try to understand the worker’s view of things at all.”

Dan Swayze, vice president of the Center for Emergency Medicine of Western Pennsylvania, discusses several ways management can address employees’ personal needs pertaining to compassion fatigue. In an article in the Journal of Emergency Medical Services, Swayze writes about the importance of implementing policies and developing programs that can help ease the onset of CF. Teaching employees how to set professional boundaries with patients, conducting meetings to solve individual client issues as a team, and offering counselling services to stressed employees are just a few options administration can take.

And a 2015 study by researcher Patricia Potter and colleagues in the Journal of Continuing Education in Nursing argues for resilience training, a program designed to educate personnel about CF and its risk factors. Workers are taught how to employ relaxation techniques and build social support networks to cope with symptoms that arise from working with difficult populations. Staff members from a US medical center who participated in the training self-reported an increase in their empathy and overall emotional health.

Volunteer crisis hotline operator, Anabel, explains the benefits of these resources in her line of work:

“The staff at the distress center are really considerate of their volunteers. In the training they prepare you for compassion fatigue, encourage volunteers to take care of themselves, and to not take the calls home with you. They also make sure to be available to the volunteers 24/7 in case they need to debrief a call with someone. It really helps to know they’re there to talk to—often after a distressing call.”

Training and intervention programs can help safeguard against the development of compassion fatigue in care workers. But many people working in the field, like Grace and Isabella, have been thrown into care-taking roles with no consideration for the risks to their mental wellbeing. Both women have identified various ways of coping as a stopgap until they receive the assistance and support they need.

Isabella suggests taking full advantage of breaks every few hours:

“Whenever you feel overwhelmed, go for a break right away—even if it’s just to the washroom or for a coffee… When you leave and come back, you feel refreshed. I’m lucky that I live so close to my workplace that I can go home during lunch.”

Grace recommends taking a deep breath and focusing on any positive aspect of the job:

“I learn so much from the patients. Hearing their stories, you can end up getting really close to some of them. I try to listen to them when I can and when I see the positive effect that has on them, I feel very fulfilled.”

These coping mechanisms do not work for everyone, which is why early intervention is so important. While camera implementation has prevented some inappropriate conduct like Susan’s from continuing, it doesn’t address the root problem.

“There are times where I get angry,” Grace admits. “I can’t always entertain patients or be friendly. I try… but it’s so hard… I know a lot of people, like myself, are really sensitive, which is why we are so emotionally affected by this job. There’s no stress management or counselling here, but… these training programs could really help.”

For many helping professionals, compassion fatigue may be inevitable. Cases like Susan’s show that the wellbeing of individuals in caretaking roles directly influences the quality of care that patients will receive. Support in the form of training programs and other preventative measures can make a difference in the lives of these workers, and, improve patient care.

–Anjali Wisnarama, Contributing Writer, The Trauma and Mental Health Report.

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

This article was originally published on Psychology Today

Category: Trauma