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Complementary and Alternative Medicine Approaches to Trauma

Complementary and Alternative Medicine (CAM) approaches to trauma treatment and prevention are treatment plans outside the realm of clinical approaches. These may include yoga, mediation, acupuncture, homeopathy, oriental medicine, massage therapy, herbal medicine, electromagnetic therapy, hypnosis, art therapy such as dance and music, among so many more. (Johns Hopkins Medicine). These forms of treatment are creative ways of healing trauma without the use of prescription medicine.

"Through the years, a significant amount of progress has been made with nontraditional approaches to trauma treatment. Some of the most researched and supported methods include yoga and mindfulness, but they are not the only options available for people who experience symptoms of PTSD." (Rousseau, Module 4).

I want to talk about how meditation is used to improve PTSD symptoms. According to an article by Healthline, "meditation is a practice that can help you focus your mind and gain greater awareness of yourself, thoughts and inner experience, surroundings, and moment-to-moment needs." There are different kinds of mediations, and some might help reduce stress-induced trauma and PTSD symptoms more than others. One of the leading meditation forms is called "mindfulness". According to Healthline, "mindfulness refers to a state of mind where you can acknowledge your thoughts, feelings, and bodily sensations without judgment." This form of meditation helps one become more aware of the present moment, while staying safe and grounded while recalling past experiences or memories.

According to Module 4 of the course materials, Mindfulness refers to "the unprejudiced noticing of physical and emotional experiences, designed to enhance clarity and reduce rumination and self-critiquing." In both definitions, the key word would be "without judgment" and "self-critiquing". It is important to realize that you are engaging in mindfulness to not only heal, but to remember that your experiences do not define you.

CAM approaches are not for everyone, just like traditional treatment options are not. Finding what works for you is all apart of your own journey to healing. The process is ongoing, but it is important to know that there are many options available to you, all you have to do is choose.

References:

Rousseau, D. (2022). Module 4: Pathways to recovery: Understanding approaches to trauma treatment. https://learn.bu.edu/bbcswebdav/courses/22sprgmetcj720_o2/course/module4/allpages.htm

Swaim, E. (2022, April 20). Can meditation help ease PTSD symptoms? Healthline. Retrieved April 21, 2022, from https://www.healthline.com/health/ptsd-medita

Types of complementary and alternative medicine. Johns Hopkins Medicine. (n.d.). Retrieved April 21, 2022, from https://www.hopkinsmedicine.org/health/wellness-and-prevention/types-of-complementary-and-alternative-medicine

Service dogs can help people who have PTSD

Posttraumatic Stress Disorder (PTSD) is a serious problem in the US, according to the "What is Posttraumatic Stress Disorder (PTSD)?" written by American Psychiatry Association, "PTSD affects approximately 3.5 percent of U.S. adults every year, and an estimated one in 11 people will be diagnosed with PTSD in their lifetime. Women are twice as likely as men to have PTSD."  (APA) We can see that PTSD affects so many people, therefore, service dogs are a way to help the people who have PTSD. Service dogs can be soothing the PTSD emotional and physical problems, let's talk about how can service dogs can help people.

First, we know that some PTSD patients cannot take care of themselves and cannot perform tasks that will keep them safe(Rousseau, D, 2022). Therefore, we need to have Psychiatric service dogs, the service dogs are trained to help the patients in their life, for example, "find a person or place, conduct a room search, signal for certain sounds, interrupt and redirect, assist with balance, bring help, bring medication in an emergency, clear an airway, and identify hallucinations. (Rousseau, D, 2022)"
Also, the service dog can help the patient emotionally because the service dog can stay with you and support you when you feel sad and lonely. Most people who have PTSD also will have some psychiatric problems like depression, anxiety, service dogs can help them to relax and service dogs can know that the patients have the symptoms of anxiety, when its know, it will try nudging, pawing, or licking the handler till the patients calm down (6 WAYS SERVICE DOGS HELP PEOPLE WITH PTSD, 2020).
Finally, service dogs can be a reminder of the patients, for example, they can remind the patients that is time to take their medicine and remind them of routine tasks such as eating and sleeping (6 WAYS SERVICE DOGS HELP PEOPLE WITH PTSD, 2020).
However, the service dogs have some weak parts, and that is service dogs cannot cure PTSD, and they just can get simple support before, during, and after the trigger(Rousseau, D, 2022). In my opinion, I think that even though service dogs cannot cure PTSD, they also support the patients a lot when the patients need help. Service dogs can be soothing the PTSD emotional and physical problems, when the patients who in danger, they also will help them to solve the problems.

I think that dogs can help us to relax and my dog lets me know that she will stay with me when I need help. I really love my dog because she helped me across the most difficult experience in my life. On the other hand, I also think that not only dogs can help us to calm down, but also cats or horses can help us to solve the problem.

References Material

American Psychiatry Association. (n.d.). What is posttraumatic stress disorder (PTSD)? Psychiatry.org - What is Posttraumatic Stress Disorder (PTSD)? Retrieved April 20, 2022, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd#section_10
Jimenez, J. (2020, December 4). 6 WAYS SERVICE DOGS HELP PEOPLE WITH PTSD. New Life K9s Service Dogs. Retrieved April 20, 2022, from https://www.newlifek9s.org/news-events/blog/service-dog-blog.html/article/2020/12/24/6-ways-service-dogs-help-people-with-ptsd
Rousseau, D. (2022). Module 4: Pathways to recovery: Understanding approaches to trauma treatment. Blackboard, https://onlinecampus.bu.edu/bbcswebdav/pid-9960461-dt-content-rid-63971458_1/courses/22sprgmetcj720_o2/course/module4/allpages.htm

A Self-Care Framework to Maximize Resiliency and Mitigate Trauma

Trauma is any type or series of event(s) that triggers a chronic stress response in your body. While an acute stress response is beneficial for accomplishing goals, like meeting a deadline at work or protecting yourself by initiating a fight/flight response, you become harmed psychologically and physically when the stress becomes chronic in nature (Rousseau, 2022). Trauma can include anything from witnessing a terrorist attack (direct trauma), to listening to a friend or stranger as they share about their experience being raped (vicarious trauma). An example of how a series of events could become traumatic, would be when a corrections officer feels manipulated by inmates, feels unsupported by her fellow officers, and feels highly scrutinized by management. In the short-term, the officer may be resilient and feel determined to succeed, but over months or even years, going to work can slowly become a traumatic experience as resiliency fades and chronic stress develops.

Resiliency in the face of trauma, is the ability to relieve stress through self-regulation (physical and emotional) and self-care (Rousseau, 2022). By combining what I have learned from Dr. Rousseau and Dr. van der Kolk, I propose the following framework as a guide for developing a self-care plan that maximizes resiliency and mitigates trauma:

1. Breath & Mindfulness – You need to be able to “feel what you feel and know what you know” without becoming overwhelmed (van der Kolk, 2014). Learning breathing and mindfulness techniques will lay the foundation for being able to emotionally handle the thoughts and feelings that have been suppressed.
2. Rhythmic Interactions – Dancing, singing, playing an instrument, and other non-musical rhythmic actions like tossing a ball back and forth, increase pleasure and connection, while decreasing stress (van der Kolk, 2014).
3. Feel Your Body – Numbness is a common symptom of trauma, but people have a need to feel their body. Exercise and hugs provide physical sensations that can calm us down (van der Kolk, 2014). On the other end of the spectrum can be body tension that prevents the feeling of calming physical sensations. Massages and floating in a pool can help to ease physical tension in the body.
4. Feel What You Feel – Do not try to suppress tears or ignore emotions. Let yourself feel what you feel and think what you think.
5. Feel Heard – Find ways to verbally express your thoughts and emotions. This could be done through close friends, a therapist, or even journaling. Finding the words to describe your deepest thoughts and feelings, without fear of criticism or broken confidentiality, is a powerful stress reliever.
6. Self-Compassion – It is impossible to heal the self when you hate yourself. Know that you are enough and thrive in that realization. Know that you are worthy of the good in your life, and that your actions and thoughts are reasonable for your circumstances.
7. Friends & Family – Surround yourself with people who will accept you as you are and be your true self around them. They should make you feel normal, not like a burden or a rare breed of stupid. They should also make you feel safe.

By ensuring that each of these aspects are thoroughly applied to your life, via a list of activities that are your self-care plan, you will maximize your resiliency and mitigate the potential effects of trauma. This is not a perfect solution for healing from trauma, but it is a great way to become chronic stress resistant.

References

Rousseau, D. (2022, March). Module 1: Introduction to Trauma [Online lecture materials]. Boston University.

van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin.

The Value of Journaling in a Self-Care Regimen

“Paper is more patient than man.” – Anne Frank

The use of words to express the thoughts of man marked the seminal invention of civilization.  The process of journaling has a history as old as mankind, and its use in the recollection and confrontation of trauma is one of the great art forms of our collective enterprise.  Whether the musings of a Roman emperor like Marcus Aurelius, the mundane and brilliant daily thoughts of luminaries like Da Vinci, Curie, or Darwin, or the heartsick memoirs of those whom the world only ever met through their words like Anne Frank, the journal has been a daily outlet by which folks vent their daily stress and personal traumas throughout history.

The beauty of the process of journaling is that it has no innate structure or demands.  Although journaling does not work for everyone, for some it is a transformational experience – one which helps them to cope with the struggles around them as they seek balance.  For some like Thomas Jefferson, the journal contained observations of the world around them.  Others, like Thomas Edison recorded quite humanizing elements in their journal – battles to avoid tobacco addiction, struggles with dandruff, and complaints of indigestion (Edison, 1885).  Marcus Aurelius waged philosophical battles with himself, speaking about the difficulties of being the person in charge of the western world on one page of his Meditations, yet personalizing a battle against the desire to curl up under the covers instead of meeting the challenges of the day just pages later.  There is no structure – there is no form.  For some, days are skipped.  Others, whole years passed between the needs to spill their guts out on the pages.  Nevertheless, many find the process illuminating, restorative, and constructive enough to continue.

On Valentine’s Day in 1884, the daily journal of future President Theodore Roosevelt recorded the sudden deaths of both his mother and wife with a simple and poignant line: “The light has gone out of my life.”  Roosevelt continued to write in his daily diary and several days later he recorded his feelings on the day of the double funeral, stating “For joy or for sorrow my life has now been lived out” (Gerald R. Ford Library, 2022).  This low point in Roosevelt’s life, confessed to the pages of his diary, marked the commencement of a five (5) year personal journey through trauma recovery.  Roosevelt gave up on his life in the east, turned his daughter over to his sister’s care, and uprooted his entire life – headed to the wide-open spaces of the American West to seek quiet and mindfulness to save his fragmented soul.  Roosevelt’s wanderlust, so fraught with self-doubt, personal loathing, and mental resurrection, gave rise to the concept of the National Park – protected spaces where others could go to heal from the ashes of their own life.  History tells us that Roosevelt’s life was certainly not “lived out” – but he did not know that story at the time of his sorrow.  Journaling was not the miracle cure for Roosevelt, but it was a piece of the puzzle, a place where he could confide in himself, trusting his thoughts to a page when he could trust them to nobody else – and Teddy does not stand alone in the annals of history.  We are learning that the use of written thought as a cathartic tool for healing is being revealed by modern research to be a powerful tool in the quest for self-care.

Studies into the efficacy of journaling during times of stress have indicated reductions in depression, reduced long-term physical health problems, and improve social supports (Riddell et al, 2020).  It has also been suggested that journaling may help restore self-efficacy and mastery and add meaning to trauma (Ullrich & Lutgendorf, 2002).  Mindfulness as a concept, which takes many forms to include meditation, yoga, journaling, expression of gratitude, and other introspective tools – have been shown to help to control emotions (Rousseau et al, 2019), lead to improved post-traumatic growth (Ekström, 2020), have positive impacts on psychiatric symptoms (Van der Kolk, 2014), and mitigate stress levels (Jaco, 2021).  For many practitioners, journaling helps to develop consciousness over their surroundings and provide a snapshot of their life to put the events of life in focus against the backdrop of their world.  Struggles, both large and small, can be confronted in bite-sized chunks.  Figurative dragons can be slain, as the journaler uses the pages to work out their thoughts or to provide introspection to a problem at hand or a traumatic event.

Abraham Lincoln would regularly write vitriolic letters to people vexing him in his life, channeling his feelings onto the page in a way that his political reality would never allow.  Relieved from the stress by committing the concept to paper, Lincoln would often file the letters away, simply writing ‘Never Sent; Never Signed’ on the envelopes (Lincoln, 1863).  Journaling can form an erstwhile ally in the quest to provide meaningful self-care, helping to keep every trauma in perspective, being available to peruse to see how much the journaler has grown, or to vent off the stress of the day or prepare for the battles to yet come.  Most of all, it serves as an outlet, it allows the journaler to be honest with themselves, to admit weakness, self-doubt, and loathing.  It allows the practitioner to confront their own weaknesses and vent – developing skills in communications, emotional growth, and trauma recovery that are a worthwhile addition to any self-care regimen which has found success in mindfulness.

“One advantage in keeping a diary is that you become aware with reassuring clarity of the changes which you constantly suffer and which in a general way are naturally believed, surmised, and admitted by you, but which you’ll unconsciously deny when it comes to the point of gaining hope or peace from such an admission. In the diary you find proof that in situations which today would seem unbearable, you lived, looked around and wrote down observations, that this right hand moved then as it does today, when we may be wiser because we are able to look back upon our former condition, and for that very reason have got to admit the courage of our earlier striving in which we persisted even in sheer ignorance.” - Franz Kafka

References

Aurelius, M., Haines, C.R. (trans.) (161-180 AD) Meditations.  Harvard University Press.  Cambridge, MA.

Edison, T.A., (1885) The Diary of Thomas Alva Edison.  Retrieved on 23 April 2022 from:  http://ariwatch.com/VS/TheDiaryOfThomasEdison.htm

Ekström, C. (June 22, 2020) Comparing the Effects of Positive Psychology Interventions: Using Gratitude Journaling and Personality Strengths Interventions.  Retrieved on 23 April 2022 from:  https://www.proquest.com/docview/2436439170?parentSessionId=Z2ugIyraIEFHKNoIIVUxY0AtP0sF%2FyL810sYV8bVO%2B8%3D&pq-origsite=primo&accountid=9676

Gerald R. Ford Presidential Library (2022). The Light Has Gone Out of My Life.  Retrieved on 23 April 2022 from: https://www.fordlibrarymuseum.gov/museum/exhibits/TR/light.htm

Jaco, B. (2021) Art Journaling as a Stress Reduction Technique for School-aged Children.  Retrieved on 23 April 2022 from: https://www-proquest-com.ezproxy.bu.edu/docview/2593201544?pq-origsite=primo

Kafka, F. (1948) The Diaries of Franz Kafka, 1910-1913.  Secker & Warburg Publishing, London, UK.

Lincoln, A. (July 14, 1863) Lincoln’s Unsent Letter to George Meade.  American Battlefield Trust.    Retrieved on 23 April 2022 from: https://www.battlefields.org/learn/primary-sources/lincolns-unsent-letter-george-meade

Riddell, T., Nassif, J., Hategan, A., Jarecki, J. (June 25, 2020). Healthy Habits: Positive Psychology, Journaling, Meditation, and Nature Therapy.  Humanism and Resilience in Residency Training, pgs. 439-472.  Retrieved on 22 April 2022 from: https://link-springer-      com.ezproxy.bu.edu/chapter/10.1007/978-3-030-45627-6_14

Rousseau, D., Long, N., Jackson, E., Jurgensen, J., Rosenbaum, J. (September 2019) Empowering Through     Embodied Awareness: Evaluation of a Peer-Facilitated Trauma-Informed Mindfulness    Curriculum in a Woman’s Prison.  The Prison Journal.  Vol. 99, pgs. 14S-37S.

Ullrich, P., Lutgendorf, S. (August 2002) Journaling About Stressful Events: Effects of Cognitive Processing and Emotional Expression.  Annals of Behavioral Medicine, Vol 24, pgs. 244-250.

Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Viking Publishing.  New York, NY. USA

A Deeper Understanding of Restorative Justice

In our brief reading in this course on Restorative Justice (RJ), we received a surface-level definition appropriate to the scope of the course itself. It is the purpose of this blog post to provide a greater level of understanding of the principles and practices of RJ, highlighting two key points: origins (relating to principles) and process (relating to practices). I will also bring in my own experience practicing RJ where appropriate.

First, the origins of RJ. It is paramount to recognize that RJ is a fundamentally indigenous practice. Howard Zehr (a white man), referenced in our reading, is certainly aware of this, himself trained by indigenous peoples in Canada. He is additionally attuned to the difficulties this creates in attempting to practice RJ. He states that a primary concern of RJ is "whether in articulating and practicing restorative justice we are replicating patterns of racial and economic disparities that are prevalent in society" (Zehr, 2015, 11). In the circles we practice in the federal RJ program, this is a point we frequently touch on. One of our circle leaders is a federal prosecutor (AUSA James Herbert), who could likely be perceived as the "bad guy" by our participants. Each of them has been prosecuted by one of his colleagues; for each of them, someone like him is responsible for how much time they are spending in prison. There is a power dynamic at play there, no matter how hard we try to remove it. This power dynamic has the potential to exert undue influence on our participants, just as the power dynamic inherent in the criminal legal system has the potential to completely erase the roots of RJ, or worse, to use it for its benefit. Yet in our circles, we attempt to subvert those power structures by two affirmations: 1. Affirming that all members of the circle are equal, and in group decisions (if they arise) nobody's vote means less than another; and 2. Affirming that we do not own the practices, as they are indigenous in nature, we simply practice them and thank the indigenous cultures in which they originated. A recent publication, Colorizing Restorative Justice, is an excellent work that explores what heeding the indigenous roots and practicing RJ in a trauma-informed and racially-sensitive manner might look like.

Second, the process. In an optional NYT article for our class, we read about the story of the parents of Conor McBride and his girlfriend Ann, whose parents (Conor's and Ann's) came together in the aftermath of Conor fatally shooting Ann in the head, that the five of them might undergo a kind of RJ process. While it is an incredibly powerful story, this is certainly an anomaly within the RJ world. It also included a story of forgiveness that is not typical of every RJ process. Ann's mother, Kate, said, "Conor owed us a debt he could never repay. And releasing him from that debt would release us from expecting that anything in this world could satisfy us" (Tullis, 2013). This is, again, an anomaly, though the anomalous nature here is perhaps due in part to the fact that it was a murder case. An important part of RJ is for the victim to define what they need from the offender in order to right the wrong that was done. RJ emphasizes that harms create needs, and needs create obligations on behalf of the offender. In this case, Kate did not feel as though there was anything that Conor could do in order to right the loss of the death of her daughter - aside from, perhaps, seeing Conor show remorse and initiative as well as being able to tell him, to his face, how she was effected by the loss of her daughter.

Conversely, in the federal RJ program, most of the people we work with have been convicted of drug charges, not murder charges. Often, we set up victim-offender conferences between former drug dealers and former drug addicts. This commonplace occurrence in our program differs from Conor's situation in two ways. First, there is no loss of life involved, and thus reparations are perhaps more quantifiable. One of the men formerly convicted of drug distribution in particular, after meeting with former drug addicts in the setting of a restorative conference (we call these people "surrogate victims;" people who were not directly harmed by the offender but who have suffered harm similar to the kind the offender inflicted), decided that the way in which he could right the wrongs of his past was to become a social worker, and work with drug addicts. This kind of concrete change is a more typical outcome of the RJ process. Second, we as a program team need to seek people out to participate in our victim-offender conferences - in Conor's case, it was the other way around, as Ann's parents reached out first to his parents and then directly to him. This process involves lengthy one-on-one discussions between us (the facilitators) and both the victims (surrogate or actual) and offenders we seek to involve. The hours of prep-work outnumber the hours of actual conferencing by a significant margin. In other words, it is a long process.

What the NYT article was helpful in outlining, however, is that ideally, RJ is an ongoing practice that is applied not just to the circumstances of a particular harm but to one's entire view of the world. In this way, RJ becomes not just a trauma response, but a preventative measure. While it is not an outright goal of our program, those who participate in our program have a significantly lower recidivism rate than the national average. Overall, RJ invites us to consider that we are more fundamentally communal creatures than our individualistic society might have us believe. It is my hope that this post furthered not just knowledge, but also interest, in restorative justice.

Works Cited

Tullis, P. (2013, January 6). Can Forgiveness Play a Role in Criminal Justice? New York Times.

Valandra, E. C., Ed. (2020). Colorizing Restorative Justice: Voicing Our Realities. Living Justice Press.

Zehr, H. (2015). The Little Book of Restorative Justice: Revised and Updated. In H. Zehr, L. S. Amstutz, A. MacRae, & K. Pranis (Eds.), The Big Book of Restorative Justice (pp. 1-108). Good Books.

Trauma-Informed Martial Arts

Yoga, meditation, qigong, expressive arts, and many other lifestyle practices have been shown to have a positive effect on trauma processing and the treatment of post-traumatic stress symptoms. Practices that stress breath awareness and connection, movement of the physical body, and intentional focus on somatic sensation have consistently generated results in allowing the survivors of trauma to access their physical selves, and reintegrate their somatic knowledge to themselves as a whole. Extending these principles and criteria outward, there are a number of other physical practices that should, in theory, provide similar benefits: dance, weight-lifting, running, the martial arts, and others (Van der Kolk, 2014). But with regard to the martial arts specifically, open calls for research and study have only been met by a handful of pilot programs and small-sample studies. As of yet, no comprehensive, well-developed studies have examined the utility of martial arts practice for the treatment of traumatic stress, and no clinically validated programs have attempted to develop a trauma-informed system of martial arts instruction.

However, small independent trauma-informed martial arts programs do exist, including a Tanzanian program developed by Brazilian Jiujitsu instructor Claire Hayes. Hayes’ program, oriented specifically toward sexual assault survivors, emphasizes re-establishing control and autonomy within one’s own body. While martial arts, especially more modern styles like jiujitsu, prioritize heavy contact and imposition of physical force, Hayes modifies her own program to take a graduated approach to the art. The program is oriented toward a discussion of sport jiujitsu, rather than drawing explicit parallels between the art and situations of self-defense and assault, and moves through a series of less-to-more-invasive techniques from wrist grabs to standing grapples to takedowns and full grappling. Hayes has begin to assemble a course framework for use in other studios. Similarly, Australian kickboxing instructor and Muay Thai fighter Georgia Verry adapted an online trauma-informed kickboxing class during the COVID-19 pandemic. Verry’s program blends shadow-boxing and pad-focused kickboxing techniques with meditation, stretching, and somatic processing of stimuli, which Verry conceptualizes as the accessing of traumatic stored emotion as it is brought up during the class (Valentish, 2020).

These pilot programs are small, do not collect efficacy data, and are not focused on building an empirically validated system of clinical intervention around post-traumatic experiences. But they nonetheless show valuable proof-of-concept that trauma-informed martial arts can exist, can draw a student base who may benefit from that specific service, and can be organized and carried out in a way that is responsible and avoids retraumatization. As these pilot programs hopefully become more common, they should ideally be paired with some form of basic participant data collection to measure program efficacy, symptom reduction, somatic reintegration, and other goals of trauma-informed movement therapies. Further, the onus is now on clinicians and researchers to begin to explore the integration of martial arts into formalized trauma-focused therapy, and explore whether martial arts can be efficacious in that manner.

References:

Valentish, J. (2020). ‘You feel like you’re getting your power back’: How martial arts helps recovery from trauma. The Guardian. Retrieved from https://www.theguardian.com/society/2020/nov/08/you-feel-like-youre-getting-your-power-back-how-martial-arts-helps-recovery-from-trauma.

Van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.

Farewell to Lin Yihan, Hope There is No Pain in Heaven

In May of 2017, Lin Yihan, a 26-year-old female author, said goodbye to the world in the form by taking her own life. Her death swiftly went viral in China. And the root cause of her death is her miserable experience in adolescence during which she had been raped by her Chinese teacher for nearly 6 years since her 13 years old (Catherine Lai, 2020). She wrote her real-life into a novel, namely Fang Siqi’s First Love Paradise. Despite the strong support from her parents and husband—she married a year before her death, she couldn’t escape from the traumatic sufferings. I, therefore, think severe childhood trauma may be among the hardest ones to get rid of.

In module 1 of this class, we talked about the reasons why trauma and stress suffers could go onto a completely different life path after experiencing trauma—some may be stronger and more resilient while some may suffer from different kinds of mental illnesses. I mentioned that the severity of trauma is a major factor. According to Van Der Kolk (2014), people with histories of severe, chronic childhood abuse lose the ability to pay attention to themselves because their brain is unable to be activated to create a sense of “self.” They are too painful to receive signals from the outside world. Therefore, they shut down the brain areas that transmit feelings and emotions. On the contrary, such stress reactions are rare among mild trauma sufferers. For example, modern office ladies encounter stress from their work. But such stress cannot be paralleled with that brought by an abnormal original family or child sexual abuse.

In addition to the degree of trauma, I believe that the time a trauma occurred may also be attributed to the results of PTSD or post-traumatic growth. Li Yihan was seduced at the age of 13 until she became an adult. As the book, Fang Siqi’s First Love Paradise describes, Lin’s mental condition was still normal in the first few years, because the man who raped her told her that "this atrocity is love". At that time, that man in her eyes was indeed a "respectable teacher who teaches Chinese, is knowledgeable and has literary talents", because she loved literature since childhood. When did things start to get sour? According to the novel, it was when Fang Siqi, the protagonist of the book, entered high school. She is beautiful, and there are boys to pursue her. These boys would use the “adolescent boys’ way” to court her: they have a crush on her first, secretly look at her every day, and then make appointments, secretly want to hold her hands but dare not do that, let alone other body contacts. For young boys and girls, engaging in intercourse is something that will happen a long time. At this moment, Fang Siqi's view of “normal love” began to collapse. Is what her teacher said right? Or are these young boys right? When she was about 17 years old, she began to experience “dissociation”, that is, she suddenly couldn't remember what she had done, and when she woke up, she seemed to be in a new place and doing new things. That's because she began to understand that the teenagers around her who liked and respected her might be the true love of youth. In other words, she had to admit that the things that she has suffered in the past do not love but boundless pain and torture. The truth was too painful and cruel to make her directly confront. Then she chose to split herself… If she was raped in adulthood, she could at least immediately know what that man did was rape rather than love.

What we learned from Lin’s blooding story is to realize the importance of early sexual education. According to Lisa S. Panisch and her colleagues (2020), a trauma in childhood is prevalent in the U.S. with over 63% of Americans, both men and women, undergoing at least one adverse event when they are young. Given the prominence of this problem, efforts need to be made to implement adolescent sexual health interventions which can help to address trauma. In their study, Dr. Panisch and her team put forward that trauma-informed content needs to be integrated into school curricula so as to give early education on sex. Yet I think we rely on school education to address child trauma is far from enough. At least the other two parties should also do their parts: the government and parents. The rapist in Lin’s case is still teaching Chinese at school. His “unguilty” is also a reason for pushing Lin to end her life because evil isn’t rewarded with evil. The government and authorities, therefore, should formulate related regulations to restrict evils behavior, making them know a crime is too costly to be committed. On the other hand, parents should be more tolerant of and kind to their wounded children and take them to resort to professional therapies. And as a reader and commentators, we should have the very basic conscience of human beings not to accuse and exact the victims.

References:

1. Catherine, Lai. (2020). Suicide of 26-year-old writer sparks public debate on rape and cram schools in Taiwan. Retrieved from https://hongkongfp.com/2017/05/21/suicide-26-year-old-writer-sparks-public-debate-rape-cram-schools-taiwan/
2. Van Der Kolk. (2014). The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma New York: Penguin.
3. Panisch, lisa S., Faulkner, M., Fernandez, S. b., & Fava, N. M. (2020). Exploring How Trauma Is Addressed in Sexual Education Interventions for Youth: A Scoping Review. Health Education & Behavior. https://doi.org/10.1177/1090198120954398

Volunteerism as Trauma Therapy

“The best way to find yourself is to lose yourself in the service of others.” – Gandhi

Trauma not only affects the brain, body and outlook, but also annihilates the perception of agency over one’s life. The abused child, the veteran struggling with memories of wartime horrors and the woman who dares not speak of what she experienced are often left feeling alone and impotent, vulnerable to the world’s ills. Mental health counseling is a time-honored technique for regaining a feeling of ownership over life, but supplements to these traditional therapies have been proven to help increase the efficacy of other methods and speed healing. When it comes to mental health, the more you give, the more you get.

Volunteerism is an alternative approach that researchers have discovered to be both personally empowering and socially productive. Studies have shown the practice to lower symptoms of PTSD, anxiety and depression while increasing life satisfaction and overall health. And frequency correlates with degree – the more hours, weeks and years devoted to service, the better the mental health outcome.

But why does an activity that focuses on others help the Self? Several theories have been floated about the power of volunteerism, but the correct one may be the sum of many, and personal accounts support that. Iraq war veteran Tim Smith credited his improved PTSD to being part of a team (Lett, 2018); Wisconsin Army National Guard veteran John Stuhlmacher appreciated his renewed sense of purpose and commitment to something “greater” than himself (Silver, 2019); meanwhile, Ricky Lawton, associate director at Simetrica Research Consultancy believes that social connection combined with the “warm glow” intrinsic to volunteering is what benefits the volunteers (Hopper, 2020). Ironic, but whether sorting cans at a food bank, walking animals at a shelter, reading to the elderly or tutoring a child, it is precisely the “escaping one’s own brain” that helps heal it.

The brain itself may play a part, as well, as the often-strenuous charitable activities (think painting houses and planting trees) relate to improved physical and, therefore, mental well-being. Research has yielded positive findings when studying the impact of healthy bodies on healthy minds, whether from the neurotransmitter dopamine released during exercise or merely the conscious satisfaction of a muscle burn.

But can volunteers absorb negative feelings from the people they help? A study out of Spain examined compassion fatigue which occurs when the compassion necessary to helping exceeds the capacity to regenerate, or “bounce back,” leaving caretakers feeling helpless (Gonzalez-Mendez & Diaz, 2021), akin to contagious sadness. The researchers explained that this arises from a “blurred self-other distinction” (Gonzelez-Mendez & Diaz, p.2); that is, the helper becomes compelled to withdraw from the situation in an effort to protect themselves from negative emotions. The answer: self-care. Altruism is admirable but going down with the proverbial ship is counter-productive, unhelpful to both the volunteer and the population in need. It is a delicate dance, deciding when to concentrate on the self or on others when overcoming trauma; self-awareness is key in finding the balance.

References:

Adams, R. E., & Boscarino, J. A. (2015, March 13). Volunteerism and well-being in the context of the World Trade Center Terrorist Attacks. International journal of emergency mental health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4358158/

Gonzalez-Mendez, R., & Díaz, M. (2021, September 1). Volunteers' compassion fatigue, compassion satisfaction, and post-traumatic growth during the SARS-COV-2 lockdown in Spain: Self-compassion and self-determination as predictors. PloS one. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409613/pdf/pone.0256854.pdf

Hopper, E. (2020, July 3). How volunteering can help your mental health. Greater Good. https://greatergood.berkeley.edu/article/item/how_volunteering_can_help_your_mental_health

Lett, B. (2018, April 15). Study shows volunteering improves mental health in veterans. DAV. https://dav.org/learn-more/news/2018/study-shows-volunteering-improves-mental-health-veterans/

Ohrnberger, J., Fichera, E., & Sutton, M. (2017, December). The relationship between physical and mental health: A mediation analysis. Social science & medicine (1982). https://www.sciencedirect.com/science/article/pii/S0277953617306639?via%3Dihub

Silver, M. (2019, November 4). Veterans and PTSD: How volunteering can bring healing. WUWM 89.7 FM - Milwaukee's NPR. https://www.wuwm.com/news/2018-07-12/veterans-and-ptsd-how-volunteering-can-bring-healing

Van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (Reprint ed.). Penguin Publishing Group.

Reducing Burnout: The Importance of Quality Self-Care

Everyday living in 2022 is stressful and balancing family, work, and free time is no easy task. In an economy with record high inflation rates, and a healthcare system burdened with the many implications of the pandemic, rest and recovery is of utmost importance now more than ever. With the US dollar having significantly less purchasing power than last year, many people are attempting to overcome this by working longer hours. More hours spent at work means less hours spent on other aspects of our lives that we value much more personally. The cognitive dissonance that a person experiences because of this work-life imbalance can lead to feelings of burnout. 

Burnout is the central theme of an article published by the Harvard Business Review. Author Monique Valcour characterizes burnout by three symptoms: exhaustion, cynicism, and inefficacy. Exhaustion is described as profound physical, cognitive, and emotional fatigue and is the primary symptom of burnout. Cynicism is psychologically distancing oneself from one's work because of feelings of disengagement and lack of pride. Inefficacy is having feelings of incompetence and lack of achievement or productivity. If you have experienced a multitude of these symptoms then there’s a good chance you've experienced burnout. 

So what can we do to address or prevent burnout? Valcour suggests making changes to some situational factors in our lives that could yield positive results. For example, we must be better at prioritizing self care. Valcour states, “It’s essential to replenish your physical and emotional energy, along with your capacity to focus, by prioritizing good sleep habits, nutrition, exercise, social connection, and practices that promote equanimity and well-being, like meditating, journaling, and enjoying nature.” In my opinion, this is the most effective, yet also most overlooked method for criminal justice professionals to take care of their physical and mental energy. 

One of the main expectations of criminal justice professionals is to put others first before themselves. This mindset is vital in the line of duty, however it can be problematic when it trickles into our day to day lives. Law enforcement officers don’t have the option of taking it easy because they are sick or they are having a rough week. It’s highly stressful to work in situations where every move you make is scrutinized and one mistake could cost you your job or even worse, someone’s life. Research indicates that law enforcement is a particularly stressful occupation due to a number of sources from within the organizational structure itself, such as role ambiguity, role conflict, lack of supervisor support, lack of group cohesiveness, and lack of promotional opportunities (Anderson et al., 2002; Gaines and Jermier, 1983; Toch, 2002). So not only do officers have to deal with on-the-job stressors like exposure to violence and suffering, but they also have to deal with organizational stressors as well. That’s why it is imperative to leave as much of the stress at work as possible and practice good self care while off the clock. 

It's necessary to delineate the differences between good self care and bad self care. Dietrich and Smith (1984) shed light on the nonmedical use of drugs and alcohol among police officers, “alcohol is not only used but very much accepted as a way of coping with the tensions and stresses of the day” (p. 304). Reducing the norm of officers turning to these maladaptive coping mechanisms is an important step in the right direction towards practicing better self care. Having worked as a first responder for several years now, I’ve experienced how stress has trickled into my daily life and how I manage my own self care through effective coping strategies. One way I do this is by leaving work at work. Some examples of how I manage to leave work at work are by muting my email while off-duty, not overanalyzing the decisions I made and what I could’ve done better, and using my time off whenever I physically or mentally need a break. I also value my health very seriously as this is another way I manage my own self care. I try my best to eat well, get adequate sleep, and exercise daily. Even when I don’t feel like lifting weights or running, I make sure I get out for at least a 30 minute walk. During this time I will usually throw on a podcast on a topic I am interested in learning about so I am essentially learning while exercising.

In summary, work burnout is a very serious and common problem for a lot of people, especially criminal justice professionals.  In order to prevent burnout from occurring we must prioritize effective self care through healthy practices rather than maladaptive ones. Even though I’ve listed what I’ve found to be successful for myself, it's important to note that every individual is different so they must find what works best for them. After all, we all have different needs and there's no one particular strategy that universally works for everyone.  

Anderson, G.S., Litzenberger, R. and Plecas, D. (2002). “Physical evidence of police officer stress”, Policing: An International Journal of Police Strategies & Management, Vol. 25 No. 2, pp. 399-420.

Dietrich, J., & Smith, J. (1984). The nonmedical use of drugs including alcohol among police personnel: A critical literature review. Journal of Police Science and Administration, 14, pp. 306.

Gaines, J. and Jermier, J.M. (1983). “Emotional exhaustion in a high stress organization”, Academy of Management Journal, Vol. 26 No. 4, pp. 567-86.

Toch, H. (2002). Stress in Policing, American Psychological Association, Washington, DC.

Valcour, M. (2016, November). 4 Steps to Beating Burnout. Harvard Business Review. https://hbr.org/2016/11/beating-burnout 

Utilizing Yoga as Treatment for PTSD

In this post, I will further the discussion that emphasizes the success of yoga as a treatment approach for individuals with PTSD. To start, I would like to express how I have personally seen yoga ease the tension that PTSD brings. As I have mentioned in many of my discussion posts, my parents are Bosnian genocide victims, and my mom still suffers from PTSD almost daily. She goes to yoga at least twice a week because she has really seen an improvement on her mental state. It allows her to disconnect from the world for an hour and focus on calming down her brain. Yoga is a powerful tool for all, but it is especially essential in treating PTSD.

For centuries, yoga has been used as a practice for the mind as well as the body (Rousseau, 2022). The process of directing your breath and energy to certain parts of your body is a beneficial skill to possess. In our book The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Dr. Bessel van der Kolk (2014) discusses how yoga was more effective in treating PTSD than medicine (p. 209). This was my favorite part of the book to read. I consider myself more “holistic”. I will try every natural remedy for a headache before I take a Tylenol. I truly believe there are natural and holistic ways of healing what ails our bodies. Obviously, this is very dependent on the individual, and medicine is oftentimes needed. However, yoga can be used in combination with other treatments since it is a physical practice.

References

Rousseau, D. (2022). Module 4: Pathways to recovery: Understanding approaches to trauma treatment. Blackboard, https://onlinecampus.bu.edu/bbcswebdav/pid-9960461-dt-content-rid-63971458_1/courses/22sprgmetcj720_o2/course/module4/allpages.htm

van der Kolk, B. A., MD. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin.