Challenges in Mental Health Care: The Sickness v. Wellness Perspective (By: Michele Babcock-Nice)

Mental health care is a challenging, but rewarding field.  There are many positive sides of mental health care, and also areas that need improvement.  One of the biggest rewards of mental health care is observing and experiencing progress, recovery, and a return to wellness of clients.  Healing, recovery, and a return to wellness of clients in mental health settings requires patience, understanding, respect, and sensitivity.  Agency and organizational stability is also needed for clients in order that they receive optimal care.  While each agency and/or organization has its own culture, a culture in which workers live in fear of becoming a statistic in extremely high turnover is unhealthy in itself.

As an individual working toward licensure in the mental health profession, I am one whose perspective is from a position of wellness.  First and foremost, one must view a person as a person.  To perceive and treat a person with respect, kindness, nonjudgment, and impartiality are requirements in supporting and empowering the wellness, healing, and recovery of clients.  In the counseling profession, one based on a view of wellness in people, there exists a positive and supportive hope for the overall optimal health of the individual.

This view is different from many other mental health professions in which the general view of the client is one of sickness.  Certainly, approaching an individual with a perspective of what can be improved is helpful, and for insurance purposes involving payment for services rendered, a diagnosis of the client is required, however it is my perspective that viewing the client from a wellness standpoint is much more healthy for all involved rather than judging a person as being sick.

Those who view and describe an individual as a “sick person” have already negatively judged him or her.  They have not viewed the person as a person, but as an “ill person.”  Such a perspective held by such individuals causes them to treat the client differently, as one who needs more and more treatment, more and more medication, more and more confinement.  In these situations, the positive view of wellness is gone, and is replaced by a judgment that the “sick person” is unable to become well.

While clients have challenges to achieving and maintaining wellness, it becomes even more of a challenge when many in the mental health field view clients as sick, and only they as the professionals who hold those views have the power and expertise to make them well – or they have already judged that they will never become well.  A professional who approaches a client from a perspective of wellness (a perspective that is in the minority), therefore, faces even more challenges, not only for themselves but also for their clients when others view them as sick and unable to become well.  A person is still a person, regardless of their diagnosis or disorder.  A person is still a person, and has the capability of becoming well.  A hopeful perspective toward client wellness must exist in the mental health profession – rather than client sickness – in order that clients are supported and empowered to experience that wellness.

A further challenge in agencies and/or organizations in which a “sickness” perspective prevails is that experienced clinicians fall into the trap of believing that their views and judgments about clients are the best – that they are the experts.  Certainly, the experience of a veteran clinician is extremely valuable in treating clients, however experienced clinicians who believe that only their views, judgments, and culture of sickness are the most helpful approaches create a potentially dangerous situations for their clients.  Clinicians of all levels of experience must be open-minded to considering and perceiving different views – including those from a wellness perspective – so that their clients receive optimal care and so that they profession, itself, can grow and develop in a healthy way.

Clinicians who view clients from a perspective of illness and negative judgment place their clients at risk for further illness.  Clinicians who are set in their ways of expertise toward mental health treatment, and who are unable to be open-minded toward viewing different perspectives regarding it have already erected walls around themselves that are harmful for themselves, their clients, the culture of their agency/organization, and the field of mental health.

What clinicians must always place as a primary priority is that people are people.  As such, people should be treated with dignity, understanding, kindness, respect, and sensitivity.  If a perspective of client wellness is lacking or absent, clients will likely experience a more difficult road to recovery and may not achieve wellness.  What is healthier – being an “expert” clinician whose views of client illness cause him or her to be closed to considering a client’s optimal recovery, or being a clinician who treats a person as a person, and who applies a wellness perspective that supports rather than negatively judges the client?  You be the judge.

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“Society Must Hold Offenders Responsible, Not Punish Victims” (By: Michele Babcock-Nice)

Mother Nature Crying (Retrieved from http://www.free-hdwallpapers.com/wallpaper/abstract/mother-nature-crying/22445, January 11, 2014)

Mother Nature Crying (Retrieved from http://www.free-hdwallpapers.com/wallpaper/abstract/mother-nature-crying/22445, January 11, 2014)

Very often in our society, we are informed of criminal offenders who are held responsible and accountable for their actions.  There are those in our society who work hard to see to it that perpetrators of crimes are brought to justice, that they are removed from the greater society for a period of time, and so that, potentially, they do not commit the same or similar types of crimes in the future.  There are many people, such as a police officers, attorneys, prosecutors, and judges whose hearts and minds are in the right place when it comes to holding responsible and accountable those who commit crimes, particularly violent crimes, including sex crimes.

Conversely, there are also times when people who have committed crimes are not held responsible or accountable for their crimes, nor are they ever required to answer for their criminal actions.  In these situations, there may or may not be extenuating circumstances in which evidence has been removed or destroyed by the perpetrators and/or accomplices; corroboration and/or substantiation of facts regarding the crime may not be obtained; confessions of those who committed the crimes were not secured; evidence and/or facts regarding the crime were concealed or never located; and other reasons.

Sometimes, in cases involving child sexual abuse, there is the possibility that police, attorneys, prosecutors, and/or parents do not desire to place children on the stand in court to testify against the person(s) who assaulted them.  In other situations, it is possible that a particular network of people, such as athletes or fraternity brothers in a college, promote and live a culture of disrespect and/or violence, covering up for each other when sexual assaults are committed.  Or, has often occurred in the Roman Catholic Church when religious have committed sex crimes, they may be protected by higher authorities in the Church.

Many years ago, a local pediatrician in my area informed me that preschools are commonly places where young children are sexually abused.  I have always remembered that, and have often wondered why doctors do not do more to inform about this and/or take measures aimed at protecting children.  Too often, physicians are more interested in treating a problem or issue after it arises rather than seeking to inform, educate, protect, and prevent such things from occurring in the first place.

In 2007, there were two police reports made regarding a preschool teacher at Sola Fide Lutheran Church Preschool in Lawrenceville, Georgia, describing her repeated sexual abuse of children, aged 2-4, who were in her care.  Four children were identified as having been repeatedly emotionally, physically, and sexually abused by the preschool teacher.  All four children were interviewed by a special investigator with the county police department.  Out of fear, three of the four children denied any sexual abuse by the teacher.  Without corroboration, evidence, or a confession by the accused, the case was unable to be substantiated and was closed.  Without a formal charge or conviction against the teacher, the case was never made public.

One of the children who had been identified as having been abused was the school principal’s two-year-old daughter, who regularly participated in classes with the three and four-year-olds that were taught by the teacher.  In these classes, there was an assistant teacher, as well as a volunteer.  The lead teacher perpetrated the abuse that was ignored and overlooked by the other two women.  Abuse was perpetrated in the bathroom, storage room, and empty classroom in the trailer that was used for classrooms.  During the investigation, the principal destroyed evidence related to the abuse so that it was never identified or recovered by police.  Following the close of the investigation, the school promoted the lead teacher who had perpetrated the abuse by providing her with her own classroom and extending the hours of her classes.  Two years later, the principal got another job, and he and his family left the school.

Child Angel Statue Crying (Retrieved from http://www.watchmanscry.com/article-get-your%20house-in-order.html, January 11, 2014)

Child Angel Statue Crying (Retrieved from http://www.watchmanscry.com/article-get-your%20house-in-order.html, January 11, 2014)

In 1995, a rape was reported to campus police at the University at Buffalo that had occurred in 1992 on the Amherst Campus.  The rape was committed by a male student against a female student.  Both students had been arranged by mutual friends to have a date.  The man took the woman to a local bar, and entered the bar and drank though he was underage, having used an inauthentic driver’s license to enter the establishment.  During the date, the man persistently encouraged the woman to drink, though she drank little.  Following the date and because the student lounge of the woman’s dormitory was a shambles, the woman invited the man in to her dorm room, where he proceeded to deceive her into trusting him, and raped her.  The action was against the woman’s will as the man held her down and caused internal injuries to her while raping her.  The attack was extremely traumatic for the victim who told her friends about it, and they did nothing, in effect becoming accessories to the crime.  In fact, those “friends” never spoke to the survivor again.  No one helped the survivor at her university; she coped the best that she could on her own.

When the rape was reported in 1995 to the campus police at the university, one of the police chiefs laughed about it, demoralizing and dehumanizing the survivor.  The case went to the county district attorney’s office, but was conveniently found to have exceeded the statute of limitations for the category in which the crime was placed.  No support or understanding was offered or provided to the survivor at the university or through the district attorney’s office.  Worse, the district attorney who handled the case told the survivor that she had not been raped, thus blaming and revictimizing the victim.  The offender got away with his crime, was never required to answer for it, and ended up being protected by the DA’s office and the university police by not being brought to justice for it.  Several years following the closure of the case, the perpetrator’s name was deleted from the police report by the campus police, as was the description of the crime that had occurred.  Neither the description of the crime, nor the offender’s name were maintained by campus police in the police report, essentially absolving him of the crime and revictimizing the victim.

These are two examples of crimes in which the perpetrators got away with their offenses.  They were not held accountable, charged, or prosecuted by the very individuals and agencies that are supposed to be protective against crimes, including sex crimes.  While these are just two examples of such situations, there are many more that occur in society every day, and from which perpetrators walk away.

It is important that society be sensitive, understanding, and insightful about victims and survivors of crimes and trauma, including sex crimes.  It seems that most people, because they have not been properly trained in relating with crime victims and trauma survivors, stigmatize and revictimize survivors by blaming, shaming, and punishing them.  Those who should be held accountable and responsible are the perpetrators, themselves, however and often, people make incorrect assumptions and judgments regarding appearances and surface information without knowing all of the details and information that is confidential.

Jesus was also a person who was inaccurately judged by many.  He was a good and merciful person of whom many in power positions were jealous.  Jesus was also different in his goodness, different in that he was so good that he tended not to fit in and was, therefore, ostracized and resented by many.  Jesus was a person who died as a result of jealousy, hated, and evil of those who were unable to tolerate a good and merciful person, a person who was unique and unsurpassable in his goodness and mercy.

Therefore it follows that it is important for people not to inaccurately judge and/or make incorrect assumptions about each other, especially without having all of the details or confidential information.  It is also important that people not stigmatize, blame, punish, and revictimize survivors and victims of crimes, simply out of their own fear, and lack of both insight and understanding.  As people, we should strive to be understanding, helpful, and supportive to each other, as well as forgiving, even in the worst of circumstances, yet also stand up for ourselves and the truth, whether or not we are blamed, stigmatized, punished, or revictimized.

Silence protects and empowers the perpetrators of crimes.  We must seek to speak out about crimes so that criminals are not protected, and so that the greater society is informed and educated about them.

References:

American Psychological Association (2014).  “Understanding child sexual abuse: Education, prevention, and recovery.  What are the effects of child sexual abuse?”  Washington, DC: American Psychological Association.   http://www.apa.org/pubs/info/brochures/sex-abuse.aspx?item=4.  Retrieved January 11, 2014.

Babcock-Nice, M. (November 23, 2013).  “Trauma-focused group therapy proposal for adult female rape survivors.” Atlanta, GA: Argosy University, Atlanta.

Baldor, L.C. (January 10, 2014).  “‘Culture of disrespect’ fuels academy sex assaults.”  MSN.com.   http://news.msn.com/us/culture-of-disrespect-fuels-academy-sex-assaults.  Retrieved January 10, 2014.

“Children Need Advocacy and Support, not Ignorance and Punishment” (By: Michele Babcock-Nice)

Not a day goes by that I am amazed and disappointed by the lack of insight and support that many people have regarding children.  Even in regard to people who one might believe are trained in child development and education may be completely oblivious to realizing that their words and behaviors are unsupportive of, and in many cases, detrimental toward children.  What children in our world need – especially those who may have special considerations, including disabilities – is advocacy, understanding, and support rather than ignorance, misunderstanding, and punishment.

When people in child development, education, and other fields are rigid and unbelieving about the needs of children – and who, in fact, do not have an understanding of children that is in the child’s best interests – children suffer in many ways and can be placed at great risk in many cases.  In medical and healthcare fields, individuals are supposed to do their best to ‘do no harm’ and adhere to the Hippocratic Oath.  While the medical field, however, often practices from a perspective of illness, the counseling field strives to recognize people from a view of wellness.  An illness or disease is not the person; but rather, it is the person who must be supported in a view of wellness in order to improve or recover from illness.

Educators, child care specialists, and others – including parents – need to have a wider view of what is best for children.  In cases of highly contentious and adversarial divorces, for example, psychological evaluations and/or assessments of the parties involved, may be ordered by a judge.  In such cases, by today’s standards, these reports, typically made by an unbiased psychologist, provide judges and attorneys with a more clear perspective of family relationships and parenting.  Thus, people in the legal field recognize that they may not have the training needed to make such unbiased evaluations.  They rely on psychologists to ethically and professionally perform them so that the best interests of the child are maintained.

Unfortunately, and to the detriment of children, not everyone recognizes that they do not have the insight or training needed to work in and make decisions that are in the best interests of children.  From my knowledge and experiences regarding many schools, particularly those in the South, individuals in education are quick to punish, including for minor issues, and may not realize that they do not have the insight necessary to best support children and do what is best for children.  Exercise as punishment (such as being made to walk or run laps outside, including in high temperatures) and lengthy detentions (including 30-60 minute lunch/recess detentions), particularly for insignificant issues, and issued toward children, do not resolve, but compound issues, making children potentially distrustful, disrespecting of, and hopeless about school officials.  (I know of at least four schools in my immediate area where these are practices.) 

These situations are compounded and worsened regarding children who have special needs.  Sometimes, it appears to be the children and/or parents who are blamed in situations in which school officials promise support and accommodation to such children, however they may just be going through the motions and not adequately or effectively be meeting such needs.  And, punishments toward children have been shown in research to be ineffective; truly, they may only serve to increase distrust and resentment in children toward adults who are supposed to have their best interests in mind, but who, in fact, do not.

In some situations, an array of psychological evaluations and assessments may be provided to educators that address children’s special needs – and parents may inform school teachers and leaders about what is best for their child – however, for whatever reasons, school teachers and officials may simply be ignorant about such needs, may not follow the suggestions of professional evaluations or parent recommendations, and may completely misjudge the situations.  Doing this places some children with special needs in greater danger and at higher risk for worse outcomes and situations at school.  Through the school officials’ own lack of insight – and in some cases – lack of compassion and motivation to learn, grow, and develop – children are, in fact, harmed by their ignorance and lack of support, and in some cases, are blamed and punished due to it – the pitfall of blaming the victim.

When children with special needs are not sufficiently, nor positively accommodated in schools, great risk and danger may be imposed upon them due to others’ ignorance.  To some people, what is clear and obvious in certain situations goes completely unrecognized – and therefore, not at all addressed – in others.  What is worse in these situations is when people who are ignorant about these situations categorically deny that they have occurred and escalate already tense situations that may involve high emotions.  Such lack of insight and understanding reflects not only their ignorance, but their rigidity, inflexibility, and absolute refusal toward even having an interest at gaining any increased understanding about the issues or situations.  

Even those most highly-trained in supporting children may sometimes miss critical pieces of information, however this should be an indication to others that as much training and information is needed to enlighten themselves to children’s needs and what is in children’s best interests.  Additionally, because there is often the tendency in people to desire to perceive issues and situations in an optimistic manner, there should be an awareness of this so that critical issues about others are not missed and do not turn potentially tragic. 

In short, particularly when it comes to educating children, it is not acceptable to be clueless about and not practice what is in their best interests.  And, situations that are detrimental and potentially tragic to children that occur out of the ignorance of educators and school officials should not be escalated – but diffused – in the best interests of children. 

In my book, perhaps schools in which ignorance and a lack of support prevails toward children may be performing okay with some students, but they may also be harming those students who are most at risk.  Such characteristics, policies, and/or the lack of policies of schools become dangerous to children when people in education do not even realize that what is occurring is creating a potentially harmful or tragic situation for children.  Parents must be acutely aware of and insightful about such circumstances in order to advocate for and protect their children as much as possible, particularly in schools where everyone may not be on the same page about what is best for children.

“Completed Suicide Risk Highest Within First Six Months After Incomplete Suicide” (By: Michele Babcock-Nice)

Child mental health is becoming an area of ever-increasing concern and research, including within the area of child sexual abuse, depression, anxiety, suicidality, and bullying that lead to suicide.  Recently, within the past two months, I had opportunities to visit a large metropolitan hospital in Atlanta at which mental health care is provided on an inpatient and outpatient basis for people of all ages.  I primarily made observations in the children’s mental health unit in which children from ages 4-12 were hospitalized as inpatients.

Since making my observations, I have done much research in the area of medicine and counseling related to depression, anxiety, suicidality, and bullying that ultimately ends in the suicide of the victim.  I have also consulted with many professionals in these areas, including pediatricians, psychiatrists, psychologists, and licensed professional counselors.  Further, I have communicated with school teachers, school administrators, school mental health professionals, school system administrators, and religious about these issues.  This blog article will share some of what I discovered related to these critically important issues in mental health care.

At the hospital in Atlanta at which I made my observations regarding inpatient child mental healthcare, the most significant part about it that was very noticeable was that most of the children were boys.  On one particular day, there were 16 children housed in the unit, and 12 of them were boys, with the majority of the boys being African-American.  Of the girls present, the majority of them were Caucasian.  It was also my understanding that the majority of the boys were hospitalized due to suicidality (and/or other mental health concerns related to it, such as depression, anxiety, and/or sexual and/or physical abuse or neglect).

To me as an untrained observer, I found this to be very significant because my personal expectation was to observe there to be a greater number of girls than boys present in the unit.  Because there were significantly fewer girls than boys present in the unit over a period of several days, it became important to me to understand the reasons for it.  I got to thinking about several possibilities to explain this reality.

Perhaps girls are more open about their feelings and experiences, and/or a depressed or otherwise upset mood in girls may be more visible to others.  Perhaps boys are keeping their feelings too much to themselves due to the societal and cultural expectations for them to “be a man,” and thus, not to show their feelings.  Possibly, adults were unable to recognize signs of suicidality or depression in boys compared to girls.

Further, it may be possible that adults did not view boys’ depression or suicidality to be as serious as that of girls until a crisis point was reached.  Culturally, it is also significant that most of the children housed in the unit were African-American boys.  Specifically related to cultural or ethnic differences, I do not yet have particular potential explanations for this.  Additionally, perhaps there are other general explanations and reasons that I have not thought of for there being significantly more boys in the unit than girls.

As I stated previously, since the time of my observations of the children’s mental health unit in the metro Atlanta hospital, I have researched several issues relating to child mental health, and I have consulted with many professionals in the field.  In a study completed by Cynthia R. Pfeffer (2001, p. 1057), she stated that during prospective follow-up into adulthood of children at risk for suicide showed that a “history of sexual abuse (RR: 5.71, 95%; CI: 1.9-16.7) imparted the greatest risk” for it.  Reading this was saddening and disheartening for me because it appears that most suicide attempters and commiters have internalized their pain and suffering, are taking it out on themselves, and appear not to be able to successfully cope.  They were hurt, have lost hope and trust, and are now hurting themselves, possibly in efforts to make the painful memories disappear.  For them, suicide seems to be the only answer for removing and escaping the emotional pain.

In a study by Stanley, Brown, Brent, Wells, Poling, Curry, Kennard, Wagner, Cwik, Klomek, Goldstein, Vitiello, Barnett, Daniel, and Hughes (2009, p. 1005), the researchers reported that individuals who attempted incomplete suicide are at the greatest risk for repeat attempts and/or actually committing suicide within the first six months following the incomplete attempt (as this study particularly relates to adolescents, aged 13-19 years old).  This is extremely important to understand because those who are untrained in this area do not understand the seriousness or severity of it, or are, perhaps, in denial that the situation is serious or severe.  Regarding children, I believe this particularly applies to those in education, including teachers, administrators, and other staff because they are not equipped with the knowledge and understanding about the manner in which to best support students who have been suicidal.

And sometimes, those adults in education who are bullies toward children truly have absolutely no understanding or compassion toward students who made an incomplete attempt at suicide because they simply do not seem to care.  In fact, those type of adults may even do more damage to the child through their insensitivity and failure to understand the situation by being even more punitive or retaliatory toward the student because the issue is one with which they, themselves, are unable to successfully cope.  It remains easier for such adult bullies of students in education to bully, blame, and revictimize the student victim.

Also unhelpful are the student peer bullies with whom the suicide attempt survivor must cope.  Student peer bullies of the victim seem to bully the survivor even more because they are aware of the emotional vulnerability of the survivor, and they capitalize on that because it makes them feel good.  Therefore, in a school environment in which bullying goes unchecked, unresolved, and not corrected, suicide attempt survivors are at an even greater risk for a future successful suicide attempt because they experience bullying from adults and peers.

Additionally, O’Connor, Gaynes, Burda, Soh, and Whitlock (2012, p. 15) reported in their study that “psychotherapy did not reduce the risk for suicide attempts in adolescents in contrast to adults.”  They (O’Connor, Gaynes, Burda, Soh, and Whitlock, 2012, p. 11) further reported that “psychotherapy did not reduce suicide attempts in adolescents at 6 to 18 months” into a suicide prevention treatment program.  They (O’Connor, Gaynes, Burda, Soh, and Whitlock, 2012, p. 11) also stated that “psychotherapy had no beneficial effect on suicide ideation beyond usual care” in adolescents.  These findings are shocking, disturbing, and disheartening, particularly when there may be the extant societal belief that counseling and psychotheraphy benefit individuals with emotional disturbances and/or self-destructive ideations.  If psychotherapy is not beneficial to adolescents who have attempted suicide and/or who have suicidal ideation, what benefit is psychotherapy to children who have had similar experiences and/or beliefs?

A professional friend of mine who is a psychiatrist provided me with an article written by a women who is a sexual abuse survivor, and who was hospitalized on three occasions throughout her life due to depression and suicidality related to her traumatic experiences.  The article, “How ‘Person-Centered’ Care Helped Guide me Toward Recovery from Mental Illness,” by Ashley R. Clayton (2013), was extremely helpful to me in better-understanding what is going through someone’s mind when they are hospitalized for a mental health crisis.  The article was further assistive to me because, as a graduate student in counseling who is working on my second master’s degree, it was important for me to perceive and understand the great value of Person-Centered Therapy in counseling suicide and sexual abuse survivors.

Because so much hope and trust has been lost in survivors of sexual abuse and suicide, it is obviously critically important for others, including mental health professionals, to be as sensitive and supportive as possible of them.  The author shared that she experienced the greatest improvement through the person-centered approach and caring relationship that a particular nurse developed with her.  This is something important for me to remember and put into practice in my own counseling of trauma survivors.

Further regarding children’s mental health in relation to surviving trauma and suicide attempts, as well as those areas in relation to children’s school attendance, I spoke with two pediatricians regarding the issues.  Both pediatricians took the issues seriously, however, they did not desire to take responsibility for children who were suicidal because they stated they were not trained or highly-experienced in those areas.  Both pediatricians also desired for parents to work with the expectations of schools, even though such expectations, stresses, and pressures may be too overwhelming for some children.  Regarding the experience of child sexual abuse, both pediatricians believed that counseling was needed for child survivors, however they both believed that medication to manage the child survivors’ moods were necessary as long as they believed the child was “functioning.”

For me, the perspectives of both pediatricians – both of whom are Caucasian women with many years of experience in pediatrics – were discouraging in many areas.  First, both doctors appeared to be very quick in the desire to refer suicidal patients to other medical professionals.  While that has advantages and disadvantages, it places those at risk in the position of believing that their doctors are unable to properly care for or understand them.  Both also believed that child survivors of sexual abuse need not be medicated if they were “functioning.”  I believe that it is one thing to survive, and quite another thing to thrive.  Merely “functioning” is not fully living or thriving, to me.  And also, both pediatricians appeared to also be too quick to go along with schools’ expectations for students, including maintaining the same academic and/or disciplinary standards for students who are trauma survivors.  As an individual who is an experienced teacher, I know that students have different learning styles; placing everyone in the same category is detrimental to those who have suffered trauma.

Both a psychologist and a licensed professional counselor (LPC) with whom I consulted about difficult, damaging, challenging, and/or overly stressful and overwhelming school experiences of child trauma survivors both believed that people in education are or may be unable and/or unwilling to change in a manner that is more supportive, understanding, and compassionate toward them.  The psychologist believed there is not likely any school that would be able to meet the needs of a child who is a trauma survivor.  And, both the psychologist and the LPC believed that schools are part of the problem in not successfully supporting and understanding trauma survivors and their needs.  Those who are in education – perhaps including school counselors and school psychologists – may be unequipped in schools at being able to fully or successfully support children who are trauma survivors; this can and does have devastating effects on such children.

Of all those in the medical and mental health fields, I believe those who are most fully trained and equipped to successfully both treat and understand trauma survivors – in particular, those who have experienced sexual trauma, depression, anxiety, and suicide attempts – are psychiatrists.  Psychiatrists are in the best position to provide urgent and necessary medical and mental health care to suicide attempters, including hospitalization, evaluations, medical care, and medications.

I assume that the psychiatrists are those who most often see patients who are suicide attempters; and they see them at their lowest points, emotionally.  Therefore, psychiatrists who truly have what is best for their patients in mind seem to help suicide attempters and trauma survivors become stabilized and recover as quickly as possible.  Psychiatrists are in a wonderful position with their patients to be supportive, understanding, and compassionate; and to inform and educate society, in general, about the medical issues and needs experienced by suicide attempters and other trauma survivors.

In communicating with several people who are education professionals regarding survivors of sexual trauma, suicide attempts, and bullying (both by peers and adults in school), I have largely encountered  biases against the survivors, as well as an incredible absence of sensitivity toward them.  Such refusals of understanding, sensitivity, and compassion toward survivors by the majority of education professionals with whom I communicated can possibly be attributed to a lack of or refusal toward being educated and informed about the needs of the survivors.  Such outright insensitivity by the education professionals – the majority of those who were insensitive toward survivors were administrators – could also be attributed to a denial about the seriousness or severity, or fear due to stigmas or the unknown, regarding the issues related to survivors.

In some situations of communicating with administrators, upper administrators, and school psychologists of schools and school systems related to student survivors of sexual trauma, anxiety, depression, suicide attempts, and bullying, I also encountered not only insensitivity and a lack of understanding toward the survivors, but also inconsistencies in their behaviors toward them.  In most school and/or school system administrative personnel and school psychologists with whom I communicated, I encountered adult bullying by them toward the child survivors that was sadistic.  In such education professionals, it appeared that their incredible harshness toward the survivors was something that they wanted to occur, regardless of the outcome or effects that may or may not have resulted in actual suicide.

In other situations in communicating with education professionals about such survivors, however, I encountered empathy, compassion, understanding, and sensitivity toward them.  Such supportive actions were those exhibited by other particular school system administrative personnel and/or educators and counselors.  Such desparities in the treatment of survivors by various school personnel reflects that education professionals must be on the same page in order to consistently understand and support, as well as be compassionate and sensitive toward survivors.  This appears to be direly and desperately needed in education in order that students who are trauma and suicide attempt survivors receive the greatest possible support and understanding in their educational environments.

Therefore, it was personally extremely shocking and disturbing to me in a life-changing manner that some of the very leaders of schools and school systems not only do not support said survivors, but are actually bullying and sadistic toward them.  In these situations, I believe it would take not less than a miracle to convince such individuals to even consider a different and more positive and understanding perspective toward said survivors.

In regard to particular religious leaders with whom I have communicated about issues related to survivors of child sexual abuse, anxiety, depression, suicide attempts, and bullying, I have – thus far – experienced their compassion, kindness, and prayers toward survivors.  I have also learned, however, to carefully choose which religious to approach; not all religious are as understanding and supportive as others.  And, I am further aware that there are those religious who would take such information and use it against the victims and/or survivors in order to revictimize them.  Presently, however, that is not what I have experienced in my recent and present communications with particular religious about these issues related to survivors; and I am thankful for and relieved about that.

I believe that society has come a long way in supporting and understanding the experiences and needs of trauma survivors, including those who have experienced sexual abuse, depression, anxiety, trauma, bullying, and suicide attempts, however there is still much more progress to be made.  Those who best-recover from traumatic experiences are those who have positive, stable support in their lives.  Stressful and overwhelming situations are serious set-backs that only cause them to regress, and to continue not to hope or trust.

It is so critically important for sexual abuse survivors and suicide attempt survivors to have the consistent and unconditional support of those around them, including family members, community members, those who are in education, and others.  Without such support, compassion, and understanding – and, in fact, if the survivor experiences the opposite of those – he or she could make a future suicide attempt that is successful.  Such tragedies are avoidable and preventable if everyone practiced more patient, respect, appreciation, and compassion toward each other, particularly trauma survivors who have attempted suicide.

References

Clayton, A.R. (2013).  “How ‘Person-Centered’ care helped guide me toward recovery from mental illness.”  Health Affairs, 32 (3), pp. 622-626.

O’Connor, E., Gaynes, B.N., Burda, B.U., Soh, C., & Whitlock, E.P. (2012).  “Screening for and treatment of suicide risk relevant to primary care.”  Annals of Internal Medicine, pp. 1-22; pp. W-1 – W-5.

Pfeffer, C.R. (2001).  “Diagnosis of childhood and adolescent suicidal behavior: Unmet needs for suicide prevention.”  Society of Biological Psychiatry, 49, pp. 1055-1061.

Stanley, B., Brown, G., Brent, D.A., Wells, K., Poling, K., Curry, J., Kennard, B.D., Wagner, A., Cwik, M.F., Klomek, A.B., Goldstein, T., Vitiello, B., Barnett, S., Daniel, S., & Hughes, J. (2009).  “Cognitive-Behavioral Therapy for suicide prevention (CBT-SP): Treatment model feasibility, and acceptability.”  Journal of the American Academy of Child and Adolescent Psychiatry, 48 (10), pp. 1005-1013.

“A Spiritual Inquiry: What is Suffering?” (By: Michele Babcock-Nice)

Suffering.  Just what is ‘suffering’ anyway?  What is the meaning of suffering, and why do people suffer?  Why do we experience suffering?  Dictionaries and encyclopedias generally define suffering as relating to pain, distress, and/or emotional pain; anxiety, stress, or aversion to something subjective; and a negative emotion or feeling, etc. 

The New World Encyclopedia defines suffering “as a negative basic feeling or emotion that involves a subjective character of unpleasantness, aversion, harm, or threat of harm.”  I would like to take this definitions and understanding of suffering a bit further, expanding on it to include many types of suffering, including emotional, psychological, physical, physiological, social, moral, and spiritual suffering.

There are so many different types of suffering, and I’m sure that most of us have experienced many – if not all – of them.  During Lent this year in 2012, I especially and personally contemplated the meaning of suffering.  This is a topic about which I have thought in the past, though I found deeper meaning in contemplating it during this past Lenten season.  I thought about Jesus, and all the suffering, pain, anguish, and turmoil he experienced prior to dying as our Savior.  I know that it was God’s will for this to occur, though I wondered why – as I have wondered why throughout my life – this was necessary to occur. 

One man – one holy, Godly man – is able to save us from our own sinfulness through the power of his suffering, death, and resurrection.  Was there no other way to achieve that?  Why was it necessary that Jesus experience such horrific and indescribable suffering in order to save us?  Why, often, does society – even now – turn against those who are good, honest, moral, and ethical.  Why, sometimes, is it that those who are self-serving, corrupt, unjust, unethical, and immoral make gains in their lives over those who are the opposite of them? 

These are not only religious questions, but also philosophical and humanistic questions worth contemplating.  Why is there suffering in the world?  Why does it occur?  Is it something that is necessary to occur as a result of our own humanity?

When I think about suffering, I think about things that I have experienced in my own life – or even that which family members have experienced – and then, when I hear about another’s suffering, what I have experienced sometimes seems to pale in comparison to theirs.  An adult daughter of a friend and colleague is struggling to heal against breast cancer.  This spring, a young girl in my child’s school was recently diagnosed with bone cancer, while another was diagnosed with diabetes.  The daughter of a close friend has been struggling against breast cancer.  Still others whom we know deal with great physical or emotional pain each day. 

Others suffer with physical pain, including a dog that was reported to have killed a family’s two-month-old baby in April 2012.  Still others also grapple with suffering that they may not be able to alleviate, of loved ones killed and who we are unable to revive and bring back.  An example of this that is still all too fresh in our minds is the suffering and death inflicted upon so many at the movie theater tragedy in Aurora, Colorado (http://www.cbsnews.com/2300-201_162-10013055-2.html?tag=page;next).  And, there are countless other examples of suffering, pain, and death that go on and on, such as the fighting in Syria and Northern Ireland, and even in some of our own neighborhoods, such as those in Chicago.

So much suffering.  Why is there suffering?  Why is it a “normal” condition of human life to have and experience suffering?  Is it expected?  Is it necessary?  Is it an unavoidable condition of human life and of all life on earth?  When people worry, are nervous, or are anxious, they experience some degree of suffering.  When people are hungry, homeless, or in need, they are suffering.  When anyone experiences any type of abuse – emotional, physical, sexual, even spiritual – they are suffering.  How can we understand, alleviate, and/or overcome pain and suffering?

If someone has experienced or witnessed a traumatic situation, such as a tragic death of a family member, loss of their home due to a natural disaster, or was involved in a terrible vehicle accident, they have experienced suffering.  There are also those who self-impose suffering onto themselves, inflicting injury on themselves, drinking, doing drugs, being promiscuous, or doing illegal actions – they are suffering.  Therefore, there exist the questions about why people hurt themselves. 

Personally, I feel sorrow and sympathy for those who are suffering, as well as for those who have some type of need within themselves to create or cause suffering on or toward others.  People who are bullies, those who are abusive, those who commit crimes, those who are hateful, those who have no conscience or sense of any wrong-doing when they take life-altering actions against others – I feel sorry for them and I pray for them.  Indeed, I sometimes also feel anger, spite, judgment, and a lack of understanding for their actions, though I also pray for them. 

For these people I just described, I believe they are those who need the most prayers.  They may be those for whom society and the world let down, didn’t help, and turned away from, forcing them to fend for themselves, to survive in whatever ways possible, even if those ways were criminal.  I feel sorry for them, and I may find it in my heart to be forgiving, but I believe it is important not to forget and not to allow oneself to be open to being hurt and/or injured by them in some way again. 

Through all of this, we still come back to the age-old questions of what is suffering and why do people suffer?  How can we alleviate and/or eliminate pain and suffering?  These are questions that I am unable to answer, and continue to contemplate.  Perhaps you can share your own insights.

References

New World Encyclopedia.  April 21, 2012.  http://www.newworldencyclopedia.org/entry/Suffering.

“The Aurora Shooting Victims.”  CBS News.  September 15, 2012.  http://www.cbsnews.com/2300-201_162-10013055-2.html?tag=page;next.

“Women need more Appreciation and Respect” (By: Michele Babcock-Nice)

Is it just me, or does this happen to women alot?  Women who are assertive, confident, direct, honest, independent, educated, and who may be single, divorced, and/or widowed are unappreciated and not respected by many men.  Not only are such women unappreciated and not respected by men, but also by other women and the greater society, and others may feel very threatened by their confidence and assertiveness – and blame the women for it due to their own discomfort!  What is it about us?  What is it that people dislike?

I’m not a person who asks for or tends to “need” alot from others.  I try to “handle” and cope with the majority of situations and experiences that I have independently.  I’m not a gossip, though when something is going wrong and could be improved or enhanced, I speak up, making myself and my views known.  What I find is that, for the most part, most people just don’t care.  In fact, I often find that the more I speak up, the worse the situation gets.

Why is that?  Do most people believe that they have enough of their own life situations to deal with?  Do they feel that there is no need to invest anything, emotionally, into someone else’s difficulties, challenges, struggles, or troubles?  Are people afraid to get involved?  Or, is it that they really, simply just don’t care?

It would be interesting to me if a study was performed to research all of these attributes and characteristics of women, and the manner in which men, other women, and even the greater society views and/or treats us.  It would also be interesting to me to ascertain whether or not there are differences in such perspectives and treatment of women across different regions of the country – such as in the north, south, east, and west – in the United States. 

The South is known as the Stroke Belt.  Of course, there are studies that have been completed about why this is so.  I would like to offer my own simple analysis, not based on any research, but based on my own observations and experiences. 

It seems to me that women in the South are often not allowed to be themselves.  In order to be fully accepted into Southern society, women are subtly and silently “required” to speak and behave more like men, be supportive cheerleaders of men, be agreeable and not ask any questions of men, and be submissive to and/or dependent on men.  Additionally, women in the South are required to do all of these things while also remaining “beautiful,” appearing young, and being a great physical, mental, and emotional condition.  Any women who does not seem to “meet” those requirements is not part of the “in” and/or “accepted” crowd.

Perhaps unknowingly, women in other parts of the country do the same, to a certain extent.  Women unconsciously “conform” ourselves to fit in and be more socially acceptable.  How many women do you know believe they have to drink with their boyfriend and/or his buddies at sports games in order to fit in and be acceptable?  How many women do you know pile on the make-up, and spend loads of money for hair and nail treatments, thinking that this makes them more attractive?  How many women do you see at your workplace who are especially kind and friendly to the boss, seeking more favor?

It is not easy to be a woman in today’s society.  Women are “required” to do, say, and “be” so many things, to serve in so many roles.  And, in all this, women are also expected not to become upset, not to complain, not to vent, not to become emotional.  We are expected to be able to handle it all!  Certainly, some of us can be considered superwomen, but after awhile, the stresses, pressures, expectations, and requirements take their toll.  Stroke, cancer, heart disease, and other conditions and/or ailments are a result of the constant, unceasing expectations and requirements that society places upon us. 

Therefore, women need more appreciation and respect in our society – in our families, our homes, our churches, our communities, our nation, our world.  People ought to try to place themselves in another’s shoes and walk in those shoes for awhile.  Rather than overlooking, not appreciating, and not respecting each other’s experiences and who we are as individuals, people must realize that life isn’t always easy for everyone.  Their lack of appreciation, and absence of understanding and respect just makes it that much more difficult for us.  But again, do they really care? 

As a member of a particular group at my church, I was recently overlooked by the male leader of the group.  The leader is about my age, married, and has a family, though he always appeared to take a sort of “flippant” and uncaring attitude toward me.  Today, he realized that he had not included me on any of the group’s e-mails and communications for several months, and that by doing so, I was not informed of a group meeting and photo.  He apologized to me about the situation – by e-mail – though it all just brought tears to my eyes. 

Why am I the person who is regularly overlooked, unappreciated, uncared for, not respected?  Are all of my positive qualities that much of a threat to others that they consciously or unconsciously exclude me from their own thinking?  It is so disppointing and tragic to keep experiencing these types of situations over and over again.  I could change who I am, but then I wouldn’t be “me.”  Maybe most people would like me better if I was more gossipy, untruthful, and fake.  I wouldn’t be true to myself if I behaved like that.  I wonder how many people would truly be able to walk in my shoes?

Book Review of “Honor Betrayed: Sexual Abuse in America’s Military” By Dr. Mic Hunter (Review By Michele Babcock-Nice)

“Honor Betrayed: Sexual Abuse in America’s Military” By: Dr. Mic Hunter

In Honor Betrayed: Sexual Abuse in America’s Military, Dr. Mic Hunter provides extensive information, citations, and experiences of some of his clients related to sexual assault, sexual abuse, and sexual harassment within the U.S. military.  In his book, Dr. Hunter covers many topics related to these issues, including hypermasculinity; hazing; homophobia; gender and status bias; sexism; aggression; misogyny toward women and homosexuals; domestic violence; and use of and even staging of prostitution in the military.  Overall difficulties and rejections experienced by veterans in seeking support, therapy, and aid from Veteran’s Administration hospitals in treating post-traumatic stress disorder or other anxiety disorders as a result of sexual trauma experienced in the military are also presented.

Dr. Hunter has so extensively researched and written on the topics of sexual harassment, sexual abuse, and sexual assault within America’s military that I can hardly begin to incorporate all of his topics in my review of his book, though I will make my best attempt at doing so.  My best suggestion is to read his book since every page – page after page – is chock full of relevant, honest, direct information to his work.  For readers who may be unsure or doubtful as to the great extent of sex crimes that occur in America’s military, Dr. Hunter’s book can be a shocking and/or painful eye-opener to the truth of what occurs.  Dr. Hunter directly, professionally, and expertly deals with all of the issues presented, not treating the issue lightly, nor with kid gloves.

As I began reading Dr. Hunter’s book, some of my first thoughts about many military men’s views about women include that most of the men believe that, due to their physical strength, sexuality, and attitudes, they are superior to women.  They believe they are more powerful and influential than women, and that they have the capability to inflict more damage on those whom they believe are inferior. 

Many military men believe that because aggression and violence are part of their job description in wartime, these negative, destructive, and criminal behaviors can also be employed in everyday interactions with others.  And, in general, it is incorrect for men to believe that just because a woman does not “protest” something, does not mean she “agrees” with it.  This is because many women have learned that the more they protest something, the greater and more intense and severe the wrongs that are committed against them.

Early on in his book, Dr. Hunter provides many positive reasons for military recruits to enlist.  To the outside world – the general public and society that has not had experience in or with the military – these reasons appear to be very healthy, beneficial, and helpful reasons for joining the military.  Once one becomes a member of the military, however, it’s true nature is often revealed in very negative, traumatic, and criminal ways – with one’s own peers and/or superiors committing sexual attrocities against them; instilling them with injury, fear, and a sense of betrayal; and denying them the health, medical, and mental assistance that is needed for their optimum recovery.

In his book, Honor Betrayed: Sexual Abuse in America’s Military, Dr. Hunter further identifies and shares “reasons” for men’s backlash against women, why they sexually harass women, and why rapists rape women or men.  Dr. Hunter also shares that there is an exaggerated and unreasonable fear of homosexuals in the military, and that most men who are heterosexuals are responsible for the greatest amount of sexual harassment.  He also states that “heterosexual” men are more likely to rape – a woman or a man – than are homosexuals. 

Later in his book, Dr. Hunter further states that the impact of rape seems to be higher on men than on women.  In this, he means that the emotional toll of this sex crime appears to be more severe when experienced by men since men generally believe they should be strong enough to ward of their attackers, and that they should be “man” enough to protect themselves, even though they may be handcuffed, restrained, and gang raped by several men in a brutal sexual attack.

Dr. Hunter provides a chart that lists and identifies the effects of rape and sexual assault.  Incredibly, the military courts generally do not convict those members of the military who have committed sex crimes, providing them with a clean record when they leave military service and re-enter civilian life.  For those sex offenders in the military who are convicted of rape, their sentences generally amount to only a few months in jail.  When men think and act aggressively and violently with their penises rather than rationally and respectfully with their brains, such a travesty of justice appears to be common in the military regarding military sex offenders.

For these and other reasons, there are women in the military who encourage other women not to report being raped, gang raped, sexually assaulted, sexually abused, and/or sexually harassed.  It would therefore appear that sex crimes are the norm in the military, and that most sex offenders in the military get away with their crimes, only to commit them again, and perhaps with greater severity in the future, to potentially include the death of their victims.

Dr. Hunter reports that nearly all of those who rape others generally have no problem with what they have done.  And, in fact, the rapists feel good about having raped another person, despite the damage, injury, fear, and/or even death caused to their victims! 

The organizational culture of the military and attitudes of many military personnel, Dr. Hunter believes, are responsible for the tolerance and acceptance of, and lack of seriousness toward sex crimes that occur in the military, between members of the military.  Such a culture goes far beyond sexual harassment, sexual objectificiation, homophobia, and hazing, to include the encouragement and acceptance of institutionalized sexual violence and aggression by military members toward other military members. 

Such an institutionalized, organizational culture that is desensitized toward respecting the physical and sexual rights of others, including it’s own, has also indirectly led to the deaths of female servicewomen.  An example of this is reflected in a situation in which female servicewomen would not leave their tents to use restroom facilities while stationed in the Middle East due to fears of being raped by their own “comrades,” contributing to their deaths from dehydration in 120 degree F or higher heat during sleep.

The end of Dr. Hunter’s book spotlights military members experiences with having been sexually abused and/or assaulted, and the effects such sex crimes have had in their lives.  Several military veterans share heart-wrenching, extremely painful, and agonizing stories of their experiences.  One veteran shared a statement of fearing comrades more than the enemy in war.  Another grapples with being able to forgive himself for having been sexually assaulted, in order to move on in his life in a more healthy manner, mentally.  The assumption that can be made upon reading all of the survivors’ stories is that anything goes in the American military because most military sex offenders can and do get away with their crimes.

Honor Betrayed: Sexual Abuse in America’s Military, by Dr. Mic Hunter is a wonderfully ground-breaking and extensive work on the problem of sexual harassment, sexual abuse, and sexual assault within the military of the United States.  Dr. Hunter’s approximately 35 years of experience as a psychotherapist, primarily treating individuals who have addictions and/or who have experienced sex crimes, contribute to making him an authority on sexual assault, sexual abuse, and sexual harassment, including that which occurs within the military since he has treated many veterans who are clients coming to him for assistance and support regarding their experiences. 

Dr. Hunter’s book is an amazing, well-written, and beneficial resource for all those who are coping with the effects of sex crimes, for those who are supporting others who have experienced sex crimes, for those who are interested in military history, and for all those who are considering military enlistment.  I recommend Honor Betrayed: Sexual Abuse in America’s Military, by Dr. Mic Hunter, highly and without reservation as another of his must-read works regarding sexual trauma.

Reference

Hunter, M. (2007).  Honor Betrayed: Sexual Abuse in America’s Military.  Barricade Books: Fort Lee, New Jersey.