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Sydneysiders witnessed horrific scenes on Saturday. How do you process and recover from such an event?

<p><em><a href="https://theconversation.com/profiles/kim-felmingham-9075">Kim Felmingham</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>Like many, I watched the reports of the violent attack at Bondi Junction yesterday with shock, horror and disbelief. My heart goes out to the people involved, the courageous first responders and to those who have lost loved ones in this tragic event.</p> <p>I also feel for those who witnessed the horror and will be working out how to get through the initial shock and, over time, put it behind them.</p> <p>Distress and strong emotional reactions are <a href="https://kclpure.kcl.ac.uk/portal/en/publications/the-psychological-and-psychiatric-effects-of-terrorism-lessons-fr">common</a> after these types of mass violent events.</p> <p>But different people will have <a href="https://www.ptsd.va.gov/understand/types/mass_violence_help.asp">different emotional reactions</a> – and some may experience a range of shifting emotions.</p> <h2>The first few days and weeks</h2> <p>In the days and weeks after traumatic events like these, people <a href="https://www.ptsd.va.gov/understand/isitptsd/common_reactions.asp#:%7E:text=All%20kinds%20of%20trauma%20create,stop%20thinking%20about%20what%20happened.">often experience</a> a <a href="https://www.sciencedirect.com/science/article/abs/pii/S0306457320308670">range of emotions</a>: from fear and anxiety, anger, sadness and grief, disbelief and numbness, guilt and worry about safety. They may be jittery, more irritable or on edge, or it may affect their sleep.</p> <p>For many, their sense of risk may be heightened, particularly as such random violence occurred during such an ordinary event – shopping on a Saturday afternoon. This <a href="https://www.ptsd.va.gov/understand/types/mass_violence_help.asp">can lead to</a> a heightened awareness of danger and concern for safety.</p> <h2>What’s likely to happen over time?</h2> <p>For most people, as they begin to process and make sense of what happened, these feelings will gradually reduce in intensity and people will begin to recover. <a href="https://pubmed.ncbi.nlm.nih.gov/25311288/">Research shows</a> the majority of people recover from mass violent events within the initial few months.</p> <p>However, for people with more direct exposure to the trauma, these events and reactions may be more difficult to process. Some people <a href="https://pubmed.ncbi.nlm.nih.gov/26084284/">may go on</a> to develop mental health difficulties, most commonly anxiety, depression and post-traumatic stress disorder (PTSD).</p> <p>Understandably, those <a href="https://pubmed.ncbi.nlm.nih.gov/26084284/">more at risk</a> are people who were present during the trauma and experienced a direct threat, as well as those who witnessed the violence or aftermath, first responders (paramedics and police) and those who had loved ones injured or lost during the event.</p> <p>People who had more intense emotional responses during the trauma, or previous psychological difficulties or traumatic experiences, may also be <a href="https://pubmed.ncbi.nlm.nih.gov/26084284/">at greater risk</a>.</p> <h2>What helps – and hinders – your recovery?</h2> <p>To help process these traumatic events and promote recovery, social support is <a href="https://www.ptsd.va.gov/understand/types/mass_violence_help.asp">particularly important</a>.</p> <p>Spending time with trusted family and friends can help people process the events and their emotional reactions. Talking about your feelings with supportive people can help you understand and accept them. But even if you don’t want to talk about your feelings, spending time with loved ones is helpful.</p> <p>It is also fine to need some time to be alone, but try not to isolate yourself or withdraw.</p> <p>If you can’t talk about your feelings, try not to bottle them up or deal with them by using alcohol or drugs. Find <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957853/">another way to express them</a> – whether through writing, art or music, or exercise.</p> <p>Give yourself permission and time to feel these emotions. Remind yourself you have just been through something extremely traumatic, take things day by day, and don’t expect too much of yourself. Try not to judge yourself for your actions or how you are coping.</p> <p>Keep some structure in your day, setting small goals, and increase your self-care: eat well, rest (even if you can’t sleep well), try yoga or relaxation. When you’re ready, try to get back to your normal routine.</p> <p>Seek out information from <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7957853/">trusted sources</a>, but try to <a href="https://journals.sagepub.com/doi/10.1177/0886260517742915">avoid</a> being saturated by images or stories about the trauma, particularly graphic footage or speculation common on social media.</p> <h2>What if children have witnessed it, too?</h2> <p>If your children have been impacted, reassure them that they are safe and loved. When they are ready, talk to them gently about the trauma, acknowledge it and answer their questions.</p> <p>Encourage them to express their feelings and spend more time together doing family activities.</p> <p>Importantly, try to limit their exposure to graphic footage and images of the events in the media, and on social media.</p> <h2>When to seek mental health care</h2> <p>Reach out for professional mental health support if you experience ongoing difficulty with your emotional reactions, or if you’re having distressing memories of the trauma, difficulty sleeping or nightmares, or you want to avoid things that remind you of the traumatic event.</p> <p>Not everyone requires professional mental health support, but if you are experiencing these types of post-traumatic stress reactions a few weeks after the trauma, it’s important to speak to your GP to seek out professional support from psychologists or counselling services.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/227867/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/kim-felmingham-9075">Kim Felmingham</a>, Chair of Clinical Psychology, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/sydneysiders-witnessed-horrific-scenes-on-saturday-how-do-you-process-and-recover-from-such-an-event-227867">original article</a>.</em></p>

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What is ‘fawning’? How is it related to trauma and the ‘fight or flight’ response?

<p><em><a href="https://theconversation.com/profiles/alix-woolard-409037">Alix Woolard</a>, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a></em></p> <p>You have probably heard of “fight or flight” responses to distressing situations. You may also be familiar with the tendency to “freeze”. But there is another defence or survival strategy a person can have: “fawn”.</p> <p>When our brain perceives a threat in our environment, our <a href="https://www.healthline.com/health/mental-health/fight-flight-freeze#in-the-body">sympathetic nervous system</a> takes over and a person can experience any one or combination of the <a href="https://pete-walker.com/fourFs_TraumaTypologyComplexPTSD.htm">four F</a> responses.</p> <h2>What are the four Fs?</h2> <p>The <strong>fawn</strong> response usually occurs when a person is being attacked in some way, and they try to appease or placate their attacker to protect themselves.</p> <p>A <strong>fight</strong> response is when someone reacts to a threat with aggression.</p> <p><strong>Flight</strong> is when a person responds by fleeing – either literally by leaving the situation, or symbolically, by distracting or avoiding a distressing situation.</p> <p>A <strong>freeze</strong> response occurs when a person realises (consciously or not) that they cannot resist the threat, and they detach themselves or become immobile. They may “space out” and not pay attention, feel disconnected to their body, or have difficulty speaking after they feel threatened.</p> <h2>What does fawning look like?</h2> <p>Previously known as appeasement or “people pleasing”, the term “fawning” was coined by psychotherapist <a href="http://pete-walker.com/complex_ptsd_book.html">Pete Walker</a> in his 2013 book <a href="https://www.goodreads.com/book/show/20556323-complex-ptsd">Complex PTSD: From Surviving to Thriving</a>.</p> <p>A fawn response can look like:</p> <ul> <li>people-pleasing (doing things for others to gain their approval or to make others like you)</li> <li>being overly reliant on others (difficulty making decisions without other people’s input)</li> <li>prioritising the needs of others and ignoring your own</li> <li>being overly agreeable</li> <li>having trouble saying no</li> <li>in more severe cases, <a href="https://www.sciencedirect.com/science/article/pii/S0149763421004917?casa_token=FzabbqNoE0UAAAAA:DAr_QkVegIa70Zheq6vTkCrsYPJdw06kdds659h-VHSRtPSUErDzVgj-YsLunjvGkn4Mwyb1">dissociating</a> (disconnecting from your mind and/or body).</li> </ul> <p>While there isn’t yet much research on this response, the fawn response is seen more in people who have experienced <a href="https://www.tandfonline.com/doi/abs/10.1080/00958964.2022.2163220?journalCode=vjee20">complex trauma</a> in their childhood, including among children who grew up with emotionally or physically abusive caregivers.</p> <p>Fawning is also observed in people who are in situations of <a href="https://europepmc.org/article/MED/37052112">interpersonal violence</a> (such as domestic violence, assault or kidnappings), when the person needs to appease or calm a perpetrator to survive.</p> <p>Fawning is also different to the other F responses, in that it seems to be a uniquely human response.</p> <h2>Why do people fawn?</h2> <p><a href="https://www.proquest.com/docview/2447256147/abstract/13E401AC2C1C40C6PQ/1">Research</a> suggests people fawn for two reasons:</p> <ol> <li>to protect themselves or others from physical or emotional harm (such as childhood trauma)</li> <li>to create or improve the emotional connection to the perpetrator of harm (for example, a caregiver).</li> </ol> <p>This type of response is adaptive at the time of the traumatic event(s): by appeasing an attacker or perpetrator, it helps the person avoid harm.</p> <p>However, if a person continues to use this type of response in the long term, as an automatic response to everyday stressors (such difficult interactions with your boss or neighbour), it can have negative consequences.</p> <p>If a person is continually trying to appease others, they may experience issues with boundaries, forming a cohesive identity, and may not feel safe in relationships with others.</p> <h2>What can I do if I ‘fawn’?</h2> <p>Because fawning is typically a response to interpersonal or complex trauma, using it in response to everyday stressors may indicate a need for healing.</p> <p>If this is you, and you have a history of complex trauma, seek psychological support from a professional who is trained in trauma-informed practice. Trauma-informed means the psychological care is holistic, empowering, strengths-focused, collaborative and reflective.</p> <p>Evidence-based therapies that are helpful following trauma include:</p> <ul> <li> <p><a href="https://www.emdr.com/what-is-emdr/">eye movement desensitisation therapy</a>, which focuses on <a href="https://theconversation.com/what-is-emdr-therapy-and-how-does-it-help-people-who-have-experienced-trauma-161743">processing traumatic memories</a></p> </li> <li> <p><a href="https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy#:%7E:text=In%20this%20form%20of%20therapy,reduce%20fear%20and%20decrease%20avoidance.">exposure therapy</a> to help expose people to things they fear and avoid</p> </li> <li> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396183/">trauma-focused cognitive behavioural therapy</a> that aims to alleviate trauma symptoms by overcoming unhelpful thoughts and behaviours.</p> </li> </ul> <p>Depending on where you live, <a href="https://www.childabuseroyalcommissionresponse.gov.au/support-services">free counselling services</a> may be available for people who have experienced childhood abuse.</p> <p>Setting healthy boundaries is also a common focus when working with the fawn response, which you can do by yourself or alongside a therapist.</p> <p><em>If this article has raised issues for you or you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205024/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/alix-woolard-409037">Alix Woolard</a>, Senior Researcher, <a href="https://theconversation.com/institutions/telethon-kids-institute-1608">Telethon Kids Institute</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-fawning-how-is-it-related-to-trauma-and-the-fight-or-flight-response-205024">original article</a>.</em></p>

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Australian researchers confirm world’s first case of dementia linked to repetitive brain trauma in a female athlete

<p><em><a href="https://theconversation.com/profiles/stephen-townsend-501829">Stephen Townsend</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/alan-pearce-734804">Alan Pearce</a>, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/rebecca-olive-944640">Rebecca Olive</a>, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p>Researchers at the <a href="https://www.brainbank.org.au/">Australian Sports Brain Bank</a> have today reported the world’s first diagnosis of chronic traumatic encephalopathy (CTE) in a <a href="https://rdcu.be/dfQiz">female athlete</a>.</p> <p>With the consent of her family, the diagnosis was made on the brain of Heather Anderson, a 28-year-old AFLW athlete <a href="https://www.abc.net.au/news/2022-11-14/adelaide-aflw-premiership-player-heather-anderson-dies-aged-28/101653188">who died</a> last November. Heather’s family donated her brain to the Australian Sports Brain Bank hoping to better understand why she died.</p> <p>The findings, which Professor Alan Pearce co-authored with the Australian Sports Brain Bank, raise questions about how a lifetime of contact sport may have contributed to her death. They come as Australia’s <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Headtraumainsport">Senate inquiry</a> works on its report into concussions and repeated head trauma in contact sport, due in August.</p> <p>Given how hard women have fought to participate in football codes and contact sports in recent years, this diagnosis has major implications for women’s sport in Australia. It also highlights the significant lack of research about women athletes in sport science and medicine.</p> <h2>What is chronic traumatic encephalopathy?</h2> <p><a href="https://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/symptoms-causes/syc-20370921">CTE</a> is a devastating form of dementia which causes a decline in brain functioning and increased risk of mental illness. It is increasingly associated with athletes who play contact sports, such as football, boxing and martial arts.</p> <p>It is incurable and can only be <a href="https://www.brainbank.org.au/cte-diagnosis/">diagnosed post-mortem</a>. Recently, a number of high-profile former Australian footballers were found to have been suffering from CTE when they died, including former AFL stars <a href="https://www.abc.net.au/news/2023-04-26/danny-frawley-family-urges-afl-to-act-on-cte-concussion/102269648">Danny Frawley</a> and <a href="https://www.abc.net.au/news/2022-08-25/brain-disease-killed-shane-tuck-not-mental-health-says-sister/101362740">Shane Tuck</a>, and former NRL player and coach <a href="https://www.abc.net.au/news/2022-10-22/qld-paul-green-brain-scans-reveal-brain-disease-cte-diagnosis/101566032">Paul Green</a>.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Adelaide AFLW premiership player Heather Anderson dies aged 28 <a href="https://t.co/ihy2i9UcRl">https://t.co/ihy2i9UcRl</a></p> <p>— ABC News (@abcnews) <a href="https://twitter.com/abcnews/status/1592079585201381377?ref_src=twsrc%5Etfw">November 14, 2022</a></p></blockquote> <p>Concussions in contact sports have long been associated with long-term neurodegeneration in <a href="https://www.frontiersin.org/articles/10.3389/fspor.2021.676463/full">Australia</a> and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3987576/">internationally</a>. While the public and researchers are rightly concerned about serious concussions, a study published last month in <a href="https://urldefense.com/v3/__https:/www.nature.com/articles/s41467-023-39183-0__;!!PDiH4ENfjr2_Jw!FvAmUDcX-ESwwl8nG_BNNkRyB2J4TBq1oXkBTE1bBcdRGEQTl4u7qmgGsLguHpGNlFpWkz-SjKg3HGwdNYxIfEWW9U6ifytx%24">Nature Communications</a> confirmed that repetitive brain trauma over time – even seemingly mild head knocks or whiplash – is the strongest predictor for an athlete developing CTE. Athletes with long careers in contact sport are at particular risk, especially if they play from an early age.</p> <h2>A sporting life</h2> <p>Heather Anderson began playing rugby league at age five before transferring to Australian rules football in her early teens. She played representative football in the Australian Capital Territory and Northern Territory before being drafted into the inaugural season of the AFLW in 2017.</p> <p>Anderson played a single season with the <a href="https://crowshistory.afc.com.au/aflw-players/heather-anderson#:%7E:text=Biography&amp;text=An%20army%20medic%2C%20Heather%20Anderson,year%20and%20starred%20for%20Waratah.">Adelaide Crows</a>, during which she won a premiership and suffered a career-ending shoulder injury. She then returned to her role as a medic with the Australian Army, a physical career which also carries a <a href="https://www.defence.gov.au/adf-members-families/health-well-being/programs-initiatives/military-health-outcomes-program">heightened risk of brain injury</a>.</p> <p>Anderson’s family donated her brain in the hope of knowing whether a lifetime of exposure to repetitive head trauma contributed to her death.</p> <h2>Was this diagnosis expected?</h2> <p>Concussion researcher Anne McKee predicted earlier this year it was a <a href="https://www.1news.co.nz/2023/02/20/its-coming-experts-worried-about-female-athlete-brain-injuries/">matter of time</a> before CTE was found in the brain of a woman athlete.</p> <p>The Australian Sports Brain Bank team believe Anderson is a “<a href="https://www.ncbi.nlm.nih.gov/books/NBK564388/">sentinel case</a>” we can learn from. She is the first female athlete diagnosed with CTE, but she will not be the last.</p> <p>Although Australian women have historically been excluded from the sports most associated with repeated head injuries, this is changing. In 2022, there were almost one million women and girls playing some form of <a href="https://www.clearinghouseforsport.gov.au/kb/women-in-sport">contact sport</a> in Australia. As women’s participation in contact sport continues to grow, so too does their risk of repetitive brain trauma.</p> <h2>Are women more prone to CTE than men?</h2> <p>There is emerging evidence that women are at significantly higher risk of mild traumatic brain injury (concussion) and may suffer more severe symptoms.</p> <p>Concussion alone does not cause CTE, but an athlete’s number of concussions is a reliable indicator of their cumulative exposure to brain trauma, which is the biggest predictor of CTE.</p> <p>While knowledge on the topic is still developing, researchers <a href="https://www.nature.com/articles/d41586-021-02089-2">propose a mix of physiological and social explanations</a> for women’s increased concussion risk. These include "[…] differences in the microstructure of the brain to the influence of hormones, coaching regimes, players’ level of experience and the management of injuries."</p> <p>More research is needed to understand sporting brain injuries specifically in women and girls. Given their growth in participation and the enhanced risks they face in sport, it is concerning that women and girls are <a href="https://bjsm.bmj.com/content/56/17/981">underrepresented</a> in concussion research.</p> <p>This is representative of a <a href="https://journals-humankinetics-com.ap1.proxy.openathens.net/view/journals/wspaj/29/2/article-p146.xml">broader trend</a> in sport and exercise science research to exclude women from studies because their bodies are perceived as <a href="https://link.springer.com/article/10.1007/s40279-021-01435-8">more complex</a> than men’s and thus more difficult to accommodate in testing.</p> <h2>A disease that does not discriminate</h2> <p>This world-first report of CTE in a female athlete is proof the disease does not discriminate and lends urgency to calls for <a href="https://theconversation.com/sports-concussions-affect-men-and-women-differently-female-athletes-need-more-attention-in-brain-research-160097">greater representation</a> of women in brain injury studies.</p> <p>Efforts to reduce concussion in women’s sport must first address resource inequalities between men’s and women’s sport. This includes giving women access to quality training and coaching support, as well as <a href="https://theconversation.com/new-study-much-of-what-were-told-about-gym-exercises-and-resistance-training-is-from-studies-of-males-by-men-205753">greater attention</a> from sport science and medical research.</p> <p>The health of <a href="https://www.tandfonline.com/doi/full/10.1080/14443058.2019.1575262">women athletes and women’s sport</a> will only progress if researchers, policymakers and sport governance bodies ensure the attention and resources required to address concussion and brain disease are not focused solely on men.</p> <hr /> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call <a href="https://www.lifeline.org.au/">Lifeline</a> on 13 11 14.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208929/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/stephen-townsend-501829">Stephen Townsend</a>, Lecturer, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a>; <a href="https://theconversation.com/profiles/alan-pearce-734804">Alan Pearce</a>, Professor, College of Science, Health, Engineering, <a href="https://theconversation.com/institutions/la-trobe-university-842">La Trobe University</a>, and <a href="https://theconversation.com/profiles/rebecca-olive-944640">Rebecca Olive</a>, Vice Chancellor's Senior Research Fellow, <a href="https://theconversation.com/institutions/rmit-university-1063">RMIT University</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/australian-researchers-confirm-worlds-first-case-of-dementia-linked-to-repetitive-brain-trauma-in-a-female-athlete-208929">original article</a>.</em></p>

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‘Psychological debriefing’ right after an accident or trauma can do more harm than good – here’s why

<p><em><a href="https://theconversation.com/profiles/richard-bryant-161">Richard Bryant</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>The recent <a href="https://www.abc.net.au/news/2023-06-18/hunter-valley-wedding-bus-crash-survivors-remain-in-hospital/102487630">tragic bus accident</a> in the New South Wales Hunter Valley has again raised the issue of how we address the potential psychological effects of traumatic events.</p> <p>It is interesting we revisit the same debate after each disaster, and few lessons have apparently been learned after decades of research. After the Hunter Valley accident, immediate psychological counselling was <a href="https://www.theguardian.com/australia-news/2023/jun/15/hunter-valley-bus-crash-company-issued-with-defect-notices-after-police-raid">offered to those affected</a>.</p> <p>While we can’t say what form of counselling was offered, the traditional approach is known as “<a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1118833/">psychological debriefing</a>”. This typically involves counsellors providing trauma survivors with a single counselling intervention within days of the event.</p> <p>Although the content of the intervention can vary, it usually involves education about stress reactions, encouragement to disclose their memories of the experience, some basic stress-coping strategies and possibly referral information.</p> <p>But the evidence shows this approach, however well-meaning, may not help – or worse, do harm.</p> <h2>The belief that feelings must be shared</h2> <p>The encouragement of people to discuss their emotional reactions to a trauma is the result of a long-held notion in psychology (dating back to the classic writings of Sigmund Freud) that disclosure of one’s emotions is invariably beneficial for one’s mental health.</p> <p>Emanating from this perspective, the impetus for psychological debriefing has traditionally been rooted in the notion trauma survivors are vulnerable to psychological disorders, such as post-traumatic stress disorder (PTSD), if they do not “talk through their trauma” by receiving this very <a href="https://journals.sagepub.com/doi/full/10.1177/1529100610387086">early intervention</a>.</p> <p>The scenario of trauma counsellors appearing in the acute aftermath of traumatic events has been commonplace for decades in Australia and elsewhere.</p> <p>Following the 9/11 terrorist attacks in New York City in 2001, up to 9,000 counsellors were mobilised and more than <a href="https://www.nytimes.com/2002/07/22/nyregion/finding-cure-for-hearts-broken-sept-11-is-as-difficult-as-explaining-the-cost.html">US$200 million</a> was projected to meet a surge in mental health needs. But fewer people than expected sought help under this program and $90 million remained <a href="https://theconversation.com/9-11-anniversary-a-watershed-for-psychological-response-to-disasters-2975">unspent</a>.</p> <h2>What do we know about psychological reactions to disasters?</h2> <p>The overwhelming evidence indicates the majority of people will <a href="http://www.psychologicalscience.org/publications/journals/pspi/weighing-the-costs-of-disaster.html">adapt</a> to traumatic events without any psychological intervention.</p> <p>Long-term studies indicate approximately 75% of trauma survivors will not experience any long-term distress. Others will experience short-term distress and subsequently adapt. A minority (usually about 10%) will <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086">experience chronic psychological problems</a>.</p> <p>This last group are the ones who require care and attention to reduce their mental health problems. Experts now agree other trauma survivors can rely on their own <a href="https://www.rcpsych.ac.uk/mental-health/problems-disorders/coping-after-a-traumatic-event">coping resources and social networks</a> to adapt to their traumatic experience.</p> <p>The finding across many studies that most people adapt to traumatic experiences <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086">without formal mental health interventions</a> has been a major impetus for questioning the value of psychological debriefing in the immediate aftermath of disasters.</p> <p>In short, the evidence tells us universal interventions – such as psychological debriefing for everyone involved in a disaster – that attempt to prevent PTSD and other psychological disorders in trauma survivors are not indicated. These attempts <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086#bibr448-1529100610387086">do not prevent</a> the disorder they are targeting.</p> <h2>Not a new conclusion</h2> <p>In the aftermath of the 2004 Indian Ocean earthquake and tsunami, the World Health Organization listed a warning (which <a href="https://www.who.int/teams/mental-health-and-substance-use/treatment-care/mental-health-gap-action-programme/evidence-centre/other-significant-emotional-and-medical-unexplained-somatic-complaints/psychological-debriefing-in-people-exposed-to-a-recent-traumatic-event">still stands</a>) that people should not be given single-session psychological debriefing because it is <a href="https://journals.sagepub.com/doi/10.1177/1529100610387086#bibr448-1529100610387086">not supported</a> by evidence.</p> <p>Worse than merely being ineffective, debriefing can be <a href="https://www.jenonline.org/article/S0099-1767(19)30453-2/fulltext#:%7E:text=It%20is%20for%20these%20reasons,%2C%20anxiety%20or%20depressive%20symptoms.%E2%80%9D">harmful for some people</a> and may increase the risk of PTSD.</p> <p>The group of trauma survivors that are most vulnerable to the toxic effects of debriefing are those who are more distressed in the acute phase right after the trauma. This group of people have worse mental health outcomes if they are provided with early debriefing.</p> <p>This may be because their trauma memories are over-consolidated as a result of the emotional disclosure so shortly after the event, when <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181836/#:%7E:text=Brain%20areas%20implicated%20in%20the,norepinephrine%20responses%20to%20subsequent%20stressors.">stress hormones</a> are still highly active.</p> <p>In normal clinical practice a person would be assessed in terms of their suitability for any psychological intervention. But in the case of universal psychological debriefing there is no prior assessment. Therefore, there’s no assessment of the risks the intervention may pose for the person.</p> <h2>Replacing debriefing</h2> <p>Most international bodies have shifted away from psychological debriefing. Early intervention might now be offered as “<a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/psychological-first-aid">psychological first aid</a>”.</p> <p>This newer approach is meant to provide <a href="https://www.who.int/publications/i/item/9789241548205">fundamental support and coping strategies</a> to help the person manage the immediate aftermath of adversity. One of the most important differences between psychological first aid and psychological debriefing is that it does not encourage people to disclose their emotional responses to the trauma.</p> <p>But despite the increasing popularity of psychological first aid, it is difficult to assess its effectiveness as it does not explicitly aim to prevent a disorder, such as PTSD.</p> <h2>Wanting to help</h2> <p>So if there is so much evidence, why do we keep having this debate about the optimal way to assist psychological adaptation after disasters? Perhaps it’s because it’s human nature to want to help.</p> <p>The evidence suggests we should monitor the most vulnerable people and target resources towards them when they need it – usually some weeks or months later when the dust of the trauma has settled. Counsellors might want to promote their activities in the acute phase after disasters, but it may not be in the best interest of the trauma survivors.</p> <p>In short, we need to develop better strategies to ensure we are meeting the needs of the survivors, rather than the counsellors.</p> <hr /> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208139/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></em></p> <p><em><a href="https://theconversation.com/profiles/richard-bryant-161">Richard Bryant</a>, Professor &amp; Director of Traumatic Stress Clinic, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/psychological-debriefing-right-after-an-accident-or-trauma-can-do-more-harm-than-good-heres-why-208139">original article</a>.</em></p>

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New lessons about old wars: keeping the complex story of Anzac Day relevant in the 21st century

<p>What happened on the Gallipoli peninsula in Turkey 108 years ago has shocked and shaped Aotearoa New Zealand ever since. The challenge in the 21st century, then, is how best to give contemporary relevance to such an epochal event.</p> <p>The essence of the Anzac story is well known. As part of the first world war British Imperial Forces, the Australian and New Zealand Army Corps (Anzacs) landed at Gallipoli on April 25 1915. For eight months they endured the constant threat of death or maiming in terrible living conditions. </p> <p>Ultimately, their occupation of that narrow and rugged piece of Turkish coast failed. The 30,000 Anzacs were evacuated after eight months. More than 2,700 New Zealand and 8,700 Australian soldiers died, with many more wounded. </p> <p>The <a href="https://nzhistory.govt.nz/war/anzac-day-resources">first anniversary</a> of the landing was a day of mourning, with Anzac Day becoming a public holiday in 1922. A remembrance day of sorrow mixed with pride, it has grown over the years to include all those who served and died in later international conflicts. </p> <p>Over time, various narratives and themes have emerged from that Gallipoli “origin story”: of Aotearoa New Zealand’s emergence as a nation, proving itself to Britain and Empire; of the brave, fit, loyal soldier-mates who emblemised the Kiwi spirit of egalitarianism, fairness and duty. All this mingled with the lasting shock and underlying anger at class hierarchy and the British leadership’s incompetence. </p> <p>But historians know well that the “Anzac spirit” is a complex and ever-evolving idea. In 2023, what do we teach school-aged children about its meaning and significance? One way forward is to rethink those Anzac narratives and tropes in a more complex way.</p> <h2>Colonialism and class</h2> <p>The Anzac story is tied up in the nation’s history as part of the British Empire. The Anzac toll was just part of a staggering 46,000 “Britons” – including many from India and Ireland – who died at Gallipoli. </p> <p>Some 86,000 Turks also died defending their peninsula. We need to teach about the Anzac sacrifice in the context of a global conflict where the magnitude of loss was horrific.</p> <p>Importantly, Anzac themes are bound up in early forms of colonial nationalism: New Zealand proving itself to Britain and developing its own fighting mentality on battlefields far from home. Part of this involves the notion of incompetent British commanders who let down the Anzac troops – but this is part of a bigger story.</p> <p>Focusing on imperial and class hierarchies of the time can place what happened in that broader context. The legendary story of <a href="https://nzhistory.govt.nz/wellington-battalion-captures-chunuk-bair">Chunuck Bair</a>, taken on August 8 by Colonel William Malone’s Wellington Regiment, but where most of the soldiers were killed when they weren’t relieved in time, is particularly evocative.</p> <h2>Māori and the imperial project</h2> <p>From our vantage point in the present, of course, we cannot ignore the Māori experience of war and colonialism. As the historian Vincent O’Malley has suggested, New Zealand’s “great war” of nation-making was actually <a href="https://teara.govt.nz/en/new-zealand-wars">Ngā pakanga o Aotearoa</a> – the New Zealand Wars. </p> <p>It’s time to teach the complexity of this past and the multiple perspectives on it. For example, Waikato leader <a href="https://nzhistory.govt.nz/people/te-kirihaehae-te-puea-herangi">Te Puea Hērangi</a>led opposition to WWI conscription and spoke against Māori participation on the side of a power that had only recently invaded her people’s land. </p> <p>Conversely, Māori seeking inclusion in the settler nation did participate. On July 3 1915, the 1st Māori Contingent landed at Anzac Cove. <a href="https://teara.govt.nz/en/biographies/3b54/buck-peter-henry">Te Rangi Hiroa</a> (Sir Peter Buck) (Ngāti Mutunga) was to say, "Our feet were set on a distant land where our blood was to be shed in the cause of the Empire to which we belonged."</p> <p>These words echo the familiar Anzac trope of the New Zealand nation being born at Gallipoli. Such sentiments led to postwar pilgrimages to retrace the steps of ancestors and claim the site as part of an Anzac heritage – a corner of New Zealand even. </p> <p>For many young New Zealanders it has become a rite of passage, part of the big OE. That a visit to Anzac Cove is still more popular than visiting the sites of Ngā pakanga o Aotearoa is something our teaching can investigate.</p> <h2>Mateship and conformity</h2> <p>The notion of the Anzac soldier as courageous and beyond reproach, willing to make the ultimate sacrifice for nation and empire, is also overdue for revision. The “glue” of mateship – a potent combination of masculine bravery and strength with extreme loyalty to fellow soldiers – is again a contested narrative. </p> <p>By the 1970s, as historian Rowan Light’s work shows, there was a significant challenge to such perceptions from the counterculture, peace protesters and feminists. And by the 1980s, veterans were sharing their stories more candidly with writer Maurice Shadbolt and war historian Chris Pugsley.</p> <p>Teaching about the meaning of mateship might examine the history of those peer-pressured into participating in war, those who were conscripted and had no choice, and more on the fate of conscientious objectors like Archibald Baxter. At its worst, the idea of mateship was window dressing for uniformity and parochialism. </p> <p>New Zealanders today have complex multicultural and global roots. We have ancestors who were co-opted to fight on different sides in 20th-century wars, including those who fought anti-colonial wars in India, Ireland and Samoa. Some came here as refugees escaping conflict. Jingoism and what it really represents deserves critical analysis.</p> <h2>Poppies and peace</h2> <p>The ubiquitous poppy, an icon much reproduced in classrooms, is also ripe for contextualisation and debate over its meaning. In the age of global environmental crisis, it can be seen as more than a symbol of sacrifice immortalised in verse and iconography.</p> <p>The poppy also reminds us of the landscapes devastated by the machinery of war that killed and maimed people, plants and animals. It contains within it myriad lessons about the threats science and technology can pose to a vulnerable planet.</p> <p>Anzac Day rose from the shock, loss and grief felt by those on the home front. And beyond the familiar tropes of nationalism, mateship and egalitarianism, this remains its overriding mood. </p> <p>Remembering and learning about the terrible physical and mental cost of war is the real point of those familiar phrases “lest we forget” and “never again”. That spirit of humanitarianism chimes with Aotearoa New Zealand’s modern role and evolving self-image as a peacekeeping, nuclear-free nation. </p> <p>Anzac Day also speaks to the need for global peace and arbitration, and how war is no viable solution to conflict. Those are surely lessons worth teaching.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/new-lessons-about-old-wars-keeping-the-complex-story-of-anzac-day-relevant-in-the-21st-century-204013" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Prince Harry reveals “fundamental” drug use

<p>Prince Harry has opened up about his recreational drug use in a livestream chat with trauma expert Dr Gabor Maté.</p> <p>During the session, the Duke of Sussex revealed to Dr Maté that he has turned to drugs to help him deal with - and overcome - the traumas of his past, and how it all began as a recreational activity for the 38-year-old. </p> <p>“It was the cleaning of the windscreen,” he explained, “the removal of life’s filters - these layers of filters - it removed it all for me and brought me a sense of relaxation, relief, comfort, a lightness that I managed to hold back for a period of time.</p> <p>“I started doing it recreationally and then started to realise how good it was for me.</p> <p>“I would say it is one of the fundamental parts of my life that changed me and helped me deal with the traumas and the pains of the past. They’re unlocking so much of what we’ve suppressed.”</p> <p>This is not the first time Harry has admitted to his drug usage, having opened up about his cocaine abuse in his controversial memoir, <em>Spare</em>. In the book, he made reference to tabloid stories from his teenage years at boarding school, and dubbed his father - King Charles - a “harried single dad coping with a drug-addled child”. </p> <p>Despite Buckingham Palace denying claims about Harry’s drug use at the time, he confessed in <em>Spare </em>that “of course” he was “doing cocaine around this time”, and that he was “at someone’s country house, during a shooting weekend” when he was offered the drug for the first time. </p> <p>“I’d been offered a line,” he later admitted, “and I’d done a few more since.”</p> <p>And while he decided that drug use wasn’t “much fun”, and that cocaine didn’t “make [him] particularly happy”, it helped him achieve his goal of feeling different. </p> <p>In his memoir, Harry also made note of the time he tried magic mushrooms during a party at actress Courteney Cox’s house, after discovering a box full of “black diamond mushroom chocolates.” </p> <p>“My mate and I grabbed several, gobbled them, washed them down with tequila,” he said, before going on to recall his drug-induced hallucinations - namely, a bin transforming into a head.</p> <p>“I stepped on the pedal and the head opened its mouth,” Harry described, “a huge open grin.”</p> <p>However, Harry’s story didn’t exactly line up with Courtney’s account, with the 58-year-old denying his story in the wake of the memoirs release, telling Variety, “I’m not saying there were mushrooms! I definitely wasn’t passing them out.” </p> <p>Whether or not the story is entirely factually accurate, the Duke of Sussex credits his experience with substances as the thing that helped him see the world, and his life, for what they were, writing in<em> Spare</em> that “under the influence of these substances I was able to let go of rigid preconcepts, to see that there was another world beyond my heavily filtered senses. </p> <p>“A world that was equally real and doubly beautiful.”</p> <p><em>Images: Getty</em></p>

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The Dark Side of the Moon at 50: how Marx, trauma and compassion all influenced Pink Floyd’s masterpiece

<p><em>Dixi et salvavi animam meam.</em></p> <p>This Latin phrase – I have spoken and saved my soul – sits at the end of Karl Marx’s <a href="https://www.marxists.org/archive/marx/works/1875/gotha/">Critique of the Gotha Programme</a>. </p> <p>Written in 1875, this text imagines a communist society that will come about “after the enslaving of the individual to the division of labour, and thereby also the antithesis between mental and physical labour has vanished”. </p> <p>Only then, Marx argues, “can the narrow horizon of bourgeois right be completely transcended and society inscribe on its banners: from each according to his abilities, to each according to his needs!”</p> <p>Roger Waters – bassist, lyricist and conceptual mastermind behind Pink Floyd’s 1973 album <em>The Dark Side of the Moon</em>, released 50 years ago today – knows Marx’s Critique. Indeed, he quotes it when discussing the record with music journalist John Harris. </p> <p>“Making <em>The Dark Side of the Moon</em>, we were all trying to do as much as we possibly could,” Waters <a href="https://www.goodreads.com/en/book/show/301401">told</a> Harris.</p> <p>"It was a very communal thing. What’s that old Marxist maxim? ‘From each according to his ability, to each according to his need.’ That’s sort of the way the band worked at that point."</p> <p>Assertions about solidarity, cooperation and shared “unity of purpose” – as Waters says – situate <em>Dark Side</em> in the context of Pink Floyd’s <a href="https://faroutmagazine.co.uk/pink-floyd-roger-waters-david-gilmour-feud/">notoriously fractious</a> recording career and helps us understand the album’s enduring appeal.</p> <h2>Shine on you crazy diamond</h2> <p>Pink Floyd formed in London in 1965. Led by the charismatic songwriter, guitarist and lead vocalist Syd Barrett, the group established itself as a leader in the <a href="https://en.wikipedia.org/wiki/UK_underground">London underground music scene</a>. They released their debut album <em>The Piper at the Gates of Dawn</em> in 1967.</p> <p><a href="https://en.wikipedia.org/wiki/Soft_Machine">Soft Machine</a> member Kevin Ayers <a href="https://www.bloomsbury.com/au/pink-floyds-the-piper-at-the-gates-of-dawn-9781441185174/">described</a> <em>The Piper at the Gates of Dawn</em> as “something magical, but it was in Syd Barrett”. </p> <p>Not long after the record’s release, Barrett suffered a catastrophic, LSD-induced breakdown. In response, the band recruited David Gilmour on guitar and recorded a second album, <em>A Saucerful of Secrets</em>, as a five-piece in 1968. Around this time, the increasingly unstable Barrett was unceremoniously ousted by the rest of the band. </p> <p>After Barrett left, says Ayers, “Pink Floyd became something else totally”. </p> <p>There are different versions of Pink Floyd. The recordings released after Barrett left the band in 1968 bear little resemblance to the first. </p> <p><em>Dark Side</em> sounds nothing like the whimsical Piper. But it is obvious the record is in large part preoccupied with the loss of Barrett.</p> <p>This preoccupation comes to the fore in the album’s penultimate track.</p> <p><em><a href="https://www.youtube.com/watch?v=g1OOQP1-wOE&amp;ab_channel=HDPinkFloyd">Brain Damage</a></em>, written and sung by Waters, references Barrett’s adolescence (“Remembering games and daisy chains and laughs”), alludes to his illness (“And if the dam breaks open many years too soon”), and acknowledges his leaving the group (“And if the band you’re in starts playing different tunes; I’ll see you on the dark side of the Moon”). </p> <p>Drummer Nick Mason confirms the group didn’t want to lose Barrett.</p> <p>In his <a href="https://www.goodreads.com/book/show/265734.Inside_Out">autobiography</a>, he writes, "He was our songwriter, singer, guitarist, and – although you might not have known from our less than sympathetic treatment of him – he was our friend."</p> <h2>If the dam breaks open many years too soon</h2> <p>What we hear on <em>The Dark Side of the Moon</em> is a band dealing with trauma. </p> <p>In this sense, Dark Side represents the start of a reckoning with the past – a process that culminated with the band’s next record, 1975’s elegiac <em><a href="https://faroutmagazine.co.uk/wish-you-were-here-pink-floyd-seminal-ode-to-the-tragic-life-of-syd-barrett/">Wish You Were Here</a></em>.</p> <p>Culmination is a useful term when it comes to <em>Dark Side</em> more generally. On this record, all the avant-garde techniques and tendencies the band had toyed with in the post-Barrett period – <a href="https://en.wikipedia.org/wiki/Musique_concr%C3%A8te">musique concrète</a>, sonic manipulation, extended improvisation, analogue tape manipulation – come together to spectacular effect. </p> <p><em><a href="https://www.youtube.com/watch?v=-0kcet4aPpQ">Money</a> –</em> with its anti-capitalist lyrics penned by Waters (“Money, it’s a crime; share it fairly, but don’t take a slice of my pie”), odd time signature, and handmade tape-loops mimicking the sounds of cash tills, bags of coins being dropped from great height and bank notes being torn up – is one of the stranger hit singles in pop music history. </p> <p>Be that as it may, Money and the album from which it is taken, of which <a href="https://www.pinkfloyd.com/tdsotm50/">more than 50 million copies</a> have been sold, continue to resonate with listeners worldwide, five decades on from its initial release.</p> <h2>The enormous risk of being truly banal</h2> <p>“I made a conscious effort when I was writing the lyrics for <em>Dark Side of the Moon</em> to take the enormous risk of being truly banal about a lot of it,” Waters told John Harris, “in order that the ideas should be expressed as simply and plainly as possible.”</p> <p>On this point, <a href="https://www.loudersound.com/news/david-gilmour-says-its-pretty-unlikely-he-and-roger-waters-will-resolve-pink-floyd-feud">if nothing else</a>, David Gilmour agrees. He told Harris, "There was definitely a feeling that the words were going to be very clear and specific. That was a leap forward. Things would mean what they meant. That was a distinct step away from what we had done before."</p> <p>Mortality, insanity, conflict, affluence, poverty and, in another nod to Marx, <a href="https://en.wikipedia.org/wiki/Marx%27s_theory_of_alienation">alienation</a> are some of the themes presented on the record. The need – and this brings us full circle – for compassion, if not outright solidarity, is another. </p> <p>This is an album about the importance of understanding, as Waters <a href="https://www.goodreads.com/en/book/show/301401">insists, "T</a>he potential that human beings have for recognising each other’s humanity and responding to it, with empathy rather than antipathy."</p> <p>Given the sorry state of the world in 2023, about which Roger Waters has many <a href="https://www.bbc.com/news/entertainment-arts-64580688">contentious</a> and <a href="https://www.theguardian.com/music/2023/feb/07/pink-floyd-lyricist-calls-roger-waters-an-antisemite-and-putin-apologist">problematic</a> things to say, I wager Pink Floyd’s masterwork will continue to resonate with listeners for a while yet.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/the-dark-side-of-the-moon-at-50-how-marx-trauma-and-compassion-all-influenced-pink-floyds-masterpiece-198400" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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New study to “give hope” to childhood trauma survivors with depression

<p dir="ltr">A new study has challenged our understanding of how to treat adults with a history of childhood trauma, revealing that using psychotherapy, medication or a combination of the two are effective treatments for those with depression.</p> <p dir="ltr">Childhood trauma, defined as abuse or neglect of a person before they are 18 years old, is a known risk factor for major depressive disorders in adulthood. It often results in symptoms that start earlier, last longer and are more frequent, and increases the risk of developing co-occurring diseases and conditions.</p> <p dir="ltr">The study, published in <em><a href="https://doi.org/10.1016/S2215-0366(22)00227-9" target="_blank" rel="noopener">The Lancet Psychiatry</a></em>, found that adult survivors of childhood trauma who receive these common treatments experience improved symptoms at the same rate as those without childhood trauma.</p> <p dir="ltr">While previous studies have indicated that common treatments for major depressive disorders are less effective for people with childhood trauma, the team argues that these findings are inconsistent.</p> <p dir="ltr">The team then examined data from 29 clinical trials of psychotherapy and pharmacotherapy (the use of prescribed medications) among adults with major depressive disorders to determine whether those with trauma were more severely depressed before treatment, had more unfavourable outcomes after treatment, and whether they were less likely to benefit from treatment in comparison to those without trauma.</p> <p dir="ltr">Among the 46 percent of participants with childhood trauma, the team found that they showed more severe symptoms at the start of treatment and after treatment in comparison to the control group (those without trauma).</p> <p dir="ltr">But, they found that both groups experienced an improvement in symptoms at a similar rate.</p> <p dir="ltr">Erika Kuzminskaite, a PhD candidate and the first author of the study, said that this finding could be a source of hope.</p> <p dir="ltr">“Finding that patients with depression and childhood trauma experience similar treatment outcome when compared to patients without trauma can give hope to people who have experienced childhood trauma,” Kuzminskaite said.</p> <p dir="ltr">“Nevertheless, residual symptoms following treatment in patients with childhood trauma warrant more clinical attention as additional interventions may still be needed.”</p> <p dir="ltr">Antoine Yrondi, a professor at the University of Toulouse who wasn’t involved in the research, wrote that the study provides a message of hope for patients.</p> <p dir="ltr">“This meta-analysis could deliver a hopeful message to patients with childhood trauma that evidence-based psychotherapy and pharmacotherapy could improve depressive symptoms,” Dr Yrondi said.</p> <p dir="ltr">“However, physicians should keep in mind that childhood trauma could be associated with clinical features which may make it more difficult to reach complete symptomatic remission and, therefore, have an impact on daily functioning.”</p> <p dir="ltr">According to <a href="https://blueknot.org.au/resources/blue-knot-fact-sheets/trauma-classification/what-is-childhood-trauma/" target="_blank" rel="noopener">Blue Knot</a>, childhood trauma can have a wider and more extreme impact than trauma we experience as adults because a child’s brain is still developing. If the trauma is unresolved, coping strategies developed during childhood can become risk factors for poorer psychological and physical health in adulthood.</p> <p dir="ltr">But, it is possible to recover from childhood trauma, with this latest study going to show that common treatments can be effective.</p> <p dir="ltr"><em>If you’re in need of support, you can contact Lifeline on 13 11 14 or Blue Knot on 1300 657 380.</em></p> <p><em><span id="docs-internal-guid-62551377-7fff-7a7f-9e23-d352d2c29923"></span></em></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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Not “your average beanie”: Smart Aussie invention to help stroke and trauma patients

<p dir="ltr">A new ‘smart helmet’ packed with tech is being developed to monitor brains of patients who have suffered a stroke, injury or trauma by a team of Australian scientists and developers thanks to funding from the Victorian government.</p> <p dir="ltr">Patients with these kinds of injuries often experience brain swelling and have parts of their skull removed to prevent the brain from pushing on structures such as the brainstem, the part of the brain that regulates the cardiovascular and respiratory systems, <a href="https://www.urmc.rochester.edu/news/story/brain-drowns-in-its-own-fluid-after-a-stroke" target="_blank" rel="noopener">which can be fatal</a>.</p> <p dir="ltr">The SkullPro, developed by Anatomics Pty Ltd and the CSIRO, is a customised protective helmet that includes sensors that relay data back to the patient’s neurosurgeon to help them determine the best time to repair the skull.</p> <p dir="ltr">With the helmet, the conditions of patients’ brains can be monitored while they recover at home.</p> <p><span id="docs-internal-guid-c30fb9f0-7fff-5de6-6b83-53be40564edb"></span></p> <p dir="ltr">Neurosurgeons can monitor their brain function in real time thanks to a ‘brain machine interface’ developed using machine learning, advanced sensors and microelectronics.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CDApuNgj68s/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/CDApuNgj68s/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Anatomics (@anatomicsrx)</a></p> </div> </blockquote> <p dir="ltr">Victorian Premier Daniel Andrews announced that Anatomics’ development of the helmet would be among 11 Victorian medical technology products funded through the latest round of MedTech grants.</p> <p dir="ltr">“This isn’t your average beanie. This is a Smart Helmet,” Mr Andrews <a href="https://www.facebook.com/DanielAndrewsMP/posts/pfbid02SJfjW1BcypXz8ubJHtQUTPvG349spbWAch4Eib1nguHedjAH1fFhWg4DaPJ9V5kNl" target="_blank" rel="noopener">wrote</a> on social media.</p> <p dir="ltr">“It helps monitor the brains of patients who've had a stroke or suffered traumatic brain injury. It lets doctors know how the brain is healing and helps surgeons decide on the ideal time to perform operations on the skull to give patients the best possible chance of a full recovery. It's been researched, designed and manufactured right here in Bentleigh East by Anatomics.</p> <p dir="ltr">“It's the kind of technology that doesn't just save lives – it changes lives too.”</p> <p dir="ltr">Mr Andrews added that the series of grants would help support “Victorian innovation” and create jobs.</p> <p dir="ltr">“We're backing Anatomics and 11 other Victorian medical technology manufacturers with a new round of MedTech grants. Creating jobs and supporting Victorian innovation,” the post continued.</p> <p dir="ltr"><span id="docs-internal-guid-2c713391-7fff-9b9e-2205-2217707d9715"></span></p> <p dir="ltr">“That's something we can all get behind.”</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/B8xqoDDnORs/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/B8xqoDDnORs/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank" rel="noopener">A post shared by Anatomics (@anatomicsrx)</a></p> </div> </blockquote> <p dir="ltr">The team developing the SkullPro hope it will lay the foundation for research relating to brain injuries, diagnostics, and treatments in Australia.</p> <p dir="ltr">In a <a href="https://www.anatomics.com/au/news/2020/07/24/smart-skullpro.html" target="_blank" rel="noopener">statement</a>, Professor Paul D’Urso, a neurosurgeon and the founder of Anatomics, said the grant would “greatly benefit brain injured patients throughout the world”.</p> <p dir="ltr">"The recently announced funding through MTPConnect’s BioMedTech Horizons program will allow Anatomics and CSIRO to lay the foundations for advanced diagnostics and therapies for decades to come that will greatly benefit brain injured patients through-out the world,” he said.</p> <p dir="ltr">"We should all be proud of the pioneering R&amp;D (Research &amp; Development) that has already occurred in Australia and the opportunities that this grant will deliver to our future."</p> <p dir="ltr"><span id="docs-internal-guid-bb14f8a1-7fff-b6d7-650f-abcedbfc94fc"></span></p> <p dir="ltr"><em>Image: @anatomicsrx (Instagram)</em></p>

Mind

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“Healing from grief is an inside job”: Why Ashley Judd found and met with her abuser

<p dir="ltr">Content warning: This article includes mentions of sexual assault, rape and child sexual abuse (CSA).</p> <p dir="ltr">Ashley Judd has opened up about the conversation she had with the man who raped her more than two decades ago.</p> <p dir="ltr">The <em>Double Jeopardy </em>star spoke about confronting the man who assaulted her in 1999 during an appearance on the podcast <em>Healing With David Kessler</em>, telling host David Kessler that they had a “restorative-justice conversation”.</p> <p dir="ltr">“To make a long story short, we ended up in rocking chairs sitting by a creek together,” Judd said. “And I said, ‘I’m very interested in hearing the story you’ve carried all these years’. And we had a restorative-justice conversation about that.</p> <p dir="ltr">"I wanted to share that story because there are many ways of healing from grief, and it's important to remind listeners that I didn't need anything from him and it was just gravy that he made his amends and expressed his deep remorse because healing from grief is an inside job."</p> <p dir="ltr">The 54-year-old added that she didn’t need closure from the man, whose identity is still unknown, or “his cooperation” or “for him to make amends” to continue healing, and that she was just “very interested in hearing” his side of the story.</p> <p dir="ltr">"Because I had the opportunity to do my trauma work, to do my grief work, to do my healing work, to have all these shifts in my own consciousness and to bond in these female coalition spaces with other survivors," Judd said. </p> <p dir="ltr">Recalling the incident, Judd described it as “crazy-making” and “unconscionable”.</p> <p dir="ltr">"I was very clear, my boundaries were intact. I was already an empowered, adult feminist woman," she recalled. </p> <p dir="ltr">"And that this could happen under these circumstances was unconscionable, unforeseen, and yet I have had a restorative-justice process with this person out of how replete my soul is today."</p> <p dir="ltr">Judd has publicly spoken about being a three-time rape survivor in the past and shared her story for the first time in her 2011 memoir, <em>All That Is Bitter &amp; Sweet</em>, and again in an <a href="https://www.mic.com/articles/113226/forget-your-team-your-online-violence-toward-girls-and-women-is-what-can-kiss-my-ass" target="_blank" rel="noopener">op-ed</a> she wrote for <em>Mic.com</em>’s ‘Pass the Mic’ series.</p> <p dir="ltr">"I am a survivor of sexual assault, rape and incest," she wrote at the time. </p> <p dir="ltr">"The summer of 1984 was tough for me. I experienced two rapes by an adult and systematic molestation from another adult, who also had another man in the room watching … This January, I read three different things that freshly triggered an additional, very specific memory from age 15 – an attempted oral rape by yet another adult man."</p> <p dir="ltr"><strong><em>If you or someone you know is impacted by sexual assault or childhood sexual abuse and need support, contact 1800RESPECT on 1800 737 732 or visit their <a href="https://www.1800respect.org.au/" target="_blank" rel="noopener">website</a>, or contact <a href="https://blueknot.org.au/" target="_blank" rel="noopener">BlueKnot</a> on 1300 657 380.</em></strong></p> <p><em><span id="docs-internal-guid-9fcf9217-7fff-3f43-fab5-e53785cce460"></span></em></p> <p dir="ltr"><em>Image: Getty Images</em></p>

Mind

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"Trauma is a beast": Grace Tame hospitalised

<p dir="ltr"><em>Content warning: This article includes discussions of suicide and mentions of sexual assault, abuse, and domestic violence.</em></p> <p dir="ltr">Two former Australians of the Year have spoken out about the toll of speaking out about the worst moments in their lives and being an advocate, warning that “trauma is a beast”.</p> <p><span id="docs-internal-guid-89efdaea-7fff-58e9-41ec-d99d785872aa"></span></p> <p dir="ltr">Grace Tame and Rosie Batty spoke about their experiences during a talk titled ‘Protecting the Outspoken’ at the 2022 All About Women festival at the Sydney Opera House on Sunday.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Grace Tame says she likely wouldn’t be alive today if it weren’t for her fiancé and has had to call ER in recent days. She says the media has a lot to answer for - that shame should be directed at perpetrators, not trauma survivors. <a href="https://twitter.com/SydOperaHouse?ref_src=twsrc%5Etfw">@SydOperaHouse</a> <a href="https://twitter.com/hashtag/AllAboutWomen?src=hash&amp;ref_src=twsrc%5Etfw">#AllAboutWomen</a> <a href="https://t.co/PdytrYiFPA">pic.twitter.com/PdytrYiFPA</a></p> <p>— Caitlin Cassidy (@caitecassidy) <a href="https://twitter.com/caitecassidy/status/1502851261883842560?ref_src=twsrc%5Etfw">March 13, 2022</a></p></blockquote> <p dir="ltr">Ms Tame revealed she had gone to the emergency room seeking mental health treatment after recent media storms, including the coverage of her drug use as a teenager.</p> <p dir="ltr">“I was actually in the ER the other day because I lost control and I was really scared,” she said.</p> <p dir="ltr">“I called up the clinic and I said, ‘I can’t, I can’t, I’ve stepped too deep into the shame spiral’,” she said, adding that she was experiencing suicidal thoughts.</p> <p dir="ltr"><span id="docs-internal-guid-e96b11fc-7fff-6eb0-d037-e099d65327b1"></span></p> <p dir="ltr">“That’s real and that’s the toll it takes. That’s the price of shame. And so that’s why I wrote that open letter. You know, I’ve got a sense of humour, I can have a laugh.”</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">AN OPEN LETTER</p> <p>To every media outlet who sought to discredit me by publishing THAT photo,</p> <p>Although my humour and strength remain intact, I’d be lying if I said it didn’t let me down.</p> <p>Not just as an individual, but more so as an advocate of the survivor community…</p> <p>— Grace Tame (@TamePunk) <a href="https://twitter.com/TamePunk/status/1494877152491487239?ref_src=twsrc%5Etfw">February 19, 2022</a></p></blockquote> <p dir="ltr">Though she said she could “make jokes” about the pressure of being in the spotlight, the media had “a lot to answer for” after publishing a photo of her with a bong when she had made it no secret that she had managed her trauma and self-harming behaviour with drugs.</p> <p dir="ltr">“The media has a lot to answer for where it directs its shame. There is a disproportionate amount of shame that is still pointed towards people who do not understand yet what has happened to them,” she said.</p> <p dir="ltr">“And that shame needs to be pointed squarely, not (at) these people who are trying to figure out what the f**k happened to them, it needs to be pointed at the perpetrators of domestic violence, of sexual assault and child sexual abuse.”</p> <p dir="ltr">Ms Batty, who has campaigned for domestic violence reform following the murder of her son, Luke, by his father in 2014, said her place in the public eye had been “bittersweet”.</p> <p dir="ltr">“I think it’s overwhelming. I think imposter syndrome. I think, ‘all these people I’ve (been) nominated against, you know, have done amazing work for decades. Who am I?,” she said of receiving the Australian of the Year award in 2015.</p> <p dir="ltr">“I always felt very conflicted. Am I just getting this award because my son was murdered?”</p> <p dir="ltr">Ms Batty said it took her many years to process her grief and had poured herself into her work to avoid the “deep trauma” of her son’s death.</p> <p dir="ltr">“I was so afraid of failing and not being good enough or perhaps overcompensating and poured myself into it,” she said.</p> <p dir="ltr">“I mean, this is eight years since I lost Luke. And it is an overwhelming journey.</p> <p dir="ltr">“I had a sense of purpose and meaning that gave me a reason to get up every day. So ultimately, it was my drive. It was my reason to keep living. So I would never change that.</p> <p dir="ltr">“But what it did do was isolate me, disconnected me, and I couldn’t understand why people didn’t keep in touch with me anymore.</p> <p dir="ltr">“I can tell you during the first year of Covid lockdown when other people were working out, and feeling dissatisfied or frustrated or pushing back on government restrictions, I was finally choosing which urn to put Luke’s ashes in. And it was uncomfortable and it was painful, but you have to eventually sit with pain. And we do avoid it, we drink, we smoke, we take drugs, we do anything to avoid pain.”</p> <p dir="ltr">Ms Tame also spoke about the backlash she faced over a campaign she was involved in to fight for women’s rights, after complaints emerged that it featured too many white, middle class faces.</p> <p dir="ltr">She has urged feminists and progressive campaigners to avoid exclusionary language and said she was still learning about the language and history of feminism.</p> <p dir="ltr">“There’s been a lot of criticism, and that’s part and parcel of the landscape. But, you know, people bring their heart and soul to this. And there’s a lot of trauma in it,’’ she said.</p> <p dir="ltr">“I’m accountable for my mistakes. And that’s one thing that I’ve tried to do as best as I can, especially as someone who, you know, I didn’t go to university. I didn’t do gender studies. You know, and I don’t have as good a knowledge as I could have of feminist history, and all the terminology, but I do my best to understand and to learn.”</p> <p dir="ltr" style="line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;"><em>Image: Roy Vandervegt / Adelaide Festival</em></p>

Caring

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TV legend Delvene Delaney’s flood “trauma”

<p dir="ltr">Former TV legend Delvene Delaney has spoken about the horrors of finding her young grandchildren floating on a mattress in flood waters.</p> <p dir="ltr">Parts of south-east Queensland and northern NSW were impacted greatly by torrential rain which saw some towns underwater. </p> <p dir="ltr">The 70-year-old former soap actress recalled the distressing moment she saw her grandsons floating on a mattress after their father’s home in Mullumbimby, a town in the Byron Shire,  dipped under from the deluge. </p> <p dir="ltr">"I had to placate my two little grandsons, six and eight, from the trauma of being found on a floating mattress in the middle of the night in Mullumbimby as their dad's house went under," she told <a href="https://honey.nine.com.au/latest/australia-unites-red-cross-flood-appeal-2022-pat-rafter-mick-fanning-local-communtiy/c31c5b93-71f4-4adc-ae60-e3245566fde0" target="_blank" rel="noopener">Nine Honey</a>.</p> <p dir="ltr">"My daughter was stranded in Murwillumbah for five days with no contact, we had no telephones, no internet.</p> <p dir="ltr">"So it was the fear of not knowing where everybody was and how safe they were that I'm sure was felt by all people in this area, not just those affected.”</p> <p dir="ltr">Despite the horrors of the floods, she commended people from all over for getting together and supporting one another. </p> <p dir="ltr">A television flood appeal by the Australian Red Cross raised more than $25 million for victims in NSW and Queensland, as communities slowly begin to clean up. </p> <p dir="ltr"><em>Image: Nine Honey</em></p>

TV

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“It has stayed with me”: Using fiction to explore trauma

<p><span style="font-weight: 400;"><em>Content warning: This article mentions sexual assault.</em></span></p> <p><span style="font-weight: 400;">Those who experience trauma can seek help in various ways, through therapy or creative outlets, and fiction is no exception.</span></p> <p><span style="font-weight: 400;">In fiction, traumatic events are often depicted as a jumping-off point for a protagonist or hero’s story - whether that’s watching Bruce Wayne’s parents die before he can fight crime as Batman, or witnessing the attempted murder of Uma Thurman as the Bride in </span><span style="font-weight: 400;">Kill Bill</span><span style="font-weight: 400;"> before she seeks revenge.</span></p> <p><span style="font-weight: 400;">These depictions of traumatic events are often the precursor to a character’s descent into revenge, madness, or both, but they don’t have to be the only stories we see.</span></p> <p><span style="font-weight: 400;">In her </span><a rel="noopener" href="https://journals.sagepub.com/doi/full/10.1177/0022167817749703?casa_token=s_BbuJyDvjAAAAAA%3Apewb-trbcPxlbO0uGRYKAqOf_cchsFgT1CCpbRZQvODADU7rWimX6gaj1of76-A1cM1u61nak6K1L40" target="_blank"><span style="font-weight: 400;">doctoral thesis</span></a><span style="font-weight: 400;"> published in the </span><em><span style="font-weight: 400;">Journal of Humanistic Psychology</span></em><span style="font-weight: 400;">, Dr Lynn Gumb defines an ‘ordinary hero’ that can emerge in fiction as a “person who, despite the challenges of trauma, continues to live an ordinary life” and doesn’t follow the well-worn path to madness or revenge. Instead, the individual can choose to “alter the landscape of their own lives” after trauma and pursue recovery.</span></p> <p><span style="font-weight: 400;">P. J. McKay, the author of </span><em><a rel="noopener" href="https://www.pjmckayauthor.com/shop-1" target="_blank"><span style="font-weight: 400;">The Telling Time</span></a></em><span style="font-weight: 400;">, uses traumatic experiences from her own life to explore this recovery process, as women from two generations navigate the Croatian immigrant experience, family secrets and backpacking as a rite of passage.</span></p> <p><span style="font-weight: 400;">“I know that my personal experience while backpacking in the 1980s, especially in a country like Yugoslavia, where there was such a chasm in the way men viewed Western women (fuelled of course by Western movies and songs) would be familiar territory for many young women,” she told </span><span style="font-weight: 400;">OverSixty</span><span style="font-weight: 400;">. “For me, novels that speak of shared experiences, or situations which feel believable, resonate most.</span></p> <p><span style="font-weight: 400;">“The backpacking experience has been a rite of passage for many, particularly in Australasia and I know many have experienced unwanted sexual attention. My experience was a close call. It has stayed with me and has felt like a significant turning point in my life.”</span></p> <blockquote class="twitter-tweet"> <p dir="ltr">Our discomfort and resulting tendency to retreat into silence only adds to the power of perpetrators.</p> — Grace Tame (@TamePunk) <a href="https://twitter.com/TamePunk/status/1464790576323170305?ref_src=twsrc%5Etfw">November 28, 2021</a></blockquote> <p><span style="font-weight: 400;">As difficult as it can be for survivors to witness these moments, stories like </span><span style="font-weight: 400;">The Telling Time</span><span style="font-weight: 400;"> keep these traumatic situations at the forefront of our minds, especially as these situations continue to happen.</span></p> <p><span style="font-weight: 400;">“I thought it was important not to shy away from the reality of sexual assault and to explore the impact of this on friendships and why sometimes (often) it seems best to hold close and not disclose what happened,” McKay adds.</span></p> <p><span style="font-weight: 400;">However, some argue that the focus of recovery stories should be on what happens after the traumatic event, and how individuals can find truth and healing despite their experiences.</span></p> <p><span style="font-weight: 400;">“There seems to be no doubt that trauma can stand in the way of finding truth and healing,” McKay says.</span></p> <p><span style="font-weight: 400;">“It remains to be seen whether society today, with its broader expectations and openness around sexual relationships, and less traditional male and female roles, will alow for more open conversations by those who have suffered trauma, particularly sexual trauma.”</span></p> <p><span style="font-weight: 400;">In an interview with </span><span style="font-weight: 400;">ABC’s</span> <span style="font-weight: 400;">7.30</span><span style="font-weight: 400;">, American activist and founder of the #Metoo movement Tarana Burke said conversations around trauma should shift, as the retelling of traumatic events comes with more costs than benefits.</span></p> <blockquote class="twitter-tweet" data-conversation="none"> <p dir="ltr">"We urge survivors to share their story, so you're re-traumatising not only the person but the person hearing that. There's not a tremendous amount of value in hearing the story, there's so much value in the hearing what happens after." – <a href="https://twitter.com/TaranaBurke?ref_src=twsrc%5Etfw">@taranaburke</a> <a href="https://twitter.com/hashtag/abc730?src=hash&amp;ref_src=twsrc%5Etfw">#abc730</a></p> — abc730 (@abc730) <a href="https://twitter.com/abc730/status/1450386432757927947?ref_src=twsrc%5Etfw">October 19, 2021</a></blockquote> <p><span style="font-weight: 400;">“We urge survivors to share their story, so you’re re-traumatising not only the person but the person hearing that,” she said.</span></p> <p><span style="font-weight: 400;">“There’s not a tremendous amount of value in hearing the story, there’s so much value in hearing what happens after.”</span></p> <p><span style="font-weight: 400;">As the conversations around trauma continue to change, it may be that having to witness these events becomes less necessary, and that we no longer need to share them to prevent future generations from experiencing them.</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

Mind

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Older Australians are already bamboozled by a complex home-care system. So why give them more of the same?

<p>More than <a href="https://www.aihw.gov.au/reports/australias-welfare/aged-care">a million older Australians</a> need care at home each year. <a href="https://www.health.gov.au/sites/default/files/documents/2021/08/ninth-report-on-the-funding-and-financing-of-the-aged-care-industry-july-2021.pdf">More than 1,000 agencies</a> provide services to them.</p> <p>Despite the federal government allocating <a href="https://www.health.gov.au/initiatives-and-programs/aged-care-reforms/a-generational-plan-for-aged-care">significant extra funds to home care</a> in the last budget, there is still a raft of problems with current home-care arrangements.</p> <p>As we show in <a href="https://grattan.edu.au/report/unfinished-business-practical-policies-for-better-care-at-home/">our new report</a>, “Unfinished business: practical policies for better care at home”, the federal government is placing too much emphasis on expanding the market of services, and not enough on supporting people to access timely and quality services.</p> <p>Home care support ranges from help with personal care and cleaning the house, to provision of mobility aids, and transport to social events and medical appointments.</p> <p>People who need care at home can explore options via the federal government’s <a href="https://www.myagedcare.gov.au/">myagedcare</a> website. Then they can get assessed, find a local provider to suit their needs, and manage their own care.</p> <p>But this system is <a href="https://www.ingentaconnect.com/contentone/tpp/ijcc/2020/00000004/00000003/art00006">impersonal and cumbersome</a>.</p> <p>Assessment of people’s needs is divorced from planning their services. Older people get little advice and support to find services, and people who need more intensive and complex care often have to wait for more than a year.</p> <p> </p> <p>Administrative and coordination costs for the <a href="https://www.aihw.gov.au/reports/australias-welfare/aged-care">200,000 people who get home care packages</a> are high, hourly service charges are unregulated, and there is more than <a href="https://www.stewartbrown.com.au/images/documents/StewartBrown_-_ACFPS_Financial_Performance_Sector_Report_June_2021.pdf">A$1.6 billion in unspent funds</a> that could be used to provide services.</p> <p>The number of private services has grown dramatically, with little oversight of quality and value for money.</p> <p>At the same time, home-care workers <a href="https://www.smh.com.au/politics/federal/canberra-told-to-pay-up-to-get-aged-care-workers-a-25-per-cent-rise-20210705-p586x9.html">remain poorly paid and under-valued</a>. Training is patchy, work is often insecure, and there’s insufficient supervision, support and staff development.</p> <p>Not surprisingly, it is increasingly difficult to recruit and retain aged-care workers.</p> <h2>What’s wrong with the extra funding?</h2> <p>The federal government’s response to the landmark <a href="https://agedcare.royalcommission.gov.au/">Royal Commission into Aged Care</a> was substantial, but it doesn’t change the fundamentals of the home-care system. It expands a market that is not working for older people.</p> <p>The government is putting its faith in a centrally regulated market model, dominated by private and non-government home-care businesses.</p> <p>Even with the massively increased home-care funding, the market may still not provide enough to reduce waiting times for services to less than a month, as the royal commission recommended.</p> <p><a href="https://images.theconversation.com/files/436568/original/file-20211209-137612-sxaiia.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/436568/original/file-20211209-137612-sxaiia.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" alt="Elderly lady using laptop at home" /></a> <span class="caption">Older people will still have to navigate a complex system and make market choices largely on their own.</span> <span class="attribution"><a href="https://www.shutterstock.com/image-photo/asian-old-woman-using-computer-69690976" class="source">Shutterstock</a></span></p> <p>There are currently almost <a href="https://gen-agedcaredata.gov.au/www_aihwgen/media/Home_care_report/Home-Care-Data-Report-1st-Qtr-2021-22.pdf">75,000 waiting for the home care support they need</a>, with some having waited up to nine months.</p> <p>We calculate that up to 15% more home-care places than planned could be needed just to clear the waiting list. We call on the federal government to keep waiting times to 30 days or less.</p> <p>The government’s budget package does include additional support to help older people navigate their way through the home-care system. But assessment, care finding, and care coordination will continue to be fragmented.</p> <p>In the main, older people will still have to navigate a complex system and make market choices on their own.</p> <h2>We need to go local to provide the best support</h2> <p>Australia needs a new home care model – one that provides much more personalised support to help older people get the services they need and that manages local service systems on their behalf.</p> <p>It’s difficult to see this being done without establishing effective regional aged-care offices. These offices need to provide a one-stop shop for older people. Yet they also need to have the authority and responsibility to develop and manage local services to make sure older people can get what they need.</p> <p>The federal government is aware of this problem, but its response is tepid – <a href="https://www.health.gov.au/sites/default/files/documents/2021/05/governance-pillar-5-of-the-royal-commission-response-strengthening-regional-stewardship-of-aged-care.pdf">a trial</a> of small, regional offices of up to ten people to plan, monitor and solve problems. But those regional offices have no responsibility for supporting older people, and no authority to manage service providers on their behalf.</p> <p>We recommend the federal government establish a network of regional aged-care offices across Australia to plan and develop services, hold funds, pay providers, and administer service agreements for individual older people who need care. These offices should include assessment teams and care finders, to help people who are trying to navigate the home-care system.</p> <p>Good quality home care depends on a well-qualified, secure and valued workforce. Again, the federal government is aware of this problem and has introduced a limited set of workforce reforms. But it has not yet agreed to support improved pay and conditions, minimum qualification standards or a full registration scheme for personal-care workers.</p> <p>The government should develop and implement a revitalised workforce plan for aged care as part of the <a href="https://www.health.gov.au/initiatives-and-programs/aged-care-reforms/aged-care-legislative-reform">new Aged Care Act</a>. Personal-care workers should be registered and hold suitable minimum qualifications.</p> <p>The government should also make it clear it will fund the outcomes of the <a href="https://www.fwc.gov.au/cases-decisions-orders/major-cases/work-value-case-aged-care-industry">Fair Work Commission</a> review of fair pay and conditions for aged-care workers, with a ruling expected next year.</p> <p>As Australia’s population continues to age, many more people with complex needs will need care. The vast majority of them will prefer to be supported at home. Massively expanding home-care services without much stronger market management, and a much more secure workforce, is a risk Australia shouldn’t take.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/173326/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><span><a href="https://theconversation.com/profiles/stephen-duckett-10730">Stephen Duckett</a>, Director, Health and Aged Care Program, <em><a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em> and <a href="https://theconversation.com/profiles/hal-swerissen-9722">Hal Swerissen</a>, Emeritus Professor, La Trobe University, and Fellow, Health Program, <em><a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></span></p> <p>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/older-australians-are-already-bamboozled-by-a-complex-home-care-system-so-why-give-them-more-of-the-same-173326">original article</a>.</p> <p><em>Image: Shutterstock</em></p>

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Rolling media coverage of missing persons cases can add to the trauma for all families left behind

<p>The public has been privy to live footage of police operations. New South Wales police, dressed in overalls, scoured dense bushland to retrieve a small piece of fabric. Reports <a rel="noopener" href="https://www.abc.net.au/news/2021-11-21/another-piece-of-fabric-found-william-tyrrell-search-day-seven/100633540" target="_blank">suggested</a> the yet-to-be-analysed fabric may be linked to the case of missing boy William Tyrrell.</p> <p>William’s case – along with the location of Cleo Smith in Western Australia and recent developments in the case of missing campers Russell Hill and Carol Clay in Victoria – have been prominent news stories.</p> <p>Media interest can invite the public into the investigative process. But rolling media coverage can have an immediate and long-lasting effect on the families left behind. That’s not only the families of that particular case, but the families of other missing people, whose case isn’t in the news.</p> <p>Non-stop coverage can invade their privacy, raise and dash their hopes, and prolong their trauma.</p> <p><strong>More people go missing than ever make ‘news’</strong></p> <p>In 2020, Australia’s <a rel="noopener" href="https://www.missingpersons.gov.au" target="_blank">National Missing Persons Coordination Centre</a> had more than <a rel="noopener" href="https://www.missingpersons.gov.au/about" target="_blank">51,000 reports</a> about the safety and well-being of a missing person. Many of those cases are resolved within one month.</p> <p>Yet more than <a rel="noopener" href="https://www.missingpersons.gov.au/about" target="_blank">2,600 cases</a> are long term – when a person is missing for longer than three months.</p> <p>It’s rare for the families of people who are missing to have had any contact with the media before. So it’s difficult for families to navigate and manage media interest.</p> <p>Bruce Morcombe’s son Daniel was 13 when <a rel="noopener" href="https://danielmorcombe.com.au/daniels-legacy/" target="_blank">he was abducted</a> from the Sunshine Coast in December 2003. His remains were found in 2011.</p> <p>Bruce <a rel="noopener" href="https://www.abc.net.au/radionational/programs/lifematters/minimising-distress-for-families-of-missing-children/13635622" target="_blank">told the ABC</a> how he managed the media interest. He said the disappearance, homicide and the criminal investigation created a groundswell of empathy.</p> <p>However, he said when the momentum slowed and it was looking like the case would become “cold”, the family and their supporters created media opportunities – to offer a new hook, a new angle – to continue community engagement.</p> <p>Families of missing people believe “someone, somewhere must know something”. Media offers the greatest capacity to reach that “someone”.</p> <p>However, media attention is not guaranteed and is not an <a rel="noopener" href="https://www.researchgate.net/publication/348632071_Lost_from_the_conversation_Missing_people_and_the_role_of_Police_media_in_shaping_community_awareness" target="_blank">even playing field</a>. <a rel="noopener" href="https://www.theguardian.com/australia-news/2021/nov/06/cleo-smith-search-ends-in-joy-but-what-of-australias-other-missing-children" target="_blank">Attention only falls</a>, and priority given, to cases assessed as vulnerable. Cases the media deems newsworthy or those that reach high engagement (through liking, commenting and sharing on social media) also get attention.</p> <p><strong>How does this rolling media coverage affect families?</strong></p> <p>When the media provides rolling coverage of every tiny development in a missing persons case, it can raise hope for some families watching on. But for others, it can have the opposite effect.</p> <p>A <a rel="noopener" href="https://www.researchgate.net/publication/280876972_'I_still_hope_but_what_I_hope_for_now_has_changed'_A_narrative_inquiry_study_of_hope_and_ambiguous_loss_when_someone_is_missing" target="_blank">2015 study of Australian families</a> I conducted as part of my PhD found increased hope also creates a “hope hangover”. Families told me this is where anticipation peaks but they need recovery time to manage the emotional assault of a possible resolution.</p> <p>Families of missing people also told me they have to remain resilient as other cases are solved, and the uncertainty of how long the investigation of their own loved one will take. In other words, media reporting of outcomes of one case can compound the trauma experienced by families of other missing people, whose case has not yet been resolved.</p> <p><strong>Then there’s the invasion of privacy</strong></p> <p>Privacy for these families is <a rel="noopener" href="https://theconversation.com/missing-and-found-understanding-the-privacy-needs-of-missing-people-13786" target="_blank">also an issue</a>.</p> <p>Loren O’Keeffe, founder and chief executive officer of <a rel="noopener" href="https://mpan.com.au" target="_blank">Missing Persons Advocacy Network</a>, was buoyed by community interest to help the search over the five years her brother Dan was missing.</p> <p>When he was found, in traumatic circumstances, despite asking for privacy, she noticed the community felt a sense of ownership over Dan and the family’s story. Earlier this week, when Loren reflected about the location of her brother, she told me:</p> <blockquote> <p>[…] journalists incessantly ringing the doorbell, flooding inboxes demanding interviews, seeing awful commentary over social media – completely overwhelmed us when we needed space and silence to process our reality. It’s an unconscionable notion; desperate families that get media and public support for “search” are then obliged to share such raw grief and delicate detail at the debilitating time of “found”.</p> </blockquote> <p><strong>Specific media quidelines would help</strong></p> <p>The reasons people go missing can be diverse and complex. These can be due to a crime, complex mental illness, suicide or misadventure. This means a number of different media guidelines or codes of practice could potentially come into play to shape media coverage.</p> <p>There are no Australian media guidelines specifically about reporting missing persons cases. They are needed.</p> <p>We may be able to learn from the success of <a rel="noopener" href="https://mindframe.org.au" target="_blank">Mindframe</a>, a national program that provides evidence-based recommendations for media reporting and public communication about suicide and mental illness, among other issues.</p> <p>The program has been developed and refined over two decades, providing a strong platform for collaboration between the media and people involved in mental health and suicide prevention, including those with lived experience of these issues.</p> <p>The guidelines do not restrict media reporting of the issues, but provide an opportunity for media and those working with the media to reflect on a number of issues. These include the types of content and messaging that may reduce risk of harm and distress, reduce stigma, and increase people’s willingness to seek help and offer help to others.</p> <p>Jaelea Skehan, director of <a rel="noopener" href="https://everymind.org.au" target="_blank">Everymind</a> (the organisation behind the <a rel="noopener" href="https://everymind.org.au/programs/mindframe" target="_blank">Mindframe</a> guidelines) told me that with media guidelines specific to missing persons, newsworthy coverage would still take place, but would also consider the potential impacts on those directly involved or impacted by similar experiences.</p> <p>Remember, the stories of the investigations of missing persons cases are not the full story of the life of the person who is lost or the families left behind.</p> <p>As the brother of a young woman missing for more than 30 years told me as <a rel="noopener" href="https://www.researchgate.net/publication/280876972_'I_still_hope_but_what_I_hope_for_now_has_changed'_A_narrative_inquiry_study_of_hope_and_ambiguous_loss_when_someone_is_missing" target="_blank">part of my research</a>:</p> <blockquote> <p>Hope can get buried deep below, we [the families of missing people] are like icebergs. We don’t have rose coloured spectacles on, it’s like they have been ripped off. We see the world as it is. There is a lot that others don’t see.</p> </blockquote> <p>The community, when watching on, needs to remember that.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/172487/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a rel="noopener" href="https://theconversation.com/profiles/sarah-wayland-18783" target="_blank">Sarah Wayland</a>, Senior Lecturer Social Work, <a rel="noopener" href="https://theconversation.com/institutions/university-of-new-england-919" target="_blank">University of New England</a></em></p> <p><em>This article is republished from <a rel="noopener" href="https://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a rel="noopener" href="https://theconversation.com/rolling-media-coverage-of-missing-persons-cases-can-add-to-the-trauma-for-all-families-left-behind-172487" target="_blank">original article</a>.</em></p> <p><em>Image: NSW Police (Facebook)</em></p>

Mind

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When missing children return: how can we avoid adding to Cleo Smith’s trauma?

<p>Four-year-old Cleo Smith was <a rel="noopener" href="https://www.theguardian.com/australia-news/2021/nov/03/cleo-smith-found-first-pictures-of-smiling-girl-as-australian-police-detail-moment-of-rescue" target="_blank">found by Western Australian police earlier this week</a>, 18 days after going missing from a remote campsite.</p> <p>Being taken and removed from one’s family is a significantly traumatic event for any child. It disrupts their entire world.</p> <p>Children are <a href="https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/j.1469-7610.2011.02399.x">dependent on their families and attachment figures</a> for their sense of security and support. Sudden loss of these important relationships can result in fear, a sense of abandonment and confusion. Children left alone can become withdrawn and depressed and have little understanding of why this has happened to them.</p> <p>There can be long-term effects, such as memories of the fearful experience, sleep disruption and anxiety. Some children will have difficultly rebuilding their sense of security and trust.</p> <p>As a child psychiatrist who’s researched trauma, I’m interested in how we can ensure such children recover.</p> <p>Family members, the media and the public also need to avoid certain actions or behaviours that could re-traumatise the child.</p> <blockquote class="twitter-tweet"> <p dir="ltr">"It's one person who has done this horrible thing"<br /><br />WA Police Minister Paul Papalia shares new details about the miracle rescue of missing girl Cleo Smith. <a href="https://t.co/CEAE1U3HFm">pic.twitter.com/CEAE1U3HFm</a></p> — Sunrise (@sunriseon7) <a href="https://twitter.com/sunriseon7/status/1455998352668053507?ref_src=twsrc%5Etfw">November 3, 2021</a></blockquote> <p><strong>How can the child recover?</strong></p> <p>The first priority after finding the child is to immediately re-establish a sense of safety and stability, and to reunite them with their family.</p> <p>The most important thing is to avoid intrusive, <a rel="noopener" href="https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1348/135532506X156620" target="_blank">probing questioning</a> straight away as this can be frightening and distressing. It’s a normal response for the child to try and not think about what they’ve just been through.</p> <p>They will take their own time before they’re able to share details of their experiences, and will need considerable support and care to do this.</p> <p>Intrusive questioning may re-traumatise the child. For survivors of trauma, being asked to focus on their memories and experiences of fear can be distressing and bring back the terror of the experience, particularly if they’re not ready to think about the events.</p> <p>Police forces have skilled interviewers who understand and avoid this when recovering a child, and perform the interviews gradually.</p> <p>There are open questions about any other sort of trauma Cleo may have experienced, but for now we don’t have any information on this. We might never know all the details and we need to respect the family’s right to privacy.</p> <p>Some children might benefit from counselling, particularly if they have severe anxiety symptoms or have been held for a long time.</p> <p>Children held for a long time often become dependent on their captor for survival, as they <a rel="noopener" href="https://www.tandfonline.com/doi/abs/10.1080/01926180902754711?journalCode=uaft20" target="_blank">adapt to their situation and attempt to survive</a>. It’s a very strange and traumatising position for the child to be in and may take a long time to recover from.</p> <p>Over time, it’s important for attachment figures such as parents and carers to allow children to express fears in a gentle way.</p> <p>Children may have “disguised anxieties”. They may develop fear about some other thing or event, for example storms or dogs, because they’re <a rel="noopener" href="https://journals.sagepub.com/doi/abs/10.1177/0829573512468845" target="_blank">expressing anxiety about the traumatic event in a disguised way</a>.</p> <p><strong>Adults should listen, not probe</strong></p> <p>Caregivers need to be <a rel="noopener" href="https://www.childwelfare.gov/pubpdfs/child-trauma.pdf" target="_blank">guided by the child’s willingness to disclose</a>, and when.</p> <p>The response to trauma varies considerably. Some children tell parents or carers a lot about the experience at first. Others may disclose small details little by little over time, while some may not speak about details for months or years.</p> <p>Parents or carers need to let the child speak at their own pace and be guided by the child’s level of anxiety. The aim is to give the child a safe space to speak to trusted people who can support them.</p> <p>When they do start talking about their experience, adults must listen carefully and validate their feelings. Adults should reassure the child that he or she is safe now. It’s not a good idea to probe.</p> <p>Believing what the child says is crucial.</p> <p><strong>Let’s not get carried away with speculation</strong></p> <p>We don’t know what the long-term consequences for Cleo will be. This will depend on what she’s been exposed to, which we don’t know yet. And we don’t always get a sense of closure – this isn’t as important as working on the best way to support her recovery.</p> <p>The media should avoid premature comment and speculation on what might have occurred. The media currently have no idea what kind of person the suspect is and shouldn’t speculate on his behaviours and motives.</p> <p>It’s also not helpful for the media to focus on extreme ideas about risk to children at the hands of predatory offenders.</p> <p>As the public, we shouldn’t speculate about the circumstances either or prejudge those involved. Police are methodical and thorough in their work and will need time to piece together the story of what may have happened.</p> <p>The local community, and many members of the public, are likely to be anxious and fearful. A missing child strikes at the core of our desire to care for children. This may have negative impacts on community trust and relationships.</p> <p>If this was random act, there’s the potential for ongoing fear. And it’s potentially more scary than the stereotypes we think of, such as a planned attack by a ring of perpetrators. A random attack is harder to make sense of, terrifying and unsettling.</p> <blockquote class="twitter-tweet"> <p dir="ltr">Missing four-year-old girl Cleo Smith has been found safe and well in a locked house in Carnarvon, WA police say.<br /><br />Here's why missing children cases grip the nation (from the archives): <a href="https://t.co/Ybv7JbjCXD">https://t.co/Ybv7JbjCXD</a> <a href="https://twitter.com/Uni_Newcastle?ref_src=twsrc%5Etfw">@Uni_Newcastle</a></p> — The Conversation (@ConversationEDU) <a href="https://twitter.com/ConversationEDU/status/1455646662102241286?ref_src=twsrc%5Etfw">November 2, 2021</a></blockquote> <p><strong>Parent's need support, too</strong></p> <p>Cleo’s parents, and any parents in a similar situation, have been through a horrendous ordeal.</p> <p>They have the vital role of helping a child feel safe again, so they also need support to do this.</p> <p>All parents may feel increased anxiety about child safety in the face of this event. Children may also hear about Cleo’s experience and worry this could happen to them. Fear is contagious when such a traumatic event impacts a community.</p> <p>If parents are worried about their child showing trauma or anxiety symptoms, they should speak to GP who can refer to a psychologist or psychiatrist if more support is needed.</p> <p><em>If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important; text-shadow: none !important;" src="https://counter.theconversation.com/content/171200/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a rel="noopener" href="https://theconversation.com/profiles/louise-newman-1753" target="_blank">Louise Newman</a>, Professorial Fellow in Psychiatry, <a rel="noopener" href="https://theconversation.com/institutions/the-university-of-melbourne-722" target="_blank">The University of Melbourne</a></em></p> <p><em>This article is republished from <a rel="noopener" href="https://theconversation.com" target="_blank">The Conversation</a> under a Creative Commons license. Read the <a rel="noopener" href="https://theconversation.com/when-missing-children-return-how-can-we-avoid-adding-to-cleo-smiths-trauma-171200" target="_blank">original article</a>.</em></p> <p><em>Image: Getty Images</em></p>

Mind

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Understanding the “window of tolerance” in trauma recovery

<p><span style="font-weight: 400;">For survivors of trauma, recovering involves learning how to cope with distress and how to increase the capacity for positive and enjoyable experiences.</span></p> <p><span style="font-weight: 400;">A common framework psychologists use while working with trauma survivors is called the “window of tolerance”.</span></p> <p><span style="font-weight: 400;">Understanding our personal windows of tolerance can help us respond to demands of daily life and utilise different strategies to return to it during stressful moments.</span></p> <p><strong>What is the window of tolerance?</strong></p> <p><span style="font-weight: 400;">Coined by psychiatrist Dan Spiegel, the </span><a rel="noopener" href="https://www.goodtherapy.org/blog/psychpedia/window-of-tolerance" target="_blank"><span style="font-weight: 400;">window of tolerance</span></a><span style="font-weight: 400;"> describes a state of arousal where a person can function well and respond to stimuli with much difficulty.</span></p> <p><span style="font-weight: 400;">In this state, a person is likely able to think rationally, reflect, and make decisions without feeling overwhelmed.</span></p> <p><span style="font-weight: 400;">When a person experiences extreme stress, they can leave this window and enter a state of hyper- or hypo-arousal.</span></p> <p><span style="font-weight: 400;">Hyper-arousal is also known as the fight or flight response, with a person usually experiencing hypervigilance, anxiety or panic, and racing thoughts.</span></p> <p><span style="font-weight: 400;">In contrast, hypo-arousal is the freeze response, where someone may feel emotionally numb, empty, or paralysed.</span></p> <p><span style="font-weight: 400;">Being in either of these states can mean that a person is unable to effectively process stimuli.</span></p> <p><span style="font-weight: 400;">They may be unable to think as rationally and can feel dysregulated.</span></p> <p><span style="font-weight: 400;">Everyone’s window of tolerance is different and can be affected by their environment - such as how supported they feel - and trauma.</span></p> <p><img style="width: 386.4533965244866px; height:500px;" src="https://oversixtydev.blob.core.windows.net/media/7844316/nicabm-infog-window-of-tolerance-revised.jpg" alt="" data-udi="umb://media/82982d740495463a868203412a0187d2" /></p> <p><em><span style="font-weight: 400;">Image: NICABM</span></em></p> <p><span style="font-weight: 400;">When a person feels supported and safe, they are generally able to stay in their window of tolerance.</span></p> <p><span style="font-weight: 400;">For those who have experienced trauma, the experience may “push” a person out of their window of tolerance, or make it much more narrow or inflexible.</span></p> <p><span style="font-weight: 400;">This can result in someone responding to even minor stressors with extreme hyper- or hypo-arousal, or believing the world is unsafe.</span></p> <p><span style="font-weight: 400;">Frequently staying outside the window of tolerance can result in an individual experiencing mental health issues such as depression and anxiety.</span></p> <p><strong>Manage mental health with the window of tolerance</strong></p> <p><span style="font-weight: 400;">People who feel dysregulated and often stay outside of their window of tolerance can return using a few different techniques.</span></p> <p><span style="font-weight: 400;">Practicing grounding and mindfulness skills can often help people be present and in the moment.</span></p> <p><span style="font-weight: 400;">With the help of a mental health professional, it is also possible for a person to expand their window of tolerance, feel a greater sense of calm, and become better equipped to deal with stress.</span></p> <p><span style="font-weight: 400;">Therapy can provide individuals with a safe space to process trauma and other painful memories, as well as a place to practice emotional regulation.</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

Mind

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5 signs complex trauma is affecting your relationship

<p><span style="font-weight: 400;">Trauma can affect how the brain works, how we deal with future stressors, and how we navigate our relationships with others.</span></p> <p><span style="font-weight: 400;">Someone who has experienced trauma might find it difficult to find and stay in fulfilling romantic relationships or they could feel unsatisfied with their current relationship but can’t pinpoint exactly why - and complex trauma could be to blame.</span></p> <p><strong>What is complex trauma?</strong></p> <p><span style="font-weight: 400;">Unlike typical Post Traumatic Stress Disorder, which is the result of a single traumatic event and is often associated with soldiers and those escaping war zones, complex PTSD (c-PTSD) is the result of multiple traumatic events over a long period of time.</span></p> <p><span style="font-weight: 400;">These events usually occur in childhood or adolescence and can include witnessing the illness or death of a caregiver, abuse, neglect, or exposure to violent or chaotic situations.</span></p> <p><strong>What does c-PTSD look like?</strong></p> <p><span style="font-weight: 400;">Although it is a fairly new term, complex PTSD shares some symptoms with typical PTSD, with some additional symptoms.</span></p> <p><span style="font-weight: 400;">According to UK mental health organisation </span><a rel="noopener" href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/" target="_blank"><span style="font-weight: 400;">Mind</span></a><span style="font-weight: 400;">, these symptoms can include:</span></p> <ul> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Constantly feeling empty or hopeless</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Difficulty regulating emotions</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Experiencing dissociative symptoms</span></li> <li style="font-weight: 400;" aria-level="1"><span style="font-weight: 400;">Headaches, dizziness, stomach aches, and other physical symptoms</span></li> </ul> <p><span style="font-weight: 400;">Those with complex PTSD may also find friendships and relationships very difficult, or try to avoid them altogether.</span></p> <p><a rel="noopener" href="https://www.psychologytoday.com/au/blog/mindful-anger/202109/7-signs-complex-trauma-is-impairing-your-relationship" target="_blank"><span style="font-weight: 400;">Dr Andrea Brandt</span></a><span style="font-weight: 400;">, a marriage and family therapist of 35 years with a PhD in clinical psychology, shares five signs c-PTSD could be affecting your relationship.</span></p> <p><img style="width: 0px; height: 0px;" src="https://oversixtydev.blob.core.windows.net/media/7843834/gettyimages-1270234171.jpg" alt="" data-udi="umb://media/360e619b1a6444b8be3bc136582b60d9" /></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p> <p><strong>1. You worry your partners are going to leave you</strong></p> <p><span style="font-weight: 400;">Experiencing constant feelings of insecurity in your relationship is common for people with c-PTSD.</span></p> <p><span style="font-weight: 400;">A constant fear your partner will leave may be the result of multiple major upheavals in childhood or having caregivers who would be very loving and attentive sometimes, and unavailable or aloof at other times, according to Dr Brandt. </span></p> <p><strong>2. Acting “clingy” or “needy”</strong></p> <p><span style="font-weight: 400;">Have you ever been described by a partner as “needy” or “clingy”? It may be due to complex PTSD.</span></p> <p><span style="font-weight: 400;">Dr Brandt points to feelings of abandonment as the culprit, as these feelings cause you to cling to your partner, which can drive your partner away and fulfill your fear of being abandoned.</span></p> <p><strong>3. You are hypersensitive or hypervigilant</strong></p> <p><span style="font-weight: 400;">If you feel hypersensitive to slights despite being in a stable relationship with a loving partner, or you feel hypervigilant towards any signs of trouble, that may indicate that you have c-PTSD.</span></p> <p><span style="font-weight: 400;">Dr Brandt says that if you feel anxious or on edge most of the time while in relationships and this occurs across multiple relationships, seeking treatment for complex trauma is a good idea.</span></p> <p><strong>4. You find trusting romantic partners hard</strong></p> <p><span style="font-weight: 400;">According to Dr Brandt, experiencing abuse or neglect or living in a chaotic environment while growing up can make it hard for you to trust romantic partners as an adult, especially if your caregiver was a source of trauma.</span></p> <p><span style="font-weight: 400;">This may result in the development of an anxious-avoidant attachment style, meaning that you crave closeness with others but push it away when it happens.</span></p> <p><strong>5. Saying yes to sex when you don’t want it</strong></p> <p><span style="font-weight: 400;">Finding yourself agreeing to or initiating sex even when you don’t feel like it? Dr Brandt says this could be because you’re craving feelings of closeness or because sex helps to dull other negative emotions.</span></p> <p><span style="font-weight: 400;">If you then pull away once physical intimacy is achieved, potentially ending a relationship before it’s truly begun and moving on to another partner, this is a sign of an anxious-avoidant attachment style resulting from complex trauma.</span></p> <blockquote style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" class="instagram-media" data-instgrm-captioned="" data-instgrm-permalink="https://www.instagram.com/p/CTaxSZ7JDwo/?utm_source=ig_embed&amp;utm_campaign=loading" data-instgrm-version="13"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"></div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"></div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"></div> </div> </div> <div style="padding: 19% 0;"></div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"></div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" rel="noopener" href="https://www.instagram.com/p/CTaxSZ7JDwo/?utm_source=ig_embed&amp;utm_campaign=loading" target="_blank">A post shared by Andrea Brandt (@abrandtphd)</a></p> </div> </blockquote> <p><strong>What you can do about it</strong></p> <p><span style="font-weight: 400;">These are only some of the ways complex trauma can affect your relationships, but Dr Brandt stresses that those with complex PTSD can still experience happy, healthy relationships.</span></p> <p><span style="font-weight: 400;">If you identify with any of these or other signs, she first suggests recognising that these issues aren’t the fault of your partner or current situation. Instead, they are the result of events that have occurred years or decades earlier.</span></p> <p><span style="font-weight: 400;">Acknowledging your trauma and processing it with a licensed professional can help you start to heal and embark on the journey to healthier and happier relationships.</span></p> <p><em><span style="font-weight: 400;">Image: Getty Images</span></em></p>

Mind

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Glenn Close opens up about traumatic cult childhood

<p>Glenn Close is opening up about her past.</p> <p>As a respected actress in Hollywood, many know that the 74-year-old has been nominated for an Oscar eight times, but what is relatively unknown in comparison is her upbringing in a movement called Moral Re-Armament (MRA), which has been described as cult-like.</p> <p>“It’s astounding that something you go through at such a young stage in your life still has such a potential to be destructive,” the star said during an interview on Prince Harry and Opray Winfrey's new Apple TV+ series The Me You Can't See.</p> <p>“I think that’s childhood trauma, because of the devastation, emotional and psychological, of the cult,” she added.</p> <p>“I am psychologically traumatised.”</p> <p>Close said that her father William became involved in the movement when she was just a child and took their family to the MRA's Switzerland headquarters. The family lived their for two years while William worked as a doctor in Africa.</p> <p>Ultimately, the family would be involved with the organisation for about 15 years.</p> <p>“It was basically a cult. Everyone spouted the same things, and there’s a lot of rules, a lot of control,” recalled Close. ”Because of how we were raised, anything you thought you’d do for yourself was considered selfish. We never went on any vacations or had any collective memories of stuff other than what we went through, which was really awful.”</p> <p>She said the way she was raised had lasting effects on her, and even played a role in her relationships. Close has been married and divorced three times, and also shares a daughter, Annie, with a previous long-time partner.</p> <p>“I have not been successful in my relationships and finding a permanent partner, and I’m sorry about that,” she explained. “I think it’s our natural state to be connected like that. I don’t think you ever change your trigger points, but at least you can be aware of them, and at least you can maybe avoid situations that might make you vulnerable, especially in relationships.”</p> <p>She joked: “It’s probably why we all have our dogs.”</p> <p>At the age of 22, Close left the organisation and went to William &amp; Mary College in Virginia to study drama.</p> <p>Close mentioned that she ended up in therapy to help treat the issues brought on by her upbringing and also went on to reveal the mental health issues her family faced.</p> <p>Her sister Jessie has been diagnosed with bipolar disorder and her nephew suffers from schizophrenia.</p> <p>“Jessie was always considered the wild one, the rebel, but when she came up to me one summer at my parents’ house in Wyoming, her kids were already in the car, and she came up to me and said, ‘I need help, I can’t stop thinking about killing myself,’ and for me it was a shock,” the star said.</p> <p>“She ended up in hospital. I took her there. She was finally at age 50 properly diagnosed with bipolar one with psychotic tendencies.”</p>

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