Category: Trauma

Experts Warn There's a Huge Problem With How Mental Health Problems Are Diagnosed

3/7/2020

When creating a universal diagnostic tool for psychiatric illness, imperfection is inevitable. Now in its fifth edition, the widely-used 'mental health bible', known as the Diagnostic and Statistical Manual (DSM-5), has had a slew of controversies and some want to do away with it entirely.

As far back as 1968, experts have criticised the manual's myriad flaws, arguing that its "disjunctive" categories are "unusable in a scientific context". A detailed analysis of five key chapters in the current edition has now come to a similar conclusion.

Researchers from the University of Liverpool argue that today's diagnoses for 'schizophrenia', 'bipolar disorder', 'depressive disorders', 'anxiety disorders' and 'trauma-related disorders' are scientifically worthless as tools to identify these conditions.

Analysing chapters for these categories in DSM-5, the authors conclude that the manual's rules are inconsistent and subjective, leaving a huge amount of overlap in symptoms between diagnoses.

The results mirror a study from 2014, which demonstrated that when using both the fourth and fifth edition, two people could receive the same diagnosis without sharing any common symptoms in the majority of cases.

That very same year, another team of researchers calculated that in the DSM-5 there are 270 million combinations of symptoms that would meet the criteria for both PTSD and major depressive disorder.

"This study provides yet more evidence that the biomedical diagnostic approach in psychiatry is not fit for purpose," says co-author Peter Kinderman, a clinical psychology researcher at the University of Liverpool.

Orchid "Reaction"

Whenever things are "WRONG" -- like the DSM 5 -- there is a tendency to pitch everything out, including an integrated physical health/mental health model of medicine.

That is what the Liverpool researchers did and it is what others have done.

Often in reaction to paradigms that don't seem to sufficiently take into account TRAUMA or ADVERSE CIRCUMSTANCES.

THE PROBLEM: That trauma and those adverse circumstances are hugely problematic because they are working on HUMAN BIOLOGICAL SYSTEMS.

It's looking more and more that we will have a piecemeal approach to biomarkers and improved treatments.

Policymakers: "Burden of Proof" and "Reason" should help us get through this. The overwhelming evidence is that the majority of criminal defendants are dealing with some type of "cognitive disability."

That doesn't mean we have great treatments for cognitive disabilities (sometimes we do) -- but we can at least have humane care.

Mental Health professionals overwhelmingly want to help -- in many cases in the criminal justice system -- they just aren't and this is one of the great ethical catastrophes of modern times.

"IN THE TIME OF JEFFERSON"--- OUR INFORMATION EXPLOSION & CURRENT SCIENTIFIC REVOLUTION IN BIOLOGY HAVE PROFOUND IMPLICATIONS FOR OUR SOCIETY & OUR CRIMINAL JUSTICE SYSTEM

3/11/2019

I remember once hearing Political Columnist & Commentator George Will say it must have been so COMFORTING to live in the time of Jefferson when it was still possible [although not probable] for 1 Individual to master the known base of knowledge.

Those days are long gone.

But we have experts, right? Yeah, but those experts are just beginning to integrate their limited knowledge bases.

I got my informational e-mail from "Neurolaw News" -- & what struck me was both how amazing it was and how incomplete it was.

"Neuroscience" alone is NOT going to get us to a complete understanding of human bad behavior.

We're IN THE PROCESS of INTEGRATING & UNDERSTANDING the relationships between:

Physical & Mental Health
Beginning to understand the HUGE IMPORTANCE of:
- The Immune System
- The Microbiome
- The Gut
- The Endocrine System
- Social Determinants of Health
- Etc., Etc., Etc.

So who are we putting the BURDEN on: poor, marginalized, often traumatized people often with cognitive disabilities.

  And let's just say a word about that trauma: sometimes it is from child abuse or war BUT sometimes it is from a SOCIETY that is still finding its way.

I don't know how many times I've listened to Judges lecture criminal defendants & thought:  "What a frickin' waste of time."

Of course, the truth is it is a "frickin' waste of time" for us to lecture the Criminal Justice System -- They need a lot more support to make the fundamental, structural changes that are necessary just as the people do who are coming before them.

Our new theme:  SUPPORT. We are taking as our first illustrative symbol: THE GREEK COLUMN -- a classic symbol of:

WESTERN CIVILIZATION,
MARVEL of ENGINEERING & BEAUTY
STRONG ENOUGH TO PROVIDE SHELTER TO FUTURE GENERATIONS

George Will -- It Must Have Been So Comforting To Live In The Time of Jefferson

Erechtheion in the Acropolis in Athens

IF WE WANT TO CLIMB THE GLOBAL MENTAL HEALTH MOUNTAIN --- WE'RE GOING TO HAVE TO WORK TOGETHER

11/9/2018

There are A LOT of FACTORS for the global epidemic in Mental Health concerns. Some of those FACTORS are more prominent in some regions of the world than others. For example, there is a 60% rate of PTSD in Afghanistan -- the TRAUMA of war probably has a lot to do with that.

We also see PTSD in American Veterans and victims of Child Abuse, Sexual Assault, etc.

BUT that is NOT all that is going on --- those antibiotics that are preventing disease are also killing off our good microbiota that mediate the immune system and ultimately mental health.

Further, our food is very different than it used to be --- certainly in the West and especially in the US.

There are over 60 Million refugees in the world today--- living very hard lives. What is one of their major health issues -- mental health problems. That's also putting A LOT of Pressure on established Nation States to take in those refugees. That's causing A LOT of Stress and mental health concerns in the populations of established Nation States.

We need RESEARCH [& the established Nation States are in the best position to do that]. We also need a commitment by all governments to focus on the SOCIAL DETERMINANTS of HEALTH of their populations. THAT MEANS EVERYBODY.

PTSD Is Silently Killing Afghanistan -- Free Women Writers (2017)
Antibiotic Use and Microbiome Function --- Biochemical Pharmacology (2017)
Metabolic abnormalities and low dietary Omega 3 are associated with symptom severity and worse functioning prior to the onset of psychosis: Findings from the North American Prodrome Longitudinal Studies Consortium. --- Schizophrenia Research (Sept. 2018)
The Mental Health Crisis Among Migrants --- Nature (2016)

Author and Polymath John Green argues that disease affects human history much more than we realize.

We would submit that the Global Mental Health epidemic is affecting human history much more than we realize from Mass Incarceration to the Refugee/Immigrant Crisis --- etc.

Further, the competence of our clinical mental health profession is just this side of that of the clerics during the Black Death.

We need a "Marshall Plan" to bring research to clinicians in ways they can use much, much quicker than what we are currently doing.

Mental Health is going to have to change a whole Lot to be effective -- & a big part of that is appreciating the large role of the immune system in Mental & brain disorders

9/17/2018

We're almost always in the position of not knowing everything.

How we deal with that has ENORMOUS MORAL & ETHICAL CONSEQUENCES for ourselves and others.

We've got a Mental Health Profession that:

Doesn't have a valid diagnostic manual;
Many treatments have stagnated or stalled;
They have a very incomplete understanding of "mental illness"
States & the Federal Government are paying Millions, Billions of Dollars for mental health treatment with pretty underwhelming results;
And yet this same profession is going into Criminal Court & testifying in criminal cases often greatly affecting the lives of very poor, traumatized disenfranchised people.

The practice of using Mental Health Evaluations as a predicate for punishment in some criminal cases has to stop, and really needs to stop TODAY on the part of both State and Private Mental Health Evaluators.

Does that cause problems well yes it does -- because we also have to reform our Criminal Justice System. Is that going to be hard -- you bet it is.

BUT LIVING THE LIE WE'RE CURRENTLY LIVING IS A SIN.

‘Drain Pipes’ in the Brain: Lymphatic Vessels Act As Pipeline Between Brain and Immune System

The Brain-Immune-Gut Triangle: Innate Immunity in Psychiatric & Neurological Disorders
https://www.researchgate.net/publication/261994663_The_Brain-Immune-Gut_Triangle_Innate_Immunity_in_Psychiatric_and_Neurological_Disorders

Oslo University Hospital, Norway

BBC:

BBC health reporter James Gallagher explores the increasing body of evidence that a dysfunctional immune system is responsible for the depression or psychotic illness experienced by hundreds of thousands, perhaps millions, of people in the UK.

James talks to the psychiatrists investigating this new understanding of mental illness and to people who may benefit from treatments aimed at the immune systems rather than their brain cells.

"I believe this is one of the strongest discoveries in psychiatry in the last twenty years", says Professor Carmine Pariante of his and other research on the immune system and depression. "It allows us to understand depression no longer as just a disorder of the mind and not even a disorder of the brain, but a disorder of the whole body.

It shifts conceptually what we understand about depression." James also talks to New York journalist Susannah Cahalan.

he began to experience paranoid delusions and florid hallucinations when her immune system made damaging antibodies against part of the molecular circuitry in her brain.

Treatment to eliminate the antibodies prevented her committal to psychiatric hospital.

Psychiatrist Professor Belinda Lennox at the University of Oxford says she has evidence that a significant proportion of people presenting for the first time with psychotic symptoms are victims of a similar autoimmune problem.

Possible linkages between Childhood Trauma -- Inflammation -- Damage to Immune System -- & Ultimate Mental Illness

Social Behavior & the Immune System

Alzheimer's & the Immune System

University of Colorado @ Denver
http://www.ucdenver.edu/academics/colleges/medicalschool/departments/neurology/clinical/rmadc/Pages/default.aspx

"Leukine stimulates immune system macrophages, which ingest and dispose of harmful microorganisms and waste products.

"Based on evidence that patients with the autoimmune disease rheumatoid arthritis do not tend to develop Alzheimer’s disease, the investigators first determined that a factor in these patients called “Granulocyte-Macrophage-CSF (GMCSF)” that stimulates production of immune system macrophages might help to protect them from developing Alzheimers.

"That possibility is consistent with recent research suggesting that patients with Alzheimer’s disease may have reduced capacity to clear away amyloid from the brain. GMCSF is the active ingredient in Leukine."
http://www.dana.org/Media/GrantsDetails.aspx?id=38876

See Also:

The Emerging Link Between Autoimmune Disorders and Neuropsychiatric Disease
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3086677/

What Does The Environment Have To Do With Diseases Affecting The Immune System
https://ensia.com/features/environment-diseases-immune-system/

Learn more about
Psychoneuroimmunology
https://www.sciencedirect.com/topics/neuroscience/psychoneuroimmunology

Below, Prof. Wieckert is the same Professor & Researcher who just made the breakthrough that some people with Schizophrenia have more immune cells in the brain.
https://neurosciencenews.com/schizophrenia-immune-cells-9867/

Is An Overactive Immune System A Cause for Schizophrenia

Houston Medical Research Center

Summary: A major finding from researchers at Houston Methodist reveals a significant number of people diagnosed with schizophrenia or bipolar disorder may actually have a treatable immune system disorder.

The condition causes NMDA receptors to stop functioning properly and can result in symptoms commonly associated with neuropsychiatric disorders.

Source: Houston Methodist.

“We suspect that a significant number of people believed to have schizophrenia or bipolar disorder actually have an immune system disorder that affects the brain’s receptors,” said Joseph Masdeu, M.D., Ph.D., the study’s principal investigator and a neurologist with the Houston Methodist Neurological Institute.

“If true, those people have diseases that are completely reversible – they just need a proper diagnosis and treatment to help them return to normal lives.”
Houston Methodist Research Center
http://neurosciencenews.com/schizophrenia-immune-disorder-bipolar-8179/

Immune System linked to Alcohol Drinking Behavior
http://neurosciencenews.com/immune-system-alcohol-7494/

University of Adelaide, Australia

Childhood Trauma Can Result in Chronic Inflammation which can affect the Immune System (2012)
http://www.medicaldaily.com/childhood-trauma-can-result-chronic-inflammation-241114

Elevated Risk for Autoimmune Disorders in Iraq and Afghanistan Veterans with Post-Traumatic Stress Disorder (2014)
http://www.biologicalpsychiatryjournal.com/article/S0006-3223(14)00457-0/fulltext

University of California @ San Francisco, Dept. of Psychiatry & VA

https://www.cam.ac.uk/research/news/mind-and-body-scientists-identify-immune-system-link-to-mental-illness

New Science is Amazing: It has Huge Moral Implications Now

Immune System & Mental Health

The Microbiome: Stress, Trauma, the Anna Karenina Principle, & Justice

5/3/2018

Personalized medicine is a big deal now -- recognizing the importance of individual differences to health outcomes.
We've argued for some time how critical personalized medicine is to mental health treatment, especially given how idiosyncratic the biological systems are for people with mental illness.
There are many, many reasons for differences -- but it turns out that one of them or trillions of them are the microbiota that make up our individual microbiomes.
Well what can our microbiomes affect:

Mood
Anxiety
Sleep
Personality
Etc.

When we have our Knowledge- Challenged Clinical Profession handing out "Personality Disorder" Diagnoses in the Justice System, how much longer can we ignore that they just don't have the knowledge available to make the determinations they are asked to make and that they are in fact making.

Good Bacteria, Mental Health Policy, & CU Research involving the Microbiome & PTSD

Nova Wonders: What's Living in You? Preview

Psychology Today

Chronic Stress Discombobulates Gut Microbiome Communities
Gut microbiome communities become unpredictable when someone is in distress.

When people are feeling healthy, relaxed, and safe, their gut microbiome communities generally work together harmoniously in a predictable symbiotic manner, according to a new study.

However, the Oregon State University researchers found that when someone is under stress, his or her gut microbiome communities become discombobulated and behave erratically, in ways that are unpredictable and vary from person to person.

This study, “Stress and Stability: Applying the Anna Karenina Principle to Animal Microbiomes (,” was published online August 24 [2017 in Nature Microbiology.]

Leo Tolstoy famously said: "All happy families are alike; each unhappy family is unhappy in its own way."

After realizing how unpredictably each individual's gut microbiome communities responded during "unhappy" stressful situations, the research team coined their discovery the "Anna Karenina principle" in honor of Tolstoy's dictum. In the study abstract, the authors write:

"The result is an ‘Anna Karenina principle’ for animal microbiomes, in which dysbiotic individuals vary more in microbial community composition than healthy individuals—paralleling Leo Tolstoy's dictum that “all happy families look alike; each unhappy family is unhappy in its own way."

We argue that Anna Karenina effects are a common and important response of animal microbiomes to stressors that reduce the ability of the host or its microbiome to regulate community composition."

https://www.psychologytoday.com/us/blog/the-athletes-way/201708/chronic-stress-discombobulates-gut-microbiome-communities

Trauma, Intergenerational Trauma, the Complicated Nature of Mental Disorders & Human Behavior --- & Due Process of Law

4/8/2018

Trauma is an extremely important factor in mental illness-- it is one of many complicated factors.
What do findings on "Intergenerational Trauma" and just the complicated nature of mental disorders and human behavior have to do with the criminal law.
Well, it means we still have to provide safety for the community. BUT letting go of punishment and make placement decisions based on our best assessments of safety is really ethically and morally required.
How can we say we are providing due process, if we're pretending to knowledge regarding human behavior we don't have?
There are a lot of things that can assault our immune systems and ultimately our brains and those assaults over a lifetime may be more individual than a fingerprint --- hence, the incredible need for personalized integrated physical and mental health care.
"Lives Are In the Balance" -- let's address the problems -- including Safety -- and let go of punishment.

Dr. Robert Sapolsky is a professor of biology, neurology and neurological sciences, and neurosurgery @ Stanford University

"You are never really going to understand what is going on if you get it into your head that you're going to be able to explain everything with this is--

the part of the brain
the childhood experience
the hormone
the gene
or the evolutionary mechanism

---That explains everything.

"It doesn't work that way. Instead any behavior is the result of biology that occurred a second ago, hours ago, days ago -- a million years ago."
. . . .

"O000h it's complicated. Well, that's very useful.

"How 'bout, 'OOOh it's complicated and you better be really careful and really cautious before you think you understand the causes of a behavior, especially if it's a behavior you judge harshly.' "
. ------Prof. Robert Sapolsky Stanford

Suicide Ideation and Attempts among First Nations Peoples Living On-Reserve in Canada: The Intergenerational and Cumulative Effects of Indian Residential Schools

Canadian Journal of Psychiatry (June 2017)

Conclusion:

Findings support the existence of linkages between intergenerational exposure to IRS [Indigenous Residential Schools] and risk for suicidal ideation and attempts and for a potential cumulative risk in relation to suicide attempts across generations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455875/

Trauma, mental health, and intergenerational associations in Kosovar Families 11 years after the war

European Journal of Psychotraumatology
(2013)

Conclusion

Eleven years after the Kosovo war, the presence of posttraumatic stress, anxiety, and depressive symptoms in civilian adults and their children is still substantial.

As symptoms of parents and children are associated, mental health problems of close ones should be actively screened and accounted for in comprehensive treatment plans, using a systemic approach.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3744842/

Physical and mental health of Afghan, Iranian and Somali asylum seekers and refugees living in the Netherlands.

BMC Public Health (2004)

A greater number of traumatic events was associated with all health outcomes, and more post-migration stress and less social support were associated with PTSD and depression/anxiety symptoms.

CONCLUSIONS:

Both physical and mental health problems are highly prevalent among refugees and asylum seekers in the Netherlands.

Although higher prevalence rates for most health outcomes were found among asylum seekers, both the specific health services for asylum seekers and the general health services in the municipalities should be aware of these problems.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC385239/

It's Kinda Funny BUT Religious Folks May Be More Adaptable to the Changing Science than Our Mental Health Profession & Legal Systems

3/22/2018

Certainly, two of the biggest historical scientific revolutions were the Copernican Revolution and Darwinian Evolution.
Now, both those Scientific Revolutions really implicated our Religious beliefs.
The Scientific knowledge we're gaining regarding:

"Immune-Gut-Brain Triangle" or the "Brain-Gut Axis,"
"The Functional Human Connectome,"
Biological Predispositions to Certain Harmful Substances
The role of discrimination in Harming Physical & Mental Health
The role of Trauma in Immune System Damage, and ultimately Cognitive Damage
Etc.

--really implicate our Mental Health and Legal Systems -- and in many ways our Religious Beliefs are ahead of the game.

The Neuroscience Revolution & the Microbiome Revolution, of course, may ultimately represent one of the great ironies of human history.

As I mentioned in a previous blog, Ancient Greek Historian Thucydides saw the benefits of religion -- he also saw its downsides in Superstition and how that could play out in the Society.

Well, the reality is "SCIENCE" is a lot more complicated than we often like to acknowledge and that was really one of the things that Philosopher of Science Thomas Kuhn demonstrated in his book, "The Structure of Scientific Revolutions" and further developing the concept of the "Paradigm Shift."

From our perspective, the evidence has been around for some time that at the very least we were making pretensions to knowledge we couldn't possibly have, especially when it comes to understanding "bad human behavior."

At the same time, we have to have safety.

The very real possibility that we are further traumatizing already traumatized people and further damaging their immune systems and their cognition -- may take the mental health & legal systems quite awhile to come to terms with.

BUT our Religious folks may be able to do this much more quickly. Are they the ones who are really ready for the 21st Century?

Saint Augustine

Robin Williams

New Science Is Amazing & It has huge moral implications for our society -- now

Pope Francis

Religious Historian Karen Armstrong

Arthur Schlesinger, Jr. -- great American historian who worked from 1939 to 2006 -- Wikipedia

The Legal System, Trauma-Informed Care & The Living Hell of Catch-22s

3/17/2018

Author Joseph Heller popularized the term “Catch-22” in the book of the same name which he picked up in his experiences in World War II.
Catch-22 is really a LIVING HELL. If you’re an attorney --- you’ve probably been in many Catch-22s or LIVING HELLS, but you’ve probably been in a Catch-22 if you’re a human being – it’s a pretty common part of the Human Experience and operating in our imperfect societies and systems.
So I think ONE of the Catch-22s of legal practice is that sometimes:

People exhibit behavior that doesn’t rise to the level of “imminent danger” BUT that behavior is nonetheless, pretty out there;
At least in some cases those behaviors are a result of abuse or other injustices [or it might be the result of a Brain Tumor, Sleep Apnea, it MIGHT be the result of A LOT of THINGS];
Now even in cases of extreme SOCIAL STRESS on the person, this can and often does affect the person BIOLOGICALLY.
So what’s an attorney to do – GET THE PERSON SOME HELP – we say as an ENLIGHTENED ATTORNEY.
BUT HERE’S WHERE THE CATCH-22 COMES IN
Taking away AGENCY & SOCIAL VIEW OF COMPETENCY increases SOCIAL STRESS AND MAKES THE PERSON WORSE.
Any talk of “TRADITIONAL OR NON-TRADITIONAL MENTAL HEALTH HELP” or a Limited Legal Representative, EVEN talk of a Limited Something with the Person Retaining Decisional Control – MAKES THE PERSON DEMONSTRABLY WORSE.

Well, how does this play out in the Criminal & Civil Justice Systems?
        Well, one of the big arguments in the “Mental Health Community” is are people with mental illness “PERPETRATORS” of crime or “VICTIMS” of crime and injustice.
         Well, the sad is truth is they are well-represented in BOTH CATEGORIES and sometimes if not often in the same person. VICTIMIZATION pretty predictably leads to TRAUMA and that can lead to a whole host of mental complaints, NOT just Post-Traumatic Stress Disorder (PTSD).
         This is why we need to have some PRETTY SOPHISTICATED TRAUMA-INFORMED CARE in both our Civil & Criminal Justice Systems.

          So a lot of VICTIMS of crime or some type of civil injustice never get their day in Court or Alternative Dispute Resolution Process – not only because they don’t have the money [which they don’t] but they often don’t have it together enough EMOTIONALLY for an attorney to work with them under many common PROFESSIONAL ETHICS RULES.

   Well what’s the attorney going to do? Seek a Legal Representative? Even talk of that makes the person much worse. Even talk of a very Limited Something makes the person much worse.
            So I don’t have the COMPLETE ANSWER to this right now. I do think it has a lot to do with a STRENGTH-BASED APPROACH, EDUCATING OURSELVES & OTHERS REGARDING THE LATEST SCIENCE, & LISTENING.
             As with most Catch-22s – this is where we need to PAY ATTENTION the most if we want to get out of our LIVING HELLS.

Alan Arkin as Yossarin in "Catch-22"

Effects of Social Stress on Mental Health

"Social Stress Leads To Changes In Gut Bacteria" -- Georgia State University http://news.gsu.edu/2018/03/08/social-stress-leads-changes-gut-bacteria-study-finds/
Social Stress & Addiction -- from the Journal of Neuropsychopharmacology, reported on mentalhealthtreatment.net.

http://mentalhealthtreatment.net/blog/social-stress-addiction-connection/

The Gut & Microbiome

Gut microbiota’s effect on mental health: The gut-brain axis (2017) -- published in Clinical Practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/

A CU Boulder-led study showing that injecting beneficial bacteria into mice can make them more resilient to stress has been named among the “top 10 advancements and breakthroughs” of 2016 by the nation’s leading non-governmental funder of mental health research.

Now, lead author Christopher Lowry, an associate professor in the Department of Integrative Physiology, is moving forward with clinical trials to see if altering the microbiome, or composition of resident bacteria, in military veterans with post-traumatic stress disorder can be beneficial.
http://www.colorado.edu/today/2017/01/05/study-linking-beneficial-bacteria-mental-health-makes-top-10-list-brain-research

Immune System & Mental Health

Mind and body: Scientists identify immune system link to mental illness -- University of Cambridge (2014)

 http://www.cam.ac.uk/research/news/mind-and-body-scientists-identify-immune-system-link-to-mental-illnes

Groundbreaking study links immune system to mental health (2016) -- University of Sidney and Perth-based Charity Meeting For Minds [M4M], reported on Australian ABC News site.

http://www.abc.net.au/news/2016-05-27/mental-health-study-a-boon-to-patients-immune-system/7455310

The Brain-Immune -Gut Triangle: Innate Immunity in Psychiatric & Neurological Disorders (2013) -- Oslo University Hospital & University of Debrecen, published in Current Immunology Reviews

https://www.researchgate.net/publication
/261994663_The_Brain-Immune-Gut_Triangle_Innate_Immunity_in_
Psychiatric_and_Neurological_Disorders

Gut Bacteria Drives Auto-Immune Diseases (2018) Yale University --reported in the magazine "Science" and on the website Neuroscience News

http://neurosciencenews.com/gut-bacteria-autoimmune-disease-8614/

I chose this cartoon by Matt Groening in his "Life in Hell" comic strip series as a metaphor for some our approaches in Mental Health.

But the fact is I can also relate to it quite literally. My arms don't straighten completely and as a child I was taken to the Bone Specialist.

The Bone Specialist advised my parents that the medical staff could break my bones and re-set them -- but it probably wasn't worth it -- and advised my parents not to worry about it. My parents thought that was pretty good advice -- and so do I.

Yet there was time when I was working as a Hostess @ a very popular Restaurant, Bar and Music Scene in Oklahoma City and an uncommonly disturbed patron asked me if I couldn't do something about my arms -- it was making it so he couldn't eat and proceeded to tell me what he thought had happened in the womb.

Well when I say "disturbed patron" -- who does he remind of -- my clients -- no -- many aspects of the Criminal Justice System -- YES.

There are things that aren't as innocuous as arms that won't straighten; nonetheless and maybe especially-- we need a strength-based approach.

Trauma-Informed Care & Justice

1/22/2018

We greatly UNDER-ESTIMATE the time and energy it takes to sufficiently address human conflicts, and that is nowhere better seen than in the concerns of marginalized populations, especially those who have been so traumatized that their presentation is a PRIMAL SCREAM rather than a concise and clear presentation of facts, law, and argument.
BUT the TRUTH is without money or resources, even if they do present the facts, law and argument --- they maybe IGNORED.
Which only tends to FUEL the PRIMAL SCREAMS and HORRIBLY DAMAGING SENSE OF INJUSTICE that is pretty par for the course for a whole lot of poor people in our society, including a whole lot of people with "mental illness."
I think some of us may have "intuited" TRAUMA-INFORMED CARE for years however imperfectly, recognizing that the Client that seems so "OFF-THE-WALL" -- Hey, there's A LOT going on there. AND the more one digs into it, the more one UNDERSTANDS:

What's going on with the Client;
What's going on with the Situation;
What's going on with the Case;
AND What is it REALLY going to take to RESOLVE this conflict and ADDRESS the UNDERLYING ROOT CAUSES of the Problem(s) which are more often than not very COMPLICATED.

AND more often than not, one finds there is A LOT OF JUSTIFICATION for the CLIENT"S PRIMAL SCREAMS and SENSE OF INJUSTICE.
BUT how many hours did it take to get that UNDERSTANDING of someone who was poor, marginalized with a "mental illness"? Many, many hours.
The LONGER people are subjected to GROSS INJUSTICE the more their mental health is damaged by it -- AND the HARDER it will be to ultimately address.
People in PAIN perceive being IGNORED as a GROSS INJUSTICE and that's because it is. STATE ENGAGEMENT and SUBSTANTIVE ADDRESSING OF CONCERNS WITH poor, marginalized people who have been TRAUMATIZED is HUGELY IMPORTANT for the SENSE OF JUSTICE in our SOCIETY.
It is not easy -- it takes A LOT of TIME and ENERGY -- BUT it is much more effective than IGNORING PEOPLE AND FAILING TO PROVIDE INCLUSION, JUSTICE and ULTIMATELY HEALING.

The Surprising Truth About the Silent Treatment
https://www.heysigmund.com/the-silent-treatment/

Childhood Trauma Affects Health Across A Lifetime

7/18/2017

At some point we just want people to get over it -- and when it is uncomfortably and painfully obvious that people are NOT over it -- well -- maybe if we IGNORE them -- they'll get over it.
   That works with DOGs doesn't it?
   Well, it doesn't work so well with traumatized children or adults or at least that's my experience.
Then people "escalate" to get people's attention -- "You must not have heard me" -- and may get threatening --
" Well, we're not going to respond to threats or if we do respond it's going to be with a Wellness Check or depending on the color of their skin just an arrest."
   Lots of times if we really dig down there often is something to the claims of injustice of people who are either in the Denver Detention Center or in the Community --- and they get written off because of the manner in which they are presented and because the people presenting them are greatly traumatized.
   If our response is to ignore them until those claims can be presented in a manner more suited to our liking, we may be waiting a long time and missing important and legitimate claims that need to be redressed.

Val's Blog