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Meghan Markle opens up about past trauma

<p>Meghan Markle has opened up about her mental health struggle in a new interview. </p> <p>In a joined interview with <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">her husband Prince Harry for <em>CBS Sunday Morning</em>, </span>the Duchess of Sussex admitted that she hasn't "really scraped the surface" on her struggle, as the couple launched their new project <a href="https://archewell.org/theparentsnetwork/" target="_blank" rel="noopener">The Parents' Network</a>. </p> <p>The Parents’ Network aims to support parents who lost or almost lost their child to cyberbullying and other traumas related to social media use. </p> <p>While speaking about online bullying and its effects on young children, <span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">the Duchess of Sussex spoke about her own experience and connection to the families, as she also had suicidal thoughts in 2021. </span></p> <p>“When you’ve been through any level of pain or trauma, I believe part of our healing journey — certainly part of mine — is being able to be really open about it,” she told Jane Pauley. </p> <p>"And you know, I haven't really scraped the surface on my experience. But I do think that I would never want someone else to feel that way," she continued.</p> <p>"And I would never want someone else to be making those sort of plans. And I would never want someone else to not be believed."</p> <p>"So, if me voicing what I have overcome will save someone, or encourage someone in their life to really genuinely check in on them and not assume that the appearance is good, so everything's OK, then that's worth it.</p> <p>"I'll take a hit for that."</p> <p>In a 2021 interview with Oprah Winfrey, Meghan revealed that she had suicidal ideation while pregnant with son Archie due to the pressure of life as a royal and the way the British media treated her. </p> <p>“I just didn’t want to be alive anymore,” she said at the time.</p> <p>She also recalled reaching out to palace officials and said that she did not receive any mental health help. </p> <p>The initiative, launched with the couple’s Archewell Foundation, aims to make sure that no other families go through what they did. </p> <p>“Our kids are young; they’re 3 and 5. They’re amazing,” she told Pauley. </p> <p>“But all you want to do as parents is protect them. And so, as we can see what’s happening in the online space, we know that there’s a lot of work to be done there, and we’re just happy to be able to be a part of change for good.”</p> <p><em>Images: CBS Sunday Morning</em></p>

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To tackle gendered violence, we also need to look at drugs, trauma and mental health

<p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a></em></p> <p>After several highly publicised alleged murders of women in Australia, the Albanese government this week pledged <a href="https://ministers.pmc.gov.au/gallagher/2024/helping-women-leave-violent-partner-payment">more than A$925 million</a> over five years to address men’s violence towards women. This includes up to $5,000 to support those escaping violent relationships.</p> <p>However, to reduce and prevent gender-based and intimate partner violence we also need to address the root causes and contributors. These include alcohol and other drugs, trauma and mental health issues.</p> <h2>Why is this crucial?</h2> <p>The World Health Organization estimates <a href="https://iris.who.int/bitstream/handle/10665/341604/WHO-SRH-21.6-eng.pdf?sequence=1">30% of women</a> globally have experienced intimate partner violence, gender-based violence or both. In Australia, <a href="https://www.abs.gov.au/statistics/people/crime-and-justice/partner-violence/latest-release#key-statistics">27% of women</a> have experienced intimate partner violence by a co-habiting partner; <a href="https://pubmed.ncbi.nlm.nih.gov/37004184/">almost 40%</a> of Australian children are exposed to domestic violence.</p> <p>By gender-based violence we mean violence or intentionally harmful behaviour directed at someone due to their gender. But intimate partner violence specifically refers to violence and abuse occurring between current (or former) romantic partners. Domestic violence can extend beyond intimate partners, to include other family members.</p> <p>These statistics highlight the urgent need to address not just the aftermath of such violence, but also its roots, including the experiences and behaviours of perpetrators.</p> <h2>What’s the link with mental health, trauma and drugs?</h2> <p>The relationships between mental illness, drug use, traumatic experiences and violence are complex.</p> <p>When we look specifically at the link between mental illness and violence, most people with mental illness will not become violent. But there <a href="https://theconversation.com/bondi-attacker-had-mental-health-issues-but-most-people-with-mental-illness-arent-violent-227868">is evidence</a> people with serious mental illness can be more likely to become violent.</p> <p>The use of alcohol and other drugs also <a href="https://theconversation.com/alcohol-and-drug-use-exacerbate-family-violence-and-can-be-dealt-with-69986">increases the risk</a> of domestic violence, including intimate partner violence.</p> <p>About <a href="https://www.aihw.gov.au/family-domestic-and-sexual-violence/understanding-fdsv/factors-associated-with-fdsv">one in three</a> intimate partner violence incidents involve alcohol. These are more likely to result in physical injury and hospitalisation. The risk of perpetrating violence is even higher for people with mental ill health who are also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/">using alcohol or other drugs</a>.</p> <p>It’s also important to consider traumatic experiences. Most people who experience trauma do not commit violent acts, but there are <a href="https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(23)00075-0/fulltext">high rates</a> of trauma among people who become violent.</p> <p>For example, experiences of childhood trauma (such as witnessing physical abuse) <a href="https://www.sciencedirect.com/science/article/pii/S1359178915000828?via%3Dihub">can increase the risk</a> of perpetrating domestic violence as an adult.</p> <p>Early traumatic experiences can affect the brain and body’s <a href="https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0895-4">stress response</a>, leading to heightened fear and perception of threat, and difficulty regulating emotions. This can result in aggressive responses when faced with conflict or stress.</p> <p>This response to stress increases the risk of <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675346/">alcohol and drug problems</a>, developing <a href="https://pubmed.ncbi.nlm.nih.gov/30798897/">PTSD</a> (post-traumatic stress disorder), and <a href="https://psycnet.apa.org/record/2015-17349-001">increases the risk</a> of perpetrating intimate partner violence.</p> <h2>How can we address these overlapping issues?</h2> <p>We can reduce intimate partner violence by addressing these overlapping issues and tackling the root causes and contributors.</p> <p>The early intervention and treatment of <a href="https://doi.org/10.1186/s12905-019-0728-z">mental illness</a>, <a href="https://doi.org/10.1177/1541204020939645">trauma</a> (including PTSD), and <a href="https://doi.org/10.1016/j.avb.2015.06.001">alcohol and other drug use</a>, could help reduce violence. So extra investment for these are needed. We also need more investment to <a href="https://www.sciencedirect.com/science/article/pii/S2212657023000508">prevent mental health issues</a>, and preventing alcohol and drug use disorders from developing in the first place.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S074937972200023X?via%3Dihub">Preventing trauma</a> from occuring and supporting those exposed is crucial to end what can often become a vicious cycle of intergenerational trauma and violence. <a href="https://journals.sagepub.com/doi/10.1177/070674371105600505">Safe and supportive</a> environments and relationships can protect children against mental health problems or further violence as they grow up and engage in their own intimate relationships.</p> <p>We also need to acknowledge the widespread <a href="https://store.samhsa.gov/product/practical-guide-implementing-trauma-informed-approach/pep23-06-05-005">impact of trauma</a> and its effects on mental health, drug use and violence. This needs to be integrated into policies and practices to reduce re-traumatising individuals.</p> <h2>How about programs for perpetrators?</h2> <p>Most existing standard intervention programs for perpetrators <a href="https://journals.sagepub.com/doi/10.1177/1524838018791268">do not consider</a> the links between trauma, mental health and perpetrating intimate partner violence. Such programs tend to have <a href="https://psycnet.apa.org/doi/10.1037/a0012718">little</a> or <a href="https://doi.org/10.1016/j.cpr.2021.101974">mixed effects</a> on the behaviour of perpetrators.</p> <p>But we could improve these programs with a <a href="http://rcfv.archive.royalcommission.vic.gov.au/MediaLibraries/RCFamilyViolence/Reports/RCFV_Full_Report_Interactive.pdf">coordinated approach</a> including treating mental illness, drug use and trauma at the same time.</p> <p>Such “<a href="https://www.sciencedirect.com/science/article/pii/S014976341930449X?via%3Dihub">multicomponent</a>” programs show promise in meaningfully reducing violent behaviour. However, we need more rigorous and large-scale evaluations of how well they work.</p> <h2>What needs to happen next?</h2> <p>Supporting victim-survivors and improving interventions for perpetrators are both needed. However, intervening once violence has occurred is arguably too late.</p> <p>We need to direct our efforts towards broader, holistic approaches to prevent and reduce intimate partner violence, including addressing the underlying contributors to violence we’ve outlined.</p> <p>We also need to look more widely at preventing intimate partner violence and gendered violence.</p> <p>We need developmentally appropriate <a href="https://theconversation.com/4-things-our-schools-should-do-now-to-help-prevent-gender-based-violence-228993">education and skills-based programs</a> for adolescents to prevent the emergence of unhealthy relationship patterns before they become established.</p> <p>We also need to address the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278040/">social determinants of health</a> that contribute to violence. This includes improving access to affordable housing, employment opportunities and accessible health-care support and treatment options.</p> <p>All these will be critical if we are to break the cycle of intimate partner violence and improve outcomes for victim-survivors.</p> <hr /> <p><em>The National Sexual Assault, Family and Domestic Violence Counselling Line – 1800 RESPECT (1800 737 732) – is available 24 hours a day, seven days a week for any Australian who has experienced, or is at risk of, family and domestic violence and/or sexual assault.</em></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. In an emergency, call 000.</em><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/229182/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/siobhan-odean-1356613">Siobhan O'Dean</a>, Postdoctoral Research Associate, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/lucinda-grummitt-1531503">Lucinda Grummitt</a>, Postdoctoral Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>, and <a href="https://theconversation.com/profiles/steph-kershaw-1466426">Steph Kershaw</a>, Research Fellow, The Matilda Centre for Research in Mental Health and Substance Use, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of 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/to-tackle-gendered-violence-we-also-need-to-look-at-drugs-trauma-and-mental-health-229182">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><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" /></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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‘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.<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" /></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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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>

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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>

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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>

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

<p><em><span style="font-weight: 400;">Content warning: This article mentions sexual assault.</span></em></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>

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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>

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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>

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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>

Caring

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Inside the story: The Trauma Cleaner - a beautiful meditation on death and decay

<p>Sarah Krasnostein’s <a href="https://www.goodreads.com/book/show/34964868-the-trauma-cleaner">The Trauma Cleaner</a> has won many awards since it was published in 2017, including the Victorian Prize for Literature and the Australian Book Industry Award General Non-Fiction Book of the Year.</p> <p>While the title may speak of a provocative premise – <a href="https://www.theguardian.com/books/2017/sep/28/i-started-dry-retching-the-compassion-of-a-trauma-cleaner">what is a trauma cleaner</a>? Are there really jobs like this? – it’s not just the content that makes it a wonderful read, it’s also the writing style. Every word, every sentence, is carefully considered, re-considered and re-considered some more, resulting in what can only be described as beautiful language.</p> <p>I was truly blown away by the power and precision of the prose. Sounds, tastes and smells emanate from the page, creating a visceral experience of protagonist Sandra’s extraordinary, often traumatic, life.</p> <p><strong>Orchestration of words</strong></p> <p>Krasnostein uses exquisite turns of phrase. Language is used to excavate facts and polish ideas that are hard to get rid of – things that stick. As Krasnostein writes, the book is “a catalogue of the ways we die physically and emotionally, and the strength and delicacy needed to lift the things we leave behind”.</p> <p>Introducing her subject, Krasnostein writes:</p> <p><em>During my time with Sandra, I met a bookbinder, a sex offender, a puppeteer, a cookbook hoarder, a cat hoarder, a wood hoarder […] I heard Sandra bend and flex language into words and idioms she made her own: “supposably”, “sposmatically”, “hands down pat!”</em></p> <p>It is this careful and playful orchestration of words – facts transformed into a scintillating narrative – that makes the book hard to put down. Every page lures you in, making you hungry for more.</p> <p>Beneath the beautiful language, resonance strikes and asks us to think of our own lives. Expressions hit like a sudden gust of wind. They bring tears to your eyes. We are not asked to feel sad, but to feel what was, and still is, being experienced by these people – to feel the complexity of the circumstances.</p> <p><em>Imagine Ailsa, the girl who loves to bake, the woman whose cakes are light and high and whose dark religion tells her to fear her effeminate son […] Imagine that baby as a boy frozen in his bed, straining to read the sound of a motor in the driveway over the noise of his own racing heart.</em></p> <p>Krasnostein’s language evokes in us the visceral aspects of a situation – the pain and pleasure of those involved. She says of Sandra, then still Peter, practising his female voice in the shower when wife Linda is out: “the refrain of thrumming along his veins that signifies his only certainty and which says: you don’t belong here”.</p> <p>Later, of his eventual parting from wife and children towards a new life as Sandra:</p> <p><em>When he steps around the food flung on the floor or smells the milk turning in bottles in the sink, or when cries momentarily shatter his sleep like a glass flung against a wall, he doesn’t really notice because in his mind he is dancing at [gay club] Annabel’s with Joe.</em></p> <p>Krasnostein is adept at laying out facts with no judgement or flourish, allowing their trauma to speak to us individually. She refuses to manipulate her readers, instead touching the facts lightly with a sense of perspective: “she will never fear what is ahead of her, only what is behind her”.</p> <p>From one trauma to the next, we learn of the murder of Sandra’s girlfriend, Maria, by a nightclub bouncer. Krasnostein uses repetition to speculate on his motives:</p> <p><em>Maybe he has it in for her. Maybe he has it in for dykes. Maybe he’s jealous of her. Maybe he’s jealous of the girlfriend. Maybe he’s repulsed that he’s jealous of either of them […] Maybe he just wants to feel the force of bone on muscle.</em></p> <p>Krasnostein gives us story perspective in a light, non-manipulative way. That last line is sparse yet stark, simple yet powerful.</p> <p>And then this, which winds all the facts into a clean knot that represents the very core of Sandra’s life journey: “Sandra does not need a physics lesson to understand that time dilates; life taught her early that some seconds are cruelly quick and others are tortuously slow”.</p> <p>Krasnostein pores over language, refining it until it says the most it can in the fewest words possible. “Something you might try to ignore, like a full bladder on a cold night”. “What chips some people like a mug cracks others, like an egg”. “The couch is a grave”.</p> <p><strong>Writing of writing</strong></p> <p>The Trauma Cleaner also speaks about the process of its being written, with authority and poignancy:</p> <p><em>I scrap draft after draft of my timeline and even when I am assisted in my task by Sandra’s recollection, the narrative remains a tangled necklace. Events link into one another only so far before they halt, abruptly, as some great knot where they loop over each other so tightly that some seem to disappear altogether.</em></p> <p>In some ways, the narrative arc of the book is not Sandra’s own journey, but Krasnostein’s understanding of Sandra and what she represents for all of us. This is achieved with a lightness of touch, the author never getting in the way of the reader’s own interpretations.</p> <p>Krasnostein writes at the start of the book:</p> <p><em>And here it hits me what it is we are doing by telling this story. It is something at once utterly unfamiliar and completely alien to Sandra: we are clearing away the clutter of her life out of basic respect for the inherent value of the person beneath.</em></p> <p>And then at the end of the book, after we have witnessed all of Sandra’s trauma, humour and resilience, an ordaining of our protagonist in language that is at once beautiful and beatific: “Sandra, you exist in the Order of Things and the Family of People; you belong, you belong, you belong”.</p> <p><em>Written by Craig Batty. Republished with permission of <a href="https://theconversation.com/inside-the-story-the-trauma-cleaner-a-beautiful-meditation-on-death-and-decay-127436">The Conversation.</a></em></p>

Retirement Life

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Zara Tindall reveals secret trauma

<p>She welcomed her second daughter Lena in June, but Zara Tindall has revealed she suffered a second miscarriage shortly after <strong><span style="text-decoration: underline;"><a href="https://www.oversixty.com.au/news/news/2016/12/queens-granddaughter-loses-her-baby/">losing her unborn baby in 2016.</a> </span></strong></p> <p>In an interview with the Sunday Times Magazine, alongside her brother Peter Phillips, Zara said the loss happened “really early on”.</p> <p>The Queen’s eldest granddaughter has previously revealed she suffered a miscarriage, but not her secret second heartache.</p> <p>“I think you need to go through a period where you don’t talk about it because it’s too raw,” she said. “But, as with everything, time’s a great healer.”</p> <p>She explained that going through her first miscarriage was tough as the pregnancy had to be made public, as is the rule for descendants of the Queen.</p> <p>“We had to tell everyone and it’s like, everyone knows — that’s the hardest bit,” she said.</p> <p>“That’s why I think a lot of people don’t talk about it because [a miscarriage] can happen early enough or it’s only your group of friends and your family that know.”</p> <p>But when Zara lost her second baby, she and her husband, former England rugby player Mike Tindall, were able to mourn in private.</p> <p>The 37-year-old equestrian said mourning was easier for her when the miscarriage happened earlier on in the pregnancy.</p> <p>“I think a lot of the time you’re lucky if it happens a lot earlier,” she said.</p> <p>“It’s something a lot of families are affected by but then, hopefully, a lot of the stories I’ve heard, they’ve gone on and had more children and they’re very lucky.”</p>

Caring

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The surprising benefit of going through hard times

<p>For those people who have faced trauma or adversity, the end result can be growth and a renewed sense of self.</p> <p>It’s not just the “starving artists” who use their own issues of love and loss to get inspired to create something great.</p> <p>Over the last two decades, psychologists Richard Tedeschi and Lawrence Calhoun coined the phrase “post-traumatic growth” and many others have also dedicated themselves to researching it in over 300 studies.</p> <p>Essentially, post-traumatic growth refers to people who experience a life changing transformation after facing challenging circumstances. Researchers found that almost seven out of 10 survivors of trauma report having some sort of positive psychological growth.</p> <p>The growth can vary in its scope, from a greater appreciation for life itself, a renewed love for family and friends, a keener eye to the beauty in nature, a spiritual connection with a higher being, or a renewed energy for work or charity.</p> <p>For instance living through a car accident may lead the survivor to decide to change jobs or move across the country, as they have the light bulb moment that life is short. Someone who has lost a child may find the inner strength and passion to set up a charity in the hope that others won’t have to live through the pain that they have experienced.</p> <p>It’s not the case for everyone though – not all people survive and thrive, and many experience the more commonly known post traumatic stress disorder (PTSD). Why is it then that some come out on the other side of trauma on the up, while others stay low?</p> <p>The model of post-traumatic growth created by Tedeschi and Calhoun states that people naturally make decisions every day that are based on their own beliefs and assumptions that have been formed over a lifetime. When trauma hits, these beliefs and ideals are shaken to the core, not unlike an earthquake, and all of a sudden our most basic foundations of life can become unhinged. Left to rebuild, many people let go of these preconceived ideas and start over from the bottom up.</p> <p>“A psychologically seismic event can severely shake, threaten, or reduce to rubble many of the schematic structures that have guided understanding, decision making, and meaningfulness,” Tedeschi and Calhoun write. </p> <p>The process of rebuilding the core structure of the individual’s belief system tends to start with some very challenging emotions such as anger, grief and anxiety. The growth tends to occur concurrently with, rather than instead of, these emotions.</p> <p>The individual needs to start over, pulling together new meanings and assumptions of the world around them, based on their new information about how the world works.</p> <p>By seeing themselves as survivors rather than victims, they can feel strong and wise rather than weak and vulnerable. From there, they may feel that they are getting closer to their true self.</p> <p>Things that we took for granted, such as our families, friends, steady income, or a comfortable home – can suddenly feel like the greatest assets in the world. This renewed sense of life as a gift can open doors to creativity such as art or photography which seek to capture the beauty of the world.</p> <p>Has your outlook on life changed as a result of trauma? We would love to hear your story in the comments.</p> <p><strong>Related links:</strong></p> <p><a href="/health/mind/2016/06/overcoming-pain-using-the-power-of-the-mind/"><span style="text-decoration: underline;"><em><strong>Overcoming pain using the power of the mind</strong></em></span></a></p> <p><a href="/health/mind/2016/06/trick-to-make-you-a-morning-person/"><strong><em><span style="text-decoration: underline;">The 4 tricks guaranteed to make you a morning person</span></em></strong></a></p> <p><a href="/health/mind/2016/06/extraordinarily-simple-ways-to-be-happy/"><span style="text-decoration: underline;"><em><strong>5 extraordinarily simple ways to be happy</strong></em></span></a></p>

Mind