Unburdened by false humility, postmodern trauma activists claim to have understood for the first time what drives all of human suffering
Trauma DispatchTrauma news you can't get anywhere else. |
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Trauma DispatchTrauma news you can't get anywhere else. |
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CATEGORY: CONTROL OF LANGUAGE AND IDEAS Julian Ford, PhD, University of Connecticut Source: Journal of Trauma & Dissociation Read time: 2.1 minutes This Happened On June 21, 2024, Julian Ford, editor of the Journal of Trauma & Dissociation, announced a call for submissions for a special issue on understanding and treating dissociation in the context of intersectional inequalities. Who Did This? Julian Ford has been a researcher on psychological trauma for over four decades. He has published over 250 articles, served on editorial boards of multiple journals, and was the president of the International Society for Traumatic Stress Studies in 2018-2019. Like the strategy of Bessel van der Kolk and Judith Herman who attack the competency of those who disagree with them, he has embraced the notion that clinicians who do not follow his beliefs do harm to trauma victims by overlooking their true problems, misdiagnosing them, and giving them the wrong treatment. Ford was an early adopter of the controversial complex PTSD diagnosis, starting with a 1998 paper with his notion that traditional psychotherapy overwhelms and retraumatizes patients who have complex PTSD, causing them to dissociate. This notion has been debunked with evidence [1]. He may be best known for publishing a series of studies trying to promote a theory that interpersonal and multiple traumas, what he calls polyvictimization, has special, harmful effects that other traumas do not have. Using weak, cross-sectional studies with samples of convenience, he has not proven such extraordinary causal relations. Ford attributes the high severity of patients’ symptoms wholly to their experiences of polyvictimization and makes no mention of the possibility that other factors, such as genetics or nontrauma factors, could have caused their problems [2]. The Claim Intersectionality was coined in 1989 by Kimberlé Crenshaw, an attorney and law school professor who was one of the founders of the systemic racism-based critical race theory. Intersectional theory posits that multiple, overlapping forms of discrimination combine to cause damaging social and political identities. Racial groups are defined not simply by additive inequalities of gender, class, sexuality, and immigration status, but by effects that are greater than the sum of those parts. While widely supported on the Left, the claim has been criticized, mainly by conservatives, as ambiguous, ignorant of broader social problems, focuses too much on group identities instead of individual differences, and a form of identity politics. The premise of Adverse Childhood Experiences—that the number of childhood experiences has a compounding effect—is the same premise as intersectionality, except in ACEs the predictors are any stress or trauma and the outcomes are mental and physical health. In the field of mental health, supporters of intersectionality claim that unless providers take intersectionality into account, they will somehow be providing inadequate, harmful, or wrong types of interventions for victims. Analysis “Intersectionality” is a successful ideological branding borne of the strategy that you can’t see a problem if you can’t name a problem [3], regardless of whether it is true. In the trauma world, the branding names of ACEs, toxic stress, and complex PTSD have been successful, too. The parallels between Ford’s theory of polyvictimization and intersectional theory are striking. It seems no coincidence that they arose concurrently during the phase of increasingly popular progressive leftist theories in academia, and not coincidentally the same time that the controversial and debunked theories of complex PTSD and toxic stress arose. It’s not clear whether they influenced each other in their early stages, but Ford’s editorial signals that these trauma theories have melded seamlessly with the racial- and class-based intersectional movement. It is noteworthy that intersectional theory is a causal theory, i.e., that oppressive life experiences borne of societal inequalities cause extraordinary human suffering and failure to flourish. ACEs, toxic stress, and complex PTSD likewise are causal theories of a similar kin. Swap discriminations, stresses, and traumas with capitalism, and they are nearly the same as Marxism, the original, enduring intellectual manifesto that attributes degradation of the human self wholly to life experiences, and which shares a skewed view of human nature that genetic differences play no role in variations of behavior and humans are highly malleable. REFERENCES [1] De Jongh A, Resick PA, Zoellner LA, et al. Critical analysis of the current treatment guidelines for Complex PTSD in adults. Depression and Anxiety. 2016;33(5):359-369. doi:10.1002/da.22469 [2] Julian D. Ford, Tobias Wasser & Daniel Connor. "Identifying and determining the symptom severity associated with polyvictimization among psychiatrically impaired children in the outpatient setting," Child Maltreatment 16 (2011): 216-226. [3] Kimberlé Crenshaw (December 7, 2016). The urgency of intersectionality. TED Talk, https://www.youtube.com/watch?v=akOe5-UsQ2o Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: CONTROL OF LANGUAGE AND IDEAS Megan McElheran, Psy.D., psychologist, founder of Before Operational Stress Source: Newswires EIN press release Read time: 2.0 minutes This Happened A press release on June 24, 2024 announced that the leadership of a Los Angeles-based emergency medical ambulance service had been trained in the Trauma Informed Leadership Program, hailing it as a milestone as the first EMS company in southern California to complete such a program. Who Did This? Before Operational Stress (BOS) provided the Trauma Informed Leadership Program training. Founded by psychologist Megan McElheran, they are a private company based in Calgary, Canada. Believing the world is in the midst of a mental health epidemic, BOS tailors their training products to public safety personnel and first responders. BOS provides pre-recorded videos, live presentations, and support programs for employees. The Trauma Informed Leadership Program costs $500 per person. The Premise The premise of the BOS business model is that the stress encountered by first responders and law enforcement causes mental disorders. Their website asserts that 23% of public safety personnel suffer from PTSD and 50% screen positive for at least one mental disorder. The leadership program content is divided into four modules:
Analysis The Canadian government has adopted the phrase “operational stress injury” as a non-medical term for psychological problems caused by trauma exposure for military or first responders. The national Operational Stress Injury Social Support program was created in 2001. The word 'injury' was selected because it was believed a shift in language away from mental disorders— posttraumatic stress disorder, major depression, and anxiety—would persuade individuals to seek help more readily. The company’s assertion on their home page that 50% of public safety personnel have mental health conditions from workplace stress is wildly higher than the normal population. This misinformation comes from a single survey with major flaws [1]. Survey respondents were a self-selected sample of less than four percent of Canada’s public safety personnel. The participants knew they were selected for being public safety personnel and they may have been motivated to register their perceptions of workplace stress. This finding contrasts with most other literature that has found first responders to be an especially resilient population. For example, a literature review of police officers exposed to trauma events found rates of probable PTSD closer to 7% [2]. An analysis of their year-long program for public safety personnel was unconvincing. Only 19 participants completed measures six months after the program out of a possible 203. Small, statistically significant improvements were found in PTSD, quality of life, stigma, and perceived social support. They failed to find improvements in depression, anxiety, stress, alcohol use, emotional regulation, and resilience [3]. Why Is This Happening? While the Before Operational Stress group has adopted some of the trauma-informed movements' branding language, they seem to have embraced a lite-version of the ideology: Their website is not filled with the trauma-informed misinformation that toxic stress and ACEs damages brains. It is a concern, however, that they promote the theory that humans are highly malleable to life stress. Evidence continues to mount that programs built on that notion are not very helpful for people who need help the most. REFERENCES [1] Carleton RN, Afifi TO, Turner S, Taillieu T, Duranceau S, LeBouthillier DM, et al. (2018). Mental disorder symptoms among public safety personnel in Canada. Canadian Journal of Psychiatry 63:54–64. doi: 10.1177/0706743717723825 [2] Regehr C, Carey MG, Wagner S, Alden LE, Buys N, Corneil W, et al. (2021). A systematic review of mental health symptoms in police officers following extreme traumatic exposures. Police Practice and Research 22(1):225-239 doi: 10.1080/15614263.2019.1689129 [3] Stelnicki AM, Jamshidi L, Fletcher AJ, Carleton RN (2021). Evaluation of Before Operational Stress: A program to support mental health and proactive psychological protection in public safety personnel. Frontiers in Psychology 12:511755. doi: 10.3389/fpsyg.2021.511755 Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: CONTROL OF LANGUAGE AND IDEAS Frank Anderson, MD, psychiatrist Source: ABC News Read time: 1.9 minutes plus brief video This Happened Two days after the attempted assassination of Donald Trump, a psychiatrist interviewed by ABC News warned viewers that you can develop PTSD by watching the video footage. Who Did This? Frank Anderson's personal website describes himself as an author, psychiatrist, therapist, speaker and “trauma specialist who’s spent the past three decades studying neuroscience and trauma treatment.” His website sells video trainings on Internal Family Systems theory—one 60-minute video for $50, three 60-minute videos for $149, and a more expensive six-video course. On the Internal Family Systems website, he is part of a team of presenters who sell twelve pre-recorded videos: This “$1,239.95 value [is] just $299.00 today.” He published a 2017 manual on Internal Family Systems therapy, a 2021 book on how to heal complex PTSD, and a 2024 autobiographical memoir of his childhood and adult struggles with shame and abuse. His memoir explained that he suffered childhood trauma when his parents took him to a psychiatrist for play therapy because they were concerned about his sexual orientation. His memoir was endorsed by Bessell van der Kolk and Gabor Maté. He appears frequently as a trauma expert on news shows and podcasts. The Claim In the adjacent 2-minute video clip, Dr. Anderson explained that individuals can get PTSD from watching the Trump assassination attempt or other violent videos. He further explained in a confusing change of topic his belief that there is a “sweet spot” of talking about violent video (not watching the video itself)—talking about the video several times is fine, but the harm occurs when talking about it six or ten times. Analysis
Those claims are wrong and debunked by evidence. There are no known case reports published of an individual developing PTSD from watching video violence toward a person they do not know personally. I have conducted or supervised the evaluations of over 500 trauma-exposed individuals in clinic work and five research studies on trauma, and have never encountered such a case. If Dr. Anderson knows of such a case, he ought to write it up: it would be the first one. The only known study of individuals exposed naturalistically to the same television footage of trauma and then assessed by interview involved children who witnessed the 1986 space shuttle Challenger explosion live in their classrooms [1]. None of the children had developed PTSD one year later. Nearly all other studies of viewing violent video were based on retrospective self-report questionnaires, methodologically flawed, and no subjects could be diagnosed with PTSD [2]. Anderson’s description of finding a sweet spot of talking about the events to prevent PTSD is misinformation. PTSD symptoms develop immediately following the moment of fear during trauma exposure in one hundred percent of cases. There is no evidence that talking about trauma events causes PTSD. His information about critical incident stress debriefing was mostly accurate but it’s relevant for decreasing severity of existing symptoms not causing or preventing them, and has nothing to do with watching violent videos. The individuals he described who watch or talk repeatedly about videos on purpose are the opposite of PTSD. In fact, individuals with PTSD typically avoid reminders about their experiences. REFERENCES [1] Terr LC, Bloch DA, Michel BA, Shi H, Reinhardt JA, Metayer S. Children's symptoms in the wake of Challenger: a field study of distant-traumatic effects and an outline of related conditions. American Journal of Psychiatry. 1999 Oct;156(10):1536-44. doi: 10.1176/ajp.156.10.1536. [2] Just one example of many such studies: Holman EA, Garfin DR, Lubens P, Silver RC (2020). Media Exposure to Collective Trauma, Mental Health, and Functioning: Does It Matter What You See? Clinical Psychological Science 2020, Vol. 8(1) 111–124, doi: 10.1177/2167702619858300 Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: GOVERNMENT PROJECTS Jim Kenney (D), former mayor of Philadelphia; Danielle Outlaw, former Police Commissioner Source: City Journal Read time: 1.7 minutes This Happened Trying to reverse Philadelphia’s slide as one of the worst major cities in the United States for homicides, violence, and crime, new mayor Cherelle Parker (D) declared a state of emergency based on crime In January 2024 immediately after taking office. During the 2023 race for mayor, Parker ran as a moderate compared to other progressive candidates by prioritizing public safety. She also selected new police commissioner Kevin Bethel. Since coming into office Mayor Parker and Commissioner Bethel cleared out the infamous Kensington open-air drug market and cracked down on illegal packs of ATV and dirt-bike riders. Why Is This Happening? These changes came on the heels of previous mayor Jim Kenney (D) who had refused to declare a state of emergency despite record homicides. The city had 561 murders in 2021, its highest total ever; 80% of victims were Black. Kenney had supported defunding the police and sanctuary city status. Bethel’s predecessor as police commissioner was Danielle Outlaw, who was lured from Portland, Oregon and hired in 2020. Emphasizing her status as the first Black woman to lead the police departments in Portland and Philadelphia, she had promised to tackle racism, gender discrimination, social injustice, inequity, and most of all, gun violence. Outlaw resigned in September 2023, shortly before the mayoral election, after three years of worsening crime under her watch. Philadelphia’s crime problems are also worsened by the policies of progressive DA Larry Krasner, who remains in office. The background of crime in Philadelphia, however, has older roots in the city’s failed attempts to use trauma-informed approaches. The Trauma-Informed Past of Philadelphia Philadelphia was the first major city to deploy large-scale public health efforts under the banner of trauma and toxic stress. As described in my book, The Trouble With Trauma: “In 2005, the Philadelphia Department of Behavioral Health and Intellectual Disability Services initiated a transformation of the city’s mental health services in order to address high unemployment and murder rates. The keystone of this transformation was the creation of a trauma-informed system based on the premise that exposure to trauma and violence was causing these problems with unemployment and murder. The transformation included efforts to train clinicians in evidence-based psychotherapy for PTSD, and to bring together a large number of community human-service organizations to train their staff according to the Adverse Childhood Experiences studies.” [1] Pulling together mental health experts, politicians, public health, and law enforcement, the plan essentially cast trauma as the largest public health issue we face in modern times, and we need massive funding for social programs to attack trauma on the order of the Manhattan Project that created the first nuclear bomb. It was supposed to address racism, inequities, and reduce violent crime. Mayor Parker’s new crackdown on crime and sudden rediscovery of law and order seems to confirm that toxic stress public health efforts didn’t work. Neither the Mayor nor the police chief mentioned the failure of the 2005 trauma-informed initiatives. REFERENCES [1] Scheeringa MS (2022). The Trouble With Trauma: The Search to Discover How Beliefs Become Facts. Las Vegas: Central Recovery Press. ISBN 978-1949481563 Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: COURTS From top left clockwise: Judge Sheila Calloway; Todd Orr, Alexandra Serralles, and Karla Iannicelli from DLR architecture firm Source: The Tennessean
Read time: 1.8 minutes This Happened A juvenile court judge and three associates from an architectural firm penned an editorial outlining their vision to provide services to juvenile criminals instead of incarceration. This includes plans to redesign the interiors of juvenile court buildings to replace the “damning architecture of yesterday.” Who Did This? Judge Sheila Calloway was elected Juvenile Court Judge in 2014 servicing Nashville and Davidson County. In her bio, she prides herself on challenging traditional perspectives in the legal system. She gave a TED Talk in 2017 advocating for restorative justice where criminals are viewed as victims of life experiences who just made some bad decisions. Todd Orr, Alexandra Serralles, and Karla Iannicelli are employees of DLR architecture firm. DLR is a large firm with 33 offices, specializes in government buildings, and champions the diversity, equity, and inclusion movement. The DLR site includes posts such as “How Design Can Decarcerate the U.S.” The Premise The editorial outlined their plans to redesign three buildings in the juvenile justice campus to help heal the wounds of adolescents who committed serious offenses based on the premise that “we don’t believe that young people are hardened, irredeemable criminals but are vulnerable individuals deserving of support and rehabilitation.” The Family Services building, where parents learn how to care for their children, is modeled after a living room and kitchen, instead of brick boxes, so that individuals do not feel isolated from the community. The Respite and Assessment Center will provide therapy, social services, and shelter for homeless youth instead of jail. The “pre-trial housing” will resemble college dorms rather than “cement, steel, and barbed wire” of jails. The editorial claimed that juveniles committed crimes in part because they were victims of trauma and adverse childhood experiences (ACEs), and it is scientific fact that trauma damages child development. They intend to break the “abuse-to-prison pipeline” be providing “services instead of incarceration.” Analysis The terms of progressive agendas are typically couched in humanitarian compassion—extraordinary promises of a better world where everyone is equal in capacities. They can also act as a balm of moral self-inflation, capable of convincing individuals that the evidence is what they assert, not what is proven. Despite the chorus of advocates for the toxic stress and ACEs agenda who claim the science is settled that trauma damages the brain and derails child development, it is not proven. In fact, the evidence far more often has disproven it (see here and here). The restorative justice agenda emerged as an alternative to traditional retributive justice in the 1970s. But after studies trickled in, a report in 2019 summarized the consistent lack of positive results. It is not surprising that these agendas merged within a relatively new offshoot of trauma-informed architecture. There are neither negative nor positive studies of trauma-informed architecture. Interior design change may seem like a trivial concern. The importance of it, however, is a constant symbolism of an intellectual framework driven by a misguided understanding of criminal behavior and human nature. Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: GOVERNMENT PROJECTS Megan Carson, First 5 Mendocino Commission Source: National Association of Counties Read time: 1.9 minutes This Happened First 5 Mendocino Commission brought together 42 agencies that support children’s wellbeing for its annual State of the Child summit in March. Speakers stressed that it is possible for children who encountered adverse childhood experiences (ACEs) to grow beyond those experiences. Who Did This? First 5 Mendocino is a government agency that falls under the California Children and Families Commission, also known as First 5 California. It is one of 58 county commissions funded by a California state proposition tax. The board that runs First 5 Mendocino is appointed by elected officials. Their charge is to create, support, or promote programs in the community focused on healthy child development in the first five years of life. The operationalization of that mission is an overarching metric of equity [1]. They emphasize that oppression, including institutional racism, creates intergenerational trauma. First 5 embraces the ACEs and toxic stress narratives which claim that “the events of childhood shape a person’s biology, personality, dreams, and aspirations: their entire trajectory of life” [1]. Their stance is that “very few families have the support they need” and it is the government’s job to provide them (pages 12-14). The Premise The premise of the summit was to shift participants’ focus to resilience. For the past two decades, the trauma advocacy movement was fixated on promoting the theory of brain damage caused by trauma. Megan Carson, Community Outreach Leader, said, “What we also started to realize was that people were getting hung up on that and losing hope.” The adjacent graphic shows the tree analogy, a fixture of the ACEs and toxic stress narratives, which displays an extraordinary assortment of societal stressors that presumably damage children’s brains and physical health [1]. Speakers included Tina Payne Bryson, social worker, director of a play therapy institute and book author who claims her works deploys the latest neurobiology research on the power of relationships to shape brain architecture and mold personalities. Georgie Wisen-Vincent, marriage and family counselor, co-author with Bryson, and director of the play therapy institute, advocates using play to process traumas. MaryCatherine McDonald, PhD, has been skeptical of using ACE scores to predict individual outcomes, and wrote a book that reframes trauma responses as the body’s natural adaptive responses rather than the breakage of fragile humans. Analysis Many within the sprawling movements of ACEs, toxic stress, and trauma-informed approaches have realized that they have a bit of a messaging problem. While their message that trauma damages the brain has been an eye-popping success at gaining adherents, the acceptance of this belief system ultimately can be a downer. It is ironic that movements that were born from marketing rhetoric find themselves hamstrung by their message. As a result, there has been a slew of branding by many groups to highlight resilience. Agencies [2], projects [3], bills [4], and a documentary [5] have incorporated resilience into their titles. Oprah Winfrey and her frequent guest, child psychologist Bruce Perry, have staked one of the most extreme positions that a nurturing relationship in the first two months of life represents a nearly irreversible period for neural development [6]. The science of resilience, however, is as misguided as the science of the trauma narrative that it supersedes. Both are based on the claim that humans are highly malleable and life experiences can mold nearly every aspect of character and predict human flourishing. While the virtue of providing good care for young children is not disputed, the claim that parenting practices can shape the architecture of brains and impact adult physical illnesses is unproven and disputed by empirical research [7]. REFERENCES [1] 2021-2026 Strategic Plan. First 5 Mendocino Commission. https://first5mendocino.org/first5-flipbook/PDF.pdf [2] Doña Ana County Resilience Leaders (New Mexico); UCLA-UCSF ACEs Aware Family Resilience Network; Hawaii Governor’s Office of Wellness and Resilience; Idaho Resilience Project [3] Healthier Together Initiative Growing Resilience in Teens (GRIT) Grant Program (Philadelphia); North Carolina Center for Resilience & Learning; Community Resilience Initiative (Washington state); MassBay Community College, Institute for Trauma, Adversity, and Resilience in Higher Education [4] Resilience, Investment, Support, and Expansion from Trauma Act, federal H.R. 4541 bill [5] Resilience: The Biology of Stress & the Science of Hope (2016). James Redford and Karen Pritzker (producers). KJPR Films. [6] Bruce D. Perry, M.D., Ph.D. & Oprah Winfrey (2021) What Happened To You? Conversations On Trauma, Resilience, and Healing. New York: Flatiron Books [7] Judith Rich Harris (1998), The Nurture Assumption: Why Children Turn Out the Way They Do. New York: Free Press Scheeringa MS (2018). They’ll Never Be The Same: A Parent’s Guide to PTSD in Youth. Las Vegas: Central Recovery Press. ISBN 978-1942094616 Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: SCHOOLS Left: David Colley, PhD, Oxford Brookes University. Right: Laura Dennis, Education Outreach Lead, Mulberry Bush Source: Oxford Mail Read time: 2.2 minutes This Happened On June 20, 2024, the Mulberry Bush charity sponsored a one-day conference on ways to address childhood trauma in schools. Who Did This? Mulberry Bush, a 75-year-old charity based in Standlake, UK, conducts trainings and runs a residential school of about 20 students, ages 5 to 12, who have suffered some form of trauma. Laura Dennis, a former school teacher, is the Education Outreach Lead. The university co-host was Oxford Brookes University, led by David Colley, PhD, in the School of Education. Colley has published several papers supportive of nurture groups in schools. The Premise This Research Conference goal was to disseminate the findings from several projects that have attempted to embed trauma and attachment training in UK schools.
Analysis This conference is an example of how the trauma-informed approaches movement is not just popular in the US. It also has strong footholds in Northern Ireland, Wales, Scotland, Australia, and perhaps other countries. The most well-developed of the programs in the conference is the nurture group model, which was developed in the 1970s and is now implemented in over 2,000 schools in the UK [1].
This model shares similarities with some American models of supporting troubled children, but there are no known nurture groups in the US. NurtureUK, a charity for promoting the nurture group model, released a report in 2019 stating that more than 100 studies have found positive effects from nurture groups. The model was hailed as a tremendously successful program that likely pays for itself after just two years. A literature review in 2014, however, found only twelve outcomes studies [2] which had multiple major limitations. None of the studies were randomized. As such, no studies had outcomes measured with blind raters. While some behaviors improved, no studies found improvements in academic tests. There is no known financial analysis that shows that nurture groups pay for themselves. Only one study had a follow-up that measured outcomes beyond the end of a school year. Researchers re-assessed children a mean of 2.7 years after the group ended, but they managed to follow only 12 of the 68 children who started the study. These children did not significantly improve on 16 of 20 domains that were tested [3]. The training for teachers in this model shares a common goal with the other trauma-informed approaches of instilling a culture in the belief of a misleading narrative of neuroscience that has been debunked. They embrace the toxic stress narrative that prolonged stress becomes toxic, and high levels of cortisol “can impact the developing brain and alter the structure and function of key brain areas” [1]. REFERENCES [1] Nurture Groups (booklet) (2019). Published by NurtureUK, https://www.nurtureuk.org/wp-content/uploads/2021/10/Nurture-Groups-Booklet-Dec-2019.pdf [2] Naomi Katherine Hughes & Annette Schlösser (2014) The effectiveness of nurture groups: a systematic review, Emotional and Behavioural Difficulties, 19:4, 386-409, DOI: 10.1080/13632752.2014.883729 [3] O’Connor, T., and J. Colwell. 2002. The Effectiveness and Rationale of the ‘Nurture Group’ Approach to Helping Children with Emotional and Behavioural Difficulties Remain Within Mainstream Education. British Journal of Special Education 29 (2): 96–100. Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. Article reviews old debate on how to define trauma events. But what is the debate really about?6/30/2024
CATEGORY: CONTROL OF LANGUAGE AND IDEAS Brian P. Marx, Ph.D., National Center for PTSD, and Department of Psychiatry, Boston University Source: Marx et al., 2024 [1] Read time: 2.5 minutes This Happened In February 2024, the leading trauma research journal published a review article attempting to bring some clarity to the controversy about how a traumatic event ought to be defined. Who Did This? Brian P. Marx, Ph.D. is a psychologist who specializes in posttraumatic stress disorder (PTSD). His work has focused on the assessment of and effective treatment for PTSD. The Premise When making the diagnosis of PTSD, the first gatekeeper criterion is whether an individual experienced a truly traumatic event or not. In the diagnostic criteria, the event is called Criterion A. If the definition of Criterion A is too narrow, individuals with PTSD won’t get the diagnosis. If the definition is too broad, individuals will be falsely diagnosed, potentially receive the wrong treatment, and contaminate the validity of research studies. The controversy about how to define traumatic events is as old as PTSD itself, stemming to its birth in 1980. Marx argued that a new review was needed because of current events—race-related events and the COVID-19 pandemic presented new quandaries with energetic challengers. Marx organized the evidence by noting that there are four sides in the debate: (1) Keep criterion A the way it is, which is restricted to life-threatening events that are either directly experienced, witnessed happening to others, or learning about events secondhand that happened to loved ones. (2) Broaden criterion A to include non-life-threatening events, such as divorce, expected death of a loved one, financial stress, giving birth, and racial discrimination. (3) Narrow criterion A to only events that are directly experienced and witnessed, and exclude events that are learned about secondhand. (4) Eliminate criterion A because any attempt to comprehensively define all events will always leave some ambiguity. Marx and colleagues recommended option #1—keeping criterion A the way it is—because the evidence for the other options is too weak or logically indefensible. Analysis The review covered the relevant issues thoroughly and without bias, and came to a sensible (mostly) conclusion supported by evidence. As review articles go in psychiatry, it's one of the better ones. The authors respected all opinions by creating four sides to the argument, but, in reality, there are only two main sides—those who want to keep it the way it is (#1) and those who want to broaden it (#2). Option #3 for narrowing criterion A probably should have been the recommendation, but it’s close to splitting hairs. The gatekeeping is implemented according to #3 in all good studies based on common sense, so it does not generate many vocal supporters. Option #4 for eliminating criterion A comes from a small but vocal, radical group who advocate for a range of other extraordinary ideas. What’s missing was an analysis of why this debate was stoked in the first place. Why Is This Happening? Nearly all the heat, and a swarm of weak studies, for changing criterion A comes from the efforts of those who want to broaden it to include non-life-threatening events. This effort is largely ideologically-driven, not science-driven. The strategic benefit for non-life-threat events to gain standing within PTSD is that it gives the appearance of authenticity to the premise that human nature is highly malleable to everyday stressful events of modern society (as opposed to the less common, truly terrifying, life-threatening events). This is fundamentally a difference in how one views human nature. This view of high malleability is key to progressive leftist advocacy movements that fighting for the care of disadvantaged and minority groups must trump other personal rights and societal obligations. The same skewed moral sentiment that drives the redistribution of wealth in the welfare state and socialism to rectify harms done to the disadvantaged is the same sentiment that attempts to elevate everyday stressors—including poverty, neglect, parental incarceration, pollution, racial discrimination, transgender discrimination, and historical treatment of minority groups—to be considered harmful, traumatic events, and sometimes even public health crises, as in the cases of COVID-19 and climate change. No good research evidence exists, however, that those types of stressors cause the harm of PTSD. If academia can control the language and ideas of science by redefining stress as life-threatening trauma, it controls an important narrative for leveraging policy, laws, and public health mandates. The attempt to redefine trauma has almost never been about science; it’s about conflating social justice with research. REFERENCES [1] Marx, Brian P; Hall-Clark, Brittany; Friedman, Matthew J; Holtzheimer, Paul; Schnurr, Paula P (2024). The PTSD Criterion A debate: A brief history, current status, and recommendations for moving forward. Journal of Traumatic Stress 37(1):5-15, doi 10.1002/jts.23007 Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: GOVERNMENT PROJECTS Nancy Osborn, MEd, PhD, KC Healthy Kids Source: KSHB 41 Kansas City Read time: 1.4 minutes plus 30-second video This Happened In June, 2024, a local nonprofit called KC Healthy Kids provided trauma-informed training for librarians and staff of Kansas City public libraries. Who Did This? The training was provided by counseling psychologist Nancy Osborn, MEd, PhD with KC Healthy Kids. Funding for the training was provided by the city of Kansas City, Missouri. The Premise The need for the training was described as library patrons often bring the problems of the outside world with them, such as not being civil, mental illness, and homeless people. According to the KC Healthy Kids website, their training includes the standard topics of trauma-informed care:
The 30-second video below explains what the training might accomplish: Another aspect that is common to all trauma-informed trainings is the claim that the science has been settled that trauma embeds itself in your body, damages brain centers, and rewires neural networks. The assertion of this neuroscience narrative is taken as settled science in trainings and serves as the crisis that makes these trainings so urgent. Analysis Despite the assertion of trainers, the science does not show conclusively that trauma damages brains. As Trauma Dispatch has documented here and here, the toxic stress and adverse childhood experiences narratives are based on weak, cross-sectional studies. When pre-trauma, prospective studies have been conducted, they consistently do not support the stress-damages-the-brain theory [1]. Rather than trauma causing brain changes, a more likely theory, and biologically much more plausible, is that of preexisting differences (also known as diathesis stress theory)—individuals who are vulnerable to the psychological effects of trauma had brain differences based on genetics that existed prior to experiencing trauma. Does it really help to approach difficult patrons from the stance that they could be trauma victims? Here, understanding their claims of brain damage is a crucial point. Activists would like us to believe that their approach is based on science. But realizing the evidence is absent, it’s clear that trauma-informed care is an ideology, making it evident that the point is not about actually helping patrons. It’s about installing an intellectual framework in society that humans are fragile, one training at a time. This framework of human nature has been underlying progressive leftist theory since Marx’s moral prophecies were promoted as science, and can be traced even earlier in philosophies such as Rousseau’s noble savage. As the reporter said in the video: the most important goal of training is to create a perspective shift. REFERENCES [1] Andrea Danese et al. "The origins of cognitive deficits in victimized children: Implications for neuroscientists and clinicians," American Journal of Psychiatry 174 (2017): 349-361. Julia A. DiGangi et al. “Pretrauma risk factors for posttraumatic stress disorder: A systematic review of the literature.” Clinical Psychology Review 33 (2013):728-744. Michael S. Scheeringa. "Reexamination of diathesis stress and neurotoxic stress theories: A qualitative review of pre-trauma neurobiology in relation to posttraumatic stress symptoms," International Journal of Methods in Psychiatric Research (2020). Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. CATEGORY: GOVERNMENT PROJECTS Mikey Latner, founder, Project:Camp Source: WESH 2 news Read time: 2.5 minutes This Happened The staff of a traveling camp to help children cope with disaster held a practice camp with local agencies in Seminole County, Florida to prepare for the next hurricane. Who Did This? Project:Camp bills itself as a disaster response organization, traveling nationwide to provide free, trauma-informed childcare for families impacted by natural disasters. Based in Los Angeles, their team travels the country to set up pop-up camps, often in collaboration with a local government agency. Their website touts experience with a fire in New Mexico, tornados in Iowa and Oklahoma, and the Maui wildfire. Mikey Latner, a former camp director, is the founder of Project:Camp. The Premise At the practice camp, children engaged in typical camp activities, such as science and art projects, and watched movies. In addition, they were encouraged to process their feelings in gratitude circles and regular check-ins. This pilot camp was a collaboration with the Seminole County Emergency Management office. The camps seem to have two purposes. One is to provide childcare; give children safe, fun activities while parents can focus on disaster recovery. The other is therapeutic; to help children deal with their negative feelings about the disaster. The Project:Camp website asserts that the camps use a trauma-informed model to “help break up the formation of trauma.” It’s not clear what formation of trauma means, but it likely means to reduce post-traumatic stress symptoms. Analysis The childcare aspect of the camps appear to be an imaginative method that helps parents focus their time and energy on disaster cleanup and repair. But there are many concerns about the therapeutic activities that the camp organizers do not seem aware of. First, there doesn’t seem to be a requirement that children have emotional issues following disasters to attend the camps. It’s not clear that any children who enroll will need emotional assistance. Second, as recent surveys have shown major increases in youths acknowledging their unhappines, arguments have been made that this may be an unintended consequence of society and overconcerned adults constantly sending messages to children that they are fragile [1]. It is possible that gratitude circles and emotional check-ins will send messages to children that they should be upset about something, which may become a self-fulfilling prophecy. Third, their staff have much experience in running camps for children but do not include any licensed counselors or child development experts. Their board of directors and board of advisors also lack clinical experience. Fourth, the developmental expectations for these children seem unrealistic. Pre-adolescent children do not have fully-developed abstraction and self-reflection skills to understand when and why they should seek emotional assistance from adults and peers. Except perhaps for the more extroverted children, children have good intuition to not disclose scary feelings to virtual strangers. Fifth, universal interventions for individuals who are not asking for help have been shown to do more harm than good. Studies have shown that debriefing with adults immediately following traumatic events seems to worsen their symptoms [2]. Following 9/11 and Hurricane Katrina, agencies implemented universal interventions in classrooms; there was anecdotal evidence that showing images and recounting stories of the disaster were the first exposures some children experienced. Vicarious trauma was experienced by children in schools who had previously been protected from exposure to the disaster. Sixth, even if the camps could be helpful, it is unlikely that families will bring their children. Massive trauma treatment programs have already been attempted following 9/11, Hurricane Katrina, and the Queensland floods and they have all failed to attract many participants, even when services were free [3]. Seventh, while camp is a fun setting that may attract more individuals than prior post-disaster programs, there is no research support for this new method. Based on the large amount of experiences with disaster programs outlined above, this type of program that aims to help children is likely to provide no real help at all, and may instead cause harm. Why Is This Happening? Promoting itself as “trauma-informed childcare” [4] the camp is another iteration of the trauma-informed approach movement that has swept over the United States and other countries in the past ten years. Trauma has become the catchword of the decade [5] and the loadstar for all progressive policies to fix society’s ills. Trauma Dispatch has documented many of these programs in schools, courts, and government policies. REFERENCES [1] Shrier; Candice L. Odgers (May 21, 2024). The panic over smartphones doesn’t help teens. It may only make things worse. The Atlantic, https://www.theatlantic.com/technology/archive/2024/05/candice-odgers-teens-smartphones/678433/ Abigail Shrier (2024). Bad Therapy: Why the Kids Aren’t Growing Up. Sentinel. [2] Rose SC, Bisson J, Churchill R, Wessely S. Psychological debriefing for preventing posttraumatic stress disorder (PTSD). Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD000560. DOI: 10.1002/14651858.CD000560. Accessed 23 June 2024. [3] Scheeringa MS, Cobham VE, McDermott B (2014). Policy and administrative issues for large-scale clinical interventions following disasters. Journal of Child and Adolescent Psychopharmacology 24(1), 39-46, doi: 10.1089/cap.2013.0067. [4] Project:Camp website, https://projectcamp.co/preparing-communities [5] Lexi Pandell (January 25, 2022). How trauma became the word of the decade. Vox, https://www.vox.com/the-highlight/22876522/trauma-covid-word-origin-mental-health Like Trauma Dispatch? You can subscribe to our email notices of new posts on this page. |
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