COVID-19 Interconnectedness: Health Inequity,the Climate Crisis,and Collective Trauma

The COVID-19 pandemic brings to the forefront the complex interconnected dilemmas of globalization, health equity, economic security, environmental justice, and collective trauma, severely impacting the marginalized and people of color in the United States. This lack of access to and the quality of healthcare, affordable housing, and lack of financial resources also continue to have a more significant impact on documented and undocumented immigrants. This paper aims at examining these critical issues and developing a framework for family therapists to address these challenges by focusing on four interrelated dimensions: cultural values, social determinants of health, collective trauma, and the ethical and moral responsibility of family therapists. Given the fact that family therapists may unwittingly function as the best ally of an economic and political system that perpetuates institutionalized racism and class discrimination, we need to utilize a set of principles, values, and practices that are not just palliative or after the fact but bring forth into the psychotherapeutic and policy work a politics of care. Therefore, a strong call to promote and advocate for the broader continuum of health and critical thinking preparing professionals to meet the challenges of health equity, as well as economic and environmental justice, is needed. The issues discussed in this paper are specific to the United States despite their relevance to family therapy as a field. We are mindful not to generalize the United States' reality to the rest of the world, recognizing that issues discussed in this paper could potentially contribute to international discourse.     

So You,My Children,Can Have a Better Life: A Cambodian American Perspective on the Phenomenology of Intergenerational Communication about Trauma

We address this question: How do Cambodian American young adults come to know about their family’s experiences of trauma? Using a social constructivist critical ideological approach, we developed a phenomenological model describing intergenerational communication about trauma (IGCT) in Cambodian American families. We found IGCT to be an interactional process in which younger and older generations each played a role. IGCT was influenced by the availability of multiple sources of information and opportunities for learning, interpersonal connectedness between the generations, emotional distress tolerance, and having motivation to empathically learn and share. When these factors were abundant, direct interactive IGCT was more likely. When wanting, the IGCT was more disrupted and incoherent, filled with emotionally charged silence and lead to negative attributions. IGCT was a dynamic process that could change over time to accommodate developmental change. Limitations of the findings, clinical implications, and future directions are discussed.     

From horror to ethical responsibility: Carl Gustav Jung and Stephen King encounter the dark half within us,between us and in the world

This paper explores the experience of horror. The term is usually understood collectively to refer to experiences of terrorism, racism and other conflicts; however, the paper explores the equal horror for the individual of facing deep and painful psychic contents and traumatic experiences. The paper explores the way that both C.G. Jung, through analysis of the psyche, and the author Stephen King, through his horror novels, have accepted and explored the experience of encountering ‘the dark half’ or ‘It’ that is the other within themselves, forming images and symbols capable of linking their personal experience to that of the collective. This encounter is transformed, as far as Jung is concerned by analytical psychology and for King by fiction, through an attitude of active imagination. This led both men to developing an ethical responsibility towards the images of the unconscious, as well as the personal and collective contents of human life. The paper depicts how encountering the ‘dark half’, through Jung and King can provide a Jungian analyst with a special attitude with which to deeply explore and ethically process the experience of horror in different fields, including therapeutic practice, analytical training and in the traumatic and conflictual facing of the other, with which, today as always, the world presents us.     

Measuring the impact on relatives of caring for people with Alzheimer's disease: Quality of life,burden and well-being

Abstract

This study compared key correlates of caregiver stress in 50 Alzheimer's disease patients and their primary caregivers. in relation to three outcome measures - perceived burden, psychological well-being, and quality of life (QoL). These were evaluated using the Zarit Burden Interview. General Health Questionnaire (GHQ-30), and Schedule for the Evaluation of Individual QoL (SEIQoL-DW) respectively. Informal social support was evaluated on Vaux's Social Support Appraisal Scale. Patients' cognitive. functional, and behavioural status were rated on Mini-Mental State Examination, Blessed-Roth Dementia Scale. and Baumgarten Dementia Behaviour Disturbance Scale respectively. Standardised multiple regression analysis was used to compare the outcome measures. In this model burden was highly related to behaviour disturbance. and also to social support (adjusted R² = 0.45). Well-being was significantly related to behaviour disturbance, and also to functional status (adjusted R² = 0.40). With regard to QoL the model performed poorly as most of the variance in QoL was not accounted for by the model (adjusted R² = 0.14). These findings highlight differences in factors determining caregiver QoL. burden and well-being.     

A developmental origins perspective on the emergence of violent behavior in males with prenatal substance exposure

Children with prenatal substance exposure are at increased risk for externalizing behavior problems and violence. However, the contribution of early life experiences for placing these individuals at risk is not well understood. Utilizing a sample of 1,388 children with prenatal substance exposure from the Maternal Lifestyle Study, we attempt to shed light on these contributing factors by examining the impact of infant temperament, maternal sensitivity, and early life stress on the expression of violent behavior at ages 12 through 14 years. Males may be more at risk for increases in violent behavior in early adolescence through a number of early life experiences, such as variability in responses to maternal flexibility and engagement related to individual differences in temperament, as well as exposure to early adversity. Comparing two prevailing developmental theoretical frameworks, deficit models and differential susceptibility, we aim to understand the developmental origins of violent behavior in males by identifying children who may be most susceptible to early caregiving experiences.     

‘Clemency on the way to the gallows’: death,dreams and dissociation

The survivor of a decade of childhood sexual trauma and violence, perpetrated by a monstrous father, produced a series of dreams in the final year of a ten‐year analysis. They illuminated the ‘death drive’ beneath a lifelong preoccupation with dying and fantasies of submission to death, perpetuated by the promise of hoped‐for freedom from pain and release from a life of suffering. The initial dream involved the collapse of a team of white horses drawing him in a pillory cart to his own hanging for a crime he did not commit. It signified the collapse of a fragile psychological system based on his role as the ‘sacrificial lamb,’ protecting a (not so) innocent mother. The raw truth was now unconcealed: primal, violent, and terrifying dreams and affects emerged where he was now the murderous aggressor. His dreams would become primary agents for an instinctive, life‐giving authenticity to emerge, offering him clemency from the shattering repetitions of persecution and dissociation.