Twenty Years Post‐genocide: The Creation of Mental Health Competence among Rwandan Survivors Through Community‐based Healing Workshops

Twenty years after the genocide, many Rwandans still suffer from the psychological wounds of the past. The country's mental health agenda is based on individualised and psychiatric approaches that help some but cannot be provided on a large scale. Further, many reconciliation initiatives have been based on public testimonies, which have been shown to be potentially re‐traumatising, leading to calls for small‐scale community‐based approaches to healing, which constitute a middle way between individualised and public approaches. Drawing on the concept of ‘mental health competence’ (Campbell and Burgess, 2012), this study evaluates one such approach: the Life Wounds Healing workshops offered by the African Institute for Integral Psychology. Twenty‐one semi‐structured interviews were conducted with former workshop participants, staff members and the institute's founder to investigate their views on how these workshops can help genocide survivors. The results suggest that the workshops succeed in creating mental health competence by establishing a safe social space for people to open up, increasing people's critical understandings of the processes of pain — and potential for healing — that informs behaviour change, generating bonding social capital and offering participants' income‐generating possibilities. Copyright © 2015 John Wiley & Sons, Ltd.     

Two boys—one event

The background of this paper is an investigation of child survivors from the Holocaust; in a study of interviews of these survivors, it could be concluded that past traumatic experiences are recovered not as memories (in the usual sense of the word), but as affects invading the present. Accordingly, affects seem to tell the story of the past traumatic experiences. In this paper, the author investigates two accounts (separately told by two survivors) of the same event in the Kielce ghetto. The two accounts present similarities, but also differences, and the author discusses these in relation to the concepts of historical and narrative truth, as well as in relation to construction and reconstruction, concluding that the interviews give a sketch of how the experiences have become idiosyncratically registered in the minds of the interviewees.     

‘Slow’ reproductive strategy: A negative predictor of depressive symptomatology

The present study examined the associations between a high‐K (slow) life history strategy and depressive symptomatology. The participants were a sample of 494 male utility workers who underwent psychological evaluations. It was hypothesised that high‐K will correlate negatively with, and will be a negative predictor of, depressive symptomatology. The results confirmed the predictions, showing that high‐K accounts for 15% of the variance in depressive symptomatology after controlling for risk factors for depression such as demographics, prior traumatic experiences, past depression, and recent negative life events. Implications of the results are discussed.     

The Lingering Effects of Our Past Experiences: The Sunk‐Cost Fallacy and the Inaction‐Inertia Effect

The effect of past experiences and actions in shaping current perceptions, emotions, decisions and goals is widely recognized in the psychological literature. When it comes to economic decisions, however, these influences are sometimes seen as impediments to rational decision‐making. In an attempt to explore the enduring consequences of the past, we present, compare, and discuss two familiar behavioral phenomena: The sunk‐cost effect, which refers to situations where continued actions are fueled by past investments, and the inaction‐inertia effect, in which continued inaction is triggered by the shadows of missed opportunities. Although one process elicits continued action and the other continued inaction, we show that there is a great deal of similarity in the psychological underpinnings of these effects, and argue that respecting sunk costs and avoiding actions that are associated with forgone opportunities are not necessarily unreasonable, or maladaptive behaviors.     

When the Third is Dead: Memory,Mourning, and Witnessing in the Aftermath of the Holocaust1

The origins of psychoanalysis, as well as the concerns of our daily endeavors, center on engagement with the fate of the unbearable – be it wish, affect, or experience. In this paper, I explore psychological states and dynamics faced by survivors of genocide and their children in their struggle to sustain life in the midst of unremitting deadliness. Toward this continuous effort, I re‐examine Freud’s theoretical formulations concerning memory and mourning, elaborate André Green’s concept of the ‘Dead Mother’, and introduce more recent work on the concepts of the ‘third’ and ‘thirdness’. Throughout, my thoughts are informed by our clinical experience with the essential role of witnessing in sustaining life after massive trauma. I bring aspects of all these forms of knowing to reflections about a poem by Primo Levi entitled Unfinished business and to our own never finished business of avoiding denial while living in an age of genocide and under the aura of uncontained destructiveness.     

Volunteer work as a valuable leisure‐time activity: A day‐level study on volunteer work,non‐work experiences,and well‐being at work

In this 2‐week diary study, with 105 employees providing data on a total of 476 days, we examined relationships between the amount of time spent on volunteer work activities during leisure time, psychological non‐work experiences in the evening (i.e. recovery experiences of psychological detachment from work and mastery as well as need satisfaction), and work outcomes during the following working day (i.e. positive and negative affect, and active listening). Results confirmed the hypothesized positive relationships between the amount of time spent on volunteer work activities and psychological detachment from work, mastery experiences, and need satisfaction in the evening. Psychological detachment from work in the evening was positively related to active listening during the following working day. Need satisfaction in the evening was negatively related to negative affect and positively related to active listening during the following working day. The amount of time spent on volunteer work activities was negatively related to negative affect during the following working day. This relationship was mediated by need satisfaction in the evening.     

Betingad avslappning vid migrän

Some psychotherapists believe that certain experiences are so overwhelmingly traumatic that some victims become incapable of remembering their worst trauma except under special circumstances (e.g. therapy) many years later. Unfortunately, clinicians who endorse this concept of traumatic amnesia often misinterpret the very studies they adduce in support of it. More specifically, they misinterpret other, unrelated memory phenomena as evidence for traumatic amnesia, such as ordinary forgetfulness, psychogenic amnesia, organic amnesia, incomplete encoding of traumatic experiences, non‐disclosure of remembered trauma, and simply not thinking about something for a long time. The purpose of this article is to dispel confusions rampant in this literature.     

A thematic analysis of practitioners' understanding of domestic abuse in terms of post‐traumatic stress disorder (PTSD) and complex‐PTSD (C‐PTSD)

There is a growing body of evidence suggesting that domestic abuse (DA) should be conceptualised within the complex post‐traumatic stress disorder (C‐PTSD) model. Recently, in the draft of the International Classification of Diseases, Eleventh Revision, produced by the World Health Organization (WHO), C‐PTSD was included as a separate criterion in which DA is incorporated (ICD‐11, WHO, 2018). In this study, a thematic analysis was used to explore to what extent practitioners working with DA survivors are familiar with PTSD and C‐PTSD. Research into such a prevalent and detrimental problem as DA is important to understand whether the development of theoretical knowledge about DA and C‐PTSD is addressed in practice. In a Women's Centre in South London, six semi‐structured interviews with middle‐aged female practitioners were conducted to investigate each counsellor's experiences, knowledge and reflections. Six final themes were constructed to summarise the main results. The findings demonstrate limited practitioner understanding of DA in terms of C‐PTSD, which seems to impact not only the effectiveness of treatment plans with DA survivors, but also counsellors’ own psychological and physical states. It is also indicated that DA can be conceptualised within the C‐PTSD model that corresponds with previous literature indicating the complex nature of DA. The overall results of the current research acknowledge that DA sectors should not be neglected and better funding and effective psychoeducation in this field are needed.     

The Comprehensive Resource Model®: Overview of basic affects in adversity & effective treatment for complex reactions to trauma

Much of the theoretical focus in post‐traumatic stress disorder has been on the role of the amygdala, the hippocampus and the prefrontal cortex. Crucially, in unresolved traumatic experiences that underlie clinical presentations, this focus misses the brain areas key to the defence responses of fight, flight and freeze—and the associated affects of anger, fear and grief. The periaqueductal gray in the midbrain, with the hypothalamus, is essential for these somatic and emotional responses to traumatic experiences. We argue that when treatment approaches thought to work at the higher brain levels have been ineffective, it is because they have failed to engage the midbrain and hypothalamic sources of the affective responses to the trauma and to the memory of it. Basic affects have been so overwhelming that dissociation, or a similarly protective neurochemical capping mechanism, has prevented full resolution of the affective content of the adversity. Treatment with the Comprehensive Resource Model^® (CRM) aims to clear the clinically relevant residues of adverse experiences by resolving the emotional responses accessed through the body memories. When the trauma has led to overwhelming distress, and/or dissociation, there is a necessity for robust resourcing to be in place before the emotional intensity of that distress is accessed. Resourcing needs to be as proximal to the re‐experience as possible to promote complete resolution and in some psychotherapy modalities, the supports provided are somewhat remote from the crucial moments of processing. Therefore, we describe how the CRM seeks to have robustly resourced states present concurrently with traumatised states to avoid overwhelming emotional distress. This allows safe entry into the deepest pain residual from the traumatic event so that it is not overwhelming during processing of the memory, and does not lead to further dissociation, allowing the individual to remain fully present throughout. This “stepping into the affect” can then be so rapidly effective that we also argue that CRM is not an exposure treatment; re‐orientation to the deepest content of the experience resolves the residual distress quickly and permanently through memory reconsolidation. Re‐learning at upper brain levels will then follow from the revoking of the affective power, which has previously driven stimulus/context and response learning in the amygdala, hippocampus and prefrontal cortex.     

Hurry up! The role of supervisors’ time urgency and self‐perceived status for autocratic leadership and subordinates’ well‐being

This study examines the connections among supervisors’ time urgency, their leadership behavior, and subordinate outcomes. Integrating cognitive perspectives on time urgency with contemporary thinking on the psychological experience of status, we reason that supervisors’ time‐urgent personality relates positively with their autocratic leadership behavior, and we cast supervisors’ self‐perceived status as a moderator of this linkage. Moreover, we enrich this leader‐centric perspective with a complementary, more follower‐centric view, recognizing that the consequences of supervisors’ time urgency likely extend beyond their own behavior to indirectly affect their subordinates’ well‐being at work. We tested our hypotheses using a field sample of 60 supervisors and 277 of their subordinates. Results indicate that (a) supervisors with higher time urgency are more likely to exhibit autocratic leadership behavior when they also perceive themselves as having relatively high status among subordinates, but not when perceiving lower status, and (b) supervisors’ time urgency exhibits a conditional indirect effect (via autocratic leadership) on subordinates’ work stress and time pressure experiences. Hence, this study illustrates an important boundary condition for the consequences of supervisors’ time urgency, and it demonstrates that this personality characteristic not only shapes supervisors’ leadership behavior but also affects the subordinates they are charged with leading.     

‘Pain Always Asks for a Cause’: Nietzsche and Explanation

Those who have emphasised Nietzsche's naturalism have often claimed that he emulates natural scientific methods by offering causal explanations of psychological, social, and moral phenomena. In order to render Nietzsche's method consistent with his methodology, such readers of Nietzsche have also claimed that his objections to the use of causal explanations are based on a limited scepticism concerning the veracity of causal explanations. My contention is that proponents of this reading are wrong about both Nietzsche's methodology and his method. I argue for this by: first, showing that Nietzsche was suspicious of causal explanations not only on sceptical grounds but also for reasons provided by his psychological analysis of our tendency to look for causes; and second, arguing for a non‐causal interpretation of Nietzsche's approach to psychological explanation.     

A longitudinal investigation of the reliability of memories for trauma and other emotional experiences

This study examined the relative consistency and characteristics of memories for trauma and other non‐traumatic emotional experiences over time. A community sample of 52 participants who reported a recent traumatic event were asked to recall both the traumatic and a positive emotional experience in two interviews separated by approximately three months (M = 105.39 days). The recollections were elicited with either a free narrative, cognitive interview, guided imagery, or written narrative approach. Results indicated that traumatic experiences were recalled more reliably over time than other emotional experiences. Traumatic memory imagery tended to persist in memory (with no apparent impairment), whereas features of positive memories were subject to considerable distortion, regardless of interview style. The findings contribute to the understanding of the impact of trauma on memory with the passage of time. Copyright © 2004 John Wiley & Sons, Ltd.     

Psychological‐Mindedness and American Indian Historical Trauma: Interviews with Service Providers from a Great Plains Reservation

The concept of historical trauma (HT) was developed to explain clinical distress among descendants of Jewish Holocaust survivors and has since been ascribed new meanings to account for suffering in diverse contexts. In American Indian (AI) communities, the concept of AI HT has been tailored and promoted as an expanded notion of trauma that combines psychological injury with historical oppression to causally connect experiences with Euro‐American colonization to contemporary behavioral health disparities. However, rather than clinical formulations emphasizing psychological injury, a focused content analysis of interviews with 23 AI health and human service providers (SPs) on a Great Plains reservation demonstrated strong preferences for socio‐cultural accounts of oppression. Reflective of a local worldview associated with minimal psychological‐mindedness, this study illustrates how cultural assumptions embedded within health discourses like HT can conflict with diverse cultural forms and promote “psychologized” perspectives on suffering that may limit attention to social, economic, and political determinants of health.     

The adaptation process of mothers to the birth of children with Down Syndrome and its psychotherapeutic assistance: A retrospective approach

The findings of Niwa/Tanaka's studies on mothers' adaptation process to Down Syndrome infants through prospective and long-term intervention were reeaxmined through mothers' retrospective accounts of their past experiences. Fifteen mothers volunteered to participate in clinical interviews prepared for this purpose. The following results were obtained from the interviews: (1) The adaptation of mothers of Down Syndrome children involved a process enduring far beyond the initial shock, so that long-term longitudinal support and intervention, both developmental and psychotherapeutic, were necessary; (2) The subjects experienced intense psychological shock twice before their children reached school age, as we had predicted through our clinical experiences. An adaptation process consisting of five stages was observed; (3) Although the maternal affects experienced by the Japanese mothers in their process of adaptation generally looked similar to those of American and British mothers, some affective reactions were discovered that seemed to reflect existing Japanese social conditions and cultural peculiarities by which these mothers were deeply influenced; (4) A tentative model for intervention to support mothers' adaptatipn process is proposed based on the findings of the present study.     

“Hey mom, look at me!”

The degree to which infant and maternal characteristics were related to maternal psychological distress and play competence was examined in 40 mother preterm and full-term dyads. Measures of maternal psychological distress, self-efficacy, infant temperament, and mother-infant interaction in a play situation, were obtained at 4 months corrected for prematurity. Results revealed that maternal self-efficacy was the strongest correlate of maternal psychological distress but was not related to maternal play competence. Interaction effects for unadaptable temperament and infant behavioral involvement were found in the regressions predicting both maternal psychological distress and maternal play competence. Mothers of more adaptable and less behaviorally involved infants reported greater psychological distress and exhibited greater play competence than mothers of more adaptable and involved infants. The results suggest that a lack of concordance between mothers' perceptions of their infants' behavior and actual behavioral experiences adversely affects mothers' affect and the quality of their play interactions.     

Working in Indigenous Contexts: Self‐Reported Experiences of Non‐Indigenous Australian Psychologists

Despite assertions in the literature that psychologists adopt culturally inappropriate strategies for working with Indigenous clients, there is little empirical evidence about this. The aim of this study was to document the self‐reported experiences of non‐Indigenous psychologists working with Indigenous clients, the factors that they felt constrain these interactions, and the clinical, assessment and communication strategies they perceived as effective in Indigenous contexts. Structured interviews were held with 23 psychologists, 18 females and five males, with age groups ranging from 20–30 to 50+. Thematic analysis of the data revealed that participants experienced contradictions between the typical Western white psychologists' ways of interacting with clients, which they had been taught and the typical ways in which relationships are structured in Indigenous communities. The results suggest that the Western model of psychological training does not work very well in Indigenous contexts, and that psychologists working in Indigenous contexts have to work out their own methods on a trial‐and‐error basis. This points to the need for more systematic cultural competence training. However, there is a lack of research into the effectiveness of psychological intervention from the viewpoints of Indigenous clients themselves.     

Affect availability, tolerance, complexity, and modulation in psychoanalysis: followup of a longitudinal, prospective study

Evaluation of 22 patients in supervised psychoanalysis showed that affect availability and tolerance changed in a positive direction during the course of psychoanalysis. In this study, we have defined criteria of change that can be clinically observed. The changes observed were present one year following the completion of psychoanalysis. Ratings of analysts' and patients' interviews, and ratings of psychological tests all revealed that patients had derived "therapeutic benefit" in relation to affect experience and management. Discriminations were made among changes in affect modulation, which reflected both loosening and tightening of controls, changes in affect availability, changes in experience of painful affects, and changes in experience of affect complexity. Analysts' interviews and psychological test data reflected notable changes in affect modulation in the direction of increased control, while patients' interviews more often reflected changes in the direction of increased expressiveness.     

THERAPISTS’ EXPERIENCES OF MOTHER–INFANT PSYCHOANALYTIC TREATMENT: A QUALITATIVE STUDY

As part of a larger research project in Sweden, a qualitative study investigated psychotherapists’ experiences of mother–infant psychoanalysis (MIP). A randomized controlled trial compared two groups of mother–infant dyads with psychological problems. One had received Child Health Center care, and the other received MIP. Previous articles on long‐term effects have found that mothers who had received MIP were less depressed throughout a posttreatment period of 3½ years, and their children showed better global functioning and psychological well‐being. The present study's objectives were to describe the therapist's experiences of MIP and deepen the understanding of the MIP process. Six months after treatment began, all therapists were interviewed. Transcribed interviews with therapists from 10 (of 33 total) MIP treatments were randomly selected and analyzed in detail by thematic analysis. Therapists worked successfully with mother and infant together and found different ways of cooperation during MIP sessions. Therapists reported overall positive experiences; however, in cases where mothers needed more personal attention, it would be important to adapt the method to them.     

"God must have been sleeping": faith as an obstacle and a resource for Rwandan genocide survivors in the United States

In 1994, 1 million Rwandans were violently killed in only 100 days. Devastating for some Rwandan survivors was the significant role that some Catholic parishes and leaders took in ignoring, facilitating, and even perpetuating the genocide. This article seeks to understand how Rwandan genocide survivors draw on religion as they negotiate their postgenocide identities in the United States and comprehend their current faiths, beliefs, and practices. Based on qualitative interviews with Rwandan survivors now located within the United States, I argue that the experiences of religiosity postgenocide serve as both an obstacle and a resource in postgenocide life, creating significant individual and local ramifications for community engagement, reconciliation, and trauma recovery.     

An Analogue Study of the Psychological and Psychosocial Processes Associated With Post‐concussion Symptoms

This study used an analogue design to investigate post‐concussion syndrome and the psychological and psychosocial processes associated with post‐concussion symptom (PCSx) reporting. The study examined the role of expectation in reporting of PCSx, the nature of associated psychological and psychosocial difficulties, and the “good‐old‐days” phenomenon. Forty‐five healthy participants were randomly assigned to one of two groups: (1) a control group or (2) an expectation group who were asked to perform as if they had experienced a mild traumatic brain injury. Fourteen psychiatric patients comprised the clinical group. Self‐report questionnaires assessing PCSx and psychological and psychosocial variables were administered. It was hypothesised that PCSx would be non‐specific, that the expectation group would report greater dysfunction than controls, and that the “good‐old‐days” phenomenon would cause the expectation and clinical groups to underestimate pre‐morbid PCSx. All participants reported some degree of dysfunction, and the expectation and clinical groups underestimated past PCSx. The expectation group reported more PCSx and psychological and psychosocial dysfunction than controls, resembling the clinical group. The results demonstrate that expectation can cause otherwise healthy individuals to resemble a clinical group in terms of their level of endorsement of psychological and psychosocial dysfunction.