Creating a ‘psychological nest’ for vulnerable infants and children: an interview with Annette Mendelsohn

This is an edited version of a recent interview with Annette Mendelsohn, Child and Adolescent Psychotherapist at the Royal Free Hospital, London, UK. It aims to make available in published form Mendelsohn's thinking and approach in relation to her work with traumatised children in a hospital setting. Mendelsohn also discusses her work in a neonatal intensive care setting and the way in which approaches to psychosocial care in the hospital setting have changed over the course of her professional life.     

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.     

“It Makes Me Worry About Her Future Pain:” A Qualitative Investigation of White Mothers of Non-White Children

In the United States, increasing numbers of White women are mothering children of color. Little is known about their psychosocial experiences of racially socializing non-White children within a culture that transmits socially constructed meanings about race. Such messages influence employment and quality and access to health care. Thirteen White mothers of non-White children (school age to adulthood) residing in the U.S. were interviewed. Their psychosocial experiences and racial socialization practices were explored. Through an analysis of transcribed interviews and interview notes, seven themes emerged: (1) Looking Like a Family and Looking Alike; (2) Mothering as Vulnerability; (3) Teen Daughters’ Perceptions of Black Men as Undesirable and Frightening; (4) Exposing Children to Culture; (5) Children and Mothers’ Experiences as “Other”; (6) Hostility from Black Women; and (7) Not Talking About Race. Study's limitations and future research are discussed.     

Mixed-Race Women

Abstract

Within the last two decades, researchers have found that the majority of mixed-race individuals are psychologically healthy, experience similar life events as other people of color, and encounter additional discrimination and stresses due to their mixed-race status. The experiences of mixed-race women differ from mixed-race men along severaldimensions: belonging and acceptance, physical appearance, cultural stereotypes, ethnic identity, power and guilt, and dating and marriage. It is important for mental health practitioners to understand how these experiences affect a mixed-race woman's life.     

One ‘knows’: self-rated health and telomere length among ex-prisoners of war

Abstract

Objective: Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length.

Methods: Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3.

Results: The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3.

Conclusions: These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.     

Generational forgiveness and historical injustices: perspectives of descendants of victims of Apartheid-era gross human rights violations in South Africa

This study explored the issue of generational forgiveness in the political sphere in contemporary South Africa. It is based on qualitative interviews conducted with 20 children and grandchildren (females?=?10, males?=?10) of victims of Apartheidera gross human rights violations. The interview data were interpretively analysed to uncover underlying meaning. The results yielded three main themes namely: the myth of forgiveness in politics; political forgiveness as an inherently difficult human enterprise; and the intrinsic value of political forgiveness. Findings suggest that political forgiveness is likely if solutions are found to persistent poverty and inequality, which are structural legacies of the past.     

Addressing Urgent Community Mental Health Needs in Rwanda: Culturally Sensitive Training Interventions

Rwandan leaders in the health and educational sectors have begun to discuss the necessity for establishing culturally appropriate community-based mental health counselling services in Rwanda, especially trauma counselling. The need for a community psychology approach is anchored in the lingering effects of the genocide and the continuing post-traumatic stress symptoms suffered by many in the population. Capacity building in an effort like this would require the design of multi-level counselling curricula that are sensitive to the social structures within Rwandan culture. These curricular endeavours call for the development of a National Counselling Centre to serve as a structural mechanism for organizing community-based counselling initiatives. We consider the community health services needs in Rwanda here, along with associated challenges and strategies for effective mental health services in a country with a recent history of genocide. A community psychology approach to mental health would benefit Rwandan society by making trauma counselling and recovery services available and accessible to citizens throughout the country.     

Languages of trauma; towards a phenomenological response

In this article, I explore the possibilities of a phenomenological perspective on trauma in psychoanalytic practice. I highlight the problem of interpretations that universalise experiences of trauma, provide explanations in terms of ‘causes’ and assume particular processes/stages of ‘recovery’ from it. The notion of trauma challenges dichotomies of ‘internal’ and ‘external’ worlds. Traumatic experiences always have a context – that of the immediate relational circumstances of the individual suffering from the trauma, including the wider social/relational context, and the person’s history. I argue for an attunement to the language and specificity of the meanings, verbal and non-verbal, conscious and unconscious, of the client’s suffering within the analytical relationship. This requires the therapist to avoid ‘ready-made’ interpretations from psychoanalytic theory and to be open to the poiesis of the speech, which emerges between therapist and client. My discussion of my reading of the Chilean documentary film, Nostalgia for the Light, which focuses on the traumatic experiences of those who survived Pinochet’s military regime (1973–1989), highlights how diverse responses to trauma are. The originality of the language of the film calls on us as therapists to discover new ways of listening and speaking to our clients’ suffering.     

Working in the Midst of Unfolding Trauma and Traumatic Loss

Abstract

Training developed for New York City social workers in the evolving aftermath of September 11, 2001 is introduced, offering a conceptual framework for clinical practice in the midst of unfolding trauma and traumatic loss. A focus is placed on the shared, collective process of learning and discussion among colleagues, as an effort parallel to work with clients, progressing together to establish meaning and hope through relationships. Professional training framing this catastrophe within trauma and traumatic loss perspectives, and addressing its impact on clinician, client, work, and treatment relationship, is needed. Also providing on-going support, a process of continuity, and a context of community, this training becomes a collective response to the profound impact and complex, evolving needs of this time.     

Multiple Attachment Representations in Clinical Practice: Case Study of a Six-Year-Old Maltreated Child

Research on attachment predominantly traces the effect of a single or primary attachment and/or attachment style on working models and behavior. However, most children form multiple attachments. This article reviews research on multiple attachment representations in children and considers how such information can usefully be applied to clinical settings. Through the case study of a six-year-old adopted boy with a history of maltreatment, it explores how those internal working models can be assessed in treatment and the clinical value of recognizing different attachment representations and styles. Implications for treatment interventions are explored.