Vol. 12, No. 10
In This Issue
Reader’s Reactions and my comments on their comments
What being trauma-sensitive means in how you talk to people with Posttraumatic Stress Disorder (PTSD)
My trip to the Emergency Room
David Mee-Lee M.D.
|As I prepare for this month’s edition, it is Martin Luther King Jr. Day. So it is fitting that I continue last month’s topic and share with you some lively responses from readers….along with my comments on their comments. It is always stimulating and informative to hear passionate responses on a hot topic that is still boiling in the pot of public opinion.
Here are some comments with the reader’s identification (or non-identification as they requested.) Where I used only their credentials, I did not yet hear back from the reader on how they wished to be identified or not. So I have edited out any identifying information.
Reader Comment #1
“So, Blacks are equally responsible for however it is that they’re treated? Hmmm, interesting. Isn’t that equivalent to “What did she wear?” “Why doesn’t she leave?” “Why was he there?” “Was that real rape?” How were the Chinese equally to blame for the Chinese exclusion laws? How were Black and Brown people equally to blame for ‘The War On Drugs’? And severely mentally ill people are at least partially to blame for their mistreatment and incarceration. Well, this notion of contributory culpability certainly helps some people feel better. Is that what this is about? Is this an idea of being fair? I’m not buying it, sorry.
Reader #1, MSW, Ph.D., LCSW
My Comments on Reader Comment #1
As I said in last month’s edition, http://www.tipsntopics.com/2014/12/race-relations-dont-be-a-rat-violence/ I don’t have any pat answers and am more intent on listening, as race relations is a complex issue with no simple answers. So I was grateful for the readers’ comments to fill me in on their varying perspectives. Here are a few bullet point comments:
The main point I heard from this reader was that African Americans, rape victims, Chinese and others discriminated against are not responsible for injustices perpetrated against them. The reader challenges the notion of “contributory culpability”.
Reader Comment #2
“Lisa raises good points about how alcohol and other drugs is a common and even determining theme in all three cases. “Drugs NOT Race!!” is what she declares.
Just a brief comment to your response in Tips and Topics. Succinctly said!! I just changed jobs and was a therapist in the mental health department of Louisville Metro Corrections, the downtown jail in Louisville, Kentucky for a total of 12 years. I was born and raised in Cincinnati, Ohio and my father was a police officer for 30 years. This month’s newsletter is an excellent message for parents but is the correct audience “listening”? If you study statistics of people on some substance who are booked into a jail, the stats do not hold up. What I mean by that is there are many other reasons they come in. For example if a probation officer drops (requires a urine drug screen) someone and they are positive, they arrest them and bring them in under the heading of PROBATION VIOLATION (but the offender was actually high on drugs). Same thing with domestic violence. There are always drugs and/or alcohol involved in an arrest but they come in with the charge of Assault IV usually, or higher with Assault 3, etc. I could go on and on.
As Lisa said: ‘People behave in irrational ways when they are in midst of very real biological “urges.” (Everyone can relate to speeding when in need of a toilet.) MB didn’t want to go jail; he wanted to go get high, and no one was going to stop him. THAT explains his bizarre response to being detained by Officer Wilson. It’s called “dope” for a reason – it turns off the “thinking” part of the brain!’”
Thanks again for bringing attention to the real reason powering these feuds.”
Addiction Services Therapist
The Brook Hospital, KMI
Louisville, Kentucky 40242
Sheila sees real value in Lisa’s explanation for each victim’s contribution to their treatment by police. That contribution was not the fact of their skin color, but their drug-induced behavior. If drugs were actually involved, that would seem to help explain their inability, even if they had been taught, to employ the SKILLS in last month’s edition.
The next reader was not so impressed with Lisa’s perspective.
Reader Comment #3
“I am a Substance Abuse counselor. I am also black, a career Navy veteran and service connected disabled veteran. I am in total agreement with having a dialogue on race/race relations.
Not knowing all the circumstances surrounding Michael Brown (MB), I won’t bother to comment on the incident, per se. However, I will give response to Lisa’s comment. In the years of my experience as a Substance Abuse Counselor, I have never seen nor heard of someone with high THC levels CRAVING to the point she mentions. Had she used her scenario to describe someone on LSD, Peyote or some other hallucinogenic, her assertion would be more acceptable and understandable. However, like so many other ‘arm-chair’ quarterbacks mentioning this atrocity, one would think she were a Forensic Therapist on the scene.
What I believe is Lisa’s not realizing what seems to be a biased perspective on race.
Lisa’s comment in my opinion would be right-on, had she had known or was a sighted witness as to what happened! Thus my bias! She believes and justifies what occurred to this young man as fact, based on what she read in the media. Mind you, I have not assumed Lisa’s race or ethnicity in my response. It merely gives reference to how some people believe all that is written in the media to be fact, when the situation/crime gives reference to race; black or brown people.
I remember years ago as a young Navy seaman stationed in Maryland, myself and a Caucasian friend and shipmate went to spend a weekend in Baltimore, Maryland. We were in full dress Navy Blues when we entered and sat for service at a White Front restaurant, service similar to White Castle restaurants. My friend and I each ordered four of the small hamburgers; his were placed on a plate, and mine in a bag. I was asked to pay and leave, or frequent one of the restaurants on the Eastside of town, a predominantly black community.
Some years later, I was appalled by the racism experienced when our ship made a Port visit in Hawaii, on the way to Vietnam. There too, racism was obvious when black and/or shipmates of color weren’t as welcome on beaches, clubs or restaurants as our Caucasian shipmates. We were obvious to being welcomed on Hotel Street, then a red light district of drug addicts and prostitutes.
Although some changes have been made since the Civil Rights movement, little in my lifetime of race relations has. Racism has become clothed with subtleties. Until there is some bond of honesty and trust on both sides of the equation, open discussion on racism will be minimal to say the least“
My Comments on Reader Comment #3
Wendell has experienced racism first hand and recounts for us these unjust and painful experiences. I agree that in most places, racism is not as blatant as in the days ofMartin Luther King Jr. As Wendel says “Racism has become clothed with subtleties”. What I don’t agree with or get from Lisa’s comments last month was that there was a “biased perspective on race”. If the media did report on drug use by Michael Brown and if Lisa accepts that as fact, I don’t see that as racism. Her point was to highlight the power of substance-induced behavior and focus on that, not race.
Reader Comment #4
“Thank you so much for addressing this issue this month. I come from a long line of former and current law enforcement officers and at times it is a fine line for me as a substance abuse professional to distinguish between behavior that I assume is substance induced and the behavior of cops that may not be as trained in Substance Abuse and Mental Health disorders that they should be. With regard to race relations, there are people of all races that do things wrong. It is the person and their actions that needs to be looked at, not the color of their skin. I wholeheartedly agree with the “RAT” concept and I believe in the mutual respect that needs to take place between detainee and police officer. At the end of the day, my family members need to come home, and I trust that they will use their best judgment if push comes to shove.”
My Comments on Reader Comment #4
Sheila and Jody remind us about what it is like for the family members of police officers who everyday risk their lives to maintain the peace and preserve public safety.
“We may have different takes on the events of Ferguson and New York. But surely we can understand a father who fears his son can’t walk home without being harassed. And surely we can understand the wife who won’t rest until the police officer she married walks through the front door at the end of his shift.”
Reader Comment #5
“Thank you so much for addressing this very difficult topic. You are right there are no simple, easy solutions, but the more we can talk and listen with compassion and respect perhaps the closer we can get to some solution. How sad it is that we have to teach our children (and adults) how not to be harmed by the police. I am trying to live and embrace the sadness without being lost in the anger and outrage. I too try to remember the Non Violent Communication (NVC)approach.”
Lori Rugle, Ph.D., NCGC-II
Maryland Center of Excellence on Problem Gambling
University of Maryland, School of Medicine
I agree with Lori about the importance of talking and listening with compassion and respect.
Reader Comment #6
“This Tips & Topics was (as they all are) right on about the current violence.”
Phil Cerrato, LCSW,
Substance Recovery Therapist
Reader Comment #7
“I am a black man who works in Maryland. I read this article and I felt both your urgency to resolve this issue as well as your discomfort with the topic. It is understandable that most people struggle and are uncomfortable with this issue and then again, when you stop and think about it, we really shouldn’t be. After all, we’re only talking about skin color here. Yes, there are cultural differences, but to tell the truth, most people only react to a person’s color.
I too have been guilty but more and more, I am able to at least speak to someone before I judge them just because of their skin color. I have been pleasantly surprised when I speak to someone who I have had preconceived ideas about (even people of my own race!) to find out that they are nothing like what I thought they were.
Regarding the police shootings, each one of them involved different circumstances but yet they are all lumped together simply because of skin color. There is no doubt that the police have, for years, prejudged people based on skin color. Yet, they are no different than any of us. This does not excuse their behavior when they do that (as many do not always do that) just as it does not excuse our behavior when we do it.
I do not think it is complicated. I think that people just have to acknowledge that when they see someone with a different skin color, they are prone to prejudge. We just need to acknowledge it and consciously work on seeing beyond a person’s color. We are able to do it when it comes to money…We value it, no matter what it might look like!
My Comments on Reader Comment #7
George is right about what he sensed: “felt both your urgency to resolve this issue as well as your discomfort with the topic”. I hesitated to raise race relations last month because there are such strong feelings being expressed about this issue and not a lot of listening. But George raises some important points thatI highlight again:
There is a lot of attention, and rightly so, on trauma and the importance of being trauma-informed. This is raised in the context of working with people with addiction and/or mental disorders; returning veterans and Posttraumatic Stress Disorder (PTSD); intimate partner abuse and domestic violence; and young people in violent and gang-infested neighborhoods.
I was recently listening to a radio piece on “Up2Us: Trauma-Sensitive Coaching Transforms Urban Youth Sports by Karen Given (September 20, 2014). You can hear the whole story at: http://onlyagame.wbur.org/2014/09/20/up2us-trauma-sensitive-youth-sports
In the training of trauma-sensitive, youth sports coaches, Lou Bergholz explained really well an approach that could help police officers and others avoid escalation of traumatized youth. He was explaining the central role the amygdala plays in how some youth react and what to do about that.
But first, here is a brief overview of the Amygdala quoted from information at http://biology.about.com/od/anatomy/p/Amygdala.htm
- “The amygdala is an almond shaped mass of nuclei (mass of cells) located deep within the temporal lobe of the brain.
- It is a limbic system structurethat is involved in many of our emotions and motivations, particularly those that are related to survival.
- The amygdala is involved in the processing of emotions such as fear, anger, and pleasure.
- The amygdala is also responsible for determining what memories are stored and where the memories are stored in the brain. It is thought that this determination is based on how huge an emotional response an event invokes.”
Coach Bergholz explains further and quoting from Karen Given’s news story:
“So the amygdala has one job, and its only job is to look around all day and wonder, ‘Can I eat it or does it eat me?’” he said.
“When there’s danger,the amygdala kicks into gear. Muscles get tense, the heartbeat quickens and blood leaves the brain. Higher-level problem solving is out. If the brainis kept in this hyper-alert state for too long or is pushed there too often, scientists say the brain loses its pathways to critical thinking.
Why is this important for a group of young sports coaches to understand? Studies have shown that as many as one-third of children living in America’s most violent neighborhoods have post-traumatic stress disorder. That’s nearly twice the percentage of PTSD-affected soldiers returning from Iraq or Afghanistan.”
These children have been exposed to ongoing physical and sexual abuse, violence in the home and streets, substance-induced yelling and arguments at home. This keeps their brains (amygdala) in a constant state of alertness and their bodies tense and ready to fight. Critical thinking goes out the window when faced with danger and survival.
How to talk to a person whose amygdala is activated
These tips are relevant in a clinical situation with clients with PTSD, but also on the street when police officers are involved with traumatized youth and others.
Writer Karen Given again:
“Bergholz says coaches already know what to do when a kid shows up to basketball practice and has no idea how to dribble the ball.
- “But you have a kid come and you say, ‘stand here,’ and they stand there, and you say ‘listen here,’ and they are talking,” he said.
- “We think of that as a will issue, that somehow they’re doing it on purpose. They’re misbehaving. But what if it’s also a skill issue?”
Here’s the tip that applies not just to trauma-sensitive coaches, but also to trauma-sensitive clinicians:
- Thetrauma-sensitive coach’s job isn’t just to teach basketball players to dribble. It also includes training kids’ brains to redevelop those pathways tocritical thinking.
Role Play at the Up2Us training session:
Player: “Oh my god, coach, did you see that? She’s all over me.”
Coach: “Calm down.”
Player: “Calm down? You calm down! What do you mean, calm down?”
Trauma-sensitive coaches know:
- Asking a traumatized youth whose amygdala is in overdrive to “calm down” doesn’t help.
- Asking “what’s wrong?” isn’t any more successful. That only works to escalate the player’s emotions.
Instead, Coach Bergholz suggests the following dialogue:
Coach: “Do you know what eight-seven-eight means?”
Player: “Eight-seven-eight, no. Eight-seven-eight, I don’t know.”
Coach: “You got eightrebounds so far, seven assists, and eight points. Do you know what a triple double is?”
“The idea is to get the player thinking, which helps to shut down the amygdala.”
These are good tips for clinicians and police officers who may inadvertently escalate an interaction with a traumatized person whose amygdala is over-activated.
Up2Us: Trauma-Sensitive Coaching Transforms Urban Youth Sports
By Karen Given September 20, 2014
Earlier this month, I was in the Emergency Room of my local hospital. I wasn’t there to do a consultation evaluation for a psychiatric or addiction patient. I was the patient. If you happen to be a woman who has given birth and knows intimately what labor pains are like, you know what I was going through.
I’m told that renal colic – the pain of your kidney’s plumbing trying to pass a kidney stone – is in the same ballpark as childbirth. My hat is off to the women of the world who graciously navigate that baby through their birth canal and even come back for more!
The older you get, the more precious the gift of good health becomes. I have been blessed with basically very good health and energy. It is easy to get smug and complacent. I’ve known for years that I should drink more water. Water is not just good for helping prevent kidney stones, but it can help prevent heart attacks from dehydrated sludgy blood that can cause clots.
But some days I can go the whole day with barely a glass or two. You can bet this was a wake-up call. Now I’m running to the bathroom all the time to keep up with my increased intake.
It was like some years ago when I used to pride myself as having normal blood pressure with little exercise. Then one day, my dentist screened for hypertension and I was in the marginal range. Knowing I wanted to avoid antihypertensive medication, that was a wake up call to get moving and start the exercise I should have been doing ages ago.
So how come I need all these wake up calls? Unfortunately I don’t think I’m the only one. There is an old Chinese proverb that goes something like:
The foolish personlearns from their own mistakes.
The wise person learns from the mistakes of others.
I invite you to be wise and learn from my mistakes.
Until next time
Thanks for joining us this month. See you again in late February.