First Native Hawaiian psychiatrist tells his story

Wednesday, August 23, 2023

By Courtney Wise

In today’s Daily, we look at how complex PTSD differs from the standard kind. A longtime journalist offers a look at her own family’s battles with mental illness and suicide. Survivors of the Maui wildfires attempt to address their trauma. Plus, an interview with the first Native Hawaiian psychiatrist, and more.

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What is complex PTSD, and what does recovery look like?

In lay terms, complex post traumatic stress disorder, or C-PTSD, is PTSD on steroids, “the kind of trauma [that] shapes our nervous systems,” therapist Michael Quirke told the Los Angeles Times. “You might be having fight, flight or freeze reactions all the time and not even know it. You may often feel disconnected from yourself and others. Or you could feel chronically depressed. It’s also quite common that people with C-PTSD avoid relationships.”

The term is relatively new in psychology, first offered as a diagnosis by psychiatrist Judith Herman in 1992. She believed the PTSD symptoms listed in psychiatry’s “bible,” the DSM, didn’t fit people who suffered repeated trauma over an extended period. People with C-PTSD tend to have more trouble regulating emotions; a negative sense of self shaped by feelings of shame, guilt and worthlessness; and difficulty forming and maintaining relationships. It remains unlisted as an official DSM diagnosis, and advocates say it needs to be there to help people with the condition get proper care. 

People seeking to heal from complex PTSD must be open to walking various paths along the road to recovery. “The trick is really experimentation,” Foo said. “There’s not one silver bullet.” Experts offer a few places to start: Take note of when you hold your breath or begin shallow breathing. Are there times when you can’t sit still or feel hot all over? “We can learn to re-introduce breath back into the body to slow down our heart rate and relieve tension,” said Natalie Gutierrez, a therapist who specializes in trauma. “We can also do this through body scanning, movement, stretching — whatever folks have access to in the moment to really calm their bodies, multiple times a day, to de-activate the stress response.”

Above all, says Foo, get support. “Whether that is group therapy, joining a volleyball team, a sewing group or having a therapist who really connects with you, or a really loving partner or best friend,” Foo said. “Whatever it is, it’s about learning how to find safe, loving people, and how to rupture and repair with them” instead of avoiding conflict.

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Meg Kissinger knows that hiding from suicide won’t solve it. So she wrote about it in her own family

“The suicide rate is at historic highs right now,” she told her old paper. “It’s a public health crisis.” Journalists should examine why people think it’s a good option, and interview people who attempted suicide and survived. Resources like reportingonsuicide.org can help news outlets tell stories in a respectful and responsible way. 

Kissinger is also walking her talk. Her new book, While You Were Out: An Intimate Family Portrait of Mental Illness in an Era of Silence, tells of growing up in a loving yet troubled family that had its own experiences with suicide and mental illness. She hopes that sharing her family’s story will encourage others to speak openly and honestly about their mental health needs. 

Stay tuned for an excerpt from Kissinger’s book to be published in MindSite News. Founding Editor Rob Waters will also be interviewing her for the CSPAN show BookTV – and we’ll share those details soon.

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The first Native Hawaiian psychiatrist tells his story

“Benjamin Young didn’t set out to be the first Native Hawaiian psychiatrist,” Ambar Castillo writes for STAT. Nor did he know when he started his residency in 1972 that he would launch a change-making program called Imi Ho’ola (“those who seek to heal”), which trained hundreds more Native Hawaiian and Pacific Islander doctors. 

Castillo’s interview with Young, who is now 85, is full of interesting tidbits about his life and the ways he worked with mentally ill patients, including this exchange:

The stigma of mental illness is still very real. Some of the work you did as a psychiatrist was helping patients with schizophrenia learn how to best communicate. Could you speak to that experience? 

These are some of the most seriously ill patients who go to the emergency room. With the schizophrenic and with the very depressed patients, oftentimes, it was so difficult to get them to communicate because they’re so sick. So I would just take out a sheet of paper and give them a pencil and tell them to write, “I am in the hospital, because of …”

I’ve collected hundreds and hundreds of essays from people who are unable to really communicate because there was so much mental anguish and so much distress. But they were able to write out why they were in the hospital. And surprisingly, people would write a whole page or pages — they couldn’t express their thoughts in speaking to me, but they would do it in writing.

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Maui survivors struggle with inconceivable loss and despair

It’s unusual for 5-year-olds in America to bury their best friends. It’s even odder for them to walk past unidentifiable dead bodies in the street. But that’s exactly the experience of one youngster who recently visited the Lahaina community health clinic. She and her mother survived the fury of the wildfire’s main burn zone, but not unscathed. “There’s a heaviness in the air that is — we’re destroyed,” Maui social worker Debbie Scott told NPR. “We’re not going to have all the answers right now…We’re coping.” 

The devastation is so great that counselors say current mental health support is really psychological first aid, a band-aid of sorts to patch a range of symptoms from unavoidable sadness, insomnia, exhaustion, and breakdowns of grief. “They’ve lost family, they’ve lost their pets. They’ve lost everything,” Scott said. And now that reality has hit, there is the settling of wrenching trauma. The goal of crisis mental health aid now: to offer people hope. “Right now it’s all about active listening, empathy and trying to connect people with services,” said disaster mental health manager Stu Coulson. 

Hawaii and federal officials are working to send an influx of mental health providers to support the 65 clinicians already on the island. An emergency order temporarily lifting the state’s licensing requirement for counseling will help there. But intensive therapy won’t be their focus. Right now it’s all about offering practical tools for survival and care, Scott said. “Whether that is breathing, whether that is progressive muscle relaxation, whether that is mindfulness and meditative practices, just sitting, stretching, or talking story, making jokes,” she said. After all, they’re survivors of the devastation, too. 

Therapist Annie Vance has started to take her dog Rio to sessions with her. He helps people open up, she said. But at the end of the day, Vance and Rio are navigating their own pain. “I ran out of the house with the dress I had on and one other and Rio got back into the car and he gave me this look like ‘Mom, I just want to go home. Are we going to go home now?’ And I just looked at him and cried and I said, ‘Rio honey, I want to go home too, but we don’t have a home anymore. But we’ll make the best of what we’ve got.'”

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In other news…

Too much of a good thing? Regular exercise is a proven way to reduce depression, but excessive exercise has the opposite effect, Runner’s World UK reports. Researchers analyzed data from 3,670 male and female ultra-runners and found that many suffer from poor mental health and eating disorders. The study was published in Sports Medicine.

The first Native Hawaiian psychiatrist began his residency a little more than 50 years ago, at the University of Hawaii. He told STAT News he had no idea he was one of less than 10 Native Hawaiian-trained physicians when he began in 1972 – or that he would launch the Imi Ho’ola program, which trained hundreds more Native Hawaiian and Pacific Islander doctors. 

There’s a lot of money being made on good-old American anxiety. The Wall Street Journal looked at “the booming business of anxiety relief” and the explosion of supplements, apparel, blankets, toys, and digital apps that were developed in the past few years and claim to bring calm.

Gun buybacks can be an important piece of a strategy to reduce suicide, says the Baltimore Sun Editorial Board. Often marketed as a way to make crime-ridden neighborhoods safer, their bigger contribution may be as a way to lower the number of guns in private homes – and make it harder for people to impetuously kill themselves. “The sad reality,” the paper says, is  that the U.S. “experiences more gun deaths each year from suicide than from homicide.” The paper also encouraged other sensible measures such as red flag laws, greater access to mental health care before it becomes a crisis, treatment that doesn’t stigmatize, as well as expanded access to affordable housing substance abuse treatment and prevention. That, says the Baltimore Sun, is how you stop suicides before they occur.

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If you or someone you know is in crisis or experiencing suicidal thoughts, call or text 988 to reach the 988 Suicide & Crisis Lifeline and connect in English or Spanish. If you’re a veteran press 1. If you’re deaf or hard of hearing dial 711, then 988. Services are free and available 24/7.

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