Wednesday, April 26, 2023

By Courtney Wise

Greetings, MindSite News Readers! In today’s daily, psychiatrist Judith Herman returns after 30 years with a follow-up to her seminal book, Trauma and Recovery. Mental health providers in Minnesota work to make psychotherapy more inclusive and culturally responsive. And we take a look – through a moving photo essay – at the last days of a homeless encampment in Oakland, as the city clears it away.

The last days of Oakland’s Wood Street Commons

Earlier this month, excavators made their way to Oakland’s Wood Street Commons, once home to the largest unhoused community in Northern California. At its peak, the encampment spanned 25 city blocks. As with any unhoused community, its residents end up there for many reasons that can’t be reduced to mental illness. Still, being displaced again is not likely to do much for their mental health. David Bacon, a prize-winning photographer documented the community’s last days for Capital and Main. We are grateful to republish some of them here.

People pack belongings at the Wood Street Commons encampment of unhoused people as city workers begin demolishing residences and evicting residents, and residents and supporters protest. Photo: ©David Bacon

Oakland city officials said they’ve made space for those being displaced in cabin communities, but residents say the cabins aren’t a permanent option. People are limited to 90 day stays, with no guarantee of renewal. They can be evicted at the whim of community managers. There’s no place to park the cars in which many residents sleep. And most importantly, say Commons leaders protesting the clearing, the cabins leave no room for their community to stay together. 

Gawit (David) Mesfin, left Ethiopia at 8 after his parents were killed. He has lived at Wood St. Commons for 7 to 8 years. Photo: ©David Bacon
Tommygun Goodluck, a carpenter, has lived at Wood St. Commons for 4 years. Photo: © David Bacon

“We want our community to stay intact,” said Commons leader John Janosko. He proposed the city allow their community to move to an old Army base not far from where they are. “And it wouldn’t be hard for us to move there, especially if the city helped us build small houses and a center and community kitchen where we could have services and meetings to keep ourselves organized.” City administrators rejected the proposal.

Wood Street resident John Jonosko speaks at a press conference. Photo: © David Bacon

After 30 years – and her own experience with traumatic pain – the ‘Queen of Trauma’ is back 

Judith Herman is a big deal, but if you’re not a mental health professional, you may not remember her name. She practically launched the field of trauma studies in 1992 with Trauma and Recovery, a book lauded in a New York Times review by feminist author and psychotherapist Phyllis Chesler as “one of the most important psychiatric works to be published since Freud.” Herman recognized and coined a new diagnosis, complex PTSD, to define the symptoms and behaviors of long-term survivors of sexual and domestic violence that she studied in Sommerville, Mass. Herman’s book made a critical point: that repeated trauma of an “ordinary” type – like physical and emotional abuse from a partner – could leave many of the same scars as “extraordinary” trauma like that experienced in war.  

Via Twitter

Herman was one of psychology’s premier voices – and then, in 1994, she tripped and broke her knee. “All you could think about was pain,” Herman said. “It’s like being in a tunnel. Like your whole existence is pain, and nothing exists outside of it.” Despite surgeries, her pain persisted, and under the fog of constant ache, she took a back seat for 25 years while trauma studies made way for another voice, that of Bessel van der Kolk, Herman’s longtime friend and colleague and the author of The Body Keeps the Score, a bestseller for nearly five years. “Judy really would have been the queen of trauma,” had she not been injured, he told the Times.

Now relieved from the pain that haunted her for decades, Herman is back with a follow-up to her seminal work. Truth and Repair: How Trauma Survivors Envision Justice was published last month. And at 81, despite the winding journey, she said she’s grateful. Freedom from the pain gave her the energy to finish the book, she told the Times Ellen Barry, and she’s reenergized by today’s social movements – like those that shaped her as a young doctor. “I’m back in that exploring kind of moment,” said Herman. “I just wish I had a 40-year-old body instead of an 80-year-old body to be able to keep up with it.”

Expanding access to culturally-responsive mental health care in Minnesota

Psychologist Layla Asamarai wants to make people who may not be accustomed to seeking therapy feel comfortable. So at the entrace of her Roseville, Minn. psychotherapy practice, The Luminous Mind, she offers Middle Eastern hospitality in the form of free tea and coffee. She calls it decolonizing therapy because “one has to realize that psychotherapy is a colonized practice, as it is employed today in the world,” she told MPR News.

In Minnesota today, 73% of psychiatrists and 88% of mental health clinicians are white and less than 2% of psychiatrists in Minnesota are Black. There has been some progress. According to the American Psychological Association, the number of BIPOC psychologists in the US has more than doubled since the year 2000 to 19,000. And that limits the ability of western psychotherapy to serve a wide range of cultures. “The ways in which people are expected to show up, what they’re expected to talk about, concepts of boundaries, concepts of relational attachment, what’s normal, what’s not, these are not test tube values, these are western values,” says Asamarai. 

Changing the playing field means expanding university-level educational opportunities for underrepresented students, says Carolyn Berger, an associate professor in the Department of Educational Psychology at the University of Minnesota. It also means adding courses on culturally-responsive practices. “In the past, we noticed…students of color were saying they felt like the training was geared towards white students,” Berger said. Some policy makers are stepping up, too. State Rep. Ruth Richardson introduced a bill that would provide $1.5 million to the African American Child Wellness Institute, making mental health services more available to families in communities of color.

In other news…

“Likability is a jail,” declares John Mulaney in his latest stand up special for Netflix. A sizable segment of the internet might argue he’s no longer behind those bars, having survived a thick backlash during his public struggles with substance use, a divorce, and becoming a father. He’s still funny though, argues Primetimer, and how he got through his toughest days rests at the heart of the performance.

A debate: Should medical assistance in dying exclude those with mental illness? 

No, says Clancy Martin, a Canadian philosopher who has attempted suicide numerous times. In a guest column for the New York Times, he writes: “It’s true that policymakers, psychiatrists and medical ethicists must treat requests for euthanasia on psychiatric grounds with particular care, because we don’t understand mental illness as well as we do physical illness. However, the difficulty of understanding extreme psychological suffering is in fact a reason to endorse a prudent policy of assisted suicide for at least some psychiatric cases. When people are desperate for relief from torment that we do not understand well enough to effectively treat, giving them the right and the expert medical assistance to end that misery is caring for them.”

Absolutely, says Wesley J. Smith, in the National Review. “If a doctor had helped Martin, he wouldn’t be alive today to be happily married, a father of five, and published in the ‘newspaper of record.’ When a doctor helps a patient die, either by prescription or lethal injection, the job gets done…We should never make suicide easy — the West is experiencing a suicide crisis, after all — and we should always strive to engage in interventions, whether the patient is suicidal because of cancer, a mental illness, or a calamity such as the death of a child. To do anything else is abandonment.”

“Likability is a jail,” declares John Mulaney in his latest stand up special for Netflix. A sizable segment of the internet might argue he’s no longer behind those bars, having survived a thick backlash during his public struggles with substance use, a divorce, and becoming a father. He’s still funny though, argues Primetimer, and how he got through his toughest days rests at the heart of the performance.

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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Courtney Wise Randolph is a native Detroiter and freelance writer. She is the host of COVID Diaries: Stories of Resilience, a 2020 project between WDET and Documenting Detroit which won an Edward R. Murrow...