Clinical Psychology

Palestinian mothers living in the friction points in East Jerusalem and the West Bank provide critical windows into the traumas that challenge families ensnarled in the vortex of ongoing political violence and living under occupation. Our paper, using interviews of Palestinian mothers, is a view of the abnormalthe violence that infects childhood and parenting, the fight of some mothers for a "real normal", and the induction into the "new normal", in which the night-time incursions, the mapping of communities, the detention of their adolescent sons, the solitary confinements of some, are "accepted" as a rite of passage. Managing terror and its anticipation exhausts and corrodes family functioning and community life. Mothers become inducted into a traumatic vortex, as they struggle to contain the anguish, multiple losses, and the outrage over the dispossession of longings and claims. Our own inescapable countransference, a simultaneous compulsion to understand coupled with an aversion to engage, provided vital information about the stench of violence that permeates these mothers' lives and the terror of losing not only children but one's mind, as well.

The present article highlights the mental health needs of children living with loved ones who have AIDS or HIV infection. In addition the article describes an intervention program which is being developed to meet the needs of the children and their families. Children who live in families affected by AIDS and HIV infection, like children who live with other life-threatening illnesses, are vulnerable to psychological distress. They experience numerous separations from parents, changes in the nature and predictability of emotional nurturing, concerns about loss, disruptions in routine and contact with peers, and economic hardship. AIDS and HIV infection present the additional stressors that stem from discrimination, stereotyping, and social ostracism. Finally, many families living with AIDS or HIV infection are disenfranchised, living under the pall of poverty and substance abuse. The intervention program described is being implemented in an urban community mental health clinic to meet the diverse mental health needs of the children living in these families. Preliminary implications of the program are discussed so as to begin a dialogue with other agencies who are challenged to meet the needs of this heterogeneous population.

YASSER AD-DAB’BAGH ABSTRACT
In response to a very moving article by Roth and Duaibis, I present commentary on the process of compassionate witnessing. Compassion, both as a concept and as a derivative of parental devotion, is explained and its importance to psychoanalysis discussed. Reflec- tions on the implications of this concept in social contexts as well as the risks to the wit- ness and the sustainability of compassion are shared. I conclude that the notion proposed by Roth and Duaibis of concentric circles of compassionate witnessing by people with a healthy capacity for maternal functions is likely the solution to alleviate the erasure resulting from chronic brutal suffering. Copyright © 2015 John Wiley & Sons, Ltd.
Key words: compassionate witnessing, compassion, Israeli occupation, Palestinian women, psychological erasure

Overtime, I have had the privilege to listen to stories from people living in the Middle east and to consult to some projects. This work changed my voice as a psychoanalyst. Clinical questions emerged that became a hub for new inquiry and networking that revolved around the following questions: What kind of witnessing presence—what kind of " accompaniment " 2 — can psychoanalysts bring to a zone of continuous and sequential trauma (Keilson, 1992)? How can we amplify the real voices of people living at the edges of what we can grasp let alone engage without betraying the stories we have had the privilege to hold? That is, can we reach for psychological truths without objectifying, simplifying, appropriating, and further " othering " the very voices we seek to humanize? And might there be some way to create a responsive presence that would be preventative of later damage? I was interested in the ripple effects of trauma and resilience as these radiated out from those most directly impacted to those less so, and I believed that if we heard voices from different points along the continuum , we would not only learn about the impact of this particular historical epoch but we would have a clearer sense of how to stand in solidarity with those living with dehumanization and oppression without igniting more circles of domination. My interest in the question of how we bear and transform the reverberations of social trauma stemmed from work with young adults in the inner city, many of them immigrants wrestling with refugee legacies, and from my own coming to terms with the lives of my parents, Holocaust refugees. It was not an accident that my work gravitated to witnessing in Israel– Palestine. My mother had escaped to Palestine as a child, and later, when

This article considers the emotional experience of the unwinding of collective identities and the shattering that ensues. It zeros in on paralysis and extreme disorientation as we awaken to our culpability, threatening capacities to self-regulate. It joins others seeking fluency with the layer of the psyche that absorbs the genocidal and for working with the inherent potential in these ruptures.

The article asks: As we engage our histories of implication, are we underestimating our grasp of the treacherousness of this terrain?  Can the experience of being an implicated-victim carrying genocidal trauma live with being an implicated-perpetrator?  Can we hold this much reactivity and agony, and – if not – what does that suggest for how we maneuver?  Are we de-centering empathy in this realm, as if empathy will impede upon our fight for justice?

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The Impact of Spirituality and Trauma on Appraisals of Psychotic-Like Experiences By: Kathleen S. Isaac Advisor: Deidre Anglin, Ph.D. Background: A substantial portion of the general population (2.5% to 31.4% internationally) reports psychotic-like experiences, which are paranormal, psychic or bizarre perceptual experiences such as voice hearing, or holding strong beliefs (i.e. superstitions) that are neither experienced as pathological nor indicative of a psychotic disorder. Cognitive models of psychosis suggest that the cognitive appraisal (i.e. personal interpretation) of the experience may help distinguish non-clinical psychotic-like experiences from clinical psychotic symptoms. This dissertation attempted to add to cognitive models by assessing whether cultural and personal factors such as spirituality and trauma inform the appraisals of anomalous experiences. This study used a moderated-mediation mediation-moderation model to explore associations between degree of spirituality...

Everyday discrimination contributes negatively to depressive symptomatology among Blacks in the US and being arrested could add to this depression. Using data from the National Survey on American Life, the present study determined the association between an arrest history and major depressive disorder (MDD), while accounting for discrimination among African Americans, US-born Afro-Caribbeans and first-generation Black immigrants. Findings from logistic regression analyses adjusted for discrimination suggested an arrest history is associated with 12-month MDD (Adjusted OR ¼1.47; 95% CI¼ 1.02-2.10) and lifetime MDD (Adjusted OR ¼1.56 CI¼ 1.17-2.09). Accounting for drug and alcohol dependence attenuated the association between arrest history and 12-month MDD, but not lifetime MDD. The associations between arrest history and both 12-month and lifetime MDD, and discrimination and lifetime MDD varied by ethnic/immigrant group. Specifically, while the association between arrest history and MDD (both 12-month and lifetime) was strongest among US-born Afro-Caribbeans, evidence consistent with the immigrant paradox, the association between discrimination and lifetime MDD was particularly relevant for first-generation Black immigrants, suggesting discrimination may hinder the protection of first-generation status. Mental health prevention and treatment programs should target the stress associated with being arrested and experiencing discrimination among US Blacks.

Underserved minority communities have few resources for addressing comorbidity risk reduction among long-term cancer survivors. To address this community need, we developed and piloted the Bronx Oncology Living Daily (BOLD) Healthy Living program, the first known diabetes prevention and control program to target cancer survivors and co-survivors in Bronx County, NY. The program aimed to facilitate lifestyle change and improve health-related quality of life (HRQoL) through weekly group nutrition education (60-90 min) and exercise (60 min) classes. We examined baseline characteristics of participants using simple descriptive statistics and evaluated program implementation and impact using the Reach, Efficacy, Adoption, Implementation and Maintenance (RE-AIM) framework. The curriculum, which drew from the social-ecological framework and motivational and cognitive behavioral strategies, consisted of 12 culturally and medically tailored modules with options for implementation as a 12- or...

Objectives-To assess heath literacy, health information seeking, and trust in health-related information among Haitian immigrants seen in primary care. Methods-Health literacy was measured by the Brief Health Literacy Screen (BHLS); items on health information use were from the 2007 Health Information National Trends Survey. Results-BHLS scores differed according to age, education, and survey language. Participants with lower levels of health literacy tended to be more likely to place "a lot" or "some" trust in family and friends and religious organizations and leaders as sources of information about health or medical topics. Conclusions-Constructing a culturally-tailored and appropriate intervention regarding health promotion requires understanding how the population accesses and conveys health information.

Addressing cultural competency in health care involves recognizing the diverse characteristics of the patient population and understanding how they impact patient care. Spirituality is an aspect of cultural identity that has become increasingly recognized for its potential to impact health behaviors and healthcare decision-making. We consider the complex relationship between spirituality and health, exploring the role of spirituality in primary care, and consider the inclusion of spirituality in existing models of health promotion. We discuss the feasibility of incorporating spirituality into clinical practice, offering suggestions for physicians.

Psychotherapy integration requires us to look beyond the confines of a particular theoretical or technical approach towards other perspectives. Integrative work with children, in particular, meets the socio-emotional needs of the child while simultaneously modeling behaviors and skills. This paper presents an explicitly integrative approach to child group psychotherapy: Relationships. Individuals. Skills. Engagement (RISE) Group. We begin with an in-depth discussion of the RISE group structure illustrated by clinical examples (the "what") followed by a review of the theory and treatment modalities that inform the approach (the "why" and "how"). The RISE group is grounded in two theoretical perspectives (psychoanalytic principles and ego psychology) and draws upon clinical techniques from multiple treatment modalities (including cognitive behavior therapy, psychodynamic play therapy and dialectical behavior therapy). Combined, the merger of these perspectives results in a multilevel intervention that forges pathways to mastery and competence within the child. Finally, we discuss the value and limitations of integration as applied to group psychotherapy for children.