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In recent years, therapy has become intensely body-based.

Everywhere you look, you're bombarded with somatic awareness and nervous system regulation and how trauma is stored in the body. I'd argue that this movement was propelled by Bessel van der Kolk's influential 2014 book, The Body Keeps the Score, which fundamentally impacted how many clinicians conceptualize trauma and healing.

In many ways, as a long-time trauma therapist, I think this unfolding has been important. For generations, psychotherapy largely favored cognition: analyzing thoughts, interpreting narratives, challenging distortions, searching deeper and deeper for more insight. The body remained a ghostly afterthought.

Maybe the pendulum needed to swing. The mind and body, after all, reinforce one another. They are not competing systems, and I do not believe they should be treated as opposing forces within some therapeutic culture war.

As the once-elusive concept of " trauma work " has expanded, it has interwoven many essential concepts rooted in neuroscience, including hyperarousal, dissociation, fight-flight-freeze reactions, and nervous system functioning. If trauma work is central, the body becomes harder to ignore.

But everything in life is a trade-off, and therapy is no exception.

"What do you notice in your body?" has basically replaced the cliched adage "How does that make you feel?"

The question can be useful. But have we become so enthralled by embodiment that we've unintentionally put it on some risky pedestal?

Therapy trends can unintentionally universalize experience.

But in real life, as most of us know, people vary tremendously in how they access their own bodies.

Yes, some individuals naturally notice subtle physiological internal states. They can identify tension in their shoulders or constriction in their throats. Their observations feel both intuitive and immediate.

But others cannot. In fact, most don't know what's happening within their bodies at all. People often arrive to therapy after living their entire lives moving through their days via intellect, creativity, spirituality, action, humor, and observation. Their internal words are often rich, even if their bodies remain comparatively opaque.

Sometimes interpreting or even talking about the body may not be as accessible to:

People with trauma histories with dissociation or chronic shutdown states: For some individuals, limited bodily awareness is survival. They learned to endure overwhelming experiences by not feeling the body and "moving through" as best they could.

People with chronic hypervigilance or anxiety disorders: Some people are not disconnected from the body at all. In fact, they often feel exquisitely attuned to every micro-sensation. But rather than feeling connected or embodied, they resonate more with a loud internal noise that never shuts off.

Neurodivergent people: Neurodivergence can impact interoception, and internal states may be noticed too late, too intensely, or sometimes without clear differentiation. Cognitive mapping or relying on external cues sometimes feels more reliable than pure body tracking.

People with alexithymia or limited emotional labeling: Some people experience strong affect, but they have difficulty translating their internal states into language. Naming what's happening in the body can feel either elusive or downright impossible.

People with chronic illness or pain conditions: If bodily sensations are painful or overwhelming, turning attention inward can increase a state of distress rather than reduce it. Here, the body feels frightening and difficult to manage rather than informative.

People with eating disorders: Those with eating disorders focus their attention toward weight, shape, hunger, fullness, and perceived body "wrongness." They are aware of their bodies, but this awareness is filtered through protection and self-monitoring rather than felt experience.

People who were never taught or modeled body awareness: Last but absolutely not least, most people were never taught this concept. Even if somatic awareness may feel "obvious" within therapy culture, the practice of turning inward in this particular way is generally unfamiliar.

I have spent many years working with trauma, addiction, and eating disorders at all levels of care, both as a therapist and supervisor. I have sat with countless people whose relationships with their own bodies feel utterly fractured.

Building a relationship with one's body absolutely has its merit. The body is the home, and it's the only home nobody but ourselves lives in. We thrive when we know when to push and when to rest. We benefit from learning how to let sensations rise and fall without immediately reacting to them. It can be important to cultivate an inward curiosity, especially when we want to feel more connected to ourselves.

In my work, I absolutely see how body-based interventions can help people interrupt relapse trajectories by creating pauses before certain unwanted behaviors. I see how it supports others in recognizing when they are moving toward dissociation, panic, or explosive anger. There is real clinical value in checking in with the body as an early warning system. And many build more positive relationships with their bodies, reinforcing their desires to nurture and care well for themselves. All of this is so important. I would never devalue that.

But the body is not the only doorway into the self.

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It's Okay If You Don't Feel That In Your Body

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Why therapists shouldn't assume embodiment is always the gold standard in therapy

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The Neurodivergence Skills Workbook for Autism and ADHD: Cultivate Self-Compassion, Live Authentically, and Be Your Own Advocate – Ouzola

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Written by neurodivergent psychologists for neurodivergent readers. This empowering workbook offers self-compassion skills to help you embrace who you are and thrive. As an autistic person or neurodivergent individual with attention-deficit hyperactivity disorder (ADHD), you may sometimes feel as if you’re living in a world that wasn’t designed for you. You may have sensory sensitivities, social difficulties, struggles with executive functioning, sleep issues, depression, anxiety, burnout and meltdowns, and trauma from a lifetime of marginalization and microaggressions. If you are struggling with your neurodivergent identity, know that you aren’t alone. Whether you were diagnosed as a child or are just now realizing your difference, this workbook can help you move beyond the internalized message that there is something wrong with you, so you can embrace who you really are and manage stress before it leads to neurodivergent burnout. The Neurodivergence Skills Workbook for Autism and ADHD offers acceptance and commitment therapy (ACT) and self-compassion skills tailored to the needs of neurodiverse people—especially those with ADHD and Autism—so you can live authentically, take pride in your identity, increase overall well-being, and build meaningful connections to thrive as a neurodivergent person in the modern world. This workbook will help you: Acknowledge your needs and be your own advocate Unmask and express your authentic self Reduce sensory overload and balance emotions Manage rejection sensitivity dysphoria (RSD) and social anxiety Build meaningful social connections Improve executive functioning to get more done Adjust your environment to better fit your needs   Most importantly, you’ll learn to take pride in your identity. Whether you’re autistic, ADHD, or both, this workbook can help you overcome self-critical thinking, advocate for yourself in effective ways, and learn practical skills to help you thrive as your authentic self.

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The Neurodivergence Skills Workbook for Autism and ADHD: Cultivate Self-Compassion, Live Authentically, and Be Your Own Advocate – Ouzola

# data[].attributes.attachment_link.description
Written by neurodivergent psychologists for neurodivergent readers. This empowering workbook offers self-compassion skills to help you embrace who you are and thrive. As an autistic person or neurodivergent individual with attention-deficit hyperactivity disorder (ADHD), you may sometimes feel as if you’re living in a world that wasn’t designed for you. You may have sensory sensitivities, social difficulties, struggles with executive functioning, sleep issues, depression, anxiety, burnout and meltdowns, and trauma from a lifetime of marginalization and microaggressions. If you are struggling with your neurodivergent identity, know that you aren’t alone. Whether you were diagnosed as a child or are just now realizing your difference, this workbook can help you move beyond the internalized message that there is something wrong with you, so you can embrace who you really are and manage stress before it leads to neurodivergent burnout. The Neurodivergence Skills Workbook for Autism and ADHD offers acceptance and commitment therapy (ACT) and self-compassion skills tailored to the needs of neurodiverse people—especially those with ADHD and Autism—so you can live authentically, take pride in your identity, increase overall well-being, and build meaningful connections to thrive as a neurodivergent person in the modern world. This workbook will help you: Acknowledge your needs and be your own advocate Unmask and express your authentic self Reduce sensory overload and balance emotions Manage rejection sensitivity dysphoria (RSD) and social anxiety Build meaningful social connections Improve executive functioning to get more done Adjust your environment to better fit your needs   Most importantly, you’ll learn to take pride in your identity. Whether you’re autistic, ADHD, or both, this workbook can help you overcome self-critical thinking, advocate for yourself in effective ways, and learn practical skills to help you thrive as your authentic self.

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DSM-5 Casebook and Treatment Guide for Child Mental Health – Ouzola

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DSM-5(R) Casebook and Treatment Guide for Child Mental Health offers trainees and clinicians who provide mental health services to children and adolescents a concise but conceptually and clinically rich guide to the types of disorders commonly found in practice. The cases are either new or updated from the previous publication, which was designed as a child mental health casebook for DSM-IV-TR, and were chosen to illustrate advances in diagnosis and evidence-based assessment and treatment with DSM-5 in mind. For each case, commentaries are included from a child and adolescent psychiatrist and child psychologist (or another mental health professional), who review each vignette and address diagnostic formulation and treatment from both psychotherapeutic and psychopharmacologic perspectives, with attention to other modalities that might be important for clinical management. This panel approach allows for a diversity of perspectives and provides valuable, complementary insights into each case. The book is structured in a logical, user-friendly way, with many features that facilitate and enhance learning: - Cases are divided into four sections, each with an introduction by the editors, who summarize and contextualize the information presented in that part, providing a framework for understanding and building bridges to the other sections.- The 29 case vignettes are fascinating, instructive, and diverse. The cases range from fairly clear diagnoses, to more complex presentations (such as when patients with comorbid conditions), to the most difficult cases (when the diagnosis is unclear, the patient has not responded to previous treatment, only limited evidence is available on the correct means of treatment, and/or the patient’s psychopathology occurs in the context of extreme psychosocial stressors).- The book’s final part addresses diagnostic and treatment decision making and includes two chapters on clinical and research issues in the diagnosis and treatment of child psychopathology. The book’s cross-disciplinary approach makes it appropriate for clinicians and trainees from all disciplines who are involved in treating children and adolescents with mental health problems. DSM-5(R) Casebook and Treatment Guide for Child Mental Health is unparalleled in its engaging style, up-to-date information, and expert, evidence-based guidance in conceptualizing diagnosis and treatment.

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You may remember them as the "guidance counselor," and their office as the place you went when you needed a correction made to your schedule. But times - and titles - have changed. The professionals now known as school counselors may have a hand in scheduling, but they also support students in many other ways.

"School counselors' work involves way more than just schedule changes and consoling crying students," Danielle Schultz, a middle school counselor in Pennsylvania, told HuffPost.

They currently find themselves on the front lines of the youth mental health crisis. Young people's distress was exacerbated by the pandemic, but had already been on the rise for years. In 2019, over a third of all adolescents, and half of female adolescents, reported "such persistent feelings of sadness or hopelessness in the past year that they couldn't participate in their regular activities," according to a survey on youth health and behavior by the Centers for Disease Control and Prevention. This number had risen significantly over the previous decade, as did the number of youth who reported thoughts of suicide. The 2021 data show those numbers continuing to climb.

In schools, the stakes are high. Whenever a student says something that makes a teacher or a fellow student wonder if they are considering harming themselves or someone else, the school counselor (or their colleague, the social worker) is called upon to do a threat or suicide assessment and determine whether the student is in immediate danger.

"'Friendship drama' or scheduling may have been past perceptions of issues that students may seek out a school counselor for," Steve Sharp, a middle school counselor in Pennsylvania, told HuffPost. But mental health is the top concern that students bring to him today.

One benefit of mental health concerns being so widespread, however, is that "there's a growing normalization and destigmatization of students caring for their mental health," Sharp said.

Parents and teachers may have not yet registered this trend. "I think parents typically think the most common issues with kids are surface level, either about friends, social groups, social media, or academic concerns," Lissett Bohannon, a former high school counselor in Texas, told HuffPost. Likewise, she said, teachers may assume that students are coming in with concerns about grades.

The reality is that students' top concerns run much wider and deeper. HuffPost reached out to a number of school counselors to ask them the top reasons that students visit their office.

Bohannon said her top priority is simply listening, and "hearing the issue from the student lens."

For students who are not accustomed to naming and articulating their feelings, this can take some practice.

"Some students have told me that they are never asked about certain feelings throughout the day, so it's hard for them to put into words how or why they feel a certain way," Bohannon said. "As a school counselor, I would really just focus on creating a safe place for the student to open up."

Their inexperience is also sometimes just a product of their youth. "It can be confusing and difficult for students to understand their emotions when they may be experiencing this emotion for the first time," she explained. "These brand-new emotions may lead them to behaviors that are not typical for them, and many times, students have a hard time understanding or explaining what is going on within themselves. Some of the feelings they may be experiencing may only show up at certain times or have certain triggers, and for a lot of students, learning these triggers is all new."

Looming college applications give students plenty of reason to worry about grades, but the pressure to succeed academically also comes from home. Particularly for immigrant students, and those who will be the first generation in their family to attend college, the weight of expectation may be a heavy one. Students often feel that they must succeed in order to honor their families' sacrifices.

"Many of my students struggle with the idea of disappointing their parents, and opening up about feelings of anxiety or depression can be scary for them to bring up at home," Bohannon said.

3. Identifying Feelings In Order To Change Behavior

A teacher who is struggling with a student in the classroom might hope that having the student speak with the counselor would put an end to a troublesome behavior - and it may - but rehashing the behavior and why it was wrong probably won't be the counselor's starting point.

"Behavior is communication and it's the result of what one is thinking and feeling," Casey O'Brien Martin, an elementary school counselor in Massachusetts and author of " Skills For Big Feelings," told HuffPost.

"I'm often working with kids to teach them that their thoughts impact their feelings, which then influences their behavior," she said. "So, I'm starting by teaching them how to identify if their thoughts are helpful or unhelpful, and then how to change those unhelpful thoughts, which then impacts their feelings and this, in turn, influences their behavior."

All of this means adults shouldn't expect to see changes overnight. "We don't have a magic wand," O'Brien Martin said. "Behavioral change and social-emotional change is slow, deep work and it takes time."

Sharp noted that students are becoming more conversant in the language of mental health, and may strategically reach out to a counselor for help navigating a challenge.

"Increasingly, I'm connecting with students who speak maturely and insightfully regarding their emotional experiences, are proactive seeking to check-in regarding their emotional health, or simply seeking to coordinate the skills or behavioral health services they're receiving outside of schools and reflecting on how that applies to school," he said.

O'Brien Martin said one of the issues she sees most frequently is anxiety, often showing up around the ages of 6 and 7. When anxiety does occur, it can materialize in some unexpected ways.

These may include: "oppositional or aggressive behavior, school refusal, separation anxiety, inattention, phobias, avoidance, control issues, tantrums, elopement, worrying 'what if...' thoughts, and more," she explained.

Sometimes, parents allow kids to avoid things that make them anxious in order to ease their anxiety - but, in the long-run, this can actually make anxiety worse, she cautioned.

"When we let our kids avoid situations that make them anxious, it stops them from mastering the skills they need to learn to cope with those feelings," O'Brien Martin said.

While a true phobia will need to be addressed with a therapist, in many instances it's best to give kids an opportunity to overcome a challenge.

"If your child is having a hard day at school, it's natural to want to dismiss them from school, but the healthier choice is to give them the tools to cope with their feelings," she said.

O'Brien Martin suggested that you validate your kids' feelings and affirm their strength by saying, for example, "I know this is hard and I know you can do hard things," or "I know you have the tools to deal with your big feelings!"

One big feeling that can lead to issues at school is anger.

"We have lots of conversations about how anger is not an 'issue' that is out of their control, it's a feeling that they are learning to manage. So we spend time reframing that automatic thought and phrase into something helpful like, 'I am learning to handle hard times and strong feelings,'" Laura Filtness, an elementary school counselor in Tennessee, told HuffPost.

With anger and other emotions, Filtness said she works with students on the skills of mindfulness and understanding what they can and can't control.

"Taking a moment to be present and thoughtful helps them respond instead of reacting impulsively," Filtness said.

"We also discuss the idea of control, and how they can make changes to improve their situation," she added. "At the same time, we acknowledge that there are things they cannot control, and we work on coping strategies for those situations."

7. Navigating Peer Conflict

Of course, there are still plenty of kids who end up in the counselor's office because of a conflict with a classmate. In these situations, counselors emphasize dealing with conflict in a healthy way.

"As grown-ups we often want to run away from and avoid conflict but it's so much healthier to teach kids ways to deal with their conflicts and how to solve problems," O'Brien Martin said. "For minor problems with peers, I find it's useful to teach kids to use I-statements: 'I feel ___ when you ___. Could you please ___?'"

When students come in with a peer conflict, she continued, "I'm often reflecting the problem back to them to solve because it's much more empowering for them. ... I'll say, 'I know you're a problem solver! How do you think we should handle this situation?' And often they'll tell me what they need to do like apologize, use a coping skill, or use an I-statement."

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7 Issues Kids Bring Up Most Often With School Counselors

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School counselors deal with a lot more than schedule changes. Here's what they'd like you to know.

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Introducing a standardized measure of eight dimensions of interoceptive awareness in children and youth, ages 7 to 17 years. It can be completed as a self-administered assessment or in an interview administered format.

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Three critics discuss the changing role of the therapist on television, from “Frasier” and “The Sopranos” to “Shrinking” and “Couples Therapy.”

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Creative, fun & fast therapeutic warm-ups! When a client walks into the therapy room they don't know what to expect-feeling anxious, unsure, and perhaps fearful.

Read the Sample Below👇🏻

Brief, art therapy warm-ups are the perfect way to break the ice and get clients feeling comfortable, less inhibited, and motivated to participate in individual or group therapy.

These unique 250 art exercises increase self-esteem, self-awareness, and a feeling of success in artistic expression and communication, allowing clients to engage in therapeutic exercises without judgment. Using simple materials like paper, pencils, and markers, these techniques can be immediately implemented in your practice.

Art techniques based in:

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250 Brief, Creative & Practical Art Therapy Techniques: A Guide for Clinicians and Clients

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Creative, fun & fast therapeutic warm-ups! When a client walks into the therapy room they don't know what to expect-feeling anxious, unsure, and perhaps fearful. Read the Sample Below👇🏻 Brief, art therapy warm-ups are the perfect way to break the ice and get clients feeling comfortable, less inhibited, and motivat

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TherapyBooks - Best Therapy Books to Read for Therapists

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TherapyBooks offers a curated collection of the best therapy books for therapists, counselors, and mental health professionals. From the latest research on psychotherapy to practical guides on cognitive-behavioral therapy (CBT), we provide expert recommendations on the most insightful and informative books in the field

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This book focuses on somatic art therapy for treating acute or chronic pain, especially resulting from physical and/or psychological trauma. It discusses the role of the psyche in physical healing and encourages combining of traditional medicine and holistic perspectives in treatment.

Translated from the French text, this volume provides case studies and examples from the author's art psychotherapy practice of 40 years, including the four-quadrants method. Chapters review the current treatments for chronic pain and PTSD and focus on art therapeutic methods to treat those conditions, such as art therapy protocols for PTSD. The book exposes the underlying rational of somatic art therapy, covering art therapy effectiveness, Levine's somatic dissociation, van der Kolk's somatic memory, and Scaer's procedural memory concepts. Also featured are chapter contributions from art therapists Sophie Boudrias, Mylène Piché, and Dr. Patcharin Sughondhabirom.

By providing a unique, clear and concise synthesis of available art therapy methods this text will appeal both to the general and professional public, including professional art therapists, psychotherapists, helping relation professionals, and medical practitioners.

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Somatic Art Therapy: Alleviating Pain and Trauma through Art - 1st Edition

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This book focuses on somatic art therapy for treating acute or chronic pain, especially resulting from physical and/or psychological trauma. It discusses the role of the psyche in physical healing and encourages combining of traditional medicine and holistic perspectives in treatment.

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Envisage - Volume 6 Issue 1 - Canadian Art Therapy Association

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Explore Membership Membership Levels Insurance Grants and Bursaries Member Profile Become a Member What Is Art Therapy? Becoming an Art Therapist News Magazine Journal Art Therapist Directory Supervisor Directory Share Your Message Conference FAQ

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Anxiety in children and youth: Part 1 - Diagnosis | Canadian Paediatric Society

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Anxiety disorders are the most common mental health concerns affecting Canadian children and adolescents. The Canadian Paediatric Society has developed two position statements that summarize current evidence regarding the diagnosis and management of anxiety disorders. Both statements offer evidence-…

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Art Therapist (M.A). During my work at schools and kindergartens, I have met dozens of children. I saw how much they need a safe place to express their emotions, to create and play. I opened the shop to provide tools to enhance emotional expression.

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You may have heard the term "Two-Spirit"tossed around without actually knowing the meaning behind it - perhaps because it's often been co-opted by non-Native people.

Two-Spirit is a modern umbrella term to describe Indigenous people who embody both a feminine and masculine energy and have traditionally held a number of important social and spiritual roles in their tribes.

"As it's been told to me, if the morning is male and the evening is female, then Two-Spirits are the dusk," Cherokee Two-Spirit musician Tony Enos told HuffPost. "We were then, and are still, the balance-keepers in our living Indigenous cultures."

The term was coined by Elder Myra Laramee in 1990 at a Native American and First Nation LGBTQ conference in Winnipeg, Canada, (though the concept has existed in Native cultures long before that) to unite the various queer identities and expressions among Indigenous people.

"The term was intentionally introduced by Native people with the goal of finding common ground and helping educate about traditional teachings in a contemporary context," Passamaquoddy Two-Spirit artist Geo Neptune explained in a video for Them.com.

Tribal nations have their own terms for and understanding of what it means to be Two-Spirit. Some individuals prefer to use words from their Indigenous languages, rather than adopting the pan-Indian term "Two-Spirit," according to the Indian Health Service website.

Before colonization, Native communities embraced the Two-Spirit identity. But the Europeans' homophobic attitudes and binary understanding of gender led to its erasure.

"The traditional place and role that we held among our people was taken from us and deemed an 'abomination,'" Enos said. "The modern Two-Spirit movement is a reclamation of that traditional role and place among our people."

Historically, Two-Spirit people were honored members of their tribes, and occupied roles such as visionary, artist, healer, matchmaker, counselor and warrior. These individuals often carried out duties that were traditionally assigned to both men and women.

Matthew Reed, a Two-Spirit from the Pueblo of Laguna tribe, told HuffPost that according to his father, Two-Spirits in their community would live and dress "according to who they were called to be."

For example, a Two-Spirit person might hunt and go to war, while also taking on domestic tasks like cooking or child-rearing.

Being Two-Spirit is also about "the spirit of our connection to our history, our culture, our traditions, and the lands in which we live," human rights activist Albert McLeod, co-director of the Two-Spirited People of Manitoba, told USA Today, "but also the spirit of inclusion in our families, our communities, and our nations."

"A lot of people assume it is particularly about gender identity or biological sex," he continued. "But myself, I think it's a more deeper meaning to it in terms of spiritual connection to the land, and to our peoples."

To Reed, being Two-Spirit is about honoring traditions and being of service to others, he said.

"It is not necessarily a statement saying 'I am here,' but rather saying, 'how can I be of service?'" he said. "Whatever roles were taken from us during the conquest are not for others to give back but rather for Two-Spirits to resume in their communities. For me that means taking part in our traditional ceremonies [and] preserving our heritage by learning and teaching."

Enos also cited the Two-Spirit gift of being able "to see the world through the lens of both a male and female spirit." For him, he said, being Two-Spirit is also about "caring for our youth and elders."

It's important to note that with hundreds of Indigenous tribes come "hundreds of different traditions, languages, songs, prayers, and even roles for Two-Spirits," Enos added. "We are not a monolithic people."

PSA: The term is reserved for Indigenous people only

In a 2018 interview with Billboard, singer Jason Mraz opened up about his sexuality and the experiences he's had with both men and women, using the word "Two-Spirit" to describe his identity.

"It was like, 'Wow, does that mean I am gay?' And my wife laid it out for me. She calls it 'two spirit,' which is what the Native Americans call someone who can love both man and woman. I really like that," Mraz told the publication.

Flat out, you don't get to call yourself Two Spirit if you aren't Native. Don't.
- âpihtawikosisân (@apihtawikosisan) July 21, 2018

He later apologized on Twitter "for misunderstanding and misusing the term."

Two-Spirit is "not a poetic way for non-Native LGBTQ people to express themselves," as Neptune explained in the Them.com video.

Reed said that non-Indigenous people claiming to be Two-Spirit is "reminiscent of colonizers and conquerors taking our identity away from us."

"We welcome allys but Two-Spirit is for Indigenous peoples only," he said. "A non-Native would or should not claim to be of Navajo descent because they felt a kinship."

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Here's What It Means To Be 'Two-Spirit,' According To Native People

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You may have heard the term "Two-Spirit"tossed around without actually knowing the meaning behind it - perhaps because it's often been co-opted by non-Native people. Two-Spirit is a modern umbrella term to describe Indigenous people who embody both a feminine and masculine energy and have traditionally held a number of important social and spiritual roles in their tribes.

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Are you looking for an educational game for your child? This Wooden Cartoon Chess For Kids is the perfect solution. Its interactive design is ideal for improving skills and intelligence. Any playful kid will love learning how to play chess with this unique and engaging set.

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Markus Scott-Alexander - Expressive Arts Introduction

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The following essay is reprinted with permission from The Conversation, an online publication covering the latest research.
Whenever I teach about memory in my child development class at Rutgers University, I open by asking my students to recall their very first memories. Some students talk about their first day of pre-K; others talk about a time when they got hurt or upset; some cite the day their younger sibling was born.

Despite vast differences in the details, these memories do have a couple of things in common: They're all autobiographical, or memories of significant experiences in a person's life, and they typically didn't happen before the age of 2 or 3. In fact, most people can't remember events from the first few years of their lives - a phenomenon researchers have dubbed infantile amnesia. But why can't we remember the things that happened to us when we were infants? Does memory start to work only at a certain age?

Here's what researchers know about babies and memory.

Infants can form memories

Despite the fact that people can't remember much before the age of 2 or 3, research suggests that infants can form memories - just not the kinds of memories you tell about yourself. Within the first few days of life, infants can recall their own mother's face and distinguish it from the face of a stranger. A few months later, infants can demonstrate that they remember lots of familiar faces by smiling most at the ones they see most often.

In fact, there are lots of different kinds of memories besides those that are autobiographical. There are semantic memories, or memories of facts, like the names for different varieties of apples, or the capital of your home state. There are also procedural memories, or memories for how to perform an action, like opening your front door or driving a car.

Research from psychologist Carolyn Rovee-Collier's lab in the 1980s and 1990s famously showed that infants can form some of these other kinds of memories from an early age. Of course, infants can't exactly tell you what they remember. So the key to Rovee-Collier's research was devising a task that was sensitive to babies' rapidly changing bodies and abilities in order to assess their memories over a long period.

In the version for 2- to 6-month-old infants, researchers place an infant in a crib with a mobile hanging overhead. They measure how much the baby kicks to get an idea of their natural propensity to move their legs. Next, they tie a string from the baby's leg to the end of the mobile, so that whenever the baby kicks, the mobile moves. As you might imagine, infants quickly learn that they're in control - they like seeing the mobile move and so they kick more than before the string was attached to their leg, showing they've learned that kicking makes the mobile move.

The version for 6- to 18-month-old infants is similar. But instead of lying in a crib - which this age group just won't do for very long - the infant sits on their parent's lap with their hands on a lever that will eventually make a train move around a track. At first, the lever doesn't work, and the experimenters measure how much a baby naturally presses down. Next, they turn the lever on. Now every time the infant presses on it, the train will move around its track. Infants again learn the game quickly, and press on the lever significantly more when it makes the train move.

What does this have to do with memory? The cleverest part of this research is that after training infants on one of these tasks for a couple of days, Rovee-Collier later tested whether they remembered it. When infants came back into the lab, researchers simply showed them the mobile or train and measured if they still kicked and pressed the lever.

Using this method, Rovee-Collier and colleagues found that at 6 months, if infants are trained for one minute, they can remember an event a day later. The older infants were, the longer they remembered. She also found that you can get infants to remember events for longer by training them for longer periods of time, and by giving them reminders - for example, by showing them the mobile moving very briefly on its own.

Why not autobiographical memories?

If infants can form memories in their first few months, why don't people remember things from that earliest stage of life? It still isn't clear whether people experience infantile amnesia because we can't form autobiographical memories, or whether we just have no way to retrieve them. No one knows for sure what's going on, but scientists have a few guesses.

One is that autobiographical memories require you to have some sense of self. You need to be able to think about your behavior with respect to how it relates to others. Researchers have tested this ability in the past using a mirror recognition task called the rouge test. It involves marking a baby's nose with a spot of red lipstick or blush - or "rouge" as they said in the 1970s when the task was created.

Then researchers place the infant in front of a mirror. Infants younger than 18 months just smile at the cute baby in the reflection, not showing any evidence that they recognize themselves or the red mark on their face. Between 18 and 24 months, toddlers touch their own nose, even looking embarrassed, suggesting that they connect the red dot in the mirror with their own face - they have some sense of self.

Another possible explanation for infantile amnesia is that because infants don't have language until later in the second year of life, they can't form narratives about their own lives that they can later recall.

Finally, the hippocampus, which is the region of the brain that's largely responsible for memory, isn't fully developed in the infancy period.

Scientists will continue to investigate how each of these factors might contribute to why you can't remember much, if anything, about your life before the age of 2.
This article was originally published on The Conversation. Read the original article.

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Why You Can’t Remember Being Born: A Look at ‘Infantile Amnesia’

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The following essay is reprinted with permission from The Conversation, an online publication covering the latest research. Whenever I teach about memory in my child development class at Rutgers University, I open by asking my students to recall their very first memories.

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Mindfulness in schools does not improve mental health, study finds

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School-based mindfulness training does not appear to boost wellbeing or improve the mental health of teenagers, according to research that found many pupils were bored by the course and did not practise it at home.

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Envisage - Volume 5 Issue 2 - Canadian Art Therapy Association

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Explore Membership Membership Levels Insurance Grants and Bursaries Member Profile Become a Member What Is Art Therapy? Becoming an Art Therapist News Magazine Journal Art Therapist Directory Supervisor Directory Share Your Message Conference FAQ

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This article was originally featured on KHN.

When Pat Paulson's son told her he was feeling anxious and depressed at college, Paulson went through her Blue Cross Blue Shield provider directory and started calling mental health therapists. No providers in the Wisconsin city where her son's university is located had openings. So she bought a monthly subscription to BetterHelp, a Mountain View, California, company that links people to therapists online.

Her son felt uncomfortable with his first BetterHelp therapist. After waiting several weeks, he saw a second therapist, whom he liked. But she wasn't available the following week.

Despite the switch and the wait, Paulson is grateful she was able to find her son help. "He was getting to the point where he was ready to give up trying to find someone," she said.

Many U.S. adults aren't able to find help because of a shortage of therapists. Nearly 40% are struggling with mental health or substance abuse issues, according to the Centers for Disease Control and Prevention.

So millions of people are turning to online companies like BetterHelp that have sprung up in the past several years, advertising quick access to therapy. Often backed by venture capital firms, these for-profit businesses offer a wide mix of services, including one-on-one and group video therapy visits with licensed professionals, supportive texting, coaching videos, and prescriptions for medications.

In their ads, some of the companies feature testimonials from celebrities like Olympic athletes Simone Biles and Michael Phelps. But veteran therapists and officials from leading mental health professional associations say there's limited evidence of the new online providers' effectiveness.

"There are fundamental questions about what these companies are doing and whether they are reaching people who really need help," said Dr. John Torous, director of the digital psychiatry division at Beth Israel Deaconess Medical Center in Boston and chair of the American Psychiatric Association's Health Information Technology Committee. "They may be doing wonderful work, but it's hard to know when we don't have that data."

Dr. Varun Choudhary, chief medical officer at Talkspace, an online and mobile-based therapy provider, said online companies can help patients who face financial, cultural, and accessibility barriers to traditional therapy. He said clients may want the convenience of getting care online at home.

"By bringing together patients on a teletherapy platform, Talkspace expands capacity to deliver treatment," he said. The company, headquartered in New York, says it has served more than a million people with 3,000 providers across all 50 states, and it charges $400 or more per month for four weekly live sessions.

Research suggests therapy delivered online can be effective and, spurred by the covid-19 pandemic, many individual therapists are offering sessions with their patients online. But the rapid proliferation of the online commercial therapy industry worries some traditional mental health professionals who have raised concerns about aggressive advertising for online services and whether patient care is compromised by inadequate training and pay for therapists working at some digital companies. In addition, news reports have detailed questionable prescription protocols, after which federal law enforcement launched probes of one company.

"Online companies inundate the internet with appealing ads that make promises about treating depression and anxiety," said Marlene Maheu, a clinical psychologist and founder of the Telebehavioral Health Institute, who trains practitioners in best online practices and evaluates services for employers who may want to offer them as benefits to workers. "But can you trust them with your kid who's in trouble?"

Therapy via text

Studies have found face-to-face video psychotherapy visits and other mental health sessions to be just as effective as in-person encounters. But veteran mental health professionals are skeptical of some online providers' texting practices and services that do not involve real-time video therapy. Research support for the efficacy of texting and similar services is scarce. On its own sites and publications, the American Psychological Association has barred advertising from one online mental health company on the grounds that its services do not meet the APA's criteria for evidence-based therapy.

"Our concern there is that a patient will leave a text and it might be hours before the therapist responds," said Vaile Wright, senior director for innovation at the American Psychological Association. "We don't have peer-reviewed research to support that this is effective."

Psychologist Bradley Boivin, who worked as an independent contracting therapist with BetterHelp for three months last year, said he had such strong concerns about the extensive use of texting for therapy that he told his clients he wouldn't do it.

Boivin, who now works for a private practice in Scottsdale, Arizona, said other BetterHelp therapists told him they felt pressured to reply to client texts at all hours of the day. A BetterHelp compensation sheet obtained by KHN shows therapists get paid by the number of text words they read and write.

Alon Matas, founder and president of BetterHelp, which spent more than $7 million in December to advertise on 556 podcasts, defended the use of texting, saying his company's therapists are not expected to respond immediately to clients' texts. Each therapist uses professional judgment to decide when is the right time to use messaging and "how it's best suited for each individual member," he said.

Many therapists working at online companies are independent contractors, with no liability insurance or health insurance from the company, according to officials at associations for mental health professionals.

The online companies often attract therapists who are less experienced because the pay is typically lower than what therapists in private practices generally earn, according to Laura Groshong, director of policy and practice for the Clinical Social Work Association. "This is a way for new clinicians to get a foot in the door, and that's something people should know," she said.

The BetterHelp compensation sheet shows that the company pays therapists on a sliding scale based on how many hours per week they work - $30 per hour for the first five hours, $35 for the next five, etc., topping out at $70 per hour for any hours in excess of 35. That's less than the typical $100 to $200 per session that private-practice therapists around the country charge clients.

Matas said the sheet does not reflect that therapists' base hourly compensation by his company may be supplemented with monthly stipends, payments for group sessions, bonuses, and caseload incentives. BetterHelp has more than 25,000 therapists in its network, and Matas said it effectively pays up to 60% more than the median compensation for licensed therapists in every metropolitan area where it has therapists.

A virtual pharmacy

There also are concerns about online companies whose clinicians prescribe psychiatric drugs - either controlled substances that are potentially addictive such as Adderall, or antidepressants such as Zoloft that are not addictive but have potentially dangerous side effects.

Federal law requires doctors to see a patient in person before prescribing controlled drugs, which are those tightly regulated by the government because they can be abused. The federal government waived that provision under public health emergency rules issued early in the covid pandemic. Officials are considering whether to extend that waiver whenever the public health emergency period is over.

That review has been roiled by recent law enforcement actions following news reports in March. The Justice Department and the Drug Enforcement Administration are investigating Cerebral, a San Francisco online-prescribing company, for possible violations of the Controlled Substances Act for its prescribing of Adderall. The company told news organizations it has not been accused of violating the law and it would pause prescribing Adderall and other controlled drugs for attention-deficit/hyperactivity disorder. In a statement to KHN last month, it said, "Cerebral is fully cooperating with the Justice Department investigation."

The DEA declined to comment on the probe, and the Department of Justice did not respond to KHN.

In a letter to the editor responding to a Bloomberg News article describing practices at Cerebral that included short patient appointments, aggressive advertising, and pressure on providers to prescribe drugs, Cerebral's founder and CEO, Kyle Robertson, said his company did not give quotas or targets to clinicians to prescribe drugs. Cerebral "follows clinical prescribing guidelines based on the latest research," he wrote.

The company's directors removed him from his position in May.

The Cerebral allegations are "a wake-up call to everyone in the industry," said Thomas Ferrante, an attorney at Foley & Lardner, which represents some online companies. "It's a reminder that health care is a highly regulated space."

"Companies like Cerebral are wrecking telemedicine for everyone," said Piper Buersmeyer, a psychiatric nurse practitioner who is the majority owner of Med Rx Partners, an online and in-person service that evaluates patients and prescribes medications in Vancouver, Washington. "They are destroying trust." She said she was concerned that some companies do not adequately evaluate patients' mental health issues before prescribing medicines.

Other companies also advertise directly to consumers about aid in obtaining medication. For instance, Hims & Hers, another San Francisco telehealth firm, has run ads offering to provide "medication for anxiety and depression in less than 24 hours" after clients fill out a short form and connect online with a Hims & Hers provider. A spokesperson for the company, Sam Moore, said providers prescribe drugs only after following "evidence-based clinical protocols."

Dr. Bob Kocher, president of Lyra Clinical Associates in Burlingame, California, said the optimal treatment pairs talk therapy with medication when needed. That generally works better than medication alone, he said. But he is concerned that some online therapy providers may not perform an adequate clinical evaluation of patients before and after they prescribe, may rely too much on patients' self-diagnosis, and may not provide enough talk therapy.

"It's not always clear it's depression," said Kocher, a practicing internist. Prescribing medications without adequate diagnostic work or continuing talk therapy, he added, would be "worrisome, because antidepressants are not without their own serious risks, including suicide."

Based on her experience reviewing some online companies for employers and training therapists in online settings, Maheu is concerned that companies may not give their therapists training in how to deliver safe, effective, and ethical therapy online. As a trainer of online providers herself, she teaches therapists how to de-escalate suicidal or other crisis situations over the video screen. Meanwhile, there's little government or professional regulation to protect consumers, she added. "What's happening is a corporate takeover of behavioral health care by digital entrepreneurs," Maheu warned. "This industry is a catastrophe waiting to happen."
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Digital therapy companies promise to make mental health accessible-but experts are skeptical

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This article was originally featured on KHN. When Pat Paulson's son told her he was feeling anxious and depressed at college, Paulson went through her Blue Cross Blue Shield provider directory and started calling mental health therapists. No providers in the Wisconsin city where her son's university is located had openings.

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Psychiatry, from its very inception, has been subject to raised eyebrows if not outright ridicule. Even before Freud came along with his batty theories about infantile sexuality and repressed wishes to kill one's father, the discipline had struggled to define its methods and objectives. More than two centuries after it emerged as a profession devoted to the care-and hoped-for cure-of the mentally ill, psychiatry is still seen by many as half-baked, neither a science nor an art, pulled hither and yon by an indeterminate purview and changing medical trends.

Two hundred years of research and theorizing have not resolved the most basic differences of opinion among psychiatry's practitioners as to whether what was once derisively called "madness" is a brain disease amenable to a purely medical treatment, such as insulin therapy or psychosurgery, or something engendered by a more complicated mix of factors. If, for instance, mental illness is based on the input of both nature and nurture, it might benefit from the talking cure-or, more likely, the talking cure in conjunction with medication.

Edging closer to the present with the birth of psychopharmacology in the 1950s (the first antipsychotic drugs appeared on the market in 1954), a biochemical model of mental illness has prevailed; the use of psychotropic medication ramped up in the 1980s and '90s, proffering relief from schizophrenia, bipolar disorder, and unipolar depression. The only problem with these ostensible advances is that the psychopharmacological revolution hasn't provided the long-hoped-for wonder drug. The drawbacks start with the intolerable side effects caused by many medications, especially those referred to as "atypical antipsychotics," such as Abilify and Risperdal. These can include major weight gain, tiredness, and uncontrollable facial tics known as "tardive dyskinesia," symptoms that, compounded, can sometimes make the supposed cure as destructive as the disease.

Still, for the many of us, like myself, who slog through days and months filled with unbearable sadness or destabilizing mood disorders, the lack of a thoroughgoing solution is in itself despair-inducing. One can unburden oneself to a therapist, swallow a bunch of meds that sort of help, or go to an emergency room and wait to be admitted to a bare, neglected psychiatric unit that couldn't be more inclined to worsen one's state of mind if it had been built as a detention center. (There are a few astronomically priced private psychiatric hospitals that go against type.)
Read: Locking up people is no way to treat mental illness
If the situation sounds rather dismal, Andrew Scull's comprehensive, sober, and compulsively readable history of psychiatry, Desperate Remedies, isn't designed to put the reader's mind at ease. Scull, a sociologist, provides a lucid and, in his own words, "skeptical" overview of the field, describing a complex and densely detailed series of developments with skill and little mercy. His empathy, which is considerable, is saved for the stigmatized and frequently dehumanized patients who are too often the victims of psychiatric arrogance as well as of the profit-fixated marketplace. Although Scull concedes that mental illness "remains a baffling collection of disorders," he has no use for psychiatrists such as R. D. Laing or Thomas Szasz, whose attempt to clarify the confusion around mental illness has been to proclaim it simply a story concocted about people who are not really ill so much as unconventional, eccentric, or even visionary.

Meanwhile, the conceptual arguments within psychiatry itself are vague and opaque, hard for professionals to read and almost impossible for the layman to parse. Scull's book is an effort to provide a sight line through the often turbulent currents of the field, touching on its strengths and (mostly) its shortfalls, from the start of the psychiatric endeavor to the present moment. His hope, I would suggest, is to provide readers with a way of thinking about people with mental illness as part of us rather than as alien or weird presences, best drugged into compliance or shuttled off to an institution. Understanding the long, sordid history of how these diseases of the mind have been treated is a necessary first step toward bringing people with even the most debilitating disorders into the fold and finding the solutions that might aid in their healing or, at the least, alleviate their suffering.

Desperate Remedies begins in the late 19th century, with the reign of what Scull calls the "mausoleums of the mad"-state asylums, which eventually were renamed state hospitals to downplay their stigma. These were basically mammoth holding pens for people who were frequently referred to in the United States as the "dregs of society," and the number of patients confined in them reached half a million by 1950. Asylum superintendents kept watch over patients who were considered unsound and lumped together-the senile, the syphilitic, and the alcoholic along with those classified as "feeble-minded" and "chronically insane"-behind grated windows and locked doors. In 1894, one eminent Philadelphia neurologist, Silas Weir Mitchell, in a lengthy critique at the American Medico-Psychological Association, pointed out that psychiatrists had been attempting for half a century to convince the public "that an asylum is in itself curative ... Upon my word, I think asylum life is deadly to the insane."

Along with the asylums overflowing with what Scull calls the "poor and the friendless," private hospitals and sanitariums, including the Hartford Retreat in Connecticut, the McLean Hospital in Boston, and the Battle Creek Sanitarium (run by the Kellogg brothers of Corn Flakes fame), sprang up in the late 19th century together with new diagnoses for "upper class" ailments, such as hysteria and neurasthenia. Self-styled "nerve doctors" treated their wealthy patients' "nervous prostration" (one thinks of Henry and William James's gifted sister, Alice, who retired to bed, never to get up again) with nerve tonics, many of which included dangerous substances such as morphine and strychnine. Hydrotherapy and electrotherapy, delivered by elaborate machines that sent painful jolts of electricity through the body, were also put into use. The best-known course of treatment for the well-to-do (primarily women) was the "rest cure," which consisted of a high-calorie diet and enforced bed rest as well as an absence of physical and mental stimulation. This approach would later be recommended for Virginia Woolf whenever she descended into one of her depressive states, and she never ceased to dread it.

By the mid-1930s, tolerance for the psychologically afflicted was at an all-time low: Some 31 states prohibited mentally ill and "feeble-minded" people from marrying; "the insane," one superintendent of a state asylum opined, were "notoriously addicted to matrimony and by no means satisfied with one brood of defectives." Scull tells us that no less a personage than the jurist Oliver Wendell Holmes Jr. "ringingly endorsed" the constitutionality of involuntary sterilization in 1927: "It is better for all the world," Holmes wrote, "if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind ... Three generations of imbeciles are enough."
Read: What American mental health care is missing
Over the following decades, the array of psychiatric interventions included insulin coma therapy; injections of camphor or Metrazol, both of which had what Scull calls "savage impacts"; brute physical force; and colectomies and abdominal surgeries, which were thought to cure psychosis but frequently led to the death of the patient (out of 79 patients whose abdomens had been operated on from mid-1919 to mid-1920, Scull reports that 23 died after the operation, generally from peritonitis). In some fashion, the favored approach seems to have been that whatever didn't kill you would strengthen you. The grim paradox that underlay this conviction wasn't lost on some observers: "It has long been known," noted Stanley Cobb, a psychiatry professor at Harvard who was struck in the late 1930s by the "widespread devastation" of patients' brains during insulin coma and Metrazol treatments, "that any situation that brings a schizophrenic patient near to death may rid him temporarily of his symptoms."

The advent of ECT ( electroconvulsive, or "shock," therapy) in the late '30s came with some caution and controversy-no one understood exactly how it worked when it did, which was mostly in cases of acute or, as it was called, "intractable" depression-but by October 1941, 42 percent of American mental hospitals had resorted to the practice. An individual sometimes received as many as four shock treatments a day and was essentially reduced to an infantile and incontinent condition. One report on a state hospital revealed that women were, on average, given twice as many shocks as men. Many of the treatments involved fractures, sometimes severe, and demonstrable signs of pain. There was a punitive side to the use of ECT as it developed into a means of subduing troublesome patients-an aspect that was captured to indelible effect in Ken Kesey's 1962 novel, One Flew Over the Cuckoo's Nest. The amnesiac effect was serious too. Ernest Hemingway condemned his Mayo Clinic doctors who had subjected him to ECT: "What is the sense of ruining my head and erasing my memory, which is my capital, and putting me out of business? It was a brilliant cure, but we lost the patient."

But undoubtedly, the most gruesome "cure" ever engineered to alleviate mental illness was the lobotomy. (More's the irony that it won its inventor, a Portuguese neurologist named Egas Moniz, the 1949 Nobel Prize for Medicine.) Reading about it today in Scull's narrative is enough to make one's skin crawl and fill one's head with wonder at man's benighted capacity for cruelty in the name of kindness.

On November 12, 1935, the Oxford-trained neurosurgeon Almeida Lima performed a frontal lobotomy under Moniz's direction (Moniz himself was suffering from gout and arthritis). Moniz began by having Lima drill holes into the patient's skull and then inject alcohol into his brain, but he changed tactics when the "destructive effects of this technique were too unpredictable." He then had Lima "crush white matter" and cut six cores out of the frontal lobes with a tool he referred to as a "leucotome." Even more zealous practitioners, such as Walter Freeman, a neurologist with no surgical training, employed far more sweeping surgeries-using a small knife to make bilateral cuts in the frontal lobes, repeating the operation if it failed the first time, and then adding on an unbelievable number of electroshock treatments in the days that followed.

As Scull recounts these developments, his tone remains detached while also suggesting his quiet horror at the violent and essentially unsupervised path the field had taken. Freeman moved on to perform transorbital lobotomies by driving an ice pick through the orbit of a patient's eye (although he would ultimately hit upon a specially designed tool). In 1941, Freeman, together with a young neurosurgeon named James Watts, performed psychosurgery on a 23-year-old Rosemary Kennedy, whose father, Joseph, feared that the combination of her nascent sexuality and intellectual slowness might bring embarrassment to the Kennedy name. The consequences were dire: "From 1941 till her death in 2005, Rosemary Kennedy was severely mentally handicapped, unable to speak, incontinent, barely able to walk and hidden from public view." Scull, always sensitive to gender issues, cites a 1949 study that found that, as with shock treatments, women were lobotomized twice as often as men.

Scull's book is an ambitious undertaking, and in his various explorations of the "crisis of legitimacy" in psychiatry and the profession's ongoing "quest for validity," he leaves few subjects untouched-be it the creation, in 1952, of the taxonomic guide now known as the Diagnosis and Statistical Manual of Mental Disorders and the fierce feuds it engendered; the initial embrace of psychoanalysis from the '40s through the '60s, succeeded by its gradually falling out of grace and its diminished influence; the emptying-out of psychiatric hospitals during the '60s and '70s, contributing to a steep rise in the homeless population and unattended-to psychotic patients; or the so-called psychopharmacological revolution.

As suicide rates among the young remain on the rise and people who suffer from severe emotional disorders continue to need professional help, one wonders whether we have reached a standstill of sorts in the treatment of mental illness-whether our knowledge of how the mind works is too limited to move decisively forward. I would have been interested to hear what Scull makes of ketamine "mills" (having tried six sessions of ketamine infusions myself, I can report that they did little for me other than put me to sleep). There is, as well, the new interest in using psychedelics and MDMA (popularly known as Ecstasy, or Molly) as well as bodywork (the alternative-medicine techniques involving massage and breathing popularized by the best-selling book The Body Keeps the Score, by Bessel van der Kolk) to rejigger the brain-altering effects of trauma.
Read: Psychiatry's incurable hubris
Then, too, his book gives much less space to the various extant kinds of traditional talk therapy. However limited in its effectiveness it may be, some people still find succor from full-on psychoanalysis on a couch, allowing them to go from "neurotic misery" to "ordinary unhappiness," as Freud put it. Less intensive psychotherapy and the treatment modalities known as CBT (cognitive behavioral therapy) and DBT (dialectical behavioral therapy) also exist. As someone who has spent decades both in psychotherapy and on a panoply of psychotropic medications, I would say that although they haven't succeeded in undoing the damage and repercussions of my past, they have been significant in making my life more tolerable.

If Scull's turbulent history were merely an indictment, it would be a far less powerful document than it is. It's also a plea for less internecine fighting between the nature and nurture proponents and a greater acceptance of the large gray area that encompasses our inability to fully discern where the influence of biology stops and the influence of environment begins. Scull has joined his wide-ranging reporting and research with a humane perspective on matters that many of us continue to look away from. And understanding these "desperate remedies" helps to elucidate the psychiatric pathologies to which they were responding. The first sentence of his preface explains why we must confront the often elusive and still stigmatized specter of psychological distress instead of consigning it to the sidelines. "Few of us," Scull writes, "escape the ravages of mental illness." It's an observation that strikes me as both tragic and true, much as we might wish to ignore or deny it.

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Can You Cure Mental Illness? Two Centuries of Trying Says No.

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Psychiatry, from its very inception, has been subject to raised eyebrows if not outright ridicule. Even before Freud came along with his batty theories about infantile sexuality and repressed wishes to kill one's father, the discipline had struggled to define its methods and objectives.

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If you were abused as a child - whether by your parents, another trusted adult, your schoolmates or anyone else - chances are good that you don't need a bunch of scientists to tell you that the ripple effects of pain will still be felt when you're an adult.

For many child abuse victims, regardless of their age, the fact that you can never fully escape the pain is tied into your very being.
RELATED: Anecdotally, gardeners call their hobby therapeutic. Scientists are trying to provide proof
Yet there is still great utility in psychologists being able to unpack the precise nature of how child abuse affects adult victims - and that is where a new study published in the journal Aging and Health Research comes into play. The study - which was conducted by a team of scientists led by research assistant Anna Buhrmann at the Institute of Life Course & Aging at the University of Toronto - examined health data from a group of more than 5,000 British Columbians who were at least 60 years old. From there, the health information from individuals who had been physically abused as children was compared to that from individuals who had not.

Their conclusions were astounding - and tragic.
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Specifically, researchers found a "significant" association between childhood physical abuse and seven health conditions. Two of those health conditions were mental health-related, and five were related to physical health. The five physical health conditions are diabetes, heart disease, arthritis, migraines and cancers. The two mental health conditions are depression and anxiety. Both were found to occur later in life, and with disproportionate frequency, among adults who had been physically abused as children.

Researchers found a "significant" association between childhood physical abuse and seven health conditions - diabetes, heart disease, arthritis, migraines, cancers, depression and anxiety.

"The association between CPA [childhood physical abuse] and 2 mental health and 5 physical health conditions remained significant, even after controlling for sociodemographic characteristics, health behaviors and other ACEs [adverse childhood experiences]," the authors explain. "Further research is needed to investigate potential pathways through which childhood physical abuse is linked to a wide range of later-life health problems."

One of the study's co-authors expressed hope that therapy may be a good way to alleviate some of the negative impacts of being abused as a child.

"Health professionals serving older adults need to be aware that it is never too late to refer people for counselling," professor Esme Fuller-Thomson, who supervised the thesis, explained in a statement. "A promising intervention, cognitive behavioral therapy [CBT], has been tested and found effective at reducing post-traumatic stress disorder and depressive and anxiety symptoms among survivors of childhood abuse."

It is unclear exactly how childhood physical abuse is able to so closely correspond to adult health problems. The study's authors acknowledge that more research is needed on the subject, as possible explanations range from the psychological changes caused in children after they are abused to the possibility that abuse victims develop physical changes like abnormal levels of cortisol, the body's primary stress hormone.

"A growing body of literature supports the biological embedding hypothesis, which describes how childhood physical abuse 'gets under the skin' to produce physiological changes that lead to poor health outcomes later in life," the study's authors write at one point. They noted that one promising explanation is that cortisol levels are warped through changes in the body's hypothalamic-pituitary-adrenal (HPA) axis. They also speculated that the adult health issues could be caused by "disruptions in the autonomic nervous system (ANS), which shapes stress response through the sympathetic and parasympathetic systems." They also speculated that childhood physical abuse could alter gut bacteria, lead to chronic inflammation, decrease brain volume, diminish cellular immunity and cause epigenetic changes.

"Accordingly, our findings support the need for further research on the biological pathways connecting [childhood physical abuse] to poor health in older adults," the authors conclude. "High rates of co-occurrence of CPA and conditions such as anxiety, depression, and COPD [chronic obstructive pulmonary disease] also reinforce previous recommendations that screening for CPA could help identify those at higher risk of developing these health conditions in older adults."

In addition to being linked to adverse health outcomes among adults, victims of childhood physical abuse also frequently deal with a range of mental trauma symptoms for the rest of their lives. Speaking with Salon in February, author Stephanie Foo described how so-called "complex PTSD" affects its sufferers.

"People with complex PTSD often develop that as a result of child abuse, domestic abuse, living in a war zone, being a prisoner of war," Foo told Salon. "It's more of a relational thing than traditional PTSD. Because the number of triggers we have is so large, it becomes less tied to very specific trigger than for example, if you were in the desert as a soldier, being in a desert environment. It's more like having an overall uneasy feeling a lot of the time."
For more Salon articles about mental health:

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The seven health conditions linked to childhood physical abuse

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If you were abused as a child - whether by your parents, another trusted adult, your schoolmates or anyone else - chances are good that you don't need a bunch of scientists to tell you that the ripple effects of pain will still be felt when you're an adult.

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Welcome to State of Mind, a new section from Slate and Arizona State University dedicated to exploring mental health. Follow us on Twitter.
Many Americans think it's a shame that only 70 percent of children in the U.S. live in one home with two parents and under 50 percent live with two biological, married parents. They see divorce and single parenthood as normal yet still unfortunate, since accepted wisdom says children suffer long-term, irreparable harm when their parents live separately. On social media, that looks like everything from an Isla Fisher meme with the quote "You can't underestimate how traumatic divorce is for the children," to Catholic influencer Leila Miller writing "Divorce is simply a bloodless form of child sacrifice."

But a careful review of academic research-and the historical and cultural context in which it was conducted-calls this shared understanding into question. Most of the problems associated with being a child of divorce are instead related to sexism, racism, homophobia, shoddy recordkeeping, and insufficient government support.

Divorce was rare before the American Revolution. For those who were not enslaved, about one-third of children lived with a stepparent or single parent. But that owed to mortality rates; marriages just weren't often dissolved. When they were, rights to the children belonged to their father. In the business section, next to ads for horse rentals, colonial newspapers published "runaway wife" reports. Illustrating just how commercial an undertaking marriage was in early white America, these husbands didn't plead for their erstwhile partners' return; they just declared themselves off the hook for debts the women incurred. But after America divorced King George III, attitudes toward personal independence and contractual obedience shifted. By the 19th century, suffragists argued that not only would an expanded right to exit marriage permit women to escape bad ones, but the threat of separation would allow them to renegotiate the terms of good ones. Men also increasingly felt entitled to love matches and fulfillment. Around the time frontier mentality took hold, runaway husband ads became more common than runaway wife ones. The "tender years" doctrine assumed children needed to be with their mothers, reversing the custodial default. By 1970, California had authorized no-fault divorce, and most states followed suit within a decade.

This liberalization of divorce during the second half of the 20th century occurred against a backdrop of increasing female employment and independence. In the attendant cultural battle, some people directly defended patriarchal gender roles ordained by nature and God. But many instead made children their rallying call. The 1965 Moynihan Report-a document written by Assistant Secretary of Labor Daniel Patrick Moynihan and his staff to convince the federal government to bolster civil rights legislation with policies addressing economic inequality-decried the "crumbling" of family structure in Black communities. Divorce rates, which were even across race until 1960, had indeed risen more steeply and earlier among Black women. But the report's emphasis on family structure gave conservatives an excuse to ignore the structural forces behind that stat and insist on self-help rather than actual help. On the campaign trail in 1976, Ronald Reagan held up the straw man of the " welfare queen," a Black single mother gaming the system. This was the sexist, racist narrative of the declining family that the conservative "family values" movement of the 1990s and 2000s carried forward. Pro-marriage PR campaigns-run by organizations like the Institute for American Values and the Promise Keepers-were also deeply homophobic. They promoted heterosexual marriage with funding from conservative groups like the American Enterprise Institute and the Heritage Foundation. (This connection continues: Leila Miller wrote an April 2022 article titled "The Ten Sins of Gay Surrogacy.")

These groups and other members of the "marriage movement" wielded as fact the findings of Judith S. Wallerstein, who began following 131 children from 60 divorced families in Marin County, California, in 1971. She checked in with this same group of kids every five years for 25 years. More frequently, she checked in with the public, spreading her dire conclusions about divorce's long-term harm to children via the Today show, Good Morning America, The Oprah Winfrey Show, and more. Another psychologist, E. Mavis Hetherington, also published findings throughout the '80s and '90s. Her studies, which included 1,400 families, showed that the vast majority of kids of divorce became well-adjusted adults. And in 1994, The Good Divorce made a big splash. In that book, Constance Ahrons argued that kids thrive when divorced parents behave like well-functioning married couples.

Despite Wallerstein's small sample size, lack of a control group, and selection effect (parents signed their kids up after seeking therapy), her "the children suffer" narrative won out. The media referenced Wallerstein somewhere between 6 and 14 times more often than Hetherington, even though fellow social scientists were more likely to cite the latter.

Her arguments appealed to the general public in part because there were incentives for some people to cast children as victims. Fathers' rights groups, such as the National Fatherhood Initiative, spread horror stories of ex-wives who alienated dads from their children or fabricated tales of abuse as vengeance ("Uncle Dad" and "Medea" stories, respectively). Mothers embroiled in court cases told of midlife-crisis abandonment, deadbeat dads, and children who were, indeed, harmed by their parent. These worst-case scenarios entered the American ethos in films. Kramer vs. Kramer (1979) encouraged audiences to empathize with the plight of devoted fathers over selfish working mothers, and The War of the Roses (1989)portrayed destructive and protracted conflict as inevitable. Fathers' rights advocacy made an impact off the screen, too, with custody law shifting again. This time, state statutes increasingly established a preference for frequent and continuing contact with both parents.

The "children will suffer" beat, produced by these different drums, had incredible staying power. An analysis of popular press articles published from 1968 to 2005 revealed an increasingly negative take on divorce. And the federal government began spending hundreds of millions on the Healthy Marriage Initiative in 2001.

But scientists immediately questioned Wallerstein's study and other early ones that looked at kids who didn't live with two married parents-and they found a slew of problems.

In a 2003 paper, Paul Amato of Penn State created an index of overall psychological well-being and concluded that the overlap between adults with and without divorced parents was 90 percent, meaning only about 10 percent of those with divorced parents had more mental health issues and reported lower life satisfaction and happiness than those with married ones. Almost half, 42 percent, exceededthe average well-being score of the married parents sample.

For comparison, this effect size is less than one-third that of parenting classes on child behavior. Statistics on teen dating and popularity also lend perspective. Partnering in adolescence tracks with poorer academics; having high status as a teen has been linked to lower-quality relationships; and both are tied to more substance use. But these outcomes don't incite parental anxiety or shame the way such marginally increased risk does in the context of divorce. No one tells parents they must keep their kids single in the same way Isla Fisher told the Evening Standard, "I'd urge parents to strongly consider working things out. I'd work things out and I'd definitely stay put." Or the way Miller wrote to adults considering divorce, "I pray that you will slam on the brakes and consider any other course than the one you are on."

There's also a time dimension in the research. Divorce is usually accompanied by disruption to routines and emotional stress. "I would never want to minimize how difficult it is for children to go through that transition," Ahrons said in an interview with us before her 2021 death, "but it doesn't mean that they are damaged." Grief and anxiety fade. Behavior tends to return to normal within two years. A study of 23-year-olds found that 11 percent of those whose parents had divorced suffered from mental health problems, compared with 8 percent of those with married parents. Yet humans underestimate resilience thanks to a bias dubbed "immune neglect." In reality, researchers have concluded that most children touched by divorce are ultimately well-adjusted, indistinguishable from peers raised in nuclear families. It's hard to overestimate the impact this information could have on a person hoping to divorce-or ruminating on how their breakup has affected their children. And women initiate more divorces than men do.

It's also possible even the small negative effect that's seen along with divorce isn't caused by divorce. Texan kids who live in homes with pools go to college at higher rates, but it's not because swimming makes them smarter; their parents' wealth independently drives both phenomena. Similarly, children whose parents divorce are more likely to have lived in a high-conflict home prior to the breakup. If a child ends up struggling with, say, substance use, the stress of that conflict would be behind it, not the divorce. In support of this theory, a 1999 study found that children whose high-conflict parents don't split experience even greater behavioral problems, and a 2004 paper showed positive effects of ending high-conflict marriages. A 2014 study found no effect of family structure on psychopathology after controlling for conflict.

There's more to a critical look at causality. For example, kids whose parents don't live together are more likely to experience poverty, both because those with less education are less likely to marry and because splitting the income that once supported one household means a lower budget for both new ones. For those kids, researchers theorized, divorce isn't driving bad outcomes; poverty is. Indeed, a 2015 study found a higher likelihood of behavior problems when post-divorce household income was lower (although a critical look at this metric is in order since Black and brown children tend to be written up more often due to bias). This result confirmed a 2013 finding out of the Netherlands that negative effects are reduced when kids have more educated mothers, and that children who were poor prior to divorce suffered more. In one of the most impressive studies of child development ever, the Australian Temperament Project, researchers were surprised to discover no significant differences between 17- and 18-year-olds with married and divorced parents in behavioral or emotional adjustment, academic outcomes, or social competence. They pointed to Australia's social security benefits and enforcement of child support.

Then there's genetics to consider. Divorce is more common among people who display aggression, mental health problems, and antisocial behavior. Their children, as genetic heirs, are more likely to score lower on psychosocial measures regardless of parental marital status. Professor Brian D'Onofrio has attempted to unravel this knot with studies on first-cousin children of twins, with mixed results. Substance use and early cohabitation appear to be more closely related to a genetic legacy that contributed to divorce rather than to the divorce itself, but the same isn't true of other outcomes. And D'Onofrio acknowledges that his team did not completely control for either post-separation income change or pre-separation conflict.

Doing that is harder than it sounds, but many modern studies have found ways to take kids' pre-divorce levels of things like depression, low self-esteem, and lackluster school performance as a starting point. A 2001 study found that such preexisting struggles almost entirely accounted for post-divorce differences. Other studies using a child or sibling "fixed-effects model" found mixed results ( 2005), no effect on achievement scores ( 2005), no effect on premarital births ( 2005), no effect on educational attainment ( 2006), and no effect on emotional well-being ( 2007). A 2019 study, after adjusting for pre-divorce factors, found that divorce moves kids from an 81 percent likelihood of graduating high school to a 78 percent likelihood. In other words, as studies got more sophisticated, already small differences got even smaller, and sometimes disappeared entirely.

Some researchers point to one more factor: lingering stigma, including terms like "broken home" and picture books and TV shows that overrepresent nuclear families. The message that divorce is rare or bad can create a self-fulfilling prophecy of distress. Authors of a 2019 study suggested that divorce isn't as big a deal to kids who know many nonnuclear families. Whether children experience "an acute sense of deprivation" could be key to adjustment, they said. Authors of a 2020 study would seem to agree.

Inevitably, some children will fare better than others in the wake of a parental split. Individual kids can wind up traumatized. Many experience subclinical effects like painful memories, and many display above-average competence and resilience (think, smooth seas and skilled sailors). But we don't have enough data to understand why divorce is such a mixed bag at both the population and individual levels. Under these circumstances, as Amato wrote in 2010, "researchers should focus ... more attention on the factors that produce variability."

For one thing, the vast bulk of the research omits an important variable: parenting quality. Research suggests high warmth and support, even from just one parent, is what children need to succeed.

Some academics have tried to apply what we know about the corrosive effects of conflict and uplifting impact of high-quality parenting (a so-called "counter-ACE") in the context of divorce. Remember Ahrons' book? Amato's 2011 paper "Reconsidering the 'Good Divorce'" tried to test her hypothesis by assigning children to cooperative co-parenting, parallel parenting, and single parenting groups. Though the researchers found that youth in the "good divorce" cluster exhibited fewer behavioral problems, that wasn't the case for other bad outcomes. This study has been cited again and again as evidence that Ahrons was wrong and Wallerstein right. But its authors acknowledged they might not have been able to accurately identify "good divorces," their sample was relatively small, parents today may behave differently than those in the '90s (from whence the data came), and findings were affected by the time that elapsed between each divorce and the study. Not even they thought their work provided a definitive answer.

And significantly more definitive answers may now be impossible. In 1988, the Centers for Disease Control and Prevention stopped gathering complete data on children affected by divorce, and in 1996, the National Center for Health Statistics stopped supporting reporting of divorce statistics.

"How many American children are the focus of family court proceedings each year?" wrote professor Bob Emery in Family Court Review. "I have no idea. ... We also don't know, for example, how many children in the United States are living in joint physical custody." The 2020 census didn't allow families to select a 50-50 share, instead requiring parents to say where their children "usually live or stay." Wisconsin keeps thorough records and a group of academics has tried to use them as national tea leaves, but no one can confidently say how many kids experience co-parenting, nor what high-quality co-parenting produces. There's little financial support for that type of research, Ahrons told us: "The money comes if you are looking for problems."

Some have joined the call for more research, yet efforts to identify best practices for kids aren't just hamstrung by limited data and low funding. These days, Emery said, divorce research is considered outmoded by psychologists: been there, done that. You may have noticed that we haven't been able to cite any research to support the idea that the majority of us still mistakenly believe divorce commonly does irreparable harm to kids. That's because the question isn't asked by nonpartisan national surveys anymore. And yet parent after parent tells us they think Wallerstein is right. In other words, while the culture warriors and academy have now largely moved on from divorce, parental apprehension and guilt persists. And it isn't helped any by a cultural trend toward intensive mothering and Instagram's #tradwife.

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This scientific evidence accumulated over the last three decades with no single study monumental enough to garner significant press coverage. That has meant divergent narratives could coexist, and the one influenced by sexism, racism, homophobia, and other types of fear prevailed. Wallerstein's take has proved indelible even though she was proved wrong. As a result of the way the Christian right was able to frame-and effectively close-the policy debate, national solutions have focused on individuals' decisions and bolstering the institution of marriage: Choose the right spouse. Go to couples therapy. All but ignored is the government's opportunity and obligation to families. And that disproportionately affects women, Black families, and lower-income kids and caregivers.

If national policy were based on research rather than zealotry, we would invest in children's well-being by promoting research-backed strategies for parenting and co-parenting, supporting caregivers financially and systemically, underwriting research on nonnuclear best practices, and dispelling myths about the "brokenness" of families and children that can become feedback loops. Other ideas supported by the data include subsidized therapy and legal reforms that make the process less onerous for everyone.

"I'm still singing the old song," Ahrons said. "Divorced families can be healthy after divorce. There is still an enormous amount of resistance to that." She said mechanisms for collaborative divorce are a start, and she found optimism in some parents' behavior as well. But still, "that baseline assumption about divorce and the results of divorce is still being perpetuated, and if not perpetuated, at least not disrupted."

State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system-and how to make it better.

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How Americans Became Convinced Divorce Is Bad for Kids

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Welcome to State of Mind , a new section from Slate and Arizona State University dedicated to exploring mental health. Follow us on Twitter . Many Americans think it's a shame that only 70 percent of children in the U.S. live in one home with two parents and under 50 percent live with two biological, married parents.

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There is a yellowed parenting cheat sheet on my refrigerator, which I first tore out of The Whole-Brain Child by Daniel J. Siegel and Tina Payne Bryson when parenting felt particularly strained during the pandemic. My kids were always losing it, and I was fumbling to find the words to respond; everything came out wrong. The sheet outlined methods for helping my kids "use both the logical left brain and the emotional right brain as a team," and included earwormy phrases like "name it to tame it," to remind me my kids need help "storying" their "big feelings."

Since I put that sheet up in April 2020, parenting in America has become a kind of psychological torture. Parents' mental and physical health is steadily declining. We're moving ever closer to the reversal of Roe v. Wade. Meanwhile, disaster capitalism is having an absolute field day, with corporations and influencers trying to convince parents of products, apps, and hacks to lessen the stress and suffering of parenting in America. I am still struggling to story my own big feelings about all this. Not surprisingly, I have barely looked at that paper on my fridge.*

In such a climate, the fanatical followings of parenting experts like Dr. Becky and Janet Lansbury only seem to be growing. Parents want help with pressing, everyday struggles. But there is also a small backlash forming against these highly child-centered philosophies and the general business of parenting advice. As of late, even the most "gentle" parenting recommendations have started to feel, to many, just a little bit laughable. In March, the New Yorker's Jessica Winter wrote about the new resistance to gentle parenting's strictures: "A fatigue is setting in: about the deference to a child's every mood, the strict maintenance of emotional affect," and the idea that the primary caregiver-usually a woman-lives their life "as only Mother," tirelessly helping along a child's emotional development in a domestic vacuum, without any consideration for how the storms of childhood might affect her own happiness, identity, or sense of personal agency.

There is a growing awareness in America that the work of parenting cannot be divorced from the world in which we live. Writer Angela Garbes' second book, Essential Labor: Mothering as Social Change, crystallizes this shift, and argues that "raising children is not a private hobby" but rather is "some of the only truly essential work humans do." For this reason, Garbes argues that mothering can't be treated as a subject that belongs only to women, but rather must be understood in "a global and national context of care-the invisible economic engine that has been historically demanded of women of color."

The "parenting book" has long specialized in context-free, allegedly apolitical counsel. Prior to the last decade, parenting books avoided bigger questions about how we parent and why, largely excusing themselves from addressing how racism, sexism, and ableism can unconsciously structure the dynamics we maintain in the home. Even fewer parenting philosophies acknowledge the pain and terror one feels preparing children to enter a world that disempowers those who raise them.

Instagram parenting sages, for their part, fill the huge gaps in support created by failing public policy, but the sheer volume of this new type of parenting advice has further reified the idea that parents-especially mothers-should take on more labor, in the form of careful, time-consuming stewardship of everyone's emotions, to better manage the nuclear family. This has often made certain parenting philosophies feel accessible only to white, middle-class families, even though, as Ashley Simpo recently wrote, these philosophies often draw on "core principles that are actually quite native to non-white culture," such as collectivism. But as Simpo writes, "Black parents face a very different daily reality, and challenges, than white parents" and are more likely to be pouring from "an empty cup."

Memes providing cookie-cutter scripts to use in reacting to kids' daily frustrations can only take us so far in our quest for knowledge about the labor of parenting and our desire to become more intentional about the work. In a climate in which parents' bodies are under attack at the national level and we're running out of new ways to describe and cope with our desperation for material support, some parenting writers have rethought their approach to advice and "service" journalism, rejecting totalizing recommendations and reporting on the unprecedented issues caregivers now face, producing pieces and packages on how to parent at the end of the world, or pushing back on child-centered guidance by daring to treat the parent as a "whole person."

Garbes' Essential Labor suggests that perhaps the parenting book is also in need of an overhaul. In her first book, Like a Mother, Garbes explored the infantilizing nature of the literature of pregnancy. In this second book, she extends the gesture of upending the way we talk about caregiving, beginning with a personal history of mothering, which she describes as hard and ceaseless work, but also potentially transformative, when understood as a form of "embodied resistance." The second half of the book explores how we pass down to children foundational understandings of concepts like pleasure, community, and natural interdependence. "Writing about mothering-right now-" Garbes writes in the book's introduction, "is more consequential than ever."

Part of what distinguishes Garbes' treatment of the subject is a question of genre. Essential Labor is a mix of political manifesto, memoir, philosophy, and cultural critique, and the writing moves with both urgency and thoughtfulness. Garbes told me in an interview that she rejects genre and doesn't really wrestle with it as she writes. She says she has come to embrace her work as "slightly illegible," and feels this is reflective of her Filipina and American identity, and living in a world marked by colonialism, white supremacy, and capitalism, which only see certain bodies and ways of thinking as intelligible. Her book is also highly interdisciplinary, citing the intersectional political writing of the Combahee River Collective, Audre Lorde's erotics of motherhood, global health statistics, and political and social history.

Other parenting books tend to emerge strictly from neuroscientific or social science disciplines, professing and preaching objectivity as they explain what's happening to children at various developmental stages, and offer parents tools for dealing with things like toddler meltdowns. The observations in books like Siegel and Bryson's, for instance, distill academic research into readable formats, but the suggestions they offer parents tend to lack an awareness of how psychology and neuroscience have themselves been influenced by sociopolitical forces. Neuroimaging, for instance, isn't an entirely objective science, and psychology, as a field of study, has certainly had its troubles with racism and misogyny. Some have even claimed Americans' over-attachment to attachment theory, which underpins many gentle parenting philosophies, is too totalizing and based on "shaky" science.

"You can say this is how a kid's brain works," Garbes told me. "But what if their cortisol level is sky high because of the daily existence of poverty?" Social determinants, or the conditions in which we live, work, and play, affect how we study bodies and brains, but also how children's and parents' brains and bodies function. As Jessica Winter writes, parenting books often pose "child-rearing as brain surgery," in which every wrong move we make has the potential to disrupt our child's psyche or life path forever. But parenting, Garbes told me, is "entirely affected by context."

Feminist writers have, of course, in the past, looked beyond "say this, not that" advice-giving to consider how politics and economics intersect with parenting. Bell hooks wrote about the revolutionary power of parenting decades ago, as well as the larger misstep in the feminist movement in revering capitalist work as an avenue toward freedom, while rejecting the idea that caring for children could be a political practice. Had Black women's voices been more central to the women's liberation movement of the last century, hooks wrote in 1984, motherhood "would not have been named a serious obstacle to our freedom as women. Racism, availability of jobs, lack of skills or education and a number of other issues would have been at the top of the list-but not motherhood."

Socialist feminists have also long thought of the home as a place where ideas about social revolution could be put into practice. In 2006, Silvia Federici argued that culturally dominant disciplinary methods, which often focus on "policing our children," train children to be workers. Garbes' book draws, in several sections, on Federici's writing, refuting the idea that parenting should be about preparing children for the workforce. She also writes in the book about her own lack of ambition to "hustle up" the "ladder" and rejects "the American idea of 'earning a living,' " despite having been raised "by immigrants who came to America with very little and worked their way into the middle class." She inherited, instead, her parents' attunement to the visceral, everyday labors of taking care-both of Garbes' parents were care workers by trade.

Even as the American right has zeroed in on the nuclear family as a means of control, such ideas as Garbes' have tended to remain fringe and radical, so that parents who consider themselves centrists or liberals regularly consume parenting advice that pictures the home as a separate sphere and mothering as personal, not political. Garbes told me that Dani McClain's 2019 We Live for the We, which explores the political power of Black motherhood, provides ongoing inspiration for her work. McClain's book, also a mix of memoir, critique, and philosophy, takes its title from the organizer and activist Cat Brooks, who is cited in McClain's book saying that parenting toward liberation often requires prioritizing the community above the individual.

In turn, Garbes' book shows the growing irrelevance and absurdity of treating parenting as a meritocracy, but also the problems with viewing parenting as an individualistic pursuit. She explores how many beliefs about parenting, such as the idea that two adults (or just one woman) are enough to shoulder the work of caring for children, are hangovers from colonialism. "It isn't just colonized people who were coerced into adopting an isolated way of life," Garbes writes in a chapter on human interdependence, "it's all Americans."

Parenting scripts and tricks remain attractive in this isolated environment because they are legible, and also easily digestible. They can feel like quick fixes: easy to implement in the hectic grind culture of America in 2022. But Garbes told me that while efficiency in parenting is for her sometimes "pragmatic and practical," it's not something she's striving for as a parent. In fact, a major takeaway of Garbes' book is that care work is simply not ever going to be efficient. This is what makes the labor so essential. "It is draining, tedious, repetitive, but the work keeps us close to one another," she writes. At the same time, Garbes believes parenting doesn't have to be what it has become in America. "Raising children should not be as lonely, bankrupting, and exhausting as it is," she writes.

For Garbes, the revolutionary potential of care work lies in the way the work forces us to dwell in the moment, body to body. There is perhaps some overlap here with gentle parenting edicts, but Garbes writes honestly about the difficult work of slowing down and making the time, something that is often missing from more rote advice: "When my toddler refuses to get dressed or wear anything other than a star dress that is in the washing machine, things can go south pretty quickly," Garbes writes. "I yell, she yells, I yell and leave the room and she cries," Garbes continues. But sometimes, she remembers, she "can do something else."

Often, that "something else" is hugging and breathing. Other times, it is talking. Garbes writes of the complex and equally trying work of synthesizing the present moment with history and the future, as we try to explain it all to children. In another moment in the book, Garbes describes her tendency to over-explain things to her two daughters, and the potential for discovery in those moments when she finds herself spinning out on "empire and the social safety net while both girls have moved on to biting apple slices into the shape of a boat or a moon or a butt." I feel weepy each time I think of these moments in Garbes' book, not only because I relate to the tendency she describes, but because they speak to the intense longing for change we so often bring to parenting. Caring for children is about understanding where we have come from, and where we might be going.

Garbes' own habit of expounding on the world, she told me, in part comes from growing up in an immigrant household, where certain topics were off the table and different linguistic histories sometimes complicated discussions. Garbes' writing is literary and luminous, and shines when she shows the messy, visceral, wet work, but also when she documents the effort she brings to the linguistic work of raising kids-that process of trying to convey the world to children, while leaving room for some other future version of it. Often, these moments come up in Garbes' discussions of bodily differences.

"I don't know exactly how to do this, of course," she writes in one chapter that explores both disability and where our sense of worth comes from, as well as how she stumbles through this work. "Sometimes I feel completely out of my depth," she admits, but she still works "to normalize concepts that are often shrouded in silence by just talking about them," like "pointing out the person in the book We March who is marching in their wheelchair," or "noting the bright green color of the leg braces worn by a schoolmate." For her, it's all tied up with teaching her daughters that every body is inherently worthy.

Garbes' willingness to insist on her own worth outside her role as Mother and Worker, which she calls "a tricky act in modern America," is perhaps the most radical thread in the book. Rather than see mothering as a labor of self-sacrifice, physical and emotional servitude, or an identity, as the role has often been shaped and defined by cultural and political mores, Garbes views the work of parenting as a chance to tune into the senses. "Mothering offers us an opportunity to form new relationships with our bodies," she writes, "to listen to them." She writes, in one chapter, about how she learned in motherhood to embrace what Carmen Maria Machado calls "fatness of the mind" and to delight in her own body.

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The author also writes of the spontaneous nature in which she has found community since becoming a parent, something she claims is a crucial aspect of parenting toward social change, including the sharing of sensory pleasures like food and dance, mangoes and farts, arroz caldo and hearty laughs. Though Garbes makes room for the mother as person in the book, she also writes, drawing on Mia Birdsong, that freedom comes from being connected. Showing up for others is foundational to Garbes' approach to the subject of parenting. To support all this essential labor, she told me, and she reiterates many times in the book, what we really need are more policies and leadership rooted in this spirit of care.

Garbes writes that more traditional parenting books leave her "agitated," not only for what they leave out. She told me she is "allergic to advice" and, in general, hates the concept. She also rejects morality in parenting-the idea that one can be a good or a bad parent-and her book is far from preachy or directive. Garbes writes that her research for Essential Labor, however, made her "reimagine everything." "I used to reject the idea that, in mothering, there is any way to judge what we are doing as 'right' or 'wrong,' " she says at the end of the book, but "making mistakes, getting over it all and getting on with it" now feels, to her, "unequivocally right."

I asked Garbes whether this inefficiency relates to the ethics of care she presents in the book. Perhaps this slow and constant exploration is what parenting teaches us and what we cannot get from the realm of advice, which simply tells us what to do and what to say? "Children are a clarifying force," she said. They force us to unearth what we really do think about certain subjects and articulate what we don't know as well, she told me. Finding our unique footing and the words in the work then, it seems, is an important part of the process. After all, as Garbes put it, "How do I know what I think until I say what I think?"

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Correction, May 16, 2022: This paragraph originally said that women's workforce participation is at a 30-year low in 2022. That is incorrect, as participation has actually rebounded to pre-pandemic levels.

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Parenting Advice Is Dying. Here's What's Coming Next.

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There is a yellowed parenting cheat sheet on my refrigerator, which I first tore out of The Whole-Brain Child by Daniel J. Siegel and Tina Payne Bryson when parenting felt particularly strained during the pandemic. My kids were always losing it, and I was fumbling to find the words to respond; everything came out wrong.

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Envisage - Volume 4 Issue 3 - Canadian Art Therapy Association

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Explore Membership Membership Levels Insurance Grants and Bursaries Member Profile Become a Member What Is Art Therapy? Becoming an Art Therapist News Magazine Journal Art Therapist Directory Supervisor Directory Share Your Message Conference FAQ

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Envisage - Volume 5 Issue 1 - Canadian Art Therapy Association

# data[].attributes.attachment_link.description
Explore Membership Membership Levels Insurance Grants and Bursaries Member Profile Become a Member What Is Art Therapy? Becoming an Art Therapist News Magazine Journal Art Therapist Directory Supervisor Directory Share Your Message Conference FAQ

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Sensory patterns of children on the autism spectrum, and those who had ASD traits but were not diagnosed, grew stronger over time. Results from a new study published today in Child Development provide the first longitudinal evidence about the trajectories of sensory reactivity patterns during early childhood among a large community sample with diverse developmental outcomes.
Many autistic children have particular preferences for specific sensory stimuli, like focused interest on the flicker of fluorescent lights, pronounced discomfort from a scratchy T-shirt tag or deep cravings for bear hugs, for example. And yet, while every child with autism has a unique sensory pattern, there is little research, either at the individual or population levels, documenting how those patterns shift throughout the stages of early childhood.

In 2013, a team of researchers from the University of Southern California and the University of North Carolina at Chapel Hill began following a cohort of more than 1,500 children, measuring their sensory patterns as the children grew from infancy to school age. Now, the researchers have generated insights into the associations between those sensory changes and various child and family characteristics, including the eventual emergence of autistic symptoms or an autism diagnosis once the children were six or seven years old.

"It's a prospective study, which means we followed each child over six years to track their individual development," said Yun-Ju (Claire) Chen Ph.D. '21, the lead author of the Child Development article.

"At the beginning, we didn't know which children would develop autism. So it's incredibly interesting to see that, once they were school age at the end of the study, autistic children's sensory patterns followed very different trajectories, compared to children with neurotypical outcomes or those with other developmental conditions."
For infants, sensory issues may be earliest signs of autism
For six years, as part of the North Carolina Child Development Survey project, the researchers followed more than 1,500 children born in North Carolina in 2013. Parents were asked about their child's sensory behaviors during three childhood stages: at infancy (9-16 months old), at preschool (3-4 years old) and at school-age (6-7 years old). Parents were also asked about their child's autistic symptoms, about various developmental concerns and whether or not their child had received any diagnoses.

Data analysis showed that the sensory patterns of autistic children, as well as children with autistic traits (but who had not been diagnosed with ASD), tended to grow stronger over time. In comparison, non-autistic children's sensory patterns, including those with parent-reported sensory issues, were relatively steadier across development. That finding may have significant implications for the ways in which scientists conceptualize, identify and study autism, as well as how therapeutic interventions are designed and delivered, beginning in early infancy, to promote developmental outcomes and provide better supports for families.

"We used to think that social communication differences were the most important behavioral markers for identifying autism in infancy," Chen said.

"But we found that sensory differences may emerge earlier than social communication differences in infants who later developed autism, and these early sensory differences may cascade into more definitive features of autism, including social-communication differences, later in life. This means that sensory processing functions may be much more important in early detection than we have previously thought."

Chen is currently a postdoctoral research fellow at McMaster University in Ontario, Canada, where she is working with the MacART McMaster Autism Research Team and the Pathways in ASD Study, one of the world's largest and longest-running longitudinal studies of the development of autistic young children and adolescents who live in Canada.

While at the USC Chan Division, she completed her occupational science Ph.D. in the Innovations in Neurodevelopmental Sensory Processing Research laboratory-also known as the insp!re lab-led by Associate Dean and Chair Grace Baranek. Chen and Baranek previously worked together at the University of North Carolina at Chapel Hill, and after coming to USC in 2016, continued using the North Carolina dataset and collaborating with their UNC colleagues.

Data analysis showed that the sensory patterns of autistic children, as well as children with autistic traits (but who had not been diagnosed with ASD), tended to grow stronger over time. Image is in the public domain

Baranek is a co-author of the article, as is Research Professor John Sideris, USC Chan's director of instrument development and psychometric/statistical analysis.

Chen notes how the study's longitudinal design honors the individuality and variability of sensory development, regardless of diagnosis.

"Previous studies have tended to compare sensory patterns across different age ranges by aggregating all their cross-sectional data, which makes it hard to draw conclusions about any one specific participant," Chen said. "But we know that every child has their own trajectory, so our type of data analysis really is a more person-centered approach."
Parental education level tied to more stable childhood sensory patterns
The researchers also discovered that children of parents with higher educational levels tended to show more stable or improving sensory patterns. While cautious not to misinterpret that finding, Chen says it may underscore the impact of early interventions upon children's long-term sensory behaviors.

"My guess is that kids with more highly educated parents may have more access to resources, so that once they are identified with sensory challenges, they are more likely to get timely help from professionals," Chen says.

"Of course, we need to do more to decrease disparity for those with lower education levels. But I think this is a promising result because, in comparison to other variables that cannot be changed, early detection and intervention are variables that we can do something about, and that can make a really big difference in children's and families' lives."

The research team is next studying how the launch of a new screening tool can improve the early identification of autism across diverse populations, including Spanish-speaking families primarily of Hispanic/Latino/a ethnicity living in the Los Angeles area.

"The earlier we identify infants at elevated likelihood for autism and begin intervention, the greater the potential for every child to grow to their fullest capacity," Baranek said. "That hinges on the work we are doing at the insp!re lab-mobilizing the most sensitive tools and new findings so that our care systems can provide families and children with access to the best possible individualized supports, and deliver them early, when they matter most."

About this autism research news

Original Research: Closed access.
" Developmental trajectories of sensory patterns from infancy to school age in a community sample and associations with autistic traits" by Yun‐Ju Chen et al. Child Development
Abstract Developmental trajectories of sensory patterns from infancy to school age in a community sample and associations with autistic traits
This prospective study examined the latent growth trajectories of sensory patterns among a North Carolina birth cohort ( N = 1517; 49% boys, 87% White) across infancy (6-19 months), preschool (3-4 years), and school years (6-7 years).

Change rates of sensory hyper- and hyporesponsiveness better differentiated children with an autism diagnosis or elevated autistic traits from those with other developmental conditions, including non-autistic children with sensory differences.

More sensory hyper- and hyporesponsiveness at infancy followed by steeper increases differentially predicted more autistic traits at school age. Further, children of parents with higher education tended to show stable or improving trajectories.

These findings highlight the importance of tracking sensory patterns from infancy for facilitating early identification of associated challenges and tailored support for families.

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Autism Correlated With Changing Sensory Preferences During Early Childhood - Neuroscience News

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Sensory patterns of children on the autism spectrum, and those who had ASD traits but were not diagnosed, grew stronger over time. Results from a new study published today in Child Development provide the first longitudinal evidence about the trajectories of sensory reactivity patterns during early childhood among a large community sample with diverse developmental outcomes.

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New research is shaking up our image of art-making in Paleolithic times, arguing that children or even toddlers may have been behind some of world's earliest known art. The findings suggest that ancient rock painting was actually a family-oriented group activity, not a solitary male pursuit.

For a study published in the Journal of Archaeological Science, researchers from Cambridge University and Spain's University of Cantabria examined 180 hand stencils painted in Spanish caves some 20,000 years ago. The study used 3-D models of hand paintings in Spain's El Castillo, Maltravieso, Fuente de Salín, Fuente del Trucho, and La Gama caves, created by the Handpas Project.

These prehistoric images would have been made by blowing pigments through a hollow reed or bone onto hands placed against the cave wall-a process that would have made the outlines slightly larger than the hands themselves.

Accounting for that difference, the researchers found that up 25 percent of the hand marks were not large enough to belong to adults or teenagers. They guessed that they came from children between two and 12 years of age, with the majority of those likely made by three to 10-year-olds.

"Many more children's hands came out than we expected," lead author Verónica Fernández-Navarrogical told the "It would appear that artistic activity was not a closed activity closely linked to male individuals and the survival of the group, as had been thought until now."

Because the smaller children would not have been able to blow the pigment hard enough to create the markings, we can safely assume that their parents or other adults were helping them. Painting could have been an important communal activity for Paleolithic peoples.

Fernández-Navarrogical is now working to further analyze the hand markings to determine if the gestures made in some images carry any meaning. She suspects that bent fingers in some of the hand silhouettes, which seem to appear in recurring patterns, could have been used as a form of non-verbal language.

"We want to find out if it is a code that they knew how to interpret, in the same way that we today interpret a 'stop' sign," she added.

Children also believed to be responsible for what could be the world's oldest art, a set of ancient hand and foot prints found in Tibet last year that were made between 169,000 and 226,000 years ago.

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A Study of Prehistoric Painting Has Come to a Startling Conclusion: Many Ancient Artists Were Tiny Children | Artnet News

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New research is shaking up our image of art-making in Paleolithic times, arguing that children or even toddlers may have been behind some of world's earliest known art. The findings suggest that ancient rock painting was actually a family-oriented group activity, not a solitary male pursuit.

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It's that wonderful time of year, when the toy aisle is filled with the newest colorful bikes, action figures, dolls, playhouses and elaborate play sets. And if you're doing your toy shopping online this year, right now is crunch time - you need to order as soon as possible to make sure everything arrives at your home on time.

But when considering exactly which toys to buy this year, think about how representation can play a part in playtime. Growing up, I remember being so thrilled when I would unwrap a birthday or Christmas gift to see a doll that looked like me, or a book with a main character on the cover who had thick hair that looked like mine (and a matching super-shiny, greasy forehead). However, I also recall walking down the toy aisle with my mom and being a little disappointed that there were only two Black dolls sitting on the shelves, usually placed behind the other dolls with whom I shared no features or history.

Every kid should be able to have toys they identify with, but there's a lack of options for dolls, toys, books and puzzles showing different faiths, genders, languages and physical abilities. However, the toy industry is finally making strides to be more inclusive, as many small and large brands are putting out toys for everyone. T he list below serves as a launching pad for discovering toys and activities that aim to do just that. From puzzles that feature images of kids of different races to handmade dolls wearing hijabs, these gifts reflect the world we all live in.

HuffPost may receive a share from purchases made via links on this page. Every item is independently selected by the HuffPost Shopping team. Prices and availability are subject to change.

The Our Generation gymnastics Nya doll

The Little People, Big Dreams coloring book

The Healthy Roots Zoe doll

"Hair Love" by Matthew A. Cherry

The Barbie Fashionistas doll with a full afro

The Baby Alive Lulu Achoo doll

"The Life Of/La Vida de Jean-Michel Basquiat" by Patty Rodriguez and Ariana Stein

Related...

A Gen Z-Approved Gift Guide

See Gallery

Parenting shopping Kids diversity holiday

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16 Diverse And Inclusive Kids Toys That Embrace Representation

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It's that wonderful time of year, when the toy aisle is filled with the newest colorful bikes, action figures, dolls, playhouses and elaborate play sets. And if you're doing your toy shopping online this year, right now is crunch time - you need to order as soon as possible to make sure everything arrives at your home on time.

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Is your child afraid of getting the COVID-19 vaccine? These books might help | CBC News

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The P.E.I. Public Library recently shared a list of books that could help ease some of the anxieties children may have ahead of getting the pediatric COVID-19 vaccine.

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It can be difficult to describe the overwhelming feeling brought on by sensory processing disorders. Bright lights feel irritating, large crowds become suffocating, and too many smells or sounds turn oppressive. Sensations that might seem completely run-of-the mill for a neurotypical person can be transformed into challenging hurdles for individuals who have difficulties filtering the world around them.

Varleisha Gibbs, a clinical psychologist and the vice president of Practice Engagement and Capacity Building at The American Occupational Therapy Association, explained that SPDs can manifest in different ways ― it's more than just meltdowns or tantrums.

"We all take in a multitude of sensations at any given moment. Some are challenged with the ability to interpret, organize or respond to such sensory information in a way that allows them to effectively engage with others and participate in everyday life activities," Gibbs said. "They may present with difficulty 'modulating' revealed in avoiding certain sensations, seeking out intense sensations and input to their body, or simply lack an appropriate response or fail to attend to stimuli."

Like most neurological disorders, they can be varied from one person to the next and can involve more than just the five senses we automatically think of.

"Some kids are sensory-seeking and others may be sensory-avoidant," said Amanda Morin, the director of Thought Leadership and Expertise at Understood, an organization that seeks to enrich the lives of individuals with learning differences.

She also pointed out that many kids' body awareness and spacial orientation are impacted. "These can affect kids' ability to know where their body is in relation to others or objects or to pay attention to their body's signals," Morin said.

As a parent, caregiver or loved one, you may wonder what tools you can use to potentially help a child process their senses in ways that are comfortable, developmental and empathetic.

"If the toy is interesting enough to a child so they are engaged with toy instead of feeling overwhelmed by what is going on around, then these types of toys can be a good tool for redirection and distraction," said Anson Koshy, a board-certified developmental and behavioral pediatrician in Houston.

Rondalyn Whitney, a clinical researcher, occupational therapist and associate professor of occupational therapy at Clarkson University, stressed that each child is different and that you need to look for more than a one-size-fits all "trendy" toy that has been marketed as a sensory processor.

"In order for a 'toy' to help, it has to provide a way to balance the sensory system," she said.

Whitney said how you introduce sensory play is more important than the kind of toy you use.

"The key in sensory-based play is that it is child-directed," she said. "The more sensory-based play opportunities, self-directed, we provide, the better we support the development of the sensory-motor system. Integrating sensory play into a family's routines is the best advice, for instance smelling vanilla before baking cookies."

Morin also underscored this when discussing the concept of a " sensory diet," which encompasses various activities to engage a child's senses.

She advised considering two main factors when shopping for sensory processing toys: "Is the toy just adding to the sensory information a child has to filter through, and does what the toy proposes to do match the sensory needs of the child?"

For instance, you wouldn't get a vacuum cleaner toy for a child who doesn't like loud noises, but you might consider it for a child who is drawn to vibrational sensations.

This is where observation comes in.

"We need to improve the understanding of development, how to observe children at play and how to provide interesting and interactive play that supports their persistence and enjoyment. The more we persist with a challenge, the more those neurons grow," Whitney said.

Whitney left us with a salient reminder: "The message, in my mind, is to view each child as unique and find what brings him or her joy."

With the help of these knowledgeable experts, HuffPost compiled a list of gifts for your sensory sensitive child that, at the very least, might "bring them joy."

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The Best Toys, Tools And Gifts For Kids With Sensory Processing Disorders

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It can be difficult to describe the overwhelming feeling brought on by sensory processing disorders. Bright lights feel irritating, large crowds become suffocating, and too many smells or sounds turn oppressive. Sensations that might seem completely run-of-the mill for a neurotypical person can be transformed into challenging hurdles for individuals who have difficulties filtering the world around them.

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I was adopted at three weeks of age and grew up in a loving family. My parents told me from the very beginning I was adopted, but I had no access to information about my origins because closed adoption was the norm in the United States well into the 1970s.

Back then, most birth parents signed away their rights to contact their child (often unwillingly), and the child's original birth certificate was amended, with the adoptive parents' names replacing the birth parents'. As a baby, my origins were literally erased.

My adoptive parents pursued adoption because they wanted a family and were unable to conceive. They explained to me that my birth mother was a teen when I was born and that in the 1960s unwed mothers had few good choices. They were compassionate about my birth mother's situation and her decision to place me with adoptive parents.

Yet much of society gives adopted people subtle and not-so-subtle messages that we have been saved from a terrible fate, and that we should feel lucky to have been "rescue d."

Perhaps it's easier for people to understand adoption if they vilify the birth mother; after all, only a "bad woman" would "give away" her child. This judgment applies the myth of the birth mother as a promiscuous, irresponsible, drug-addicted or generally bad person. Of course that's not true; the reasons for relinquishing a child are many and nuanced. But for decades, the dominant paradigm has been that women who up and get pregnant without meaning to are seriously flawed.

The sexism of such thinking notwithstanding, it also implies that the resultant child of an unwed, unwanted, or unplanned pregnancy must also be damaged ― and in need of rescuing. And therefore, that child is oh so lucky to be adopted by caring, kind, financially solvent people.

When the adopted child is of a different race than the adoptive parents, the bigotry can be exponentially worse. I have friends who were adopted transracially or transnationally: Not only were these kids removed from their racial and/or cultural origins, but few of their adoptive parents knew the importance of giving their kids opportunities to reconnect with their heritage. These adopted kids grew up confused, angry and lonely. They grew up hearing things such as, "I'm sure you have a better life than you would have if your birth mom had kept you."

The racism of this message would be harmful to anyone on its receiving end, but it is devastating to someone who has lost not only their birth parents but their connection to their culture and ethnicity to adoption. For transracial adoptees, this is part of their adoption trauma, as well as having to process racism and racial differences without the support of people of their own race.

Adoption is a permanent fixture in human society; there will always be a need for it. I'm not anti-adoption, but I'm exasperated with how the media often glosses over, exploits or simplifies adoption's complexities for popular consumption.

In her book " American Baby: A Mother, A Child, and the Shadow History of Adoption" (Viking, 2021), veteran journalist Gabrielle Glaser works doggedly to expose truths about adoption, including the fact th at adopted people often experience lifelong effects of the trauma caused by being removed from their original family, and that our society mostly ignores or denies such trauma.

As adoption researcher and psychologist Nancy Verrier explains in her book " The Primal Wound ," " Many doctors and psychologists now understand that bonding doesn't begin at birth, but is a continuum of physiological, psychological and spiritual events that begin in utero and continue throughout the postnatal bonding period. When this natural evolution is interrupted by a postnatal separation from the biological mother, the resultant experience of abandonment and loss is indelibly imprinted upon the unconscious minds of these children."

How does that trauma show up in adoptees? We may have problems with intimacy and attachment; we may experience loss in a much different way than non-adopted people; we may feel and express anger in ways that seem outsized or unfounded. We fear abandonment. We are afraid if we do the wrong thing we'll be given away, left behind or excluded. We are afraid we're inherently flawed and therefore expendable.

To my knowledge, my parents didn't read any of the research about the psyches of adopted children or adult adoptees. Like most people involved with closed adoptions in the 1960s, they were ignorant about the psychological trauma babies experience when separated from their mothers, how those babies might grow into children who felt they didn't belong, that they had been abandoned, that there was something intrinsically wrong with them.

Do I blame my parents for not knowing, not reading these things? Not really. Doing so wasn't part of adoption protocol at the time. Unfortunately, it still isn't. And that must change.

In my mid-30s, after a circuitous, decade-long search, I reunited with my birth families. Only after meeting them and giving birth to my own child did I begin to understand my loneliness was a side effect of my closed adoption ― something for which I never had context until I experienced the momentous events of adoption reunion and motherhood.

When a traumatized person struggling with issues of abandonment is told they are lucky, that they should be grateful, or that they were "chosen," it negates the emotional experience of that person. When it happens to me, it makes me feel as though my feelings and thoughts and experiences don't matter.

I tried to explain that loneliness to friends, some of whom brushed me off. "Everyone's lonely," they said. "You're no different."

But I am different ― adopted people are different. And we deserve our individual and collective truths to be heard, believed and respected.

What we don't need is myths ― of rescue, of salvation, of being less-than, of requisite gratitude for the fact of our adoption.

In this country, we have been trained to see adoption as a fairy-tale ending to a tragic story, one that elides the birth mother's complex feelings about relinquishing a child and the adopted child's complex feelings of loss and abandonment.

Few things in this world are truly binary. Adoption is not an "either/or" situation. Like every other institution, it has flaws and strengths. It's time to think of adoption in terms of "both/and," to hold its opposing truths as equal and valid.

We must train skeptical eyes on the myths of adoption, work to debunk them, and start paying attention to the real struggles adopted people experience. For the benefit of all involved, we must shine light on adoption's shame, secrecy, fear of abandonment, trauma, and loneliness, and work to heal these things.

Andrea Ross is the author of " Unnatural Selection: A Memoir of Adoption and Wilderness," (CavanKerry Press, 2021). She is on faculty in the University Writing Program at UC Davis, and she speaks and teaches workshops about the adoptee experience. Find out more at andrearosswriter.com.

Do you have a compelling personal story you'd like to see published on HuffPost? Find out what we're looking for here and send us a pitch!

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This Is What No One Tells You About Adoption

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I was adopted at three weeks of age and grew up in a loving family. My parents told me from the very beginning I was adopted, but I had no access to information about my origins because closed adoption was the norm in the United States well into the 1970s.

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Experts generally agree that, no matter how many words you use, a large percentage of communication comes via nonverbal actions - facial expressions, body language, and so on. If you are autistic like me, that means you struggle with many aspects of this non-verbal communication.

Now, a new study now offers insights as to why that might be the case - though many autistic people say the study is reaffirming exactly what they've known for years.

The study, published in the Journal of Autism and Developmental Disorders, suggested that those on the autism spectrum find it difficult to accurately identify angry facial expressions when they are displayed with the intensity and speed that neurotypicals find "normal."

As the lead author of the study explained in a University of Birmingham news release, "We identified that autistic people had a specific difficulty recognizing anger which we are starting to think may relate to differences in the way autistic and non-autistic people produce these expressions. If this is true, it may not be accurate to talk about autistic people as having an 'impairment' or 'deficit' in recognizing emotion - it's more that autistic and non-autistic faces may be speaking a different language when it comes to conveying emotion."

PhD researcher Connor Keating, the lead author of the study, elaborated on this issue in an email to Salon where he discussed the so-called "double empathy problem." This is the idea that empathy relies heavily on both how we instinctively express emotions and what we have grown to expect from previous social interactions - experiences that can be very different for autistic people. When that happens, there is a communication breakdown which upsets both autistics and allistics (non-autistic people).

"The double empathy problem was conceptualized by Damian Milton, an autistic academic," Keating explained. "Many autistic individuals over the years have endorsed the double empathy idea, agreeing that it matches their own experiences."

His study, he added, is the first "to show that a difficulty recognizing moving, rather than still, angry expressions is associated with autism, and not alexithymia." Alexithymia is a condition related to autism that impacts emotional communication.

It is fair to say that many autistic people, when reading that, will probably react the same way that I did: Of course!

"As a kid I only understood obvious outright expressions of anger and aggression," Jen Elcheson, a school support worker from Prince George BC Canada, told Salon by email. "Subtle ones? Forget it. Especially if the person had ambiguous body language."

Elcheson recalled incorrectly thinking other people were being humorous when in fact they were expressing facetiousness.

"My response would just further piss them off," Elcheson recalled. "Confusion, shame, and my own anger towards myself followed. I got it wrong, again!"
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Even as an adult nearing 40, Elcheson says it is a "struggle at times" to understand subtle non-verbal and sometimes even verbal cues. "I don't always know what may be going on with someone who is not autistic," Elcheson added. "I can usually understand fellow autistic just fine. Ditto for people who are otherwise neurodivergent, as I have other [neurodivergent] diagnoses as well."

Alex Plank, founder of a popular forum site for neurodivergent people, observed that he often feels like he is speaking a different language from neurotypicals, particularly when it comes to emotions.

"I often have people think I'm being rude when I'm just being factual or trying to communicate urgency," Plank explained in an email. He added that he often overlooks social customs such as remembering to greet someone or avoid talking over them.

"I've noticed when talking with other autistics, we tend to talk over each other and it works fine - we stop talking if we need to or the other person does," he mused.

Indeed, this unexpected anger can be mystifying to those on the spectrum, and often seems to emerge entirely unprompted. Morénike Giwa-Onaiwu, a visiting scholar at Rice University who is also on the autism spectrum, recalled how both she and other autistic people often have the experience of communicating with people who suddenly become very angry.

"I would just be really confused," Giwa-Onaiwu told Salon. "I didn't understand where they were getting that vibe or what was happening because I'm thinking we're holding a conversation and I'm not taking up whatever cue I guess I'm supposed to be picking up from their face or their body language." This is more than a mere faux pas or embarrassment; as Giwa-Onaiwu observed, "it puts you in a really dangerous situation" because neurotypicals may not react well to an autistic person who does not correctly process their anger.

"I think they truly don't understand that we are not perceiving what they're perceiving," she added.

Podcast host and life coach Danielle Sullivan (who is late-diagnosed autistic) expressed hope that the study would help people better understand the precise nature of how autistic people struggle.

"I think this study's conclusions are absolutely correct," Sullivan wrote to Salon. "Although emotional intelligence varies in autistic people (the same way it does in allistic people) as a whole, autistic folks don't have impaired emotional intelligence. We do have a distinct and different language and expression for our emotions that can be just as hard for neurotypical to read in our faces as it is for us to read in neurotypical faces."

For what it's worth, not all autistic individuals feel this way. Iconic autism and animal rights advocate Temple Grandin, for instance, told Salon by email that "I have always been able to recognize anger. I use the tone of voice as the main indicator for anger."

Either way, if there is one common theme from all of the conversations I've had with autistic individuals - both for this article and many, many others - it is that our neurology simply makes us different, not worse. As British psychologist and autism specialist Tony Attwood once wrote, "I see people with Asperger's syndrome as a bright thread in the rich tapestry of life."

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Being autistic may amount to a language difference - not an impairment

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Experts generally agree that, no matter how many words you use, a large percentage of communication comes via nonverbal actions - facial expressions, body language, and so on. If you are autistic like me, that means you struggle with many aspects of this non-verbal communication.

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As a White art therapist who has worked cross-racially for almost my entire career, I am regularly reminded that there are always racial-social-political influences that enter into the art therapy relationship. My current work in an open art therapy studio at a drop-in center for runaway and homeless adolescents and young adults, most of whom are Black, reinforces three strategies for art therapists for understanding and responding to power differentials.

1) Develop an Anti-racist Perspective

Dr. Ibram X. Kendi (2019) and Dr. Robin DiAngelo (2018) teach that ignoring race, promotes racism. Actively confronting race-based injustices, promotes anti-racism. I apply their teachings by:

establishing cross-racial rapport with each new client as their previous experiences with White people may inform expectations;

assuming presence of racial dynamics as a factor in how clients and I react to each other;

acknowledging distress may be perpetuated by racism and White supremacy - otherwise, there is a false assumption that current situations are only a result of personal choices rather than a product of discrimination, violence and systemic policies;

stating my willingness to discuss how racial differences impact worldviews and experiences when the client is ready.

2) Re-examine Core Art Therapy Concepts

The mental health frameworks by Dr. Angela Clack (2018) and Dr. Kenneth Hardy (2013, 2016) offer ways to re-examine art therapy concepts through anti-racist paradigms.

Metaphor: Clack describes psychological masks that Black women wear as an adaptive defense that conceals shame, vulnerability, and rage that results from interpersonal discrimination and systemic racism. Honoring the mask as a form of coping against racial trauma enacts Dr. Hardy's insistence for Black clients to express themselves in self-chosen and genuine manners. Client metaphors allow for simultaneously concealing facts but revealing a truth.

Studio: Clack cautions that the mask reinforces a compulsion to hide weakness or ask for help. Dr. Hardy observed how some Black clients sacrifice authenticity by censoring themselves in order to take care of White people who might find them threatening. One way to promote anti-racism is by creating a studio in which Black clients can rest their masks to the degree to which they feel comfortable.

Art Materials: Emotional expression requires vulnerability. Dr. Hardy describes the pain of connecting personal experiences to racial trauma. Clack sites impediments to trusting White therapists as rooted in how Black people have been punished, shunned, manipulated, and killed for expressing their views. They both recommend moments for contemplative pauses. Experimenting with art materials may offer such a space.

Witnessing: Witnessing in art therapy entails supporting a client to make meaning of their art. Dr. Hardy insists that therapists avoid a race neutral position when assessing or prescribing solutions. For example, Dr. Clack redefines depression for Black people as a "disconnection" from ancestry, body, and source of power (p. 42).

3) Pursue System Change

Adapting practices in one's work merely accepts the reality of race dynamics but does little to challenge them. To fully serve clients, art therapists must advocate to reduce barriers to treatment and dismantle harmful institutions. Within the drop-in center, clients create semi-public works of how they want to portray themselves and homelessness. Aside from direct service, I volunteer with local and national organizations that pursue policies to end homelessness by eradicating systemic racism and poverty, such as Sasha Bruce Youthwork and the Poor People's Campaign: A National Call for Moral Revival Art and Culture Committee. I am also a member of my university's Faculty Learning Community on Black Lives Matter for continuous education and to help develop curricula resources across academic disciplines. Re-imagining art therapy theories and practices is just the first step for carrying a commitment to justice beyond the studio walls to the streets, legislative bodies, and voting booths.
References
Clack, A. R. (2018). Women of color talk: Psychological narratives on trauma and depression. Clack Associates

DiAngelo, R. (2018). White fragility: Why it's so hard to talk to white people about racism. Beacon Press.

Hardy, K. V. (2013). Healing the hidden wounds of racial trauma. Reclaiming Children and Youth, 22(1), 24-28.

Hardy, K. V. (2016). Anti-racist approaches for shaping theoretical and practice paradigms. In M. Pender-Greene & A. Siskin (Eds.), Anti-racist strategies for the health and human services (pp. 125-139). Oxford University Press.

Kendi, I. X. (2019). How to be an antiracist. One World.

Jordan S. Potash, PhD, ATR-BC, REAT, LCAT (NY), LCPAT (MD)

Dr. Potash is Associate Professor in the Art Therapy Program at The George Washington University and Editor in Chief of Art Therapy: Journal of the American Art Therapy Association. For more information, podcasts, and articles, please visit www.jordanpotash.com.
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Antiracist Approach to Art Therapy: Re-examining Core Concepts - American Art Therapy Association

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As a White art therapist who has worked cross-racially for almost my entire career, I am regularly reminded that there are always racial-social-political influences that enter into the art therapy relationship. My current work at a drop-in center for runaway and homeless adolescents and young adults, most of whom are Black, reinforces three strategies for art therapists for understanding and responding to power differentials.

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Are rhythm-based experiences beneficial for people with traumatic stress? Some have suggested that it is one way to bypass cognitive functioning and support connections via more primitive parts of the brain impacted by trauma (Perry, 2009). In other words, interventions that focus on a sensory-based level could be more effective than purely cognitive strategies. Current thinking tells us that rhythm stimulates patterned and repetitive experiences and influences mind and body in wide-reaching ways. Depending on the beat, rhythmic experiences can energize, bring about sensations of enlivenment, or engage us through entrainment and synchrony. When trauma has dulled the ability to experience joy, playfulness, and pleasure, rhythm can be a way to reintroduce aliveness to body and mind (Malchiodi, 2020).

Technically, by definition rhythm is the length of notes. Tempo is another important term; it actually refers to the pace of a piece of music and how quickly or slowly it goes by. There is also meter -how hard or light you tap your foot or clap your hands, for example, when listening to music. So. when you are tapping or clapping to music, there are some beats that seem stronger than others when grouped together. All three of these components are often implied in the experience of rhythm even though each has a slightly different meaning. For simplicity's sake, just think of rhythm as the overarching concept when it comes to applying it in expressive arts and trauma treatment. It's often easiest to think of it as how you or your client perceives the "heartbeat" or pulse of any rhythm, sound, or song.

Everyone reacts differently to music; we respond to cadence, melody, and lyrics depending on our experiences and other factors. In working with individuals of all ages who have traumatic stress there are personal preferences for rhythms (fast, slow, loud, soft) along an extensive continuum. In working with traumatized children over decades, I observed that their engagement with percussion often emerges in extremes. That is, often a child with traumatic stress used instruments very loudly or very softly and very fast or very slow [or not at all after initial attempts]. Another might sing in monotone or in a narrow range of rhythms, often getting stuck in repetition without flexibility. I learned that helping these children and later, adults understand different ways to experience rhythm began to support the flexibility necessary to self-regulate their struggles with hyperactivation. In other cases, rhythm became the starting point to re-sensitize children and adults to experiences of play, energy, and enlivenment that years of traumatic stress and adverse events robbed from them.

There are many ways to introduce rhythm into psychotherapy including combinations of movement, gesture, image-making, and vocalization. But drums and percussion instruments are possibly the most widely used because they are accessible forms of "rhythm communication" for children and adults. Here are four functions of expressive arts in addressing traumatic stress that are particularly relevant when introducing rhythm as a reparative and restorative experience with a focus on music and sound:

1. Self-Regulation. The most basic function of rhythm is found in physiological regulation. In other words, rhythm is a source of stabilization that supports an internalized sense of safety. For many individuals in the beginning stages of trauma treatment, focused music listening and soothing sounds or playing instruments with calming tones such as a tongue or "Panda" drum are part of decreasing hyperactivation. Similarly, when withdrawal or dissociation are prominent reactions, rhythm-based experiences can help the individual safely explore what enlivens or energizes, grounding and anchoring the person in the "here and now."

2. Co-Regulation. When making sounds, vocalizations, or music together, entrainment and synchrony become core components of rhythmic experiences. In expressive arts therapy sessions, this takes place between the therapist and individual; in a group, this may include drumming together, sharing singing, or structured expressive arts designed to support co-regulation. While physiological regulation is the main goal, positive attachment and cohesive relationships are also reinforced.

3. Exploration. Rhythm-based experiences are the foundation of improvisational activities that lead to eventual expression of emotions and thoughts. For example, drumming sounds to express emotions is a form of implicit, sensory-based communication that stimulates narrative (cognitive) explanations in psychotherapeutic sessions. Exploratory rhythm activities also can be a basis for deepening arts-based expression that lead to songwriting, an integrative experience.

4. Restoration. In expressive arts therapy, my goal as a psychotherapist is to ultimately facilitate restoration of the self. That is, to see the individual, family, or group recover wholeness through a sense of well-being, resilience-building, and social engagement. In her three-part trauma recovery model, Herman (1992) cited the important step of re-entering community-the integrative process for the private and public self. While some of the restorative process is supported in psychotherapy sessions, the "rhythm of restoration" often includes a wider audience through performance of what one creates. In other words, this function is not restricted to psychotherapy, but often includes peers, support groups, community arts programming, and other community contexts where arts-based expressions such as songs and performance are shared.

While rhythm-based experiences may influence brain activity when it comes to trauma, there is actually a continuum of reparation we can look to when working with expressive approaches. Although regulatory properties of rhythm can be physiological pathways to both soothing and enlivening the body, ultimately restoration is found in the "social rhythm" of expressive arts therapy and how those rhythms connect us in healing and health-giving ways.
To find a therapist, please visit the Psychology Today Therapy Directory.

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The 4 Functions of Rhythm in Expressive Arts Therapy

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Are rhythm-based experiences beneficial for people with traumatic stress? Some have suggested that it is one way to bypass cognitive functioning and support connections via more primitive parts of the brain impacted by trauma (Perry, 2009). In other words, interventions that focus on a sensory-based level could be more effective than purely cognitive strategies.

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The academic discipline of psychology was developed largely in North America and Europe. Some would argue it's been remarkably successful in understanding what drives human behaviour and mental processes, which have long been thought to be universal. But in recent decades some researchers have started questioning this approach, arguing that many psychological phenomena are shaped by the culture we live in.

Clearly, humans are in many ways very similar - we share the same physiology and have the same basic needs, such as nourishment, safety and sexuality. So what effect can culture really have on the fundamental aspects of our psyche, such as perception, cognition and personality? Let's take a look at the evidence so far.

Experimental psychologists typically study behaviour in a small group of people, with the assumption that this can be generalised to the wider human population. If the population is considered to be homogeneous, then such inferences can indeed be made from a random sample.

However, this isn't the case. Psychologists have long disproportionately relied on undergraduate students to carry out their studies, simply because they are readily available to researchers at universities. More dramatically still, more than 90% of participants in psychological studies come from countries that are Western, Educated, Industrialised, Rich, and Democratic (W.E.I.R.D). Clearly, these countries are neither a random sample nor representative for the human population.

Thinking styles

Consider which two of these objects go together: a panda, a monkey and a banana. Respondents from Western countries routinely select the monkey and the panda, because both objects are animals. This is indicative of an analytic thinking style, in which objects are largely perceived independently from their context.

In contrast, participants from Eastern countries will often select the monkey and the banana, because these objects belong in the same environment and share a relationship (monkeys eat bananas). This is a holistic thinking style, in which object and context are perceived to be interrelated.

Biswarup Ganguly/wikipedia, CC BY-SA

In a classic demonstration of cultural differences in thinking styles, participants from Japan and the USA were presented with a series of animated scenes. Lasting about 20 seconds, each scene showed various aquatic creatures, vegetation and rocks in an underwater setting. In a subsequent recall task, both groups of participants were equally likely to remember salient objects, the larger fish. But the Japanese participants were better than American participants at recalling background information, such as the colour of the water. This is because holistic thinking focuses on background and context just as much as foreground.

This clearly demonstrates how cultural differences can affect something as fundamental as memory - any theory describing it should take that into account. Subsequent studies have shown that cultural differences in thinking styles are pervasive in cognition - affecting memory, attention, perception, reasoning and how we talk and think.

The self

If you were asked to describe yourself, what would you say? Would you describe yourself in terms of personal characteristics - being intelligent or funny - or would you use preferences, such as "I love pizza"? Or perhaps you would instead base it on social relationships, such as "I am a parent"? Social psychologists have long maintained that people are much more likely to describe themselves and others in terms of stable personal characteristics.

However, the way people describe themselves seems to be culturally bound. Individuals in the western world are indeed more likely to view themselves as free, autonomous and unique individuals, possessing a set of fixed characteristics. But in many other parts of the world, people describe themselves primarily as a part of different social relationships and strongly connected with others. This is more prevalent in Asia, Africa and Latin America. These differences are pervasive, and have been linked to differences in social relationships, motivation and upbringing.

South African Tourism/Flickr, CC BY-SA

This difference in self-construal has even been demonstrated at the brain level. In a brain-scanning study (fMRI), Chinese and American participants were shown different adjectives and were asked how well these traits represented themselves. They were also asked to think about how well they represented their mother (the mothers were not in the study), while being scanned.

In American participants, there was a clear difference in brain responses between thinking about the self and the mother in the "medial prefrontal cortex", which is a region of the brain typically associated with self presentations. However, in Chinese participants there was little or no difference between self and mother, suggesting that the self-presentation shared a large overlap with the presentation of the close relative.

Mental health

Another domain that was originally dominated by studies on W.E.I.R.D. samples is mental health. However, culture can affect our understanding of mental health in different ways. Because of the existence of cultural differences in behaviour, the framework - based on detecting deviant or non-normative behaviours - isn't complete. What may be seen as normal in one culture (modesty) could be seen as deviating from the norm in another (social phobia).

In addition, a number of culture-specific syndromes have been identified. Koro sufferers (mostly in Asia), are men which have the mistaken belief that their genitalia are retracting and will disappear. Hikikomori (mostly Japan) is a condition that describes reclusive individuals who withdraw from social life. Meanwhile, the evil eye syndrome (mostly in Mediterranean countries) is the belief that envy or other forms of malevolent glare will cause misfortune on the receiver.

The existence of such culture-bound syndromes has been acknowledged by both the World Health Organization and the American Psychiatry Association recently, as some of these syndromes have been included their respective classifications of mental illnesses.

Clearly culture has a massive effect on how we view ourselves and how we are perceived by others - we are only just scratching the surface. The field, now known as "cross-cultural psychology", is increasingly being taught at universities across the world. The question is to what extent it will inform psychology as a discipline going forward - some see it as an extra dimension of it while others view it as an integral and central part of theory making.

With more research, we may well find that cultural differences pervade into even more areas where human behaviour was previously thought of as universal. But only by knowing about these effects will we ever be able to identify the core foundations of the human mind that we all share.

Read more: How the Partition of India happened - and why its effects are still felt today

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How knowledge about different cultures is shaking the foundations of psychology

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The academic discipline of psychology was developed largely in North America and Europe. Some would argue it's been remarkably successful in understanding what drives human behaviour and mental processes, which have long been thought to be universal. But in recent decades some researchers have started questioning this approach, arguing that many psychological phenomena are shaped by the culture we live in.

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Children and Youth Mental Health - Background

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Attachment Style Observation Master Copy

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During self-isolation due to coronavirus, many are turning to the arts. Perhaps they seek a creative outlet or opportunity for expression; but it's also possible that their attraction may be driven by an innate desire to use their brains in ways that make them feel good.

As a professor and arts educator for over 20 years, I have witnessed the mental benefits of an arts-rich life - but don't take my word for it. There is a powerful and compelling case, supported by cutting-edge research, that the arts have positive effects on mental health.

Mental health issues affect nearly half of the global population, at some point, by age 40. Add to that, recent challenges of the pandemic for maintaining mental wellness, managing fears and uncertainty, and one thing is clear: it's time to think differently when it comes to how we engage our minds.

(AP Photo/Matt Dunham)

The arts offer an evidence-based solution for promoting mental health. While practising the arts is not the panacea for all mental health challenges, there's enough evidence to support prioritizing arts in our own lives at home as well as in our education systems.

For managing well-being

The relationship between the arts and mental health is well established in the field of art therapy, which applies arts-based techniques (like painting, dancing and role play) as evidence-based interventions for mental health issues, such as anxiety and depression. There is also growing evidence that the arts can be used in non-therapy contexts for promoting mental health, such as using performing arts to learn about the core subject areas in schools or doing visual art with adults who are mentally well, and want to sustain that sense of wellness.

In other words, practising the arts can be used to build capacity for managing one's mental and emotional well-being.

Neuroesthetics

With recent advances in biological, cognitive and neurological science, there are new forms of evidence on the arts and the brain. For example, researchers have used biofeedback to study the effects of visual art on neural circuits and neuroendocrine markers to find biological evidence that visual art promotes health, wellness and fosters adaptive responses to stress.

In another study, cognitive neuroscientists found that creating art reduces cortisol levels (markers for stress), and that through art people can induce positive mental states. These studies are part of a new field of research, called neuroesthetics: the scientific study of the neurobiological basis of the arts.

Neuroesthetics uses brain imaging, brain wave technology and biofeedback to gather scientific evidence of how we respond to the arts. Through this, there is physical, scientific evidence that the arts engage the mind in novel ways, tap into our emotions in healthy ways and make us feel good.

(Shutterstock)

Mindfulness and flow

The arts have also been found to be effective tools for mindfulness, a trending practice in schools that is effective for managing mental health.

Being mindful is being aware and conscious of your thoughts and state of mind without judgement. The cognitive-reflective aspects of the arts, in addition to their ability to shift cognitive focus, make them especially effective as tools for mindfulness. Specifically, engaging with visual art has been found to activate different parts of the brain other than those taxed by logical, linear thinking; and another study found that visual art activated distinct and specialized visual areas of the brain.

Read more: Visual arts help marginalized youth learn mindfulness and self-compassion

In short: the arts create conditions for mindfulness by accessing and engaging different parts of the brain through conscious shifting of mental states. For those of us who practise regularly in the arts, we are aware of those states, able to shift in and out and reap the physiological benefits through a neurological system that delights in and rewards cognitive challenges. Neuroesthetic findings suggest this is not an experience exclusive to artists: it is simply untapped by those who do not practise in the arts.

Research shows that the arts can be used to create a unique cognitive shift into a holistic state of mind called flow, a state of optimal engagement first identified in artists, that is mentally pleasurable and neurochemically rewarding.

There is a wealth of studies on the relationship between the arts, flow and mental health, and flow-like states have been connected to mindfulness, attention, creativity and even improved cognition.

Benefits in education

Despite increasing evidence published in top, peer-reviewed journals, on the measurable benefits of the arts in education, such as increased academic performance and the development of innovative thinking, the arts continue to be marginalized in education.

Could the study of neuroesthetics finally provide the evidence decision-makers require to prioritize the arts in education? If so, we may be on the verge of a renaissance that remembers our human instinct to create.

One thing is certain: the mental health crisis affecting young people implicates a systematic failure to provide the right tools for success. That should not be acceptable to anyone.

Three tips for arts-based mindfulness

Make mistakes: Try something new and be willing to make mistakes to learn. Most artists practise for years before they are able to render something realistic, and they are willing to make many mistakes along the way, likely because the brain rewards learning. If you are trying this at home, don't encourage anything messy with children unless you have time to oversee it. There is nothing worse for kids than getting in trouble for something you have encouraged - it can crush their love of art and inhibit creative exploration.

(Shutterstock)

Reuse and repeat: Play and experiment with reusable materials, like dry-erase markers on windows that can be easily wiped away, or sculpting material, like playdough that can be squished and reshaped. This emphasizes practice and process over product and takes the pressure off to make something that looks good. If you really must keep a copy, snap a quick photo of the work, then let it go.

Limit language: Try not to talk when you are making art, and if you are listening to music, choose something without lyrics. The parts of the brain activated during visual art are different than those activated for speech generation and language processing. Give those overworked parts of the mind a break, and indulge in the calm relaxation that comes from doing so. The neurochemicals that are released feel good, and that is your brain's way of thanking you for the experience.

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Brain research shows the arts promote mental health

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During self-isolation due to coronavirus, many are turning to the arts. Perhaps they seek a creative outlet or opportunity for expression; but it's also possible that their attraction may be driven by an innate desire to use their brains in ways that make them feel good.

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Digital therapy can be just as effective as in-person treatment, according to a new study from the University of Alberta. In the age of social-distancing, researchers say this is a promising find.
According to Chelsea Jones, the study's lead author, the Covid-19 pandemic raised a lot of necessary questions about the importance of mental health supports - especially with the shift to online therapy options.

"Up to that point, there hadn't been a ton of research," she said of digital therapy versus in-person sessions.

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"Does it work? Is it safe? How does this population react to the delivery of health care mental health support over video conferencing and telephone?"

Chelsea Jones, lead author of new study which found digital therapy can be as effective as in-person options. Photo: Submitted

Jones is an occupational therapist for the Canadian Armed Forces and a PhD candidate at the University of Alberta's faculty of rehabilitation medicine.

Jones' study, co-authored with other mental health and military experts and published this month, examined previous research on digital and remote mental health care for veterans, military personnel, and emergency responders dealing with trauma.

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It showed certain types of post-traumatic stress disorder (PTSD) therapies -cognitive processing therapy, prolonged exposure therapy, and behavioural activation treatments - were just as effective delivered digitally as in person.

And it's not just veterans or first responders who could benefit from these findings, Jones clarified. While the research focused on this particular group, it could be applicable to the general population as well.

"Certainly, if we can increase the accessibility for some people of mental health care ... that might also reduce the stigma. If they can have therapy within their home, it might be a good match for a lot of people," she said.

The NWT has established a virtual care response to the pandemic to keep health services accessible, allowing residents to carry out appointments over the phone or through video conferencing.

The territory is also working with the federal government to develop a phone app through which residents can access mental health supports online.

However, Jones pointed out that while digital therapy can be effective for some people, "it isn't one size fits all."

"There are still people who are going to have trouble with connectivity, wifi, their hardware," she said. "There are going to be kids running around in the background, dogs barking, things like that.

"It's not going to be a fit for everybody but certainly, the research so far is looking really promising."

Weathering the digital divide

Raymond Pidzamecky, who has worked as a therapist in northern communities for years, seconded Jones' conclusion.

"Not everybody in the communities has the resources to participate in online counselling," Pidzamecky said. "Not all of them have cellphones with unlimited minutes. Wifi is very expensive up here in the North.

"A lot of clients want to have that physical proximity with a counsellor. They want to be able to see the counsellor. Just as we observe our clients, they observe us. Online, that's kind-of difficult to do."

Jones and Pidzamecky agree the best mental health support system would combine digital and in-person treatment.

"[Before Covid-19] we thought the sky was going fall in as people work from home and actually, we're finding that's working out fairly well, provided they have the technology," he said.

"I think that should be always an option that's presented. Here's the service. How do you prefer to access it: online or in person? Give them that choice."

Jones added: "I think there needs to be more research and those communities need to advocate for those needs as well.

"Mental health, rehabilitation, recovery should be something everyone can access and attain. We have to make it as accessible as possible for everyone in the country."

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Online therapy is as effective as going in person, study finds

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Digital therapy can be just as effective as in-person treatment, according to a new study from the University of Alberta. In the age of social-distancing, researchers say this is a promising find. According to Chelsea Jones, the study's lead author, the Covid-19 pandemic raised a lot of necessary questions about the importance of mental health supports - especially with the shift to online therapy options.

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We are facing huge public health challenges in the UK. Mental ill health accounts for more than 20 percent of these challenges, more than cancer and cardiovascular disease ¹.

As the number of people with long-term conditions increases and with an ageing population who may experience high levels of physical inactivity and social isolation, innovative and effective treatments are needed, more than ever ²!

The arts seem to have an important role to play in this - through offering help, promoting well-being and creating a space for social connection.

We've looked at the added value of the arts and how they can keep us happy and in good mental health:

Being engaged in the Art

Do you recognise a feeling of joy that you can get when taking part in cultural activities such as music, museums, dance groups and theatre?

Getting involved with the arts can have powerful and lasting effects on health. It can help to protect against a range of mental health conditions, help manage mental ill health and support recovery ³.

There are many ways to engage in arts and improve your mental health:

Art and health programmes led by artists and musicians can deliver health benefits through participatory arts programmes and arts engagement in everyday life.

When we talk about the arts, we include visual and performing arts, such as traditional craft, sculpture, digital art, text, dance, film, literature, music, singing, gardening and the culinary arts.

"Arts and creativity are an important part of the programmes we run at the Mental Health Foundation, art can be a different and fun way to express and talk about emotion." Jolie Goodman, Programmes Manager for Empowerment and Later life.

Arts can make a powerful contribution to our mental health

Engaging in the arts seems to be growing in popularity as a way to improve your wellbeing. Participating in the arts can enable people to deal with a wide range of mental ill health conditions and psychological distress.

The best part is that it helps people to improve their mental health through creativity. Making art is helping many people express themselves, without having to use words 4 5.

Arts can create a feeling of community

The arts also help at a community level. As we age, we might face isolation through a loss of social connections, such as friends, family and workplace - as well as other limitations such as decreasing physical health.

Through getting involved in arts programmes, people in later life can rebuild their social connections and extend existing support in their communities. Getting in touch with others helps in alleviating loneliness and isolation. This is also true for care homes, where arts activities can help increase social interactions between residents and residents and staff which can improve mood and wellbeing 6.

At the Mental Health Foundation, we are starting a new project. Creating Communities is an 18 months project funded by the Mercers Trust. We are facilitating peer groups in partnership with Anchor Hanover Housing using creativity and access to the outdoors to improve wellbeing and social connectedness for tenants in different types of later life housing scheme. In terms of creativity we will use paintings that people may be familiar with to begin conversations about emotion and build on these.

We will help participants to use different materials to produce artwork that is relevant to them. Even if they don't think of themselves as creative, we want to create an environment that encourages them to have fun and be playful. It may be that people are interested in bringing their memories to life.

The arts valuable role in mental health is being recognised

More and more people now appreciate that the arts and culture can play a valuable role in helping people who have mental health problems.

As we've noted: engaging in arts, social activities and interaction within our communities can help with major challenges such as ageing and loneliness. It can help to boost confidence and make us feel more engaged and resilient. Besides these benefits, art engagement also alleviates anxiety, depression and stress.

The arts and health economics - it just makes sense

Since it can be used as a non-medical approach to preventing mental health problems it could help save money in the health service and social care.

Making art can enable people to take greater responsibility of their own health and wellbeing by helping maintain levels of independency and curiosity and improve the quality of life by bringing greater joy ⁷.
We have posted this blog that details the potential value of arts for mental health considering the new MARCH network. The MARCH Network is one of 8 new national networks funded by UK Research and Innovation (UKRI) as part of the 2018 Cross-Council Mental Health Plus call to further research into mental health. The Mental Health Foundation is one of the collaborating partners in this network, which is led by Dr Daisy Fancourt (University College London).
Learn about the Scottish Mental Health Arts Festival

One way that the Mental Health Foundation supports using the arts to improve mental health is through the annual Scottish Mental Health Arts Festival (SMHAF). Now one of the largest festivals of its kind in the world, SMHAF brings together communities, artists and activists from all over Scotland to be creative and engage with arts events exploring mental health, including film, theatre, literature, visual arts, dance and comedy.
Find out more now

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How arts can help improve your mental health

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We are facing huge public health challenges in the UK. Mental ill health accounts for more than 20 percent of these challenges, more than cancer and cardiovascular disease 1. As the number of people with long-term conditions increases and with an ageing population who may experience high levels of physical inactivity and social isolation, innovative and effective treatments are needed, more than ever 2!

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People who go to therapy have a variety of methods for processing and implementing the lessons they learn from their discussions with mental health professionals.

One approach that has gained traction is recording therapy sessions and then listening back to them later. It's difficult to recall everything that's said during an appointment, so some people believe listening to a recording aids their memory and allows them to process more of the discussion. For others, the listening process is therapeutic in itself and can provide a sense of calm in moments of panic or uncertainty outside of sessions.

While there are have been some studies into this technique, professionals aren't necessarily in agreement on the benefits and drawbacks. Some are also concerned that modern technology and circumstances can allow clients to covertly record their sessions without the counselor's knowledge.

HuffPost asked therapists for their thoughts on the practice ― the pros, cons and other considerations. (While the comments they shared are generally geared toward audio recordings, many can apply to video as well.)

Here's what you should know about recording therapy sessions:

This is not a common practice ― but that could change

Every therapist HuffPost spoke to noted that recording therapy sessions is not a common practice for clients.

"Some clients may take notes, but recording is not something that happens a lot," said Nicole M. Ward, a licensed marriage and family therapist in Los Angeles.

Brief notes can be helpful for behavior modification issues like breaking bad habits and adopting better ones. Some therapists offer their clients printouts illustrating relevant concepts as well.

"It is more common, if anyone is recording, for it to be the therapist," Ward said. "Some therapists may record sessions, but that is with client knowledge and permission."

Recorded sessions can be a training tool for therapists to review their work with clinical supervisors and meet requirements for evidence-based treatment practices. Such recordings are generally obtained with client consent, securely stored and destroyed after use.

"I have not heard of clients recording sessions without telling their therapist, although I imagine with the increase of teletherapy services being offered due to the pandemic, this issue will become increasingly important for therapists and clients to navigate together," said Becky Stuempfig, a licensed marriage and family therapist in Encinitas, California.

"With video and phone sessions becoming more common, therapists may want to consider proactively raising the topic of session recordings with their clients before beginning sessions to make sure the client is aware of their policy on recording sessions," Stuempfig said.

There are privacy concerns

"Generally, it is not a good idea to record the therapy session," said Zainab Delawalla, a clinical psychologist in Atlanta. "Once a client records a session, there is no ethical mandate that compels the client to keep that recording private, the same way professional ethics and federal law require the therapist to keep the contents of the therapy session confidential. If shared, knowingly (e.g., on social media) or unknowingly (e.g., a snooping spouse), it would be easy for others to take the therapist's words out of context."

If it's a group therapy session, recording the discussions may violate the privacy of the others present as well.

When a client records a session, there's always the possibility that the file could fall into the wrong hands. Thus, it can compromise the confidentiality of therapy sessions ― breaching the trust involved in the client-therapist relationship and potentially bringing psychological harm.

"Confidentiality is at the heart of the therapeutic relationship ― it is what makes the relationship completely unique and unlike any other dynamic," Stuempfig said. "The client needs to know that what they share is absolutely going to be kept private, giving the client the peace of mind needed to share their innermost fears, past traumas, insecurities and worries without being concerned about judgment."

It may hinder the therapeutic process

As a client, knowing that you're recording a session may take you out of the moment. You may also misinterpret the session after reviewing the recording or fail to get the full experience by only listening to portions of it.

"The client may be embarrassed by how they present and over-analyze what they say and how they say it, which can be a hindrance to the therapeutic process," said Saniyyah Mayo, a licensed marriage and family therapist in Los Angeles. "Clients may also become upset after listening to themselves being challenged or confronted by their therapist."

Another upsetting drawback is that it could be emotionally damaging to replay the recording without the supervision of a therapist if you processed traumatic events during the session.

"That would be something that should be discussed thoroughly between therapist and client before either party agrees to recording the session," Stuempfig said.

The client may over-invest in the therapist's words

"Recording a session therapeutically may make you over-invest in the therapist and their magical powers to heal you and under-invest in your part of the work," said U.K.-based psychotherapist Noel McDermott.

He advised focusing on what happens outside of therapy and understanding the ways that things you learn in sessions help you manage real-life occurrences more effectively.

Clients also shouldn't hyper-focus on the literal interpretation of the therapist's words without context.

"A therapist is just a person with professional training, and I worry that, with the wrong person, [recording a session] could idealize a therapist as being all-knowing," said Meg Gitlin, a psychotherapist and the voice behind therapy insight Instagram City Therapist. "While this is a common occurrence in the therapeutic relationship, I could imagine access to sessions could intensify this deification of or dedication to the therapist. Just like anyone else, therapists are flawed and misspeak or misunderstand, and preservation of these sessions without an understanding of this could be detrimental to growth."

It's important to discuss recording sessions with the therapist

"If a client did want to record a session, they should ask the therapist's permission to do so," Delawalla said. "Recording sessions without the therapist's consent would represent a breach of the therapeutic relationship."

It may also be illegal, depending on what state you're in. That's the case in California, which has a "two party consent" requirement for recordings, so both the therapist and the client (and anyone else in the session if there are multiple clients) would be required to sign a consent form.

"As therapists, we do not have a legal or ethical obligation to allow a client to record sessions ― it is left up to the therapist's discretion," Stuempfig explained. "Before recording a session, it would be crucial for the therapist and client to discuss the potential risks involved, such as a break in confidentiality or emotional damage if replaying a session without live support from their therapist."

If you feel compelled to record your therapy sessions, Delawalla recommended reflecting on the reasons you want to do this.

She advised asking yourself: "What purpose does the recording serve? Is it a way to distance yourself from the strong emotions that might come up in a session with the knowledge that you can go over it later? Is it that the pace of therapy is too quick and it seems like you don't have time to fully process a topic or understand a technique before the therapist moves on to something else? Is it that the revelations in therapy only make sense when the therapist says it in those words in session but if you think about them later, it no longer fits?"

"Under any of these circumstances, it would be more beneficial to bring up these underlying concerns with your therapist and work through them together," Delawalla said.

And if you are tempted to secretly record sessions, it may also be helpful to examine why you don't feel comfortable talking to your therapist about potentially recording your conversations.

There are ways to make it beneficial

Recording therapy sessions can be helpful, assuming it's part of a client and therapist's mutual understanding of their goals and follows a meaningful conversation about the benefits, purpose and potential harm. The key is to be collaborative and approach it on a session-by-session basis.

"It could be beneficial if the client uses it for their own private use to reflect later," Ward said. "A client may also use it to track their personal growth throughout the therapeutic process."

Gitlin said that recording and replaying sessions could indicate a client's commitment to self-improvement and therapy and help them master specific skills they learn in sessions. For these same reasons, she encourages clients to take notes so they may better integrate changes discussed in therapy into their everyday lives.

"I received the request [to record sessions] from a client for the first time last week and was encouraging of them taking whatever measures they wanted to make the most out of our time together," Gitlin said. "Therapy is notoriously expensive and can be time-consuming, and it's important to me as a clinician to respect the clients' use of our time together."

Stuempfig agreed, noting that recordings may remind clients about their goals outside the therapy room, without the constraints of a time-limited session.

"The reality is that therapy sessions are typically only 50 minutes long and oftentimes, clients are flooded by intense emotions throughout the session and many different topics are usually covered in that short time span," she said. "When clouded by emotion, it can be hard to recall specific details of what was discussed. It could be helpful for a client to have a recording to play back when they are in a calm, relaxed state and can better incorporate the positive changes or practice skills discussed in session."

It could be helpful for people with memory disorders

"Recording therapy sessions could also be beneficial for memory-impaired individuals such as people who have suffered traumatic brain injuries or individuals with dementia," Stuempfig said.

If someone has severe challenges with memory, it may be useful to have a recording of a session, especially if it focused on implementing specific strategies to aid memory, Delawalla noted.

"Or, if the therapist is using guided meditation or a progressive muscle relaxation script to treat anxiety, it would be beneficial to have a recording to be able to use the script between sessions," she added.

It may help with couples counseling

Mayo noted that recording a session can also be beneficial in the context of couples or group counseling ― assuming you have the consent of your therapist and any other people in the session with you.

"It can allow a client to see how they present in session especially with couples," she said. "I have recorded sessions with the couple's consent to show them how they verbally attack one another. Many times people do not realize how they speak or present until watching or hearing it played back on audio or video. Recording sessions can be used as a tool to teach effective skills such as communication, body language, and/or facial expressions."

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Is It OK To Record Your Therapy Sessions?

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People who go to therapy have a variety of methods for processing and implementing the lessons they learn from their discussions with mental health professionals. One approach that has gained traction is recording therapy sessions and then listening back to them later.