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Sem New Develop Psych

by: Trever Reichert DDS

Sem New Develop Psych PSY 607

Marketplace > University of Oregon > Psychlogy > PSY 607 > Sem New Develop Psych
Trever Reichert DDS
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This 50 page Class Notes was uploaded by Trever Reichert DDS on Tuesday September 8, 2015. The Class Notes belongs to PSY 607 at University of Oregon taught by Staff in Fall. Since its upload, it has received 9 views. For similar materials see /class/187253/psy-607-university-of-oregon in Psychlogy at University of Oregon.


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Date Created: 09/08/15
Trauma s Legacy Psychology 607 Winter 2004 University of Oregon January 12 2004 The Politics of Denial Part 1 Discussion Questions and Responses What s Missing from this Picture 1 we do present evidence that childhood experiences exert a signi cant effect on his or her politics p 8 Really Or do they show an association An association is about as much as we can hope for because an intervention would involve putting people at risk A longitudinal study would show a stronger relation perhaps but the multitude of intervening circumstances would limit that too Another option would be using therapy as an intervention the study could show what factors the treatment effects This might be especially revealing if the treatment didn t address political views Pennebaker has demonstrated the effects of writing about feelings as opposed to ideas and strategies for dealing with a trauma example unemployment The subjects who hadn t written about their feelings were less likely to get new jobs and some evidence indicated subjects who didn t get hired because of showing hostility in their job interviews 2 Let s bring in your expertise What evidence is there about choice making and emotions in the literature in advertising psychology and elsewhere Lots For example there is an aphorism in social psychology that attitudes are a poor predictor of behavior iattitudes being cognitions The Theory of the Rational Man was disputed through a study that showed that people buy more at the supermarket when they are hungry Economists and advertisers however don t study scienti c research literature that we know of For the realms of propaganda and advertising it has been shown that an increase in irrationality leads to an increase in support for a beliefregime or buying respectively Side note there are multiple levels of denial conscious and unconscious There is manipulation of denial and o en that happens without our awareness Sometimes what looks like denial is an actual unawareness of a phenomenon or fact which can happen through cognitive inability to comprehend information On the other hand we wonder about the extent to which denial can be a planned objective for media or a regime To what extent does denial seem to differ between the United States and other countries we have experience in Us denial may be greater because we have more to defend in terms of our position as the greatest country in the world or people s support for the American Dream Smaller countries have less at stake and may have less denial However when it comes to an issue that is threatening to a people s safety and wellbeing denial will erupt even there as in people denying the threat of war Level of income disparity in a country may increase the amount of denial could this be related to a perceived lower level of denial in Canada 3 The authors point to a dichotomization in our thinking the split between good and evil p 8 To what extent is this true as research based knowledge for adults And do we know about the extent to which it has changed In other words do we know if critical thinking skills developed in adolescence during neocortical re nement have decreased relative to different historical periods Could it be that it seems our critical thinking skills have decreased only because the world we are living in is so much more complex There may be an inverse relation between the level of religious dominance and that of critical thinking This probably in uenced critical thinking over the last many hundreds of years It is possible that for the last 20 years or maybe since the sixties critical thinking practices have strengthened Action movies and video games tend to dichotomize good and evil Sometimes the news looks like a video game An example of the polarization in Us is the political criticism of fuzzy Al Gore 7 we demand one kind of image in a leader Social oppression leads to increased polarization dichotomization 4 What do you know about the shift in public access to government documents since 911 They ve been made inaccessible across the board Hear No Evil See No Evil 1 Milburn and Conrad have a list of aphorisms associated with the process of denial in chapter 2 Can we come up with some new aphorisms that psychologists and teachers could use with kids and embed in our lexicon that support acknowledging and processing negative affect as opposed to denial of affect We agreed this would be helpful and will keep it in mind One possibility is The data is in Your feelings matter We want to know how it was for you Talking about it helps No really I m ne 1 patients high in denial though they appear to function better may jeopardize their long term recovery Again do we have a statement about physical health that could be analogized to our political process When it rst happens denial is adaptive It enables people to cope with as much as they can at one time Absorbing reality at a moderate pace may be adaptive but denying it isn t A Canadian minister noted US denial that it had done anything to provoke 911 If we get back to the question we could note that the question of US doing anything wrong was very absent from public discourse When a feeling is stigmatized denial increases 6 Do levels of within person protection from intergenerational transmission of trauma correspond inversely with levels of caregiver attachment classi cation Yes The data is in The Politics of Denial 1 What do you think about Milburn and Conrad s use of the data about the cost and lack of effect of the death penalty in their argument about the relation of attitudes on the death penalty with personal history of punishment Legislators do read this datamaybe sometimes they deny it when other pressures intervene The data is in on media Violence being associated with Violent behavior in people exposed to it Same with the negative repercussions of spanking The timing of getting the facts to the people is important 2 What has research shown about any compensatory effects of efforts parents make after harsh punishment or emotional aggression of their children lVIight there be an interaction between the level of trauma x cognitive stage of the child x attachment level x child disposition with these efforts What do psychological researchers believe about the tenet that if there is a higher order interaction it reduces or even nulli es the simple effects The plasticity of the brain makes reparations very effective such a logic is reductionist reducing the human to his neurons And the sooner the reparations occur the more effective they are Nevertheless reparations are effective even when they come about many years after the fact Positive interactions create positive changes in emotion and development 4 I was taught that the ethics of revising a hypothesis after data collection and analysis adding the gender construct in reanalysis of Milburn Conrad et al 1995 is questionable What do you think It s surprising that they didn t include the gender construct originally Poor research design At least they were honest Anna will contact the authors to see if the second analysis was written up Another note 5 On page 65 the authors state that girls are more empathic This has been contradicted before and since publication in 97 especially through Hodges study that found that males were just as empathic when they were offered money for empathic responses In other words empathy seems to be a motivated response Part 2 Questions circulated prior to discussion What s Missing from this Picture 1 we do present evidence that Childhood experiences exert a significant effect on his or her politics p 8 Really Or do they show an association 2 Let s bring in your expertise What evidence is there about choicemaking and emotions in the literature in advertising psychology and elsewhere 3 The authors point to a dichotomization in our thinking the split between good and evil p 8 To what extent is this true as researchbased knowledge for adults And do we know about the extent to which it has changed In other words do we know if critical thinking skills developed in adolescence during neocortical re nement have decreased relative to different historical periods 4 Has minimization been consistent in US history In text bookspublic education In the news media Do you believe that minimization is perhaps slightly less dangerous than outright exclusion of information from the public eye 5 What do you know about the shift in public access to government documents since 91 1 Hear No Evil See No Evil 1 Have psychologists who focus on cognitive processes neuropsychologists explained the process of denial as one linked to individuals failure or refusal to ground memories or information into memory through the process of verbalization 2 Milbum and Conrad have a list of aphorisms associated with the process of denial in chapter 2 Can we come up with some new aphorisms that psychologists and teachers could use with kids and embed in our lexicon that support acknowledging and processing negative affect as opposed to denial of affect 3 The physical punishment of children we believe remains acceptable because parents deny the very nature of what they are doing their motives for doing it and the consequences of this behavior for their children s emotional wellbeing and behavior p 22 Does this remind us of our military ethos If we were to advance that those in charge of the military are educated and informed about developmental and psychological theory could we attribute motivation to their decisions Reactions and discussion 4 How could we tell if our own interpretation of trends and events were biased by our own hostile attribution No really I m ne 1 patients high in denial though they appear to function better may jeopardize their long term recovery Again do we have a statement about physical health that could be analogized to our political process 2 Does the repeated experience of watching mainstream broadcast news create a psychological dependence on the relief from stress that the denial inherent in it provides 3 Could dispositional optimism sometimes be easily confused with denial since it s hard to measure the extent to which persons are confronting their problems In other words people could verbalize such a rationalization and then fail to engage in resolution of their con ictsproblems Is this something psychologists and educators should keep in mind 4 Does the term psychic numbing seem like one that might be more effective to use in discussing the global political denial with nonprofessionals This postulate doesn t argue that the terms are equivalent and it might be interesting to talk about the relationship between the two terms 5 Modification of the perception of threat sounds like a great therapeutic objective Is that difficultor not What about for the perception of threat by US citizens 6 Do levels of withinperson protection from intergenerational transmission of trauma correspond inversely with levels of caregiver attachment classification The Politics of Denial 1 What do you think about Milbum and Conrad s use of the data about the cost and lack of effect of the death penalty in their argument about the relation of attitudes on the death penalty with personal history of punishment 2 What has research shown about any compensatory effects of efforts parents make after harsh punishment or emotional aggression of their children Might there be an interaction between the level of trauma X cognitive stage of the child X attachment level X child disposition with these efforts What do psychological researchers believe about the tenet that if there is a higher order interaction it reduces or even nullifies the simple effects 4 I was taught that the ethics of revising a hypothesis after data collection and analysis adding the gender construct in reanalysis of Milbum Conrad et al 1995 is questionable What do you think It s surprising that they didn t include the gender construct originally Poor research design 5 Did the Milbum Conrad et al research address the hypotheses on p 67 What questions do you have about the first and second studies they did Problems Support Questions 6 What do you think about these two statements that Milbum and Conrad make anger resulting from childhood punishment is associated with holding more punitive political attitudes p 70 and our political attitudeshave their source in childhood p 71 Neurobiology of trauma April 21 2003 page 1 of 9 Class Notes Prepared by Lisa Cromer Anne Mannering amp George Hanawahine For Psychology 607 21 April 2003 Comments based on class discussion in italics BETRAYAL TRAUMA Freyd JJ 2003 What is a betrayal trauma What is betrayal trauma theory Retrieved April 2 2003 from httpJ 39 noreoon edn jjfdef1neBThtml betrayal trauma is a kind of trauma betrayal trauma occurs when the people or institutions we depend on for survival violate us in some way examples of betrayal trauma include childhood physical emotional or sexual abuse betrayal trauma theory is often utilized to explain the cause of unawareness and amnesia of traumatic events posits that there is a social utility in remaining unaware of abuse when the perpetrator is a caregiver for a child who has been sexually abused their survival may be better ensured by being blind to the betrayal and isolating the knowledge of the event this helps the child to remain engaged with the caregiverperpetrator betrayal trauma and betrayal trauma theory were introduced in 1991 by Jennifer Freyd at a presentation at the Langley Porter Psychiatric Institute traditional assumption in trauma research has been that fear is at the core of responses to trauma the distinction between fear and betrayal may be important to posttraumatic outcomes betrayal trauma may be more 39 A with J39 39 quot yup and other trauma more fear and anxiety symptoms victims don t need to be conscious of the betrayal in order for it to be called betrayal trauma it appears that men experience more nonbetrayal traumas then do women while women experience more betrayal traumas than do men Freyd JJ DePrince AP amp Zurbriggen EL 2001 Self reported memory for abuse depends upon victim perpetrator relationship Journal of Trauma and Dissociation 23 517 study using the Betrayal Trauma Inventory BTI to test predictions from betrayal trauma theory about the relationship between amnesia and betrayal by a caregiver this instrument uses behaviorally de ned events in the domains of sexual physical and emotional childhood abuse to assess trauma history when participants endorsed an abuse experience followup questions assess a variety of factors including memory impairment and perpetrator relationship results supported the prediction that the greater the victim s dependence on the perpetrator the more likely that memory for the abuse would be impaired or disrupted age was found not to be a significant factor in predicting memory loss duration of the abuse was also found to not be significant Discussion Questions Neurobiology of trauma April 21 2003 page 2 of 9 1 Studies have shown that the greater the victim39s dependence on the perpetrator the more likely that memory for the abuse will be impaired or disrupted What are some speci c aspects of the victimperpetrator relationship that you think would increase or decrease memory retrieval What other factor could affect memory impairment things about the Victimperpetrator relationship that may increase memory retrieval were difficult to identify some hypothesized that the older the Victim the more chance of memory retrieval things about the Victimperpetrator relationship that may decrease memory retrieval are the following 1 the perpetrator is a single parent 2 the perpetrator repeatedly threatened harm on the Victim if they chose to disclose the abuse 3 outside of the abuse the Victim and perpetrator had a warm and very loving relationship other factors that could affect memory impairment were the level of awareness of the Victims other primary caregiver level of support or denial of other adults around the Victim the level of support or nonsupport given by a Victim s sibling whether or not the Victim had a sibling who suffered the same type of abuse by the same perpetrator 2 In many cases where a child is abuse by a caregiver there is another caregiver that may be unaware of the abuse In essence the child victim may not be totally dependent on the perpetrator How do you think this affects the drive for a child victim to dissociate him or herself of these traumatic memories if a second caregiver had no idea about the trauma being in icted on their child by their partner their may be mixed effects the child may feel greater resentment towards that caregiver and have a greater level of anger towards that caregiver for not know what they are going through the child may also feel the need to keep this information from that other caregiver to avoid more issues in the family the level of confidence that the Victim has in the other caregiver believing their story may impact their decision to disclose or not often caregivers will dismiss such reports by children therefore Victims don t feel confident in disclosing such information experiences with another child in the family sharing such information and being called a liar may cause one to dissociate more in situations where the perpetrator is a step father there may be certain dynamics at play especially if the mother and the children are all dependent upon this individual betrayal theory may go into effect not only for the Victim but also the other caregiver who is just as reliant upon the perpetrator as the Victim Additional Discussion Questions In order to further the research by Freyd DePrince amp Zurbriggen designed a study that would clearly classify categories of closeness between victims and perpetrators And explain WHY you made those decisions Hints consider amount of time spent with person types of dependence is it closeness between perpetrator and child or perpetrator and child39s family What is the role of attachment Neurobiology of trauma April 21 2003 page 3 of 9 0 Using Maslow39s hierarchy of needs may be useful in designing a classi cation system physical needs love and safety etc 0 there are emotional and physical components that need to be taken into consideration 0 may be useful to develop a questionnaire type measure to establish level of dependence 0 main effects for actual person vs interaction mediation through relationship with other care givers 0 need to assess if relationship between victim and perpetrator has effects on other relationships 0 Check out level of deception and fear if you tell then this will happen Treatment Question of Betrayal Trauma case vs Non betrayal trauma case need to evaluate the extent of betrayal trauma single incident vs longer period of time need to identify the specific symptoms more dissociation or more anxiety type symptoms for BT cases focusing on rebuilding trust within the victim may be important decisions of when to involve parents in treatment can be tricky especially if one of the parents is the perpetrator age of child may determine what treatment will look like timing between traumatic event and treatment may determine treatment implemented drug treatment is something that needs to be taken into consideration gaining an understanding of the victim s support system is important this is an important aspect of ways to increase the trust within a child who has experienced ET 0 gain an understanding of accompanying emotions 0 Treatment gets tricky depending on the context you are working in our current mental health system may force you to focus on symptoms and not allow you to focus on things such as relationship building etc RECOVERED MEMORIES Sivers H Schooler J Freyd J J 2002 Recovered memories In V S Ramachandran Ed Encyclopedia of the Human Brain Volume 4 pp 169 184 San Diego California and London Academic Press What about Recovered Memories website httpdynamicuoregonedujjfwhatabouthtml Questions to ponder 1 What is the difference between Memory Accuracy and Memory Persistence a Memory persistence is the degree to which a memory has remained available over time Memory accuracy is the degree to which the memory is historically true The distinction is important because they are orthogonal One dimension is sometimes used to infer the other and this is incorrect b Are they correlated No Neurobiology of trauma April 21 2003 C page 4of 9 What kind of memory is more likely to be false Neither Trick question No research to date has been able to accurately answer this question 2 Why do people forget and then remember a Several reasons here Memories sometimes are state dependent so one sometimes needs to be in the same state emotional cognitive environmental in order for a memory to be recalled Also there can be other processes at work such as normal forgetting and then recall with words stimuli or experiences that trigger the memory Also noted that events that are talked about are more likely to be remembered 3 What is shareability see page 5 of website for this one a Refers to the extent to which information is shareable Internal information is often qualitatively different than external shared spoken written information Internal information is not shareable often The theory states that communication effects the representation of information in that in order to share it it becomes more languagebased and therefore more categorical explicit declarative in nature 4 What memory encoding mechanisms are probably at work with recovered memories a Fquot O D There is some laboratory evidence for repression being at work in forgetting negative material Acute dissociated state could be at work in leading to poor encoding of the traumatic event Dissociated state could lead to statedependent effects eg a woman may not remember the details of being raped until she is intimate with a partner and the memory could come ooding back Fear can interfere with memory pathways evoked through the hippocampus Betrayal trauma postulates that information can be blocked from mental mechanisms that control attachment therefore information can be encoded but retrieval is blocked in order to maintain the attachment relationship 5 What are the wellestablished memory mechanisms Trauma and nontrauma specific a Fquot 0 Simple forgetting Forgetting childhood experiences even negative ones can just re ect the passage of time Direct intentional forgetting As demonstrated by the Anderson lab here at the U0 individuals can intentionally forget information when they try This is a logical route for forgetting traumaiwhy not try to forget that which is painful Interference theories of memory When two related pieces of information are learned practicing one piece can interfere with the other piece Therefore in the case of abuse this can be demonstrated in the case of the perpetrator either before during or after or some combination there of telling the victim contradictory information If the victim is told by someone in a threatening or powerful position that what happened is not abuse or that they wanted it or some other confabulation then this memoryinformation could compete with the unshared internal experience of abuse Neurobiology of trauma April 21 2003 d D quot1 W Pquot page 50f 9 Change in understandingreinterpretation Individuals have very poor memory for which they do not have a schema Therefore particularly in cases of child abuse or bizarreunusual forms of trauma a person can have no way to label understand or describe an experienceithis could impair memory However if a schema framework is later presented then the abuse can be remembered This is sometimes seen in cases for example of date rape or domestic violence where as the woman receives an education about consensual sex she can realize and understand posthoc that she was raped and make more sense of her experience as having been negative Encoding specificitystate dependency Research with mood and with alcohol have clearly J J tat r J memory 39 This theory related to trauma in that fragmented memories can be more dependent on highly specific cues Forgotitallalong effect Just as sometimes we rationalize that we knew it all along this theory postulates that people can have memories for a while but then forget the memory At the time of forgetting they may underestimate any prior knowledge of the event Precipitous forgetting of nocturnal experiences We often forget dreamseven traumatic bizarre and disturbing ones This parallels what could happen in sexual abuse particular abuse that happens at night Metaconsciousness This theory assumes that the experiential awareness can be distinct from the metaconsciousness It postulates that as the metaconsciousness gains a different meaning of an experience that it can be as if the memory experience is being remembered for the first timeieven though it is only being newly perceived by the metaconsciousness NEURO BIOLOGY OF TRAUMA How child abuse and neglect damage the brain Kendall 2002 amp Scars that won t heal The neurobiology of child abuse Teicher 2002 The content of these two articles overlapped considerably so the following summary points are taken from both Summary points Evidence from neuroscience shows that physical abuse sexual abuse and neglect affect brain structure and chemistry Trauma is linked with brain wave abnormalities in one study 54 of abused child and adolescent psychiatric patients showed abnormalities compared to 27 of non abused controls Severity of abuse is positively correlated with the impact of trauma on brain function The left cortex hippocampus and amygdala show reduced volume in abused individuals Neurobiology of trauma April 21 2003 0 Trauma alters the production of stress hormones e g cortisol and neurotransmitters epinephrine dopamine serotonin Low levels of serotonin in particular have been associated with depression and impulsive aggression Drug therapy and psychotherapy can change neurobiology Although neurobiological consequences of trauma are easier to change in childhood the brain is capable of change in adulthood although Teicher 2002 suggests the effects are irreversible page 6of 9 Discussion Questions 1 How extensive are the effects of trauma on the brain Which structures and systems are affected In assessing the extent of neurobiological effects of trauma temporal considerations are important as chronic abuse may have a greater impact Currently the full extent of the effects of trauma on the brain is not known but it appears that the entire limbic system ie hippocampus amygdala is affected 2 How permanent are the neurobiological effects of child abuse What do developmental differences in brain plasticity suggest for intervention efforts The permanence of the neurobiological effects of child abuse is an empirical question These effects may be timesensitive and vary depending on when in development the abuse occurred Additionally new evidence suggests that neurogenesis is possible postnatally in the human brain This evidence in turn suggests the effects of abuse are at least partially reversible 3 Several studies have found differences in the hippocampi of psychiatric patients compared to control groups What patient groups have been studied How might this evidence support Ross s trauma model as a potential answer to the problem of comorbidity Many studies showing reduced hippocampal volume are based on Vietnam veterans and sexual abuse survivors and thus may have some limitations However hippocampal and amgydalar reductions have been found in people with different psychopathologies e g PTSD DID borderline personality disorder and depression suggesting that trauma may be a common underlying factor in these disorders despite the differences in symptomatology 4 Could the diminished integration of the left and right hemispheres in abused individuals be related to dissociation Diminished integration between the left and right hemispheres might plausibly be related to dissociation Specifically if verbalsemantic memories are stored primarily in the left hemisphere and sensoryemotional memories in the right hemisphere it is possible for a person to have emotional memories of trauma but not be able to put these memories into words The disconnect between the left and right hemispheres also seems related to alexithymia Neurobiology of trauma April 21 2003 page 7 of 9 5 How might the neurobiological effects of abuse be related to intergenerational transmission of abuse We didn t get to this one in class The body keeps the score approaches to the psychobiology of post traumatic stress disorder Van der Kolk 1996 Summary Points Individuals with posttraumatic stress disorder PTSD show hyperarousalhyper reactivity to stimuli persistent intrusive memories of the trauma and emotional numbing These symptoms have been observed in combat veterans and survivors of sexual and physical abuse both adults and children Hyperreactivity occurs both in response to speci c reminders of the trauma and to intense but neutral stimuli loss of stimulus discrimination Chronic stress reactions are related to reduced hippocampal volume and alterations in stress hormones and neurotransmitters in patients with PTSD During ashbacks patients show activation of the amygdala and sensory areas in J quot with J J quot quot of Broca s area speech production area High level activation of the amygdala interferes with hippocampal functioning and prevents categorization of experience 1 How does the neurohormonal response at the time of trauma produce both over consolidation of traumatic memories and inhibition of memory consolidation Stress triggers a pattern of events that disallows cohesive memory Two simultaneous appraisal systems are activated one for verbalsemantic informationmemory and the other for sensoryemotional informationmemory The verbal memories are consolidated in the hippocampus which is shut down by overstimulation of the amygdala sensory emotional system Thus emotional memory becomes overconsolidated excess of norepinephrine and is not linked to verbal memory Oxytocin and endogenous opiods are also released in response to stress and have been related to amnesia affects the hippocampus 2 If emotional memory may be forever what are the implications for treating patients with PTSD Could the hyperreactivity to traumarelated stimulimemories be attenuated by increasing the integration of the right processing of negative emotion and left semantic processing hemispheres We didn t really get to this one in class Discussion Questions IIllIIIIIIIllIIIIIIIllIIIIIIIllIIIIIIIllIIIIIIIIIIIIIIIIIIIIIII Given that dissociation is a cognitive mechanism sometimes used as a coping strategy for dealing with abuse how would you design a study that would answer these questions 1 Is a dissociation a copying style developed in childhood adaptive or maladaptive in adulthood a How would you measure adaptivemaladaptive Operationalizeaccess with things like job performance interpersonal relationship success risky behavior attention healthy behaviors Neurobiology of trauma April 21 2003 page 8 of 9 2 Are there neurobiological differences between people who do and do not dissociate a Createobtain a transcript of traumatic event Conduct an lRI study Provide the transcript as stimulus and measure the brain activity Compare with a control group OR Get a group of people e g veterans who have experienced similar trauma Match groups of high and low dissociators 3 Are there neurobiological differences between people who have been abused by a caregiver vs noncaregiver a lRI study of those abused by caregiver and noncaregiver Can also use other physiological measures such as blood tests hormonalchemical tests to get at between group differences What are some obstacles to the study Ethical issues Ethical issues not an intervention study so what benefits to the participants At what risk Difficulty infinding survivors who do not remember abuse Dissociationnot rememberinghard to recruit participants How to differentiatecategorize abuse severity duration age of onset and type Human subjects committee challenges Are we pushing people to remember things they are not ready to remember Your rm is hired to prepare expert witness testimony for a child abuse recovered memory case The plaintiff is a 42yearold woman who is experiencing post traumatic symptoms from abuse she claims to have experienced between ages 5 and 12 from her father She recovered her memories of abuse when watching Montel one afternoon She saw an episode about a woman whose abuse was just like her own and it triggered her memories back There is no corroborating evidence for her case Create a list of important points that you would use to support the validity of the plaintiff s claim Be sure to include hypothesized memory retrieval mechanisms that might be involved and issues related to memory persistence and memory accuracy Important points to support the validity of the woman s claim 0 Betrayal trauma theory Freyd 1994 1996 provides a mechanism to explain why she would forget the abuse abuse perpetrated by a caregiver is more likely to be forgotten She is experiencing symptoms of PTSD which suggests that the trauma did occur Additionally the physical e ects of trauma on the brain have been related to the inhibition of verbal memory in patients with PTSD Memory persistence versus memory accuracy Although often misconstrued to be the same memory persistence and memory accuracy are orthogonal Thus a memory that is not continuously held is no more or less accurate than one that is continuous Memory retrieval mechanisms Many of the processes involved in normal forgetting can also be involved in forgetting and later recalling traumatic memories State dependent memory and reinterpretation of the memory seem especially relevant The Neurobiology of trauma April 21 2003 page 9 of 9 memory was not necessarily lost completely but not having the vocabulary to express it could have prevented earlier retrieval of the memory T ranma 5 Legacy Psychology 607 Winter 2004 University of Oregon Discussion Questions and Thoughts from the Class The Politics of Denial January 12 2004 Note Questions that we did not address are included without responses following them Milburn and Conrad present an anecdote about a couple in Oregon who are members of the Christian Coalition They include the following quote Obviously says Christie speaking of homosexuals in the last twenty years since they wrote their homosexual agenda they have had a methodical plan That s why we ve had to wake up p74 It seems that this couple s concerns go beyond punitive and move into the realm of paranoia How might this fear relate back to Milburn and Conrad s theory about childhood punishment What is the relationship between paranoia as it is manifested in this example and denial Perhaps if we think of fragility of self as a common characteristic of those high in denial it helps to explain the link between denial and paranoia such that the fragility creates the type of fearparanoia exempli ed in the above anecdote It might be useful to think about how variations in the degree to which a person has a self serving bias might play a role in these processes For example individuals with depression tend to have a limited selfserving bias compared to normals Paranoid individuals on the other hand may I can t remember from discussion whether this has been shown empirically or if this was a hypothesis have a more extreme selfserving bias The book Madness Explained by Richard Bentall deals with some of these ideas The idea of physical punishment being necessary to break a child s will comes up repeatedly in the examples that Milburn and Conrad present Where does this conception of the child as this almost evil being stem from Do individuals learn from parents who use it as a means to justify their punitive behavior It seems so contrary to another prevailing societal image of the child that of children as innocent clean slates that it seems strange to imagine how the two could coexist What were your thoughts about Milburn and Conrad s parallel between the Calvinist minister s description of Hell and a child s perception of physical punishment p79 Are they stretching their theory too far I was struck by the statistic that the most common cause of death of children under the age of four is abuse at the hands of parents or other caretakers p82 Knowing that I must have heard this before I was embarrassed at my surprise How is the denial of such an atrocity so pervasive Why have more people not rallied around this issue Why has education in this area lagged behind other causes Or is the education there and people are ignoring it A point that I found particularly interesting about the discussion of the Christian Coalition was the quiet methods they seem to use use By quiet I am referring to the fact that for example Milburn and Conrad suggest that they teach political candidates not to mention that they are a part of the coalition Do you think that it is true that their in uence on society is happening quietly and that people are being tricked into electing candidates whose beliefs they aren t aware of or is it that the American public would rather look away than deal with the increasing in uence of this group The Christian Coalition is also extremely organized and has tremendous power to mobilize people for events and other peoplepowered functions How aware is the average American of this movement How aware can they be given both the tactics the CC uses and the content of the current media Assuming that punitive child rearing has existed in throughout America s history what do you think about the question Milburn and Conrad pose concerning why it seems to be playing an increasing role in politics in current times They propose the idea of economic threat as one possible explanation p115 Can you think of others Historical example that the number of lynchings in the South were correlated with the difficulty of economic times However couldn t you argue that a society is experiencing some threat at any given time and that this isn t a sufficient explanation Backlash deals with the idea that perhaps successive gains for one group e g women homosexuals result in subsequent backlash against the group Perhaps this could explain some of the attitudes that are playing out in our current society In the reading for the last class Milburn and Conrad addressed the idea that perhaps punitive child rearing has differential effects depending on gender However they did not return to this idea in these chapters How do you think the issues they discuss in this chapter might play out differently depending on gender This is a complicated issue because you are dealing both with the socialization aspects and the fact that boys and girls tend to be subject to different types of punitive child rearing andor trauma e g sexual abuse is substantially more common in girls The movie Tough Guise addresses the unique socialization of American boys The discussion of the effect of emotional arousal on cognitive complexity seems so relevant to the tactics being used in both advertising and public policy today How much do you think this is impacting our current political climate Is this a tactic that has been used throughout history or has it become more prevalent It is difficult to strike a balance between reality e g showing things that are Violentdramatic but provide necessary truths and drama used to sway public opinion It is also important to recognize the fact that the content of the news may be driven by supply and demand Perhaps if people did not watch or spoke up about the content of media things would change However consider the example of the image of the towers falling on 9 11 Apparently there were many who spoke up asking the media to stop repeating the image to no avail It is interesting to consider to what extent the cases of inaccurate facts arguments presented by politicians media etc are the result of insufficient dissemination of information versus ignoring the facts Perhaps it is often the case that it is selective reporting of facts picking out what is useful for the point that they want to make Milburn and Conrad s chapter on slavery made me think about how other countriescultures address negative historical events For example has Germany done a better job than the US has done with slavery of coming to terms with the Holocaust and acknowledging the atrocity This comes back to something we discussed last week to what extent are these patterns of denial culture speci c It is hard to compare these two events because Germany was forced to engage in the Holocaust Psychology and psychiatry tend to be guilty of the same type of historical whitewashing Even now people are more likely to ack 39 Ag the 39 str 39 39 J 39 39 39 J l with slavery than they are to acknowledge the personal struggles e g rape assault Disciplined Hearts deals with how similar issues have affected Native American populations Other thoughts from discussion How strong is Milburn and Conrad s empirical argument Why is there such a relative lack of this kind of work Perhaps psychology is better at thinking about internal psychological processes and not as good as examining broader interpersonalcultural issues Why do people who bring up social injustices get punished Perhaps this has gotten more severe after 911 but it seems to be a response that goes much further back It is important to remember that Milburn and Conrad s hypothesis is that both punitive child rearing and DENIAL of that experience are prerequisites for the effect on punitive political attitudes It is interesting to consider what a bad childhood is Most often people jump to thinking about the single mom poor etc whereas the bad childhood we are talking about as correlated with punitive political attitudes may be very different T ranma 5 Legacy Psychology 607 Winter 2004 University of Oregon F ebrnary 2 2004 Part I Questions about the last part of the book The Politics of Denial In Julius Lester s book To Be a Slave two ways for enslaving human beings are listed one through force and one to teach him or her to think that herhis own best interests will be served by doing what his master wishes him to do The latter was more subtle way with a main goal to brainwash the slave In the cruelest way slave was asked to deny his own identity in addition to his feelings Many parallels could be made with Milburn and Conrad s book One that comes to mind is emotional numbing that s associated with denial Could you think of some others Milburn and Conrad cite a classic article p 168 by political scientist Murray Edelman 1971 that argues that governments attempt to generate a series of public perceptions in support of their actions These perceptions are often not representative of reality and are simpli ed version of events if not falsi cation Some of these perceptions are particular groups in the world are evil certain kinds of actions are evil Maybe it s just me but doesn t this sound familiar hint evildoers While we re discussing evil isn t it interesting that the other Bush administration referred to Manuel Noriega once on CIA s payroll as an evil man engaged in evil deeds p 172 maybe this adjective runs in some families The authors illustrate how the power of personal motives can initiate policies that impact many people by using the example of JFK and Khrushchev pp 169170 Is this stretching it or do you think that there is some validity to this claim The authors do a great job of illustrating how war is described like a game using words like cleaning up and owning the air p 174 How does this contribute to mass denial I was absolutely surprised by the results of Milgram 1963 study p 179 65 of subjects obeyed orders to administer 450 volts of electricity to a fellow human being Authority is the key variable that predicts obedience 7 What are some reasons for people s willingness to do horrible things to other human beings in addition to obeying an order The authors argue that the international community did not intervene in Rwanda because there is a possibility that other nations ignore or deny the occurrence of genocide as a result of their own ethnocentrism or racism I can relate to this statement 7 the European Community did not do anything for 3 years while neighboring Bosnians were being exterminated 200000 people killed constituting the worst genocide Europe has seen since the WWII If one can assign different magnitudes of tragedy Rwanda was even more tragic story as it received little or no attention and close to million people were killed Would this happen if the same thing was happening in Belgium Saudi Arabia Does economy alone dictate the worth of a nation Or are there alliances based on values race religion etc By ignoring genocide aren t we denying the existence of those people Aren t we denying their humanity 7 cheese sandwich p 190 How can public gures such as Pat Buchanan make outrages comments and deny Holocaust and get away with practically no media scrutiny Who has a power to de ne what s important and what s not Who controls the media The authors mention p 196 Weine and his colleagues 1995 study that found Bosnian refugees in the United States suffer high rates of PTSD and depression What about those detainment camp survivors who still live in Bosnia and Herzegovina surrounded by Serbia and Croatia who constantly minimize if not deny their responsibilities for war crimes committed against humanity They are denying it in the face of the victims or equalizing responsibility of all 3 ethnicities by calling it civil war The authors relate the importance of power and toughness and survival of the ttest of a laissezfaire capitalism to authoritarianism that contributes to denial Do you agree Texas Rep DeLay assembled more than a hundred business lobbyists into Project Relief whose goal is to eliminate regulation of business by federal government p218 Wasn t the regulation implemented by FDR during the Great Depression because lack of business regulations was one of the reasons that led to stock market crash in the late 20 s Are conservatives denying historical facts now Actually they do 7 remember Pat B case What did you think about Ingo Hasselbach s case p224 Part 11 Questions about the two articles on slavery NYT magazine article and Scienti c American article As dif cult and challenging as it was to read the two articles I cannot believe the human brutality that is still going on somehow I managed to write down a few discussion questions Denial is a powerful thing Scientific American article writes Often slaveholders have interposed many layers of management between themselves and the slaves They purposely deny themselves the knowledge of what they are doing and thus the responsibility for it This reminds me of Milbum and Conrad s comments on proximity s role in denial Do you think that the more distance or insulation one makes between themselves and injustice that it is easier to deny the injustice After all wasn t Vietnam far away Iraq In 1865 when slaves were emancipated in the US they were denied any rehabilitation that is needed after centuries of enslavement This freedom without rehabilitation is also a form of denial of the seriousness of the institution 7 denying them rehabilitation is like saying that what they went through is not that signi cant Scienti c American article ends with Our ignorance of their hidden world is vast Is their world hidden or are we not looking for it Or is media not reporting things that are too disturbing The New York Times article states estimates that there are 30000 to 50000 sex slaves in captivity in the United States at any given time Laura Lederer a senior State Dept adviser on traf cking told me We re not nding victims in the United States because we re not looking for them This happens despite the Traf cking Victims Protection Act and the Protect Act but these acts address most of the injustice that s going on outside our borders By focusing on sex traf cking elsewhere are we forgettingneglecting or denying the abuse of sexslaves in the US Part III Discussion Notes from call discussion 12204 Two ways to enslave man 7 by force or by brainwashing often both used 7 examples slavery with Native Americans Also battered women often experience the interplay between violence and brain washing as violence scares people into obeying The power of language 7 words like evil used often by politicians 7 power of language is denied Conservatives are not as constrained by morality better use and manipulation with words Some politicians use words like crusade Part of denial is decomplexifying often complex reality Political correctedness turned around complexity presented by more liberal politicians often interpreted as less genuine Science OK only if it agrees with certain political agenda Emergence of faith based programs and abstinence Cannot be beat by logic Vietnam 7 desensitizing war Corruption in science community 7 for example pharmacological rms pushing their products to physicians 7 physicians may think that they are not being in uenced 7 general attitude of I ll accept this but won t be corrupted Power of wealth in political discourse 7 book Buying of the President 7 applies for both Democrats and Republicans Historical causes of constitution taken out of context Power of media new lm whose director is using the lm to push his own agenda of getting the case overturned this applies to some politicians Who decides what gets more attention 7 church child abuse or domestic abuse Media who runs the world What are the implications for the future of the intemet Mass hypnosis 7 TV and the passive nature of watching it 7 reduces our critical thinking Hopefully the Protect Act will take effect after a while and be fully reinforced Dorothy Lewis book 7 case studies on murders 7 they themselves had injuries and were abused The way we raise our children is very in uential and very meaningful and has implications for larger societal processes James Prescott 7 societies that are more touchy hugging and sexuality is OK is less violent Q 63 WW Consequences Trauma Carolyn B Allard amp M Rose Barlow 7 April 2003 Rc E 5 LongTerm Health Effects KendallTackett 2000 T Dr visits surgery symptoms Pain l threshold depression controlled v T Headache back pelvic pain l surgery success Fibromyalgia rates but worse v T Irritable Bowel Syndrome y W3 4 LongTerm Health Effects KendallTackett 2000 Why v T health compromising behaviors risky sex substances eating seat belt use v T depression decreases immune system Selfful lling prophecy of poorer health perception controlling for depression y W 4 Turning Gold into Lead Felitti 2002 Huge Adverse Childhood Experiences ACE study m 17 000 participants middle aged middle class had insurance Triggered by findings that for many people obesity not problem but solution Er LongTerm Health Effects KendallTackett 2000 Timing child vs adult no effect Ier dbn 39t seem to 52 any good stud izs a out quot timing wit in c ifd ood somzw at qfa new area 41130 Harri to stud acamztz r Type physical vs sexual no effect Severity T overall severity is associated with T problems Treatment implications integrate mental and physical Dr should ask Er Turning Gold into Lead Felitti 2002 8 categories of adverse childhood experiences Assessed current and prospective health tatus Experiences Over 12 experienced 1 adverse experience 7 Given exposure to 1 80 chance of having experienced 2 i Ex y Turning Gc into Lead Felitti 2002 Findings l ACE score 08 l likelihood of making 39 Chronic obstructive pulmonary disease 39 Deprssion Suicide attempts 39 Drug use 39 Other health problems hepatitis fractures diabetes Selfmedication E 5 Turning Gold into Lead Felitti 2002 Implications General ignorance of common and destructive experiences v Rather than focusing on primary prevention we are currently trying to catch up far down stream and it s not working 4 Equot lquot 55 5F W3 4 E amp The Trauma Model Ross 2000 Discrepancies between teachings and observations Comorbidity polypharmacy unsuppor e Single gene single disease model myth of young Johnny Lip service to biosocial interactions Trauma irrelevant to treatment plan a gx The Trauma Model Ross 2000 Assumptions Comorbidity is accompanied by high rates of chronic childhood trauma Biology is not irrelevant genome is dependent on environmen Trauma model is designed to be falsifiable scienti cally testable Equot lquot Equot 4 5F UK 4 The Trau a Model Ross 2000 4 Dissociation observable phenomenon is 5quot core feature of trauma response Memories for traumatic and non traumatic events can be true andor false recovered andor continuously held rather than theorizing can study scienti cally Class discussion points n m at extent mm rt mm matter ow amurataa mama u Maj 72 w atmr mamory tr Mere ix 1112fqu pre ttitm of pxyt oyati Perth commrm wry important it39 tiarapautr39rarg important to Mmyour a amtr tut remarr mm to 07105011112 mamorr39a a mut a pmi a Corro omtitm may aim m uma t e mamory tray 1m ot er march pzr apx t e important yart ix praramtmg t e trauma in t e nt puma W at g ut mm retweringa mamory aw am it 11111211011512 oriJ rt aaMatr39mgum p mom i Ex y E To Ask or Not to Ask Read amp Fraser 1998 High prevalence of abuse among psychiatric patients when surveyed BUT low rates found in medical records Clients not asked directly QR 0 As or 0t 0 Read amp Fraser 1998 EVEN when question included in admission form form only used with half and question only asked in 1753 While overall prevalence 32 82 in those asked Males and more severely disturbed may be less likely asked 4 Class gio s ng a out trauma elicits a lot ofnarrative aanossiElyl opens a can ofworms W at do you t en ab wit t e information s ng a out trauma mig t also not He relevant to some doctors39 views ofpsyc opat ology Mere mig t e some tric y legal issues S ameta oost eragnsts own History can a ect w et er a to Does it violate or validate to Are traumatized39 people fragile victims or strong survivors ic is more dangerous as ng or not as ng er aps mandated39 reporting is just an excuse in researc settings Training is very important around39 issues of trauma Q39 erapist s gender could39 He important Me Hoof is mideal A E y DlSCUSSlOl l tOPlCS What are the benefits of ignoring trauma when it may underlie many dif erent forms of psychopatho ogy7 J zrd39to come up wit reasons not to address traumatic Weriences Way He ene cialto notfocus on it at rst or w en more pressing issues s oulif e ad39d39ressed39 rst Tor clinicians to avoid39possi ility of overemp asizing trauma Tor clients cultural issues ofdisclomre Teasi ility issues limitedconstrained39t erapy y VZ W3 4 Er 0 As or Ct to k Read amp Fraser 1998 Assumptions 1 Crucial to diagnostic formulation 2 Important for treatment planning Considerations 1 Method of inquiry 2 Preparationdebrie ng for questioning quot Discussion topics How can we empirically study traumatic memories Retrospective selfreports rUsin descriptive items rat er t an traumaa use Met Trospectively Hut Having eqmienced39 ac nowledgedycorro orated39 trauma may in uence memory for it Implicitly e usingStroop tasks Does veracity matter If el ymience is real7true to client t en may e it s ou e ad39d39ressed39as suc 4 ISCUSSIOI39 OPICSI 3 Is it fruitful to look into genetic bases of Dlscusslon toplcs 39 psychopathology o Wo neact 4 Discuss pros and cons of obtaining abuse geneticstudies are correlationafin nature and39itis istory how would you develop and extremeijr di icuft fnot impossi ie wit current implement abuse assessment met ods to entangle environmentfrom genetics 39 Tros conceptualizing symptomatoiogy treatment Rat er t an cause genetic vufnera in it may e more promising u 39 39 t39 planning researc questwns E tneeJto e cautious a out vic tm mm Cons more time discomfort need39 to esta s rapport Important to di erentiate ioiogicaf from genetic at factors Best apyoac ismul twisapharya bwfw di nt osst ie areas oftmprovement eia orattons tn SCIfD perspectives options to pass not answer questwn More inclass discussion tliougli tiis ass is anut trauma as etiology it39s important not to STOG ath inli tiat tie trauma is tie answer to everytiing If trauma is seen as tie cause ofeverytiing we migit miss some rea Eut suEtfe pliysica or psyciotbgicat39 factors T ranma 5 Legacy Psychology 607 Winter 2004 University of Oregon F ebrnary 92 2004 February 9 Topic Betrayal Blindness Politics and Ethics Discussion Leader Rose Barlow I d like to hear your thoughts on the relationship of betrayal trauma theory to politics and ethics It seems like we ve already discussed situations of political betrayal blindness leaders not wanting to see the public not being educated about what their leaders are doing etc I found this passage which I thought was very relevant It s from an article in Smithsonian about Baghdad In a neighborhood of stucco houses the headmistress of the Moral Shan primary school told me with apparent sincerity that she was angry about the destruction of Saddam s regime and was grieving for him She described him as a father figure to her as well as her nearly 1000 students asked her about the horrors that Saddam had wrought on his people such as the murders then coming to light with the discovery of mass graves I do not believe it she said adding And if he did kill those people they deserved it People love Saddam because they are afraid of him my driver a 42yearold man named Ali explained to me This is a very strong kind of love We are always afraid to say our feelings What do you think it will take in order for the Iraqi people to stop being afraid In another part of the article the headmistress says they are teaching their children to forget what happened under Saddam s rule To what extent is this a good idea 9 It seems related to traumatic attachment need to be attached to the abuser therefore the self is bad Does the Us have some sort of official policy about what is taught in Iraqi schools regarding Saddam probably not What happens to a family when an abusive father is suddenly gone It probably depends on the circumstances Is the US also an abusive father Iraqis don t see us as liberators If one abusive father is merely replaced with another perhaps generalized amnesia is the best response If the situation changes though it could be empowering for the family and make it ok to talk about things If there are limited resources available for higherorder thinking then you have to react with emotions cognitive dissonance and focus on survival needs The American media seem to portray the Middle East in a skewed way Who owns the media No alternative viewpoints presented It seems that more and more there is censoring of the news due to marketing concerns What possible betrayal blindness exists in our own lives We are all adults and somewhat cynical about political leaders Are there people or institutions that we as a group depend on and trust FDA Who depends on us 9 Even scienti c journals show signs of censoring and the in uence of advertising What are the motivations for the observers not just the oppressed to have betrayal blindness Power differentials can you have betrayal blindness in a relationship where the power is totally equal Does such a relationship exist Maybe thinking it s equal is part of the blindness Love means never having to say you re sorry Lots of implications for therapy There are lots of power differentials in academia Here is the article about lack of hierarchy at Cambridge httpchroniclecomprmweeklyvS0i2222a0320lhtm If you took away all denial would there still be hierarchy Is there still dominance Perhaps increasing communication decreases both denial and the strictness of hierarchies When is it ethical to lift someone else s betrayal blindness BB Is it better that they not know what happened to them The Blease and Freyd paper also raises the issue about the costs of not asking about trauma What would happen to our society if we all asked about childhood abuse 9 If they are still in the situation let them keep their defenses If they do have power currently you might try to lift the blindness Perhaps it s unethical not to make people aware because denial perpetuates abuse H ow do you lift BB Logical argument is not the way Again lots of implications for therapy Should we be neutral no Acknowledging a therapeutic mistake acts out a powerful counter to denial Therapy is about having a good relationship not about having an agenda Therapy means having to say you re sorry Helen Garrod s case Reading her description of why she decided to bring a lawsuit years later she says Then in January 2001 I quotsnappedquot or quotswitchedquot it was sudden and quite disturbing like Ms Angry Betrayed had just stabbed Ms Deeply Attached in the back Why did it require violence against herself in order to make her story public Could it have something to do with why she is still a member of the party she brought a case against Do you think her anger and betrayal towards the Labour Party were affected by the oppression she felt in society as a disabled person 9 simultaneous love for the abuser and anger at the abuseriit s hard to have both at once There seems to be intolerance in this country for ambivalence for both loving and criticizing at the same time More stories about Helen s case httppoliticsguardiancouklabourstory0906178320100html httpwwwtimesonlinecouknewspaper0173 39768300html username anonymous password anonymous Speaking of people who felt betrayed by a political party how do you think the disastrous mess of the 2000 presidential election in uenced Bush s subsequent approval ratings for unrelated matters 9 I was thinking a lot about cognitive dissonance here Maybe we feel in need of a powerful father gure to protect us Lloyd DeMause The Political Life of Nations httpwwwpsych0hist0ryc0m has chapters online fascinating reading Birrell and Freyd quote the Dalai Lama as saying that compassion arises from the inability to bear the sight of another s suffering BampF p 15 Given that we can t do relational therapy with an entire society or can we how can we take in the sight of atrocities in the world and turn to compassion rather than dissociation and denial every moment is the ethical moment p 16 91s it right to try and impose our View that we must get rid of denial Maybe it s really ok to have an agenda even if just for public health reasons There are different types of denial of course Education is sorely lacking in a lot of ways Healthy relationships education in middle and high school doesn t include information about parenting Can we teach in schools about the intergenerational effects of child abuse without making it personal Definitely teens need to be taught about asking before initiating physical contact Talking about things in general helps those with less power Not talking about sex perpetuates power differentials Articles about Antioch College s askbeforeyoukiss policy httpwwwantiochcollegeeduc0mmunitysurvivaliguidecampus7resourcessopsaphtm httpwwwh01ysm0ke0rgfemfem0064htm httpwwwthe1anternc0mnews20021031CampusDefiningRape311816shtml here s an interesting backlash httpwwwmenweborgthroopfalsereportantiochhtml httpwwwysnewscomhistory T ranma 5 Legacy Psychology 607 Winter 2004 University of Oregon Discussion Questions for Denial of Abuse Readings Monday Feb 23 130330 Becker Blease K A amp F reyd JJ under review Research participants telling the truth about their lives The Ethics ofAsking analNotAsking aboutAbuse General comments An additional belief which stands in the way of researchers asking about abuse that can be implicitly or explicitly known is that trauma has no relevance to their topic of investigation One avenue to increasing researcher awarenesswillingness to consider trauma is graduate education This seems to be particularly relevant to clinical psychology It may be a valuable study to survey faculty about topics they dodon t cover in their courses including trauma This could help us understand any obstacles to having trauma considered as part of the curricula The article compares asking about abuse to asking about income Is this a valid comparison Is asking about income equally stigmatizing regardless of income level Could there be other reasons why subjects didn t want to disclose income level Are there other things that would make better comparisons There are different reasons that people may choose not to report their income one of which may be that it s highly stigmatizing Given that this seems to be a reasonable comparison BBampF discuss research that details how few abusetrauma survivors are negatively affected by being asked about abuse What is an acceptable risk benefit ratio Should the risk benefit ratio be any different for this type of research than any other Is it acceptable to conduct research at all when anyone is upset The way that IRBs define risk in terms of suicide potential is unscientific ie we can t tell if not asking about abuse leads to suicide and we can t be sure to attribute suicide to asking about abuse when it occurs after participation in research Is it fair to equate upset or mad with harmful What are the researchers responsbilities when abuse is disclosed for the first time and the researcher knows it is the first time What is the researcher s responsibility for intervention when a research participant is visibly upset by a study What is the minimum standard of care interventi on The current protocol of dealing with disclosures of suicidality was presented as an example of an IRB approved strategy that seems to be acceptable to participants as well The protocol requires informed consent of a 48 hour response offering clinical psychology resources The protocol has been exible so that it was modified after each incident of a suicide report until it seemed that it was best meeting the needs of those involved This would be the ideal modelithat the benefit be exible to reflect the magnitude of the risk and that the intervention be matched for the risk as well This is difficult to achieve in trauma research however since we often don t look at the data until after it is all collected so that respondents have anonymity We can only modify protocols between studies What about giving participants the option to waive their right of anonymity if they would like to receive followup attention and resources Becker s dissertation study was able to find a happy compromise in that when participants disclosed or asked for resources the researcher was able to respond immediately by making community and counseling referrals Campbell S 2003 Constructing the quotAemory Wars quot chapter 1 p 1 24 in Relational Remembering Rethinking the Memory Wars Rowman amp Littlefielal Publishers Inc General comments The way that this author has reframed many of the arguments in this debate were appreciated For example that we should just accept the fact that memory and emotions are relational shaped by our relationships and that that does not mean that all our memories nor our emotions are false This was a thought provoking chapter in that Campbell encourages the reader to think beyond the dichotomy of the memory wars Importantly Campbell also discussed the resistance to recovered memories as a feminist issue Why does Loftus get hailed as a memory expert and seemingly unbiased by the mediapublic whereas Read gets presented only as a psychologist ie not an expert Loftus approach for making her points refuting recovered memories etc was contrasted to more conservativetraditional scientifrc approaches to presenting data and arguments Was Read s resignation the most effective way of making his case against Loftus being the keynote speaker What would you have done if she was going to be a keynote speaker at Oregon Why did Loftus presentation at AAAS receive so much media exposure when Freyd amp Pezdek s recent symposium did not It s easy to just chalk it up to media bias alone but there are probably numerous other factors at play What might they be How can recovered memory researchers advocates get more media attention Or is it old news In research the null hypothesis rarely gets published This also seems to be the case in the media Ie studies that do not support FMS are not published How can we educate the public despite this obstacle Advocating more media attention 1 ridiculing out group 2 pack audience with supporters 3 make gross overgeneralizations with integrity 4 bring denial to light e g in the form of inconsistency in proportion of false memory reporting in media versus reality of child abuse 5 change the spin false memory of childhood as idyllic and recovered memories are debunkers of that myth 6 introduce new language Question could we create false memories in people of having shaken the penis of Mickey Mouse at Disneyland It seems that this question is more ecologically valid when applied to the nature of recovered memories for child sexual abuse Dallam S J 2002 Science or P 9A7 39 39 ofRz39nd Tromovitch and Bauserman 1998 Journal ofChz39ld SexualAbuse 934 109 134 Shouldcan children have sexual desiresexperiences Is children a cultural construct Our culture defines childhood lack of ability to consent from 018 years Therefore our child abuse definitions necessarily fall within these confines and our culture assumes the impossibility of consensual sexual relations by children Other cultures however define childhood differently and consider some sexual relations between adults and children as consensual For example child brides in India some cultures allow children to openly masturbate at an early age sometimes on adults older adults having sexual relations with youth as a learning experience How do we reconcile this with our culture s views Consider this scenario a 14 year old and a 17 year old having sexual relations and this is considered consensual 15 years later the now 15 year old and 19 year old would not be considered as having consensual sexual relations Is there anything wrong with this picture Rind states that the child abuse industry negatively framing manboy sex is what frames it as wrong Ie it is only bad because they say it is bad Is this possible Is it possible that children in some cases are only harmed because an adult tells them what they did was bad Is this exacerbated by being made a witness in a criminal trial Are there any occasions that children can give full informed consent For research purposes we believe parental consent is acceptable If that s the case why don t we think it s acceptable in the case of sexual relations F reyd J discussion of DAR VO Freyd made four disclaimers when presenting DARVO theory Do you think it would have made a difference if the FMSF had made similar disclaimers about their false memory syndrome in terms of its adoption into mainstream media and homes Do you think it would have led to less polarized more rational scienti c enquiry namely scienti c research of the syndrome itself Or perhaps the better question if Freyd did NOT make disclaimers and called DARVO a syndrome could this increase the media appeal to such a concept Is this responsible Compare and contrast DARVO and FMS For example in terms of conscious and unconscious processes How do they relate to each other What are the possibilities obstacles for finding empirical support for each concept Can both concepts coeXist Does one or the other seem to make moreless sense to different people Why or why not Psychology 607 Spring 2003 Trauma as Etiology May 19 Effects on Political Processes Discussion Leaders Sara Wilson Stephanie Allred amp Jessica Smith Adolf Hitler s Childhood From Hidden to Manifest Horror Psychoanalysis can be used to answer the question of why wars occur on the basis of early childhood conditioning We can possibly understand Hitler s political career by knowing his early traumatic experiences being physically abused by his father daily Hitler s childhood included a family structure that can be characterized as the prototype of a totalitarian regime This hierarchy is also seen in the way the concentration camps were organized Hitler s father is also reported to have had a traumatizing childhood characterized by Being poor Being illegitimate Being separated from his biological mother at 5 yo Having Jewish blood possible but unproven Thus Alois Hitler expressed his rage at his own childhood suffering by repeatedly beating his son Based on psychoanalytic theory Hitler unconsciously took on his father s behavior and displayed it during WWII which is indicative of how he saw his fatherias a snappy uniformed dictator Thus Hitler transferred the trauma of his family life onto the entire German nation The role of antiSemitism All people harbor a forbidden hatred against their caregivers and are eager to legitimate it This is evident by the fact that Hitler had so many enthusiastic followersithey must have had similar upbringings Hitler no longer needs to hate his father He can transfer his revenge onto the Jews and will not be beaten for it while honoring and idealizing his parents Hitler s mother must not have loved her son If he had been loved he would have been capable of love which obviously is not true Lost her first 3 children within one month Her anxieties and depression were communicated directly to Hitler as a baby Therefore had a disturbed early relationship Unconsciously delegated Hitler to rescue her from her husband thus Germany comes to symbolize his mother and must be saved from the Jews his father Hitler has been used as an example to show that Criminals are not born Those who persecute others are warding off knowledge of their own fate as victims Consciously experiencing one s own victimization provides a protection against sadism By honoring parents we over look crucial factors in a person s early childhood Living out hatred is the opposite of experiencing it The Politics of Denial Millbum amp Conrad Defense mechanisms How we skew reality to make ourselves feel better Denial Person s inability to tolerate a particular emotion Projection Process of putting unacceptable emotion onto others Displacement Finding a scapegoat to take out unacceptable emotions Personal is Political Residual childhood emotions are played out in politics How denial works hear no evil see no evil Feels better to create fantasy world than to accept feelings of anger rage and anxiety in ourselves It is easier to claim someone or something is evil than to look inside ourselves Denial can protect us but it can promote complacency Causes of Denial Reaction to Trauma can emotionally protect us from horrifying events Children use denial to deal with upsetting feelings and events because they don t have the power to change their external world Poisonous Pedagogy Child rearing philosophy that posits children s wills need to be broken in order to protect them and teach obedience Doing this may require physical punishment Negative Effects of Physical Punishment Teaches children to be violent and accept violence around them Does not allow child to develop internal set of moral standards Creates fear and anger in child reduces selfesteem Can start a cycle of violence Promotes denial and may fuel punitive political and social attitudes Early Personal Experiences Determine Political Behavior DeMause 2002 The Emotional Life of Nations The Assassination of Leaders 9 Demause tracks the emotional mood of the nation using political cartoons editorials magazine clippings historical trends political speeches etc O O eg Reagan s early speeches included rhetoric like terror of in ation doomed frightened weak and disintegrating as a nation full of pentup furies toward gov t in greater danger today than we were after Pearl Harbor despite the period of peace and prosperity Leaders are expected to sense the irrational wishes and fears of their nations and do something to de ect or relieve their anxieties nations go through emotional cycles Presidents are regularly depicted as strong during 1st year with high approval ratings but weakening and collapsing as their polls decline over the term Wars have never begun during the ISI year of a term Disappointment and sense of betrayal when leaders don t go to war when the nation is emotionally ready ie when the leader has become impotent Kennedy and the Cuban Missile Crisis example of a leader who was too impotent to go to war Only 4 opposed Kennedy s actions in amassing troops near Cuba but 60 thought it would lead to a nuclear WWIII When Khrushchev backed down Americans felt let down rather than relieved accused Kennedy ofbeing soft on Communism Political cartoonists began picturing Kennedy getting beheaded one columnist said let s shoot him literally before Christmas Psychopaths may see these media death wishes as permission to kill as signals or commands Increase in the number of death threats begged and warned not to go to Dallas the hate capital of Dixie by his aids and Dallas citizens due to the danger of assassination 100 s of reporters ew in because they had been alerted that something might happen 0 Kennedy even thought he was in danger looking at the platform he remarked that someone could get him if they wanted to warned his wife that something might happen said they were nothing but sitting ducks in a shooting gallery 0 but accepted the martyr s role anyway he actually instructed the Secret Service not to go to Dallas ahead of time not to scout out open windows along the parade route and not to put a bulletproof top on the convertible Similar scenario with Reagan who inherited illwill from Carter for not going to war with Iran after the hostage crisis 9 Peace as betrayal O O 6 out of 7 assassination attempts took place either after unusually long peaceful periods eg Garfield s assassination or after a peace treaty at the end of a war eg Lincoln The Gulf War as an Emotional Disorder Main determinant of whether a president will be able to resist the nation s call to war is the kind of childhood they had Only childhood photos of Carter and Eisenhower showed their mothers smiling at them also happen to be 2 presidents who resisted going to war In contrast Reagan experienced neglect amp abuse from an obsessively religious mother and a Violent alcoholic father George Bush Senior s childhood full of fear and punishment father was aloof and distant formidable and stem not a warm person Dad was really scary Mood of America when Bush ran for president depressed Unprecedented period of peace and prosperity 1980 s were a decade of indulgence Manic spending binges on the military financial speculation financed by borrowing periods like this usually end with war But our traditional enemies e g Soviet Union East Germany had collapsed period of unprecedented world peace without any enemies Predictions of doom decline and the death of the American dream something catastrophic coming No foreign enemy to project our fears and hatred on so America had only one choice to end its feelings of depression have a sacrificial economic recession to punish ourselves and our families for our peace and prosperity In order to keep us from punishing ourselves too much with a lengthy recession need to create an enemy abroad to punish Preparing for a new sacrificial war first requires avoiding the guilt for starting it Bush s task was to find some country that was willing to start a war against a weaker country so that America could come to the rescue in a war that would make us feel better again Political cartoons and magazine covers began expressing death wishes toward children depicting terrifying mother gures and questioning Bush s masculinity Sadam Hussein paid by US supported in war with Iran and in 1990 was encouraged by US envoy to raise oil prices and implicitly understood that America supported his invasion of Kuwait and wouldn t intervene Bush s rhetoric we ll kick the ass of Sadam Hussein ghting for a new world order a new era of peace When Iraq agreed to withdraw peacefully Bush said Instead of feeling exhilarated my heart sank We have to have a war 0 Desert Storm lasted 43 days plus embargo 80000 tons of smart bombs dropped 70 missed targets and hit civilians illegal napalm used to destroy farm lands all shown nightly on TV but we didn t see them actually hitting anything Elected to pull back without actually removing Saddam sensing that the US might need a reliable enemy in the future Bush s approval rating soared depictions no longer questioned his masculinity The Childhood Origins of Terrorism 9 Origins of terrorist attacks lie not in this or that American foreign policy error but in the extremely abusive families of the terrorists Islamic terrorists are products of a misogynist fundamentalist system that often segregated the family into two separate areas the men s and the women s 0 What about American terrorists Horrible treatment of girls and women genital mutilation high rates of sexual abuse and rates wife beating no access to education or employment 0 Common physical abuse at home corporal punishment at school sexual abuse for boys as well For males originally attracted to Western culture Westerners came to represent their own bad boy self in projection and had to be killed off as they felt they themselves deserved for such unforgivable sins as listening to music ying kites and enjoying sex O O 0 Iranian Ministry of Culture all American TV programs are part of an extensive plot to wipe out our religious and sacred values 0 Osama bin Laden a drinker and a womanizer but felt extreme guilt for his sins and began preaching killing Westerners for their freedoms and their sinful enticements of Muslims Islamic terrorists have been taught to kill the part of themselves and by projection othersi that is selfish and wants personal freedoms and pleasures If we want to prevent terrorism we should back a UN sponsored Marshall plan such as that for Germany after WWII that includes community parenting centers to teach more humane child rearing practices Interesting thoughts Time and Newsweek ran scare stories about a wildly out of control crime wave that was supposed to be occurringialthough they had paid little attention to crime in previous months and in fact the actual crime rate had been decreasing during those moths seemed to the military an embarrassment calling it ridiculous because the whole goddam operation depends on nding one guy in a bunker Who would be our enemy in the next sacrificial war where could he find an enemy crazy enough to be willing to fight the most powerful military force on earth yet small enough for us to defeat easily The arming of Iraq was a 15 year love affair for America Saddam Hussein was our creation our monster We built him up and then tried to take him down Gore on Bush senior Bush wants the American people to see him as the hero who put out a raging fire But new evidence now shows that he is the one who set the fire He not only struck the match he poured gasoline on the ames Discussion Questions amp Group notes thanks for your great discussions Hitler s Childhood from hidden to manifest horror p t N M What are criticisms of using psycho analytic theory to explain Hitler s behavior Does it adequately explain it ignores political climate contexts retrospective after the fact conjectured hypothesesibased on theory and used to put puzzle pieces together theory that reader believes can be extrapolated from this explanation What is the in uence of Hitler possibly having a Jewish grandfather in his attempt to eradicate the Jews probably knowing did Hitler know that he had a Jewish grandfather Hints that he had knowledge of this hates g pa and father but easier to hate Jews than own family What political and contextual factors should also be considered in explaining Hitler s behavior and rise to power political context economics pointing ngers at Jews childrearing context hierarchical structure perhaps made it easier for Hitler to take power had been peace for awhile maybe needed a war alliances of Hitler eg PR guy who helped him move up interact with people provided funding where would Hitler have gone wo this guy helping him betrayal from the fact that lost WWI humiliation How is living out hatred the opposite of experiencing it affects more people to live it out experiencing hatred intrapsychic process don t think it s opposite if you experience it and feel you can t get it out eventually it will come out in some form selfdestructive or harmful to others feels more like a continuum relationship than opposite What are similarities btwn the organization of families and totalitarian regimes How did Hitler s family experience affect how he organized his regime concentration camps uncompromising in regime compromise weakness control to take away when you want to leader can ask you to do anything and you have to do it admiration love and respect is unquestionable for leaders of family II Politics of Denial How does the media coverage of war international relations and world news perpetuate denial Iraqis are not depicted as peopleidenies their humanness Makes it easy to distance ourselves from their experiences Use of passive languagei War is inevitable Few casualties refers to US troops does not acknowledge the enemy casualties Seeing self own nation as victorsiwinning is associated with successful and with what is right Capitalizes on fear Politicians use the media to create an image and change the focus of the war Weapons of mass destruction do not matter because the US won What function does denial serve in creating acceptable targets for aggression ie war capital punishment Politicians who can be more free to ban capital punishment are already perceived as masculine such as Jesse Ventura Can not take out own aggressionia scapegoat is needed The media helps with this by dehumanizing the enemy Categorizing into good and evil is very oversimplified Portrays Bush as superhero Denial of history Lack of attention to the roots of violence Hard to admit that part of it Will being faced with unpleasant truths p8 promote healing or increase anxiety or both Support system needs to be in place Need to be OK with being vulnerableistop being so stoic Unpleasant truths need to be paired with something that can be done about it What purpose does spanking serve adults according to Millburn and Conrad How might cultural differences in attitudes about corporal punishment affect children differently Different meanings for Caucasians and African Americans with possibly less detriment to African Americans 0 Right of passagei I went through this and I am OK 0 Easier to trust own painful experiences as normal and not because it was bad 0 What makes adults want sense of poweriown childhood experiences Dissociationineed to function in an unjust society 0 5 How does denial of our emotions and dilemmas experienced in childhood affect our political behavior eg as leaders voters or political party alignment Empathy versus reenacting denying own experiences High levels of dissociationimore likely to abuse children 111 The r quot 39 Life of Nations 5 diagnoses question Some diagnoses sociopathic Some symptoms male histrionics dysthimia millitant PTSD esp post 91 1 hypervigilant pre TSD unprecedented paranoid delusions delusions of demonstrations before the war that grandeur were mostly ignored feeling of feel the need to justify actions inevitability embedded reporters on front lines DID split personality overly patriotic erratic aggressive behavior side vs opposition of war extreme patriotism unamerican for opposing war feelings of inadequacy a little bit of borderline projecting feelings of lack of control into action vs external evil source after 91 1 anxiety lack of control leads to homeland security bill that in effect destroys human rights therefore turning against self 2 Rhetoric question axis of evil myth of good vs evil Wild West metaphors Osama bin Laden as wanted dead or alive Middle east as last frontier Manifest destiny divine right terror terrorists victim language of terrorists our duty to stand up fight back not be victimized anymore all serves to keep anxiety level up leads people to believe its true without questioning 3 ways to reduce anxiety scapegoat minorities and other groups nd a problem in the community to tacklecreate crisis and try to fix it eg kidnappings war on drugs gangs etc more positive solution talk and use diplomacy Psychology 607 Trauma as Etiology Class Discussion Notes By Jessica Kieras and Bridget Klest For 14 April 2003 Chronic Pain The next frontier in child maltreatment research by Kathleen KendallTackett 0 Pain is very common among abuse survivors o Studying pain can help us understand the long term effects of abuse 0 Pain depression sleep disturbance often co occur and are all related to serotonin 0 Chronic pain patients heavily use the medical system 0 Researchers should ask about pain throughout the lifespan Physiological correlates of childhood abuse Chronic hyperarousal in PTSD Depression and Irritable Bowel Syndrome by Kathleen KendallTackett 0 Abuse and chronic medical conditions can be linked by looking at chronic hyperarousal 0 PT SD low cortisol high norepinephrine o MDD high cortisol low norepinephrine o IBS Pain associated with prefrontal activation 0 Trauma may alter CNS including raphe nuclei and locus ceruleus 0 Age of onset may play an important role in brain adaptations Childhood abuse and later medical disorders in women by Romans Belaise Martin Morris and Raf 0 Community sample of 354 New Zealand women 0 Found links between abuse experiences and physical complaints 0 Child sexual abuse fatigue athsma cardiovascular problems 0 Child physical abuse chronic pain 0 Adult sexual abuse chronic fatigue pelVic pain 0 Adult physical abuse chronic fatigue pelVic pain headache 0 Many other links marginally significant 0 No link found with IBS 0 Community sample may differ from clinic sample Zurbriggen amp Freyd in press Dissociation amp Betrayal Trauma Theory Betrayal Trauma Theory Dissociative Tendencies Cognitive Environments Clinical Implications Dissociation Adaptive amp Maladaptive Possible Mediators Between Abuse and Risky Behavior Selfesteem RealityDetecting Mechanisms Cheater Detectors Dissociation Divided Attention and Sex Damaged CSDMs Feletti 1991 0 Study Group Participants Persons who answered yes to quotHave you ever been raped or sexually molested during a complete medical examination 0 Average time between abuse and evaluation three decades 0 90 of Participants First time ever discussed 0 Most seemed grateful to discuss abuse 0 96 of Study group were female males underreported Abuse group shows more of 0 Depression sleep disturbance chronic fatigue despondency crying spells attempted suicides ECT panic attacks 0 Obesity more severe more frequent Doctor Office Visits Recurrent Gastrointestinal Distress IBS most common Chronic Headaches Asthma Augmentation Mammaplasty Other Factors 0 Extraordinary Degrees of Family Dysfunction Worth Mentioning this list not exhaustive 0 Questions about sexual abuse almost never before been asked 0 In past psychiatric hospitalizations abuse history had not surfaced o Forced participation in a social taboo loneliness low selfesteem not talking about the event Fiction Reading Suggestion She39s Come Undone by Wally Lamb l Felitti says doctors should ask their patients about trauma history and KendallTackett says psychological researchers should ask their participants about pain Should therapists ask their clients about physical health symptoms such as pain Yesithere is a strong mindbody connection Asking opens up this connection Therapist could possibly provide some psychoeducation on this topicgexplain the rnction pain may serve It 39 quot 39 39 39 39 man ulculal health and this could help rrther the therapeutic relationship quot quot r 39 39 health nrofe ional If we do ask it could be done during an intake interviewon an intake form Could be used to help facilitate deeper conversation between c ient and therapist Howeveri e pro em with a rief erapy mo is at there is already so much to do is such a short time It is possible that askin would bring up issues and leave them unresolve For kids and younger people chronic pain may not be an issue and may not be relevant 2 Is there a difference between a somatization disorder and a physical disorder with a strong psychological component Is every physical disorder with a psychological cause a somatization Most physical disorders have a psychological component whether in the cause or the outcome Having a chronic medical condition can lead to psychological distress There is a strong link between the psychological and physical disorders and it may be difficult to tease apart In some cultures maybe this distinction isn t as strong Perhaps peoplew o 39 quot 4 A with h39 are also more likely to somatize Luau emotionally 3 How might culture play a role in the development andor experience of chronic pain and chronic medical conditions It is important to think about how we are defining culture when we answer this question For example gender may be thought of as a cultural difference and women may endure more pain while men may not be inclined to express pain Social le ma play rr 394 39 while lower classes may live with chronic medical conditions as a normal part of life Manifestations of trauma may be different in different cultures For example in some Asian cultures physical manifestations may be more likely than psychological Clienttherapist relationships and the cultures ofthe client and therapist may play arole Treatment of medical conditions may be different in different cultures For example acupuncture may have a psychological component as well as a physical component 4 How can we distinguish between the attentional effects of dissociation and symptoms of ADHD in children Are there ways that we can change our current educational system to better accommodate children who show attentional difficulties as a result of dissociation Kids with trauma history may not respond the same way to treatment Teacher training but not holding teachers responsible for distinguishing between ADHD and dissociation Districtlevel changes Biological distinction attention systems being affected a be ab s causes AD Fatigue is associated with prefrontal activation which is associated with attention re is a decrease in prefrontal activat39on Most if not all kids with ADHD have turbulent homes some possiblyjust as a result ofhaving a difficult child I the symptoms 39 A h A 4quotquot 39 39 ADIID from dissociation is not important Rebuttal It is important how we conceptualize the problemiin the child or in the child s environmentgbecause otherwise we are neglecting a root cause of the problem 5 In Felitti s study of people who had been raped or sexually molested what sort of people should make up the control group In this study the control group consisted of people who answered no to the question that the experimental group answered yes to The question was have you ever been raped or sexually moleste It is likely that the control group included some false negatives However this control group is pretty good for this stu An alternative would be comparing people with sexual trauma and people with nonsexual trauma 2 3 4 5 Q V L L Discussion Questions Set 2 Is it possible to provide people with the right medical treatment given our current health care system If not how should things change Do different pathways lead to different illnesses How can we determine the most effective treatment given that any given illness may have resulted from multiple different pathways What are some problems in treating disorders that also serve as coping mechanisms How could physicians refer patients to counseling without making the patient feel like their physical symptoms are being ignored Developmental Pathways From ch dhood Trauma to Poor physical Health Jes 39 a 39 raskB39 nelKlesl thslcal lruurv Cagnltlve stress thslcal Abuse Emutlunal Abuse Sexual Abuse Nealect other Chlldhuud stressars Dlssaelatwe Tendencles EelfrEsteem thslcal Hvuerserrsltwltv Emutlunal Hvuerserrsltwltv R2 urtan laS sleep Dlsturbances Rlsk Taklng aehawar Drug Use Overaatlng Under atme UnDrDtected 52x Erratl sleeblrre Patterns Avnldl g Ductan hmnl Palrl lbmmvalula leauaehesMleralrres exuallv Transmltted Dlseases EDatltus c rrltable aawel Svndmme labetes besltv ammarr Illness te


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