Carl Allen Hammerschlag

"I am a Yale-trained, community psychiatrist whose professional life took an interesting departure from ordinary clinical practice when I went to work with American Indians instead of going to Vietnam. 

I joined the Indian Health Service for my 2-year military obligation, and it turned into a 20-year commitment, most of it as Chief of Psychiatry at the Phoenix Indian Medical Center. 

This experience moved me from doctor to healer -- a transformational journey in which my scientific healing repertoire was expanded to include more mystical explanations for how people get sick and how they get well. 

In Indian country I learned how to use the power of language, stories and beliefs, incorporating them into my psychotherapy.  I saw how rituals, ceremonies, prayer, meditation, fasting, drumming, natural medicines, and hands-on healing could open channels into the unconscious mind to promote insight and change behavior. 

Over the last 40 years, I have come to embrace shamanic healing practices.  A shamanic healer understands that everything that exists in life has an energy that can be a force for healing. 

Every scientific discipline and every religious group uses its own words to describe that energy.  Scientists explain that force in physical terms such as quanta, strong and weak, or in molecular, biological, and genetic terms.  Mystics explain the force in spiritual terms:  unknowable, unfathomable, or ineffable.   

The critical issue to remember is that both scientific practitioner and shamans find a way to develop a relationship with that force that allows them to harness its energy and promote healing." 

Hammershlag, C. (2009). The Huichol Offering:  A Shamanic Healing Journey. J Relig Health, 48, 246-258.

The Flash Mob that Makes Me Cry :)

I cry freely when the spirit moves me and the spirit is alive and well in this YouTube video of a flash mob of middle school students, each with their favorite book, dancing and singing in unison, about the utter joy of reading!! (only 2 exclamation points is me showing restraint).

The collective power of the spirit of community knocks me over. Working at schools, I can attest to the powerful individual and collective energy of students.  Being a nerd and avid reader, I can bear witness to the power of reading to transform and open up imagination, creativity and ideating.  As a lay dancer, I can testify to the power of movement and music to express self and joy and heal.

Here it is:  Gotta Keep Reading Middle School Flash Mob, enjoy!

If you work with young people or at a school, or if you work with older folks anywhere for that matter, here is a YouTube video with  Music and Lyrics for "Gotta Keep Reading".  Feel free to use it to start your own flash mob of love.

In the paraphrased words of will.i.am, flash mobs show that deep down we all really want to collaborate and work together.  "Shamanistic healing practices involve rituals that enhance social integration, strengthen group identity, and promote interpersonal and social bonding at physiological and psychosocial levels. . . these shamanic activities affect opioid-attachment interactions, utilizing the innate drive for affiliation to evoke opioid release. (Winkelman, 2001, p. 343)"  The spirit of shamanism lives in us. Let's wake the spirits for good health and community and reading! Oh, what a feeling, baby! ooh oo oo.

Winkelman, M. (2001). Alternative and traditional medicine approaches for substance abuse programs: a shamanic perspective. International Journal of Drug Policy, 12, 337-351.

Learning to Edit

I gave my adviser a draft of my publishable paper.  He is a rock star when it comes to writing, having been the editor of a top social work journal.  He said I could cut out 60% of the words in my "reasonably good" draft.

I gave Dr. Glik, an international expert on social media and health communications, a copy of the "statement of problem" from my dissertation proposal.  She gave me thoughtful written feedback and when I met with her she said, "leave them in suspense."

In an effort to scale back, I am taking a full leave of absence from work to dedicate my time and (limited psychic) energy to writing.  Just in time.  Stretching myself thin by juggling work, school and family takes its toll.  Lesson learned:  Never experiment with cutting corners in time by cutting your time with friends and extended family.  It is a recipe for disaster (duh). 

I am learning to edit.  Less is more.

Family Violence

Title:  Silent victims: children exposed to family violence

Author:  Kolar, Kathryn R; Davey, Debrynda

Source:  Journal of School Nursing, vol. 23, no. 2, pp. 86-91, April 2007

Abstract:
Annually an estimated 3 million or more children are exposed to acts of domestic violence between adults in their homes.

These children are at risk for abuse themselves as well as other immediate and long-term problems, especially if they have been exposed to repeated episodes of domestic violence. 

Multiple behavioral manifestations, including anxiety, depression, and PTSD, may be associated with violence exposure, and it is imperative that school nurses recognize these.

All children should be screened for domestic violence exposure at regular intervals, and those who are at risk should have a more thorough health assessment. Planning for the safety of the child, nonoffending caregiver, and siblings and the school nurse involved in the situation is of utmost importance.

Cannabis Findings

Title: Stress-related factors in cannabis use and misuse: implications for prevention and treatment

Author:  Hyman, Scott M; Sinha, Rajita

Source:  Journal of Substance Abuse Treatment, vol. 36, no. 4, pp. 400-413, 2009

Abstract:

We examined the role of stress as a risk factor and motivation for cannabis use/misuse. A systematic review of studies gathered from PsycINFO and MEDLINE databases was conducted. Findings suggest that cannabis is commonly used as a stress-coping strategy. Negative life events, trauma, and maladaptive coping were all related to consumption.

Cannabis use for stress-coping purposes was most evident when examining chronic as compared with experimental use. Although many individuals may be able to use cannabis without consequences, there appears to be a subset of individuals who experience greater life stress and who may be more likely to use for stress-coping purposes. These individuals may be at greatest risk for addiction. Chronic use may potentiate stress-related motivation to use/abuse cannabis and is associated with decision-making deficits and alterations in brain-stress pathways that may exacerbate compulsive drug seeking and sensitize individuals to stress-related drug use. Overall, stress-coping interventions and harm reduction focused on reducing the amount ingested may facilitate prevention and recovery efforts.

What We Know about Trauma Treatment Outcomes for Children

Title:  A meta-analytic review of the treatment outcome literature for traumatized children and adolescents [dissertation]

Author:  Puttre, Jessica J

Source:  St. John's University (New York), 2010. 120 pp.

Abstract:

More than two thirds of children in the general population report exposure to at least one traumatic event by the age of 16.

In addition to high prevalence rates of PTSD, the children exposed to trauma have almost double the rates of developing psychiatric disorders such as affective and anxiety disorders than those not exposed.

Evidence-based psychological interventions are clearly needed to address these psychiatric difficulties; however, the treatment outcome literature for traumatized children is limited as compared to the breadth published for adults. Furthermore, research disseminating the treatment outcome literature is even sparser as only one meta-analysis has examined all trauma types and reactions in traumatized children.

Results from this meta-analysis revealed that Cognitive Behavioral Therapy resulted in statistically significant treatment effects for Post Traumatic Stress Symptoms (PTSS) (d = .50). Although, this research filled a gap in the treatment outcome literature for traumatized children, the strict article inclusion criteria left many studies out of the analysis. The present research attempts to build upon the research of Silverman et al. by widening the inclusion criteria and more than tripling the amount of research studies included in the analysis. In fact, this present meta-analysis identified 67 usable studies (61 published journal articles and 6 dissertations).

The most commonly utilized form of treatment was general CBT (20.9%), followed by TF-CBT (16.4%). In general, CBT interventions were more commonly used than non-CBT interventions (respectively, 58.2%, 41.8%). These interventions were more often conducted in a group format (40.3%); however, individual therapy was also a highly utilized form of treatment delivery (34.3%).

A large overall trauma within group unweighted effect size was found (M = 0.80; SD = 0.68) which indicates that after receiving treatment for trauma, children and adolescents demonstrated positive changes on the outcome measures. Effect sizes were also examined by treatment type, construct used to measure change, service delivery method, duration of treatment, and setting of treatment. This was the first meta-analysis of trauma with children and adolescents to examine effect size as a function of who was reporting change, and the largest effect sizes were found for ratings by structured interview, followed by clinician-report, self-report, parent report, and teacher report, with structured interview being the only significantly different rating. A medium to large positive effect size was found for the overall comparison of trauma treatment to control groups. A small to medium positive effect size was found for the overall comparison of TF-CBT to alternative groups. Limitations and implications for school psychologists are discussed.

Adapting CBITS for American Indian Youth

Title:  Adaptation and implementation of cognitive behavioral intervention for trauma in schools with American Indian youth

Author: Goodkind, Jessica R; LaNoue, Marianna D; Milford, Jaime L

Source: Journal of Clinical Child and Adolescent Psychology, vol. 39, no. 6, pp. 858-872, November 2010

Abstract:
American Indian adolescents experience higher rates of suicide and psychological distress than the overall U.S. adolescent population, and research suggests that these disparities are related to higher rates of violence and trauma exposure. Despite elevated risk, there is limited empirical information to guide culturally appropriate treatment of trauma and related symptoms.

We report a pilot study of an adaptation to the Cognitive Behavioral Intervention for Trauma in Schools in a sample of 24 American Indian adolescents. Participants experienced significant decreases in anxiety and PTSD symptoms, and avoidant coping strategies, as well as a marginally significant decrease in depression symptoms. Improvements in anxiety and depression were maintained 6 months postintervention; improvements in PTSD and avoidant coping strategies were not.