Author Archives: Lori Edelman

Celebration, Eid, and Mental Health

Eid al-Fitr marks the end of the month of Ramadan. For Muslims the world over, it’s an important feast day. From Morocco to Malaysia, New York to Niger, Eid is a time to reflect on the sacrifices of Ramadan, celebrate with loved ones, exchange gifts, wear new clothing, visit with friends, and eat delicious foods.

Celebrating in non-Muslim-majority countries can be disorienting, where Eid is often just another normal day. Increasingly, school systems and employers are becoming more sensitive about spiritual days and religious holidays. In many larger school systems, Eid can be taken as a holiday by students and faculty.

The Eid holiday comes on the heels of a month of fasting during Ramadan.

Fasting (abstaining from all food and water between sunrise and sunset) in the workplace and during the school day can pose challenges. Solutions include alternative activities during lunchtime, sports, and gym class. Faculty and administration can encourage psycho-education for the student body; employers can be sensitive to team members not sitting in on a lunch meeting where everybody is devouring sandwiches; and the timing of Iftar, the breaking of the fast is very important when meeting colleagues or friends for dinner. Colleagues and friends can participate by learning more about Ramadan. Several Muslim patients have told me that a partner, best friend, or colleague fasted in solidarity with them, and how much it meant to them. Most importantly, carving out a space/time that is personally significant, spiritual, and rich, matters.

How to celebrate

Call loved ones.
Calling or video chatting with family and friends can ease the loneliness of being away from community. This means not just immediate family but also cousins/extended family, neighbors, and close friends.

Enjoy traditional foods.
Sheer khurma, or saviyan, is a sweet vermicelli that’s a favorite across South Asia on Eid, for instance. Biryani is a dish that can be made with a variety of nuts, herbs, spices, meat if desired, and basmati rice, and is literally a feast in a pan. The BBC has a great collection of Eid recipes on their website.

Get together with friends.
Whether a potluck, picnic, or buffet to mark the occasion, visiting friends, hosting an open house, or throwing a dessert party, being with friends and neighbors is a huge part of Eid. Often people visit multiple homes to say their Eid greetings, drink tea, and celebrate. Virtual get-togethers have also become popular during the pandemic.

Honor the traditions that make the holiday special.
These include praying, volunteer work and community service, reflection, and charitable giving. Part of the importance of fasting includes empathy with those who have less, in order to feel the hunger of those who frequently go without. Eid is also a time to give presents, wear new clothes, and give children money (Eidi), a time-honored tradition that predates gift cards.

Eid Mubarak from Embolden Psychology.  We value culturally informed and multiculturally competent practice.
Also see Cultural Competency with Muslim Patients.

Black Moon Rising

Although there are several definitions, the term “Black Moon” is generally used to describe the scenario when there’s more than one New Moon in the same calendar month. This weekend brings an unusual convergence of events.

*This last weekend of April will be the only universal “Black Moon”. In other words, there will be a Black Moon in every country on Earth.

* Look to the East just before dawn on Saturday, April 30, 2022, and you may see the two brightest planets, Jupiter and Venus, in a detailed conjunction. In fact, they’ll be a mere .2° away from each other. You didn’t read that wrong. Almost touching. Ancient writers called these planets the Wanderers. Venus, named for the goddess of love, and Jupiter, the god of the sky, are going on a date. We hope it works out.

* This weekend marks the end of Ramadan for those who practice (Shawwal moon on the Lunar calendar).

* April 30, 2022, will be the year’s first solar eclipse; visible only in Chile and Antarctica.

* Eta Aquarids, an important meteor shower begins May 1, and peaks on May 4, with shooting stars that appear to travel from the star Eta Aquarii, one of the brightest stars within the constellation of Aquarius.

The party in the sky. Humbling and awe-inspiring.

South Asian Mental Health

1 in 5 South Asians in the United States report experiencing a mood or anxiety disorder in their lifetime, with women reporting higher levels of distress than men. Obviously, these numbers, in general, are vastly underreported, as South Asians often express greater stigma toward mental illness than other groups. Stigma toward mental illness is a major barrier to getting a diagnosis or help.

South Asians commonly experience psychological distress as physical symptoms. Mental health problems may manifest as somatic, such as sleep troubles, bodily pains, headaches, fatigue, and stomach problems. When this occurs, it increases the likelihood of being undiagnosed and untreated since mainstream models of medical treatment may focus attention on physical symptoms instead of potential underlying causes, including systemic, familial, social-emotional, and historical.

Medical and mental health professionals must address the following areas in addition to presented physical symptoms. Issues that impact the mental health of South Asians may include:

Stereotyped Roles
The “model minority” myth is a microaggression known as “ascription of intelligence,” where one assigns intelligence to a person of color on the basis of their race. South Asian students are often perceived to be nerdy, academically rigorous, and driven to pursue fields in medicine, science, and technology. At home, a student earning less than stellar grades may be regarded as lazy or incompetent by family members, rather than needing support or accommodations.

The Perpetual Foreigner
This occurs when someone is assumed to be foreign, exotic, different. Some questions that perpetuate this stereotype include “Where are you from?” “Where are you really from?” “Your name is too hard to pronounce so I’m going to call you Sam,” and “How do you say (or write) _____ in your language?”

South Asian clients often tell me that they cringed in school when called upon, hearing their name mispronounced repeatedly. Others report that they could not eat their lunch in front of others without comments from peers about their “weird food.” Ramadan and fasting can be a challenge for Muslim students, particularly when faced with the social aspects of school lunch, participation in sports, and gym class. For South Asian girls/women in particular, the experience of fetishism is not uncommon. For example, in college, this writer was frequently asked questions about the Kama Sutra on dates, or inquiries about harems. When these occurrences become commonplace, feelings of isolation and loneliness may occur in routinely being treated as an outsider.

Trauma
First-generation immigrants, particularly from global conflict areas, may experience trauma. This trauma can be passed down to their children and subsequent generations. South Asians with a history in the US may have compounded trauma due to racial discrimination. Of note, South Asian parents are frequently unlikely to speak up or address bullying of their children in the school system or in social settings. This may include a lack of awareness, lack of access to resources, and a desire to be under the radar.

Stigma
According to statistics by the American Psychological Association, South Asian Americans are the least likely racial group to take actions on their mental health and are more likely to reach out to friends and family, if at all. Lack of knowledge or stereotypes regarding mental health, learning disabilities, and psychiatric disorders contributes to this dearth in treatment.

Expectations
Criticizing appearance, comparing successes, chores and family obligations, and an emphasis on academic and financial success create an often unrealistic set of expectations. Children of first-generation immigrants may also be expected to serve as cultural and linguistic liaisons for older family members in addition to frequently serving as a caregiver for younger children, all while attending school.

Religious intolerance
Religious minorities, for example Muslims and Sikhs, are often discriminated against for their appearance and beliefs, bearing the brunt of racial profiling due to Islamophobia. Some clients report being called a terrorist ‘in jest.’ There is also religious intolerance between groups, such as Muslims and Hindus; Ahmadi Muslims and Sunnis, and Sikh-Hindu conflict which carries forward to US immigrants.

Lack of data
Empirically validated research studies on mental disorders have historically not included participants of South Asian descent. For example, there are no large studies on bipolar disorder or schizophrenia which included significant samples of South Asian patients/participants. In addition, psychology and mental health concerns are rarely discussed in families, places of worship, and medical offices. See Cultural Competency with Muslim Parents.

Embolden Psychology is dedicated to culturally competent practice, social justice, and psychoeducation.

References, Dr. Siddique in:
Siddique, H: The Meaning of Difference, sixth edition (2011). Rosenblum, K.E. and Travis, T. C. (Editors), McGraw-Hill.
Mental health and stress among South Asians. Journal of Immigrant and Minority Health (2019), volume 21.

The power of social activism + neural science.

Dr. Anne Beaumanoir was a human rights activist and clinical neuropsychologist/neurologist in France during World War II. Her parents were activists who appreciated education, science, and research as tools to help improve daily lives. Her mother, the milkmaid daughter of an organic farmer, and her father who owned a bicycle shop, were both shunned by their families for their marriage. Together, they opened a popular bistro where they served local food and libations. The bistro was known as a gathering place for intellectuals and the bookish.

Dr. Beaumanoir spent many hours in the family restaurant where she had the opportunity to interact with her neighborhood and community. She helped Jews in her town evade Nazis, once saving two teenage neighbors by arriving at their home just before the Gestapo came to their door, to spirit them away to her parents’ restaurant. Later, she moved to Algeria which was a colony of France in North Africa, and worked with the Algerian resistance movement, doing everything from working as a chauffeur to hotel bellhop.

She completed medical school in France and fell in love with EEG technology. She is one of the first advocates of using EEGs to diagnose different types of seizure activity. Throughout her lengthy career, she emphasized the importance of using medical research to help the less advantaged and was especially interested in cerebrovascular disease and childhood epilepsy. She died in March 2022 at the age of 98, in Quimper, France.  Learn more:  Anne Beaumanoir, Activist and Clinical Neurologist, Dies at 98

The psychology of eating chocolate bunnies (A tongue in cheek abstract). Or, ear in cheek.

Abstract
This retrospective observational analysis hypothesizes that an increase occurs in online reports and images of auricular amputations of confectionary rabbits during the spring, particularly in April. Using the online search engine Google, social media content, anecdotal data, case studies, and visual portrayals of confectionary rabbits, an uptick in auricular amputations from 2018 to 2022 were identified and trended against seasonal variations.

To determine incidence, commercial availability of chocolate rabbits in retail facilities were assayed. A statistically significant increase in mention of rabbit auricular amputations occurred during the spring. Mapping techniques showed the annual peak incidence for the specific years assessed to be near Easter for each year studied. Human adults and children appear to be wholly responsible for the reports of rabbit auricular amputations. Reconstructive techniques are dependent on the percentage of auricular defect.

Validity disclosure: Dr. Siddique, the primary researcher, showed a marked preference for dark solid chocolate. Therefore, milk chocolate and hollow confectionery mammals may have a different statistical significance. Importantly, across all types of randomly assigned chocolate bunnies, 75% of research participants devoured the ears first.

The word Easter comes from a mythical goddess. Eostre was the mother goddess of the Saxons of Northern Europe. She was, according to writings by Grimm (yes, one of those Grimms), the goddess of the growing light of spring. She predicted warmth and abundance to come. Happy Easter.

Making a Nest

Photo: Renwick Gallery, DC, 2019

A client tells me after going hard all week, she retreats on Friday evenings to a corner of her sectional sofa. She dons her softest hoodie and brings with her a favorite pillow, fuzzy blanket, books, warm beverage, journal, pens, aromatherapy candle, headphones, and healthy snacks. Often, her dog joins her. During the tumult of the week, she can picture her nest in her mind and looks forward to the comfort it brings. She is no couch potato, she has two jobs, lots of personal responsibilities, and wins awards at Pure Barre.

Nesting can be any means of turning a living space or area into a place of comfort, belonging, and physical and emotional stability. In animals, the nesting instinct is all about preparing a home space/cave and making it safe from predators. For humans, nesting can mean creating a living space that provides warmth and stability, especially in times of danger and stress. Our threats may be different than other species, but the safety component is the same.

Creating your own, personalized “escape zone” where the focus is on comfort and soothing can create another strategy to add to the anxiety toolkit I frequently discuss with clients. Your space could be as basic as a favorite chair draped with a warm quilt, or one part of the sofa set aside with puffy throw pillows. Dedicate that space as a place to read, nap, meditate, sip a cup of tea, or simply sit in quiet for awhile.

Nesting can be any means of turning a living space into a place of comfort, belonging, and physical and emotional stability. Nesting is also about taking mental control. The comfort of a chosen physical space can be internalized and brought into mind during a difficult day or meeting.

Some nesting principles that are common include physical comfort: coziness, a few personally significant items, and a change from everyday routine.

*Many people are also drawn to being embraced on three sides. Literally, in a nest, you are safe and yet able to see what’s in front of you.
*A nest invokes a sense of curling up in a small space.
*A nest is personal. What you bring with you that invokes comfort and a sense of security is different for everyone.

The Nest. An internal and external place of nourishment and refuge. Also see Anxiety Toolkit

Ancestors; an appreciation

Mahmudah (Urdu), meaning: One of glory; worthy of praise.

It is the death anniversary of my darling Dado, my paternal grandmother, Mahmudah. The kindest, most dignified, calm soul I have known.

Born in India before Partition, she had a difficult life. Following an arranged marriage, she raised six children with grace and deep love. Although she had bachelor’s and master’s degrees in philosophy and teaching and was the principal of a school, she was raised in a patriarchal society and was often silent about her needs.

She emphasized education, and all six of her children, including the eldest, my father, obtained advanced degrees. I am the eldest child of her eldest child. She visited us for extended periods in Canada and the United States, spending her time between the homes of her children/grandchildren. Even after my parents divorced, she stayed close to our family, rejecting no one.

What we remember about ancestors can be poignant flashes as well as detailed memories.
* She was the only one who could brush out and untangle my extremely long and unruly hair when I was a child without me screaming. I was a rough and tumble outdoor kid with long hair; not the wisest combination.

* She hated cold weather, but walked many blocks with me to the public library, snow piled on both sides of the sidewalk. We even walked through snowbanks so I could check out my beloved books.

* She had long silky hair, flawless skin, and a delicious personal scent, through her 80s.

*She loved flowers; we frequently picked wildflowers and stopped to smell the roses.

*She always held my hand while walking and hugged me frequently; she understood the importance of expressed affection.

* She was truly able to accept and appreciate individual differences. My parents bucked every norm in the society they grew up in. I never heard her express judgment or criticism, a rare thing culturally and generationally.

* She was incredibly smart and cognitively sound, always. Even when physically fragile, her mind was razor sharp.

May she be at peace in Jannah (Heaven).
Also see on the importance of Grandmothers and Mental Health

Diabetes and Mental Health

37.3 million Americans—about 1 in 10—have diabetes.

About 1 in 5 people with diabetes don’t know they have it.

96 million American adults—more than 1 in 3—have prediabetes.

More than 8 in 10 adults with prediabetes don’t know they have it.

For the past three years, approximately 1.5 million new cases of diabetes were diagnosed each year. Many more go undiagnosed.

For people aged 10 to 20 years, new cases of type 2 diabetes increased for ALL racial and ethnic minority groups, especially Black teens.

This past week, the House of Representatives passed a bill capping the cost of insulin on Thursday night with unanimous Democratic support, a mere 12 Republicans voted for the legislation, with 193 voting against it (five didn‘t vote at all). The House (Democrats) voted to cap the price of insulin at $35. (The bill will go to the Senate after Easter).

FACT: The cost of insulin for patients WITH insurance ranges from $334 to $1,000 a month.
FACT: The manufacturing cost for a vial of insulin is approximately $10.
FACT: Many diabetes patients ration their medicines or discontinue them because of the cost.

NEUROPSYCHOLOGICAL AND MEDICAL IMPLICATIONS

  • uncontrolled diabetes is implicated in a threefold increase in vascular dementia
  • uncontrolled diabetes drastically increases the chance of stroke, which also brings an entire set of cognitive and physical consequences
  • untreated diabetes and prediabetes results in impaired attention and concentration, brain fog, fatigue, headaches, learning problems, and lethargy
  • diabetics have a much higher level of clinical depression and anxiety, medical related worries, financial hardship, and overall stress
  • diabetics are at higher risk for secondary events, such as car accidents, work disability, and falls
  • people with prediabetes are at far greater risk for long-term cognitive decline and memory problems because they most often walk around without any diagnosis or treatment
  • most people will have/will have a loved one, family member, colleague, or friend who suffers from diabetes and related sequela in their lives. As such, diabetes affects everyone
  • BIPOC individuals have a significantly higher rate of diabetes, with the highest group being Black men, women, and children
  • diabetic medical consequences that affect daily life include vision problems, neuropathy, chronic pain, kidney problems and possible renal failure, memory weakness, increased risk of hypertension, sexual dysfunction, tooth/gum problems, and foot/mobility problems
  • individuals with diabetes have a much higher chance of long-term consequences from COVID-19
  • the consequences of untreated or undertreated diabetes will create an added strain on the medical and mental health system, which is already under severe pressure. This, in turn, has a trickle-down effect on treatment of other conditions
  • as a psychologist, management of diabetes, medication regimen, diabetic self-care, nutrition, and related stressors are often a focus of treatment

(Data sources: Kaiser Health, WebMd 4/22, CDC, 1/22)

Cultural competency with Muslim patients

As Ramadan begins, Embolden is working with several DC area schools and school systems, as well as offices/businesses, to create understanding and comfort for Muslim students and professionals who are fasting or participating in other spiritual activities. Muslim individuals differ in every possible way. The Muslim community has a rich variability that is a complex and nuanced mix of religion, cultural identity, family traditions, and individual personality.

Muslim individuals differ in socioeconomic background, family structure, level of religiosity, cultural identity, knowledge of spiritual practice, gender identity, community, career paths, and personality. There is no single coping style or mental health profile that Muslims share as a group. In order to serve Muslim clients and mental health needs best, an open stance of curiosity, inquiry, and humility is required by medical and mental health professionals.

On a pragmatic level, some schools are adapting to Ramadan, a time when students fast and cannot drink water from sunrise to sunset and often cannot participate in sports, by creating alternative activities during lunchtime, psychoeducational presentations for students and faculty and awareness for both the vulnerabilities and strengths that all students bring with them to school communities.

Also see Nine Reasons Why Cross-cultural Friendships Are Good For Your Health.

The Psychology of Pranking

Psychologists have studied pranks for years. Humor, in general, is good for us. Neuropsychology research has shown that laughing improves well-being.

Humor and laughter release endorphins and oxytocin, neurochemicals that are associated with happiness and social bonding. But why are practical jokes or pranks even funny in the first place?

From clinical psychology, a summary of research on pranks:
*Practical jokes are a subtle form of “play-fighting.” Jokes imply a sense of closeness or insider group feelings in the relationship. That is, you tend to prank those you believe you’re close with or can handle the joke.

* A good prank satirizes human fears or vulnerabilities, and is found in a wide variety of international initiation rites and coming-of-age rituals. The Daribi of New Guinea, for example, have children make a small box and bury it in the ground, telling them that after a while a treasure will appear inside but they must not peek. Invariably the youngsters succumb to curiosity, only to find a box of animal feces (research cited from the University of Virginia, department of psychological anthropology).

* The prank releases inhibition, liberating us for a moment from having to act “properly”.

* In psychoanalysis, motivations for the impulse to prank one’s own family or friends has been described as a subtle form of the desire to do bad things to the very people one claims to care for. It may be one of the modalities through which everyday sadism can manifest (i.e., potentially obtaining pleasure from hostile forms of humor, sarcasm, and practical jokes).

When NOT to Prank:
Has the target of the prank stated they want this behavior to stop, or have they shown previous distress with any pranks?

Is the target of the prank a vulnerable person, such as a child, an individual with a mental disorder, or person with disabilities?

Could this prank in any way cause harm to a person, either psychologically, physically, or both?

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Embolden offers the ADOS-2, the gold standard assessment for kids on the spectrum.

Combined with psychoeducational testing, it helps provide comprehensive information and recommendations to help children and teens six and up.

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