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The Riggs Blog
The Riggs Blog is a mix of news about clinical work, research and educational activities from the Austen Riggs Center, as well as a source for information beyond our walls that we find interesting and thought-provoking. Senior clinical experts, researchers, and editors review all clinical content on this blog before it is published.
Austen Riggs Center Chief Nursing Officer Cheryl Puntil writes about the importance of talking about suicide, prevention and personal experience.
We focus on the whole person, including the trauma. “We try to learn from a person’s relationships—past and present. We try to understand the thoughts, feelings, and behaviors that come up in relationships, some of which otherwise might sabotage treatment,” she says. People with complex trauma histories often become reactive to relationships in ways they don’t understand. We try to help them understand and organize themselves so they can stay in treatment and approach their trauma in a safe way.
“Post-traumatic stress disorder (PTSD) is the body’s physical and emotional response to extreme stress,” explains Dr. Christina Biedermann, staff psychologist at Austen Riggs Center. That stress is triggered by a life-threatening event, either a single incident, such as a car accident, or chronic trauma, such as military combat, abuse or chaotic relationships.
“Post Traumatic Stress Disorder (PTSD) is diagnosed when clusters of symptoms get in the way of a person living the life they want to over time,” says Dr. Christina Biedermann, staff psychologist at Austen Riggs Center.
The recent New York Times editorial, “If Addiction Is a Disease, Why Is Relapsing a Crime?” explains clearly and succinctly why criminalization of addiction can never be an effective way to reduce drug use, addiction, or death.
In April 2018, the Austen Riggs Center held its second Multi-Family Education Workshop, a new initiative that brings family members of current Riggs patients together with Riggs clinical staff members for a day-long educational program.
Jane G. Tillman, PhD, ABPP, Evelyn Stefansson Nef Director of the Erikson Institute for Education and Research, has received a significant grant from the Fund for Psychoanalytic Research through the American Psychoanalytic Association (APsaA) for her work, “Follow Up to States of Mind Preceding a Near Lethal Suicide Attempt Study.” In making this award, the review committee indicated that this was an important topic for study and may yield valuable information.
This year, at the American Psychiatric Association (APA) Annual Meeting, I heard a new catchphrase: "practicing at the top of your license." While I had heard this phrase a few times before, it seemed to be everywhere this year. The context in which this phrase tended to be uttered was when psychiatrists were describing the position that their employers took, when those psychiatrists wanted to provide some form of psychosocial treatment in addition to (or as an alternative to) the model of "15-minute med checks." The implication seemed to be, "you are medically trained, while others are not, so your energies should be devoted exclusively to providing medicine."
When world-renowned child development researcher Dr. Ed Tronick spoke in April 2018 for a mixed audience of Austen Riggs staff and community members who work with children and families, he began with a quote from Steven Hawking, “One of the basic rules of the universe is that nothing is perfect. . . .Without imperfection, neither you nor I would exist.”
While the show demonstrates the danger of contagion, the creators appear not to have considered how their particular approach to presenting the series may create similar vulnerabilities and danger in young viewers. Suicide is fundamentally an irrational act that occurs in a state of tremendous distress. When a suicide occurs, this increases feelings of pain and guilt, as well as making suicide feel more accessible. For this reason, showing Hannah’s suicide in such detail seems likely to be counterproductive.
Although 13 Reasons Why is rated TV-MA in the US, the amount of publicity the show has received has served to draw in increasingly larger youthful audiences. For many adults, trying to stop younger children from watching 13 Reasons Why is like stopping a train after it’s left the station – the show is available on electronic devices, and parents who use parental controls at home can’t necessarily stop what happens with their children’s friends. Nonetheless, it’s important for youth and adults to note the MA-17 rating and treat it with respect. Most children under 17 should not watch this show, or should only watch it in the company of a trusted adult. Reading online reviews, it’s clear very young adolescents are watching 13 Reasons Why, and parents and educators should be aware of this.
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