By Lisa Turner, LMHC
May 2018 

In any given news cycle, there are reports of atrocities committed by people against people: chemical warfare attacks in Syria, school shootings, cars plowing through crowds of pedestrians, and more. And the common human impulse is to try to make sense of the senseless and try to understand, why do people do what they do?

Too often, the blame for the inexplicable has been mental illness and by extension, those who provide them love and care. These acts of violence are hard to understand and they are complicated and instead of thinking issues through thoughtfully (because that can be difficult and not feel very good), human nature seeks out the easy answer. Additionally, because acts of violence and things we do not understand (like mental illness) are scary, we want to distance ourselves from it. Put it in a box. Label it. Mental illness. This is the definition of stigma – negative attitudes towards something, often accompanied by negative behavior.

According to the National Association for Mental Illness (NAMI), one in five people – one-fifth of the population of the United States – have experienced a mental health issue. One in 20 people live with a serious mental illness like bipolar disorder, schizophrenia, schizoaffective disorder, or severe depression. Eighteen percent of adults struggle with anxiety in any given year.

NAMI reports that mental illnesses are biologically based brain diseases that can severely disturb a person’s ability to think, feel, and relate to other people and the environment. Unfortunately, due to how mentally ill individuals are characterized in the media, including the news, television, social media, and the movies, mentally ill people are feared or stereotyped as irrational, aggressive, and violent when in fact, they are more likely to be isolated, passive, and withdrawn. Recent reports have indicated that those who live with a mental illness are more likely to be the victim of violence, or die by suicide than to perpetrate a violent crime. The American Psychiatric Association reported in 2016 that “public health and education campaigns are needed to teach people how to report concerning behavior to authorities and how to learn coping skills for anger and conflict resolution.” Our society is often quick to judge those who struggle with a mental illness even though many of these illnesses are clearly biologically based.

The NAMI website states that people with mental illness might be denied the opportunity to rebuild their lives in the community because of discrimination in housing, employment, and insurance coverage.

Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness isn’t always easy. There are no easy tests that can let someone know if there is mental illness or if actions and thoughts might be typical behaviors of a person or the result of a physical illness. One or two of symptoms alone cannot predict a mental illness. However, if a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work, or relate to others, he/she should be seen by a mental health professional.

People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

So you’re reading this and you’re thinking, I think I know someone who fits some of these criteria. Now what? When interacting with someone with a serious mental illness:
• Always be calm both in volume and mannerisms
• Ensure safety for yourself and the individual, to the degree that it is possible
• Respond to their feelings nonjudgmentally
• Talk about feelings rather than content (this is especially appropriate if someone is displaying delusional thinking)
• Be helpful, encouraging, and supportive
• When speaking or responding, do so simply, truthfully, and briefly
• Limit your input to minimize overstimulation
• Stay on the topic without showing disregard or disrespect
• Do not argue with delusions

It is difficult to convince someone to get help when they don’t think they need it. Listening, empathizing, agreeing, and partnering with them or others is the first step.

Catholic Charities has taken the initiative to have three of its counselors – Clinical Director Lynne Lutze in Dubuque, Lori Eastwood in Decorah, and Lisa Turner in Ames – trained as trainers in Mental Health First Aid. Mental Health First Aid “is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves.” As trainers, Catholic Charities will be at the forefront of educating others on how to preserve life, provide help, promote and enhance recovery, and provide comfort and support within the Archdiocese.

If you or your organization is interested in being trained in Mental Health First Aid, and joining the fight against stigmatizing mental illness, please contact 563-588-0558.

A Prayer for the Mentally Ill (From Catholic Health Association of the United States)
The righteous cry out, the Lord hears and he rescues them from all their afflictions.
The Lord is close to the brokenhearted, saves those whose spirit is crushed.

PSALM 34:18-20 LOVING GOD, YOU ARE ALWAYS NEAR TO US, ESPECIALLY WHEN WE ARE WEAK, SUFFERING, AND VULNERABLE.

Reach out to those who experience mental illness. Lift their burdens, calm their anxiety, and quiet their fears. Surround them with your healing presence that they may know that they are not alone. We ask this through the intercession of Our Lady of Lourdes and in the name of your Son, Jesus, and the Holy Spirit, now and forever. AMEN.

Resources Amador, Xavier. “I’m Not Sick, I Don’t Need Help,” 10th-anniversary edition. Vida Press, 2011 Amador, Xavier and Epstein, Laura. “When Someone You Love is Depressed: How to help without losing yourself.” Fireside, 1998 National Association for Mental Illness (NAMI), www.nami.org – includes information about support groups for family members https://www.namigdm.org/documents/resources/NAMIIOWAchildrensmentalhealthresou r_83A18D4074C73.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/Children-MH-FactsNAMI.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/NAMI-Want-to-know- how-to-help-afriend.pdf The National Mental Health Association (NMHA), www.nmha.org https://www.chausa.org/publications/health-progress/article/january-february- 2018/behavioralhealth-basics-for-chaplains

By Lisa Turner, LMHC
March 2019

We are all too aware of the stories and statistics: “mass shootings” or “mass tragedies” (there is no clear-cut definition of these terms) happen all too frequently. Thousand Oaks – Borderline Bar & Grill. Las Vegas. Sandy Hook. Marjorie Stoneman Douglas High School. Like wildfires, they are named for the geographic location in which they occurred, they are all-consuming for a period of time, and they change forever the lives of those touched by them.

Whether we are directly or indirectly impacted by these incidents, they leave a mark. Maybe our exposure is only through the news and social media. But maybe we know someone who has been directly exposed or worse yet, we’ve lost someone to a senseless act of violence. For many, the world feels less and less safe all the time, and yet for most, life goes on.

What do we do with all this? How do we heal and grieve and remain present for our friends and family, and attuned to their needs? How do we not grow hard-hearted in an effort to protect ourselves? How do we not fall apart?

First, it might be helpful to do a brief review of what grief is. Grief is a normal, human reaction to loss, whether through death or some other means (i.e. transitioning a child to college, moving, changing jobs, etc.). According to Linda Schupp, normal grief has a known cause and no correlation with self-esteem. Normal grief is also known as uncomplicated grief or uncomplicated bereavement. “…normal grieving is a process, recreating the cognitive schema around the meaning of life… Part of the grieving process involves restructuring a life without the deceased.” Normal grief reactions following a loss through death include appetite disturbance, heart palpitations, insomnia, anxiety, guilt, numbness, memory problems, inability to concentrate, crying, and keeping the room of the deceased intact (to name just a few).

Complicated grief “is a disruption in the normal grief process which prohibits healthy closure and healing for the affected person.” Factors that complicate grief include a history of depression, social problems, the death of a child, a history of childhood abuse, repressed emotions, and unresolved previous losses. Another factor that complicates grief is a sudden unexpected death or loss.

Mass shootings or mass violence would fall into the category of “sudden unexpected death or loss,” or traumatic grief. Traumatic grief reveals the lie that grief “follows a specific course and resolves at a predictable point – or that it resolves at all.” Unfortunately, in these situations, there sometimes is no sense of closure.

There are unique qualities to traumatic grief. This is a shocking loss that can’t be prepared for, and it rocks your world. The world no longer meets your expectation of safety. With normal grief, reminiscing about the deceased often brings peace, but with traumatic grief, talking about the person may be what triggers or retraumatizes family and friends. In fact, the criterion for Traumatic Grief includes efforts to avoid reminders of the deceased and a shattered worldview (e.g., lost sense of security, trust, or control).

People are not often ready for counseling or other professional help immediately following a tragedy. Most people experience some level of shock and have a hard time just moving through the day. In time, they may be ready for counseling, but in the meantime, a gentle presence and support from a caring friend or family member is recommended. Memory is not always sharp following a loss, as poor concentration and forgetfulness are hallmarks of grief.

An instrumental piece in helping children following a mass tragedy is parents and adults first assessing and dealing with their own responses to the crisis and to their own stress. Children look to adults to make them feel safe and adults need to be models for how to manage traumatic events. Keep regular schedules as much as possible, including meals and exercise. Try to balance out the upsetting news by reminding yourself of people and events that are meaningful, comforting, and encouraging. And always engage in healthy behaviors that enhance your ability to cope and heal. This includes eating well-balanced meals, getting plenty of rest, build physical activity into the day, avoid drugs and alcohol, and add relaxation techniques if necessary (yoga, breathing, meditation, prayer).

Click HERE for the PDF Version

1 Jackson, p. 12
1 Schupp, p. 11
1 Jackson, p. 12

“I should exercise more.”
“I didn’t make it to Bible study last night and now they probably think I’m a horrible person.”
“I said something embarrassing and I’m afraid my friends won’t like me anymore.”
“That was the dumbest thing I’ve ever done! I’m so stupid!”
“I never get anything right.”

At some point in our lives, we have said one or more of these things to ourselves or something like it. On the surface, these sentences sound innocuous, right? I mean, they don’t really mean anything, do they?

The above statements are examples of negative self-talk, which can fuel negative feelings like anxiety. According to Amy Scholten, MPN, anxiety is a state of dread, tension, and unease. Anxiety is a normal response to stress or uncertain situations, but feeling anxious for long periods of time or at intense levels may mean that you have an anxiety disorder.

You may have an anxiety disorder if the anxiety:
• Occurs without an external threat (called “free-floating” anxiety)
• Is excessive or unreasonable for the situation or threat
• Negatively affects how you function during the day

The most common types of anxiety disorders are:
• Specific phobias
• Post-traumatic stress disorder (PTSD)
• Panic disorder
• Obsessive-compulsive disorder
• Social anxiety disorder
• Generalized anxiety disorder

Anxiety may occur with other conditions, such as alcohol abuse, drug abuse, and depression. Anxiety can be genetic or caused by a chemical imbalance in the brain (i.e. serotonin or norepinephrine). Other risk facts can include being female, stressful life events, poor coping strategies, and a history of physical or psychological trauma.

Anxiety can result from negative thoughts about external events. David Burns, M.D., the author of The Feeling Good Handbook, says that how you think about your circumstances influences your mood. Many bad feelings come from illogical thoughts or distorted thinking. As we go through our day, we are often triggered by an event or a conversation, which causes us to think a certain way about ourselves.

If our thoughts are negative, we are probably guilty of one of these ten things:
• Should statements
• All-or-nothing thinking
• Magnification
• Jumping to Conclusions: Fortune-telling/Mind reading
• Personalization and Blame
• Labeling
• Emotional reasoning
• Overgeneralization
• Discounting the positive
• Mental filter

(NOTE: The first five sentences of this article were examples of some of these thought distortions. Can you match the sentences to the correct distortion? Answers at the end of the article.)

Anxiety indicates a level of fear in our lives or feeling afraid or scared. Other words that we use to describe anxiety include worry, nervousness, and stress. Sometimes this feels like butterflies in our stomach, tense shoulders and neck, headaches, tightness in the chest, a racing heartbeat, racing thoughts, dizziness, nausea, and sweaty hands – the list of symptoms of anxiety can go on and on.

Other psychological symptoms could include worry or dread, obsessive or intrusive thoughts, sense of imminent danger or catastrophe, fear or panic, restlessness, irritability, impatience, ambivalence (uncertainty), and trouble concentrating.

Negative thoughts that lead to unhealthy emotions such as depression, anxiety, and anger are nearly always illogical and distorted even though they seem realistic – often times the lies sound very true. Reality does not produce clinical depression or anxiety, but wrong thoughts about reality do. Therefore, if you can replace distorted negative thoughts with thoughts that are positive and realistic, you can change the way you feel. You can decrease the anxiety, or better yet, make it go away.

How can I do this, you might ask? Some will experience a decrease in symptoms by making lifestyle changes, such as:
• Getting sufficient rest and sleep
• If you smoke, quit
• Reducing or eliminating caffeinated beverages
• Drinking alcohol in moderation
• Avoiding using drugs
• Reducing exposure to stressful environments
• Exercising regularly

Some people report that relaxation techniques help reduce their anxiety significantly when used regularly as part of a daily self-care routine. Relaxation can include but is not limited to
• Practicing deep breathing and meditation. Choose a positive mantra (“I can overcome!” or meditate on your favorite Bible verse.)
• Learning how to do progressive muscle relaxation.
• Working with a massage therapist.
• Engaging in pleasurable activities. This is could absolutely anything you enjoy doing – take an art class, play with your cat, drink a cup of hot tea.
• Do yoga

Having a strong support system of family and friends is key to coping with any mental health issue. Also, consider seeking therapy to improve your coping skills, and/or join a support group. You might find that talking to a counselor can help you to address thoughts, feelings, and behaviors that play a role in anxiety. Cognitive-behavioral therapy (CBT) in particular can help you identify negative thought patterns and behaviors. Over time, you can learn to retrain your thinking. This will help you choose better options in response to stress and anxiety.

As you practicing retraining your brain, remember to focus on what is true. Jesus is the “Prince of Peace” and holding on to this promise can also bring us peace of mind. Isaiah 26:3 says “You will keep him in perfect peace, whose mind is stayed on you because he trusts in you.” Trust in God to work in you, and to get you through this potentially difficult and scary time. “Casting all your care upon Him, for He cares for you.” I Peter 5:7

For severe anxiety or anxiety disorder, medication may be necessary. Please talk to your doctor or psychiatrist about what the best options might be for you. Finally, to help prevent anxiety, consider taking the following steps:
• Avoid situations, occupations, and people that cause you stress.
• If unavoidable, confront and overcome situations that provoke anxiety.
• Find a relaxation technique that works for you. Use it regularly.
• Develop and maintain a strong social support system.
• Express your emotions when they happen.
• Challenge irrational beliefs and thoughts that are not helpful to you.
• Correct misperceptions. Ask others for their points of view.
• Work with a therapist.

All of the therapists at Catholic Charities are experienced in working with anxiety and its associated disorders. Most of the counselors in the Ames, Decorah, Dubuque, and Waterloo offices are also trained in Eye Movement Desensitization & Reprocessing (EMDR), a cognitive-behavioral technique that has been proven to reduce anxiety and panic attacks, as well as stress, depression, phobias, and self-esteem.

For more information call 800-772-2758

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Answers to quiz: 1 – should statement; 2 – mind-reading; 3 – fortune-telling; 4 – mental filter; 5 – all or nothing

Resources Anxiety :
The Feeling Good Handbook by David D. Burns, M.D. When Panic Attacks by David D. Burns, M.D. The Anxiety Cure by Archibald D. Hart Thought distortions and the definitions: http://www.pacwrc.pitt.edu/curriculum/313_MngngImpctTrmtcStrssChldWlfrPrf ssnl/hndts/HO15_ThnkngAbtThnkng.pdf

by Lisa Turner, LMHC
March 2018

Counselor Bob (not his real name) looked around the circle. Joining a group was not really his thing, but it was recommended as a way to meet people when he started college. So here he was. But Bob had a difficult time meeting new people and starting conversations with strangers, and all these people seemed to have no problem with it, just chatting away. Maybe they all knew each other before getting here, and he’s the only one who is new? And those girls across from him are laughing. Are they laughing at him? It’s so hard to tell what people are thinking. Bob turns more and more inward and eventually, slips away from the group.

Over the years, a lot of people have walked into my office and shared with me thoughts and feelings that they have shared with no one else. And so often these people, no matter how different the stories and life experiences, have one thing in common – low self-esteem.

What is self-esteem? According to Linda Sanford and Mary Ellen Donovan in Women & Self Esteem, “Our level of self-esteem is the measure of how much we like and approve of our self-concept. The self-concept is the set of the beliefs and images we all have and hold to be true of ourselves.” Sanford and Donovan also go on to say that global self-esteem is the measure of how much we like and approve of our perceived self as a whole, while specific self-esteem is the measure of how much we like and approve of a certain part of ourselves.

Matthew McKay and Patrick Fanning in Self-Esteem define self-esteem as “more than merely recognizing one’s positive qualities. It is an attitude of acceptance and nonjudgment toward self and others.” “Building self-esteem more often means learning to accept who you already are rather than creating a new you.” (Sanford & Donovan)

David Burns in 10 Days to Self-Esteem contends that conditional self-esteem is based on our accomplishments or what we have decided about ourselves, and unconditional self-esteem is based on a decision to love and respect ourselves. But what does the Bible say about self-esteem? Is this something that is on God’s radar? Psalm 139:14 says that we are “fearfully and wonderfully made.” Jeremiah 1:5 says, “Before I formed you in the womb I knew you; before you were born I sanctified you; I ordained you a prophet to the nations.” (NKJV) We are made in the image of God and every believer should have high self-esteem because of who we are in Christ. (I John 3:1)

Do you agree or disagree with these definitions? How do you make the decision about what is most important to you? Is it based on accomplishments or your own innate value? What are you particularly good at? What aren’t you particularly good at? Does this affect your self-esteem? What is the basis of your self-esteem? Is it altruism? Religion? Looks? Intelligence? Success? Personal efficiency? Fame and power? Love? Happiness? Another way to think about this is, if you lack in any of these areas, do you think less of yourself? What areas are more significant to you, or more meaningful?

Regardless of our own personal definition of self-esteem, we all arrive at our self-esteem cognitively, which means that our self-esteem is directly related to how we think about ourselves. How we think about an upsetting event affects how we feel and our mood, therefore, you feel the way you think. Increased depression and anxiety, and decreased relationship satisfaction are closely linked to self-esteem. In fact, people with lower self-esteem tend to tolerate abusive situations and relationships.

Negative feelings like depression, anxiety, guilt, and anger result in more from negative thoughts than from external events. This is not an easy concept to grasp because it is hard to separate the event from the thought and from the feeling – we’ve always thought this way and it’s just automatic, and this automatic thought is usually negative.

It turns out there is a connection between self-esteem and stress. Nathaniel Branden, in his book The Six Pillars of Self-Esteem, has found that increasing someone’s self-esteem will reduce the amount of stress they experience. If your self-esteem levels start out low, however, stress will often reduce them even further. But if your self-esteem is high, you are less likely to tolerate things you find stressful. Instead, chances are you will do something about it – either find out how to fix the stressor or avoid the stressor altogether – simply because you believe you deserve better than to have to suffer. In a very real way, higher self-esteem causes behaviors that reduce stress and that includes stressful relationships.

So how do we do this? Maintain, or improve, self-esteem? There are two important components to this: decreasing negative self-talk and increasing positive self-talk. One overly simple way to decrease negative self-talk is to talk to yourself the way you would talk to your best friend. Most of us would never tell our close friends that they were a loser or stupid or lazy or fat, but we don’t hesitate to tell ourselves that exact thing. So when you find yourself talking rudely to yourself about yourself, change it up. Instead of being a loser, you are doing the best you can; instead of being stupid or an idiot, you are smart, but not thinking as clearly as you could; instead of lazy, you are putting something off because you tend to procrastinate; and instead of fat, you are full-figured or husky or athletically built. Be nice to yourself. And kind. And gentle.

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Resources Branden, Nathaniel. The Six Pillars of Self-Esteem. A Bantam Book, 1994. Burns, David D., MD. 10 Days to Self-Esteem. Harper, 1993 (This is a workbook that is great for use individually or in a group.) McKay, Matthew PhD. and Fanning, Patrick. Self-Esteem, 3rd ed., New Harbinger Publications, Inc., 2000 Sanford, Linda and Donovan, Mary Ellen. Women & Self-Esteem. Penguin Books, 1984 www.goodtherapy.com #selfesteem

by Lisa Turner, LMFT
February 2019

It might be surprising to some living and working outside of agriculture to learn that a new farm crisis is looming. Some experts would argue that this is the same farm crisis of the 1980s, continuing. This crisis is not just of a financial nature, but a mental health crisis as well.

Between 2013 and 2017, net farm income for US farmers declined 50 percent. In 2018, median farm household income is expected to increase .8 percent from its 2017 level. (Farm household income includes both farm and off-farm income.) What translates into affordable prices at the grocery store does not always translate into a livable wage for a farmer. Michael Rossman, a farmer, and psychologist in Harlan, Iowa, has become a leading voice in farmer behavioral health. He, along with other psychologists, has developed something called the “Agrarian Imperative Theory.” In short, that theory holds that most human beings have an innate urge to provide food, clothing, and shelter for their families. In the case of farm families, that imperative goes further, in that they also want to own and hold onto the land that produces these things, sometimes at any cost. Even though a farmer might not be making ends meet, they are unlikely to stop trying, until the trying gets very, very hard. Historically, the cost of the agrarian imperative is a person’s mental health. The guilt of walking away from a farm that has been passed down through the generations, and that a farmer has been raised to love, is overpowering. When a farmer can’t fulfill this purpose, he or she often feels despair all the while pushing themselves and moving forward because it’s all they know. Adding to the strain on one’s mental health, farmers work long hours, and with these long hours comes a lack of time for themselves and their families, poor self-care, limited hobbies, and social isolation.

Recent studies into the suicide rates among farmers are as alarming as they are conflicting. A study by the Center for Disease Control and Prevention (CDC) in 2016 “suggested that male farmers in 17 states took their lives at a rate two times higher than the general population in 2012 and 1.5 times higher in 2015” (The Guardian, 2017). However, some speculate that these numbers are low, given that certain agricultural states like Iowa were not included in the data. At the same time, other studies cite difficulty in gathering accurate data and place the suicide rate double that of the general population. No matter how you look at it, the numbers aren’t good.

The good news is that the agriculture industry is aware of this trend, and continues to work to bridge barriers to care. Rossman, the farmer, and psychologist in Harlan created Sowing the Seeds of Hope, which provides behavioral health services to uninsured, underinsured, and other at-risk farm and ranch families and agricultural workers. Seven states (Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin) formed the regional program in 1999. Sowing the Seeds of Hope became a model for the delivery of behavioral healthcare to farmers and their families, and inspired the Farm and Ranch Stress Assistance Network. Although unfunded in the 2008 Farm Bill, it is on the verge of being resurrected in the new farm bill, which was authorized on January 3, 2019. Included in this authorization is grant funding to extension and nonprofit organizations “to initiate, expand, or sustain programs that provide professional agricultural behavioral health counseling and referral for other forms of assistance as necessary through farm telephone helplines and websites; community education; support groups; outreach services and activities; and home delivery of assistance, in a case in which a farm resident is homebound.”

The Archdiocese of Dubuque represents the 30 counties of northeast Iowa, which is predominantly rural. So if you aren’t a farmer or don’t work in agriculture, you probably know someone who is or does. This issue is not just an agricultural issue or even a mental health issue – it’s an Iowa issue and better yet, a humanitarian one.

In the resource section of the Catholic Charities website is a long list of resources used for this article, as well as resources that will put farmers directly in touch with providers of all types – financial counseling, legal assistance, and stress management. Please feel free to share this information, and this article, with someone you know who may be struggling.

For more information about resources available to farm families, please go to www.catholiccharitiesdubuque.org/catholic-charities-services/counseling-services. For more information about the services that Catholic Charities provides, or to talk to a counselor, call 800- 772-2758.

Prayer for Farm Families in Crisis
Oh God, our costs are up and prices for our produce down. The loan is due and there’s no money to buy this year’s seed. We feel alone, embarrassed in our need, like failures in our efforts to farm. The harder we work, the worse it seems to get. There’s no laughter or joy anymore, just a constant struggle to believe, to hope, and to keep trying. Strengthen us, God. Keep us gentle and yet firm, generous yet open to receive. Let us see your face in those who want to help and don’t know-how. Grant us perseverance and openness to your will. Hold our family close as we do our best to know and act according to your will in the days ahead. We ask this through Christ our Lord. Amen.

Click Here for Additional Farm Stress Resources

Resources
Churches’ Center for Land and People Address: P.O. Box 203, Monticello, WI 53570-0203 Phone: 681.821.3104 Contact: Tom Nelson Email: tnelson@ccmadison.org Website: http://www.cclpmidwest.org/ Resource Description: Since its founding in the 1980s, the Center has remained true to its mission, staying attuned to rural realities. The organization offers hope to farm families in changing and challenging times through prayer and celebration, action and reflection, education and advocacy. The Center’s Winter Farmers’ Markets & Meals for Hope program brings farmers and consumers together, and the Center collaborates with the Harvest of Hope Fund, a nonprofit, faith-based group that offers financial help to distressed farmers through grants.

Farm Aid Hotline 800-FARM-AID (800-327-6243) Monday – Friday, 9 – 5pm eastern time

Farm Bill Law Enterprise (FBLE) http://www.farmbilllaw.org/2018/11/19/what-usda-is-doing-to-address-mental-health-farmersuicide/ Farm Crisis Center https://farmcrisis.nfu.org/

Iowa Concern Hotline Address: 10861 Douglas Ave., Suite B, Urbandale, IA 50322 Phone: 800.447.1985 Contact: John Baker Email: iowaconcern@iastate.edu Website: http://www.extension.iastate.edu/iowaconcern/ Resource Description: Iowa Concern Hotline is a program of the Iowa State University Extension service and provides access to an attorney for legal education, stress counselors, and Information and Referral services. The web site features and extensive Frequently Asked Questions database for legal, finance, crisis and disaster, and personal health issues. The web site also features a live chat service where one can connect with a stress counselor and talk oneon-one in a secure environment. All services are available 24/7 at no charge. The Iowa Concern Hotline is also connected to the IA Farmlink program for new and retiring farmers, and to the Beginning Farmer Center, Sowing the Seeds of Hope, and Agriwellness to strengthen their range of services. National Farmers Union https://nfu.org/2018/11/27/cdc-study-clarifies-data-on-farm-stress/ National Suicide Prevention Hotline 800-273-8255 Sowing the Seeds of Hope http://www.agriwellness.org/ssoh.htm

by Lisa Turner, LMFT

Betsy (not her real name) is exhausted from a day at work and is now racing around town, picking up children and getting them to various appointments and activities. She is looking forward to getting home and talking to her husband Alex (not his real name) about a phone call she received today from her mom about her grandpa, who was recently diagnosed with dementia. Betsy’s mom is using her to vent her frustrations and sadness, and in turn, Betsy needs her own sounding board. However, when Alex gets home, he remains glued to the television while she talks, making it clear that he is not really listening to her. This is a pattern in their communication – each too preoccupied or too tired to pay attention to the other. At the end of the day, they each collapse into bed without ever connecting.

There are some destructive myths about marriage, the main one being “I can put my marriage on auto-pilot.” Studies show that marital satisfaction decreases during the years that children are at home, and that marital satisfaction hits an all-time low right before the kids leave home and transition into adulthood. After 20 years of disconnect, like in the example above, there might not be a marriage to return to after the kids leave home.

A second myth about marriage is “My kids are little so their needs are more important than my marriage or my spouse.” The idea behind this is that my spouse will not mind if I throw myself into the kids and their well-being, at the expense of the marriage relationship. This can be a destructive idea for many reasons, one of which is becauseit is important for children to see their parents modeling a healthy, loving relationship. This is where, as children, we first learn what a good relationship looks like. Research has shown that couples reporting high marital satisfaction spend at least 15 hours a week together, without children. This is a daunting statistic, and it certainly creates food for thought.

Spending time together does not have to come at the expense of someone else, and it does not have to be expensive. Go for a walk, take a drive around town, run errands together, take up or renew a shared hobby, and take advantage of times when your kids are otherwise occupied. During the dating years, prior to marriage, most people just enjoyed the company of their significant other, regardless of the activity.

Speaking of dating, how do we get started on the right foot when looking for a life partner? What are some characteristic of healthy relationships, and how does one know when to stay in a relationship and when to get out?

According to Charlotte Kasl, it is helpful to set a bottom line of behaviors in yourself and your significant other that you will not tolerate in a relationship. This includes unacceptable behavior in the other person, such as being superficially charming, having a volatile temper, and showing disrespect for boundaries. This also includes unacceptable behavior of your own, like feeling inferior to your partner, giving more than you get in return, and trying to change the other person. If at any point in the relationship, you find yourself rationalizing your behavior or the behavior of the other, or disregarding your bottom line and your own self-care, these are red flags that the relationship is not healthy.

So what should one look for in a healthy relationship, and what makes a person healthy? According to Paul in his letter to the Romans: “Let love be without hypocrisy. Abhor what is evil. Cling to what is good. Be kindly affectionate to one another with brotherly love, in honor giving preference to one another; if it is possible, as much as it depends on your, live peaceably with all men. Do not be overcome by evil, but overcome evil with good.” (Romans 12: 9, 10, 18, 21 NKJV) October is Domestic Violence Awareness Month, and with that in mind, it is important to review some healthy characteristics of any God-honoring relationship.

• A desire for closeness and connecting and that is more than superficial, charming, or physical;
• The ability to feel empathy, and an ability to act on empathy;
• A level of comfort with separateness and individuality
• Being comfortable ENOUGH with confrontation that small and large issues do not get swept under the rug;
• An capability to forgive others and yourself;
• The aptitude to be an adult, and relate like an adult in adult relationships, and not revert to childish behaviors;
• Possessing the skill to be stable and consistent in behaviors and emotions;
• A wish to be a positive influence for your partner; and
• The capacity to keep confidences.

In the current culture in which we live, we sometimes find ourselves in the awkward situation of having to either confront unhealthy relationship behaviors or report them. What should you do if you suspect someone is in a relationship that is unsafe? According to http://www.nationaldomesticviolencehelpline.org.uk/:
• Express concern for his/her safety. Try to be direct and perhaps start with, “I’m worried about you because…” or “I’m concerned about your safety…” If you suspect intimate partner violence and the victim remains reluctant to discuss or disclose, let her/him know that should she/he need your assistance in the future, you are available. The goal is not to get the victim to admit to the problem, but to let her/him know that you are a resource should intimate partner violence ever be an issue for them.
• Listen without making judgments. Focus on supporting her and building her self-confidence. Acknowledge her strengths and remind her that she is coping with a challenging and stressful situation.
• Tell victims that they are not alone. There are resources. Encourage him/her to contact a local domestic violence agency. Help him/her develop or keep outside contacts to reduce isolation.
• Tell her/him that the violence is not their fault, she/he does not deserve to be abused and that only her/his abuser can stop the abuse, and that there is no excuse for intimate partner violence.
• Do not tell her to leave or criticize her for staying. She has to make the decision. Research shows an abused person is most at risk at the point of separation and immediately after leaving an abusive partner. Leaving takes strength and courage. There are obstacles of nowhere to go, no money, little support, etc.
• Offer further assistance if you are able. Help with a safety plan. Research resources. Continue to listen.
• Be patient. It takes time to recognize and accept that you are being abused and longer to decide safe actions to take. Recognizing the problem is an important first step.

Help Us Remember Lord, help us to remember when we first met And the strong love that grew between us. To work that love into practical things So that nothing can divide us. We ask for words both kind and loving, And for hearts always ready to ask forgiveness as well as to forgive. Dear Lord, we put our marriage into your hands.

Click HERE for the PDF Version

Resources Cloud, Henry and Townsend, John. (1995). Safe People. Zondervan Kasl, Charlotte. If the Buddha Dates. Penguin Publishers Real, Terrence (2002). How Can I Get Through to You: Closing the Intimacy Gap Between Men and Woman. New York: Simon & Schuster Tatkin, Stan, PsyD (2011). Wired for Love. California: New Harbinger Publications, Inc. National Resource Center on Domestic Violence www.nrcdv.org

by Lisa Turner, LMFT

The statistics are sobering. Almost 45,000 Americans die by suicide every year? (American Foundation for Suicide Prevention) For every suicide completed, 25 people attempt suicide. There are 123 suicides a day on average, and the overall suicide rate rose by 24 percent from 1999 to 2014. (Centers for Disease Control and Prevention) The numbers for adolescents are equally alarming. Suicide is the third leading cause of death for individuals aged 10 – 24.

September 7 – 12 is designated annually as National Suicide Prevention Week, and September 10 is World Suicide Prevention Day, with the purpose to inform and engage health professionals and the general public about suicide prevention, to educate about the warning signs of suicide, and to decrease the stigma surrounding suicide and mental health.

According to the National Council for Behavioral Health, suicide is the 10th leading cause of death. In 2013, suicide took the lives of 41,149people – this was the second leading cause of death among individuals aged 15 – 35 years. This same year, 17 percent of high school students reported that they had seriously considered attempting suicide during the previous year. During any 12- month period, 3.7 percent of adults had serious thoughts about suicide, 1.1 percent made a plan, and .6 percent attempted suicide.

Understanding suicide and talking about it is not easy, whether are you approaching someone you care about or struggling with it yourself. If you are concerned about someone who you think might be struggling, the first step is to approach and engage that person, and then assess whether the person is in crisis. According to Mental Health First Aid, some factors that might make someone at risk for suicide include:
• Gender – males kill themselves more often than females, although females attempt suicide three times as often as males
• Age – adolescents and older adults pose a higher risk
• Chronic physical illness 
• Mental illness – people who are depressed are more prone to suicide
• Use of alcohol or other substances
• Lack of social support
• A previous attempt
• Organized plan

These last two risk factors are the most significant indicators. One of the myths surrounding suicide is the idea that if you ask a person directly about their suicidal intentions, you will encourage the person to kill themselves by putting the idea in their head. The opposite is actually true – asking someone directly about their suicidal feelings actually acts as a deterrent. Another myth is that someone who talks about suicide isn’t really serious. If a person mentions suicide, it is always important to check if that person has definite intentions to take their own life. Ask directly if a person is suicidal by asking, “Are you having thoughts of suicide?” or “Are you thinking about killing yourself?” If the answer to either of these questions is “yes,” follow up by asking, “Have you decided how you are going to kill yourself?” or “Have you decided when you would do it?”

A “yes” answer to any of these questions needs to be taken seriously. Let the person know that you are concerned and willing to help. Do not express negative judgment, and appear confident as this will be reassuring to the person. Do not leave this person alone; instead, help them to identify ways they can remain safe and helpful resources that they have used in the past. If they cannot guarantee their safety or a safety contact, or if they appear to be a threat to themselves or others, do not hesitate to call 911. It might give you some peace of mind to put the phone number for the National Suicide Prevention Hotline in your phone – you can share it with the person in need, or call the number in their presence. That number is 800-273-8255.

There is also a myth that suicide happens without warning. Studies show that there are often signs and clues that indicate suicidal intention. Some of these warning signs are:
• Threatening to hurt or kill themselves
• Seeking access to means
• Talking or writing about death, dying, or suicide on social media, or other places
• Expressing hopelessness
• Feeling worthless or expressing a lack of purpose
• Acting recklessly or engaging in risky activities
• Feeling trapped, like there is no way out
• Increased use of drugs or alcohol
• Withdrawing from friends, family, or society
• Appearing agitated
• Dramatic change in mood
• Demonstrating anger, rage, or seeking revenge

Suicide is not an easy topic to talk about. These are not easy steps to take and to be honest, none of us really want to find ourselves on either side of this conversation. But statistics don’t lie: suicide is a real fact of the world we live in today, and death by suicide takes far too many lives. If you would like to learn more about how to help someone in crisis, or just have a greater comfort level with having this type of conversation, you may want to consider attending a Mental Health First Aid training and becoming a Mental Health First Aider!

In Catholic Charities’ continual effort to build parish and community partnerships, three counselors have been certified as Mental Health First Aid instructors, and are offering trainings in the Archdiocese. These trainings are 8 ½ hour courses with lunch and snacks provided. Participants pay for the cost of the manual. For more information, or to talk to a counselor call 1-800-772-2758.

Prayer Litany for Suicide Prevention Week God, we celebrate the gift of life for each person. We commit to nurturing the wellbeing of each person here. We know for some, life is a burden filled with suffering. Help us to talk about our fears, our anger, and our despair with someone we trust. We celebrate that life has purpose and meaning. For some, purpose and meaning are like dry bones, dead and lifeless. Remind us that You know us by name. You know our place and purpose in this world. We are created to live in the community. Some feel alone, unloved, and disconnected. Give us the courage to reach out with love to someone who needs us. May we be Your presence with them. Teach us to be gentle and non-judgmental. We remember those who ended their life before it was time. Comfort those who grieve and bring healing.

Resources Burns, David MD (1999). The Feeling Good Handbook. New York; Quill Publishers National Suicide Prevention Hotline 800-273-8255 Mental Health First Aid training 800-772-2758 Suicide Prevention Resource Center www.sprc.org American Association of Suicidology www.suicidology.org

by Lisa Turner, LMFT
August 2018

Adolescence is a time of great change: life is getting busier, responsibilities at school increase, work becomes an added responsibility for many, college and work decisions loom, and above all else, puberty hits.

Typical adolescent development includes physical, mental, emotional, and social changes. Physically, hormones change and so do a teenager’s body and voice. Mentally, they develop abstract reasoning skills, begin forming their own beliefs, and question authority. Emotionally, mood shifts become more apparent, as does some impulsive behavior. And socially, the peer group (and social media) take on greater importance, there can be more experimentation, and sexual identity cements itself.

Most youths pass through these stages despite challenges. They thrive, mature, build competence and resiliency. But what if they don’t? How does one know if a teenager is developing normally, and how does one know if they are having problems?

Trying to tell the difference between what expected behaviors are and what might be the signs of a mental illness isn't always easy. One or two symptoms alone can’t predict a mental illness. But if a person is experiencing several at one time and the symptoms are causing serious problems in the ability to study, work, or relate to others, he or she should be seen by a mental health professional. People with suicidal thoughts or intent, or thoughts of harming others, need immediate attention.

Most everyone at some time in their life will experience periods of anxiety, sadness, and despair. These are normal reactions to the pain of loss, rejection, or disappointment. In fact, according to the National Council for Behavioral Health, the prevalence of anxiety disorders among teens in the United State is 31.9 percent, with 8.3 percent experiencing a severe impact from anxiety. The prevalence of anxiety among females is higher than for males in this age range (12 – 17), and it increases as they get older. The median age of onset for anxiety is 11 years old. Depression also impacts girls more than boys – the prevalence of mood disorders in the United States for kids ages 12 – 17 is 14.3 percent, with 11.2 percent experiencing a severe impact.

Those living with serious mental illnesses, however, often experience more extreme reactions that can leave them mired in hopelessness. Signs and symptoms of serious mental illness in teenagers can cross physical, emotional, thought, and behavioral lines. Physical and emotional signs and symptoms can include extreme paranoia, hallucinations and delusions, hyperactivity, crying, substance use, and poor sleep patterns. A person can also experience symptoms that affect their cardiovascular system (rapid heartbeat, chest pain), respiratory system (shortness of breath), neurology (dizziness, headache, sweating), gastrointestinal system (nausea, choking, vomiting), and musculoskeletal system (aches, pains, restlessness). Signs and symptoms can also be apparent in someone’s appearance and affect their hormones.

Frequent self-critical thoughts; difficulty making decisions, concentrating, and remembering; pessimism; rigid thinking; and an altered sense of self in relation to others are just some of the thought life indicators of a mental illness. Nonsuicidal self-injury is a behavior that would also indicate that a teen is struggling with something outside the norm. Examples of self-injury include cutting, hair pulling, burning, or otherwise inflicting pain on oneself. Other types of behavioral changes could include missing school. Typical adolescent behavior can look like withdrawing from family to spend time with friends, wanting privacy, and moving from childhood behaviors to teen behaviors. Warning signs that an adolescent is struggling with something outside of normal teenage behaviors would include withdrawing from life in general, secrecy and hiding, and losing interest in all hobbies and activities.

Risk factors for mental illness in adolescents are wide-ranging but can include experiencing stressful events, abuse, or trauma; learned behavior; chemical imbalance; substance misuse; ongoing stress and anxiety, medical conditions and hormonal changes; and side effects of medication. According to the National Council for Behavioral Health, half of all lifetime cases of mental illness begin by age 14; three-quarters of all mental illness will present by age 24.

Suicide can be a real risk for anyone struggling with mental illness. For teenagers, there is an increased risk due to a number of factors: impulsivity, lack of awareness of risk and time, substance misuse, and the influence of their peer group. The best way to approach this, or any situation where there is a mental health concern, is to have a conversation. Asking a person “What’s going on?” or “What’s happening?” is an open-ended and non-threatening way to begin a dialogue.

Resilience is the ability to thrive in spite of risk or adversity. The term comes from physics: resilient objects bend under stress but then springs back rather than break. A resilient person not only springs back from adversity but also can become stronger in the process. The feeling of accomplishment that comes from solving life problems is the core of resilience. Resilience is a natural trait in all humans. Human brains are specifically wired to cope with problems and some would say, crave a challenge. However, humans cannot survive and thrive alone – they require support and encouragement from others.

There are protective factors that can insulate teenagers from the effects of life and mental illness, and make them more resilient. Studies have shown that community is key to resilience, and that community can come in many forms. Family support, pro-social activities, a good friend and peer support, and spirituality are found to be key in the lives of all young people. In fact, the most important component in a teenager’s life to help promote resilience and good mental health is feeling close to at least one adult.

The faith community has the opportunity to play an important role in this. In the Archdiocese, the offices of Adolescent Faith Formation, Catechetical Services, and Marriage and Family Life directly touch the lives of young people and are important protective factors. Catholic Charities also provides affordable mental health services to children and families.

Mental Health First Aid training for youth is an excellent way to learn more about how to identify healthy and unhealthy behaviors in adolescents, and how you can help a teenager experiencing a mental health crisis. Mental Health First Aid “is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves.” This training is available for individual adults and organizations. For more information, or to talk to a counselor, go to www.catholiccharitiesdubuque.org/catholic-charities-services/counselingservices, or call 800-772-2758.

A Blessing for Those in Need of Healing May you be held in love. May tenderness carry you. May the pain you know too well be lifted from you. May your heart’s heaviness be lightened by grace. May hope to abound for you. May you know you are not alone but always loved by God. And may you dwell in peace in the midst of the depth and breadth of your being. Amen.

by Lisa Turner, LMHC
June 2018

Joe (not his real name) is frantic. He is the caregiver for his elderly mother who has dementia. She is distraught and causing problems at the nursing home. The staff is asking him to help manage his mother’s situation, and he doesn’t know-how. Joe has a life-long substance use disorder and is missing most of his teeth. He smokes and engages in other unhealthy coping skills when his anxiety gets too high – which it is most of the time. He has tried to stop drinking and smoking so many times, but alcohol and nicotine make his anxiety symptoms go away… for a little while. And when the anxiety comes back, so does the use of alcohol and cigarettes.

Joe is caught in a vicious cycle that is most likely the result of Adverse Childhood Experiences, or ACEs. ACEs are incidents that harm social, cognitive, and emotional functioning and dramatically upset the safe, nurturing environments children need to thrive. Examples include childhood abuse (physical, psychological, sexual), and household dysfunction (substance abuse, incarceration of a family member, mental illness, adult violence, parental separation, or divorce).

According to the Centers for Disease Control and Prevention (CDC), The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study is one of the largest investigations of childhood abuse and neglect and later-life health and well-being. Adverse Childhood Experiences are common. Almost two-thirds of study participants reported at least one ACE, and more than one in five reported three or more ACEs.

ACEs are defined by a person’s answers to ten specific questions about their first 18 years of life. If an adult responded “once or more than once” or “yes” to a question, they were considered to have experienced that category of ACEs. An ACEs score is determined by the total categories an adult reported experiencing, with a total possible score of eight. The ACEs data only measures categories of ACEs, not the frequency or severity of each ACE. The categories of questions are as follows:
Emotional abuse: How often did a parent or adult in your home ever swear at you, insult you, or put you down?
Physical abuse: Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking.
Sexual abuse: How often did anyone at least 5 years older than you or an adult ever touch you sexually, try to make you touch them sexually, or force you to have sex?
Substance abuse in home: Did you live with anyone who was a problem drinker or alcoholic, used illegal street drugs, or abused prescription medications?
Incarcerated family member: Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facilities?
Family member with mental illness: Did you ever live with anyone who was depressed, mentally ill, or suicidal?
Domestic violence: How often did your parents or adults in your home ever slap, hit, kick, punch, or beat each other up? Separation/divorce: Were your parents separated or divorced?

As the number of ACEs increases so does the risk for the following (this list is not comprehensive):
• Alcoholism and alcohol abuse
• Chronic obstructive pulmonary disease
• Depression
• Fetal death
• Health-related quality of life
• Illicit drug use
• Ischemic heart disease
• Liver disease
• Poor work performance
• Financial stress
• Risk for intimate partner violence
• Multiple sexual partners
• Sexually transmitted diseases
• Smoking
• Suicide attempts
• Unintended pregnancies
• Early initiation of smoking
• Early initiation of sexual activity
• Adolescent pregnancy
• Risk for sexual violence
• Poor academic achievement

An Iowa study of ACEs found that more than half of all Iowans (56 percent) reported at least one ACE. “Fourteen and a half percent experienced four or more ACEs, indicating a significant level of childhood trauma that greatly increases the risk of poor outcomes.” (Beyond ACEs: Building Hope and Resiliency in Iowa)

Why do ACEs matter? According to IowaACEs360, people who report four or more ACEs are two times as likely (as those reporting zero ACEs) of reporting their health as poor or fair; two and a half times as likely to rate their mental health as “not good;” and two and a half times as likely to report limitations to their physical activity due to physical, mental, or emotional problems. Those reporting four or more ACEs are also more likely to be developmentally delayed, and/or suffer from depression.

According to a white paper published by the United Way of Central Iowa, Iowa’s adult population has health problems strongly associated with ACEs. In 2010 an estimated: 
• 66 percent of Iowans were overweight or obese
• 8 percent had been told they were diabetic
• 6 percent pre-diabetic
• 8 percent had cardiovascular disease
• 6 percent were current smokers
• 23 percent were former smokers
• 5 percent were heavy drinkers
• 17 percent were binge drinkers

So back to Joe. Joe has a substance use disorder, both alcohol, and nicotine, as well as emotional struggles with anxiety. His inability to think clearly might point to a developmental delay when he was younger. Joe is a good example of someone who is living with an ACEs score of four or higher.

Research has shown that early intervention for mental health and substance use disorder increases the chances of recovery exponentially. During the summer, this space will further explore the impact of ACEs on children and adults, and the best form of treatment for both. For more information, or to talk to a counselor, go to www.catholiccharitiesdubuque.org/catholiccharities-services/counseling- services, or call 800-772-2758.

Most merciful God, bless all who have suffered trauma in their lives. Support them with love during their time of shock. Grace them with peace as they wrestle with the challenges of each day. Sustain them in hope as they prepare for the days ahead. Amen.

Resources https://www.iowaaces360.org https://www.cdc.gov/violenceprevention/acestudy/about.html https://www.unitedwaydm.org/aces Van Der Kolk, Bessel M.D., The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin, 2014 Corsi, Jasmin Lee, MS, LPC. The Emotionally Absent Mother: A guide to self-healing and getting the love you missed. The Experiment, 2010

by Lisa Turner, LMHC
July 2018

Michael (not his real name) cannot sit still. He constantly fidgets in his seat and is always restless. Currently in the fourth grade, he reads at a second grade level and slips a little bit every year, especially after breaks from school. Michael is eligible for free and reduced lunches, but his teacher suspects that he comes to school hungry, which contributes to his inability to sit still and focus. He is noticeably disheveled and often uses the school’s supply of winter coats and gloves every year. Occasionally, he has unexplained outbursts that result in him being removed from his classroom until he can calm down. It is common knowledge that Michael’s dad has been absent from the family for some time due to various criminal offenses including domestic violence and drug use, and that his mother also struggles with a substance use disorder.

The first few years of life are the most important in terms of brain development. Genetics go a long way in forming who we are as people, but experience plays a role also. Learning to cope with stress is a major part of human and brain development. When a body experiences anxiety or danger, our first instinct is to fight, flight, or freeze. Our stress hormones, including cortisol, and our heart rate and blood pressure rise. These early, biological instincts are meant to keep us safe. As infants and toddlers, it is our primary caregivers who are to keep us safe when our bodies go on high alert. They provide safety and security by making appropriate eye contact and touch, using calm voices, and maintaining a lifestyle that is free from chaos.

In homes and families where there are more ACEs present – physical, verbal, and/or sexual violence; substance misuse; mental illness; divorce or separation of the parents; the incarceration of someone in the household; or domestic violence – the level of stress experienced by a small child hits the toxic level. As babies and toddlers have not yet developed their own ability to selfsooth, and as their primary caregivers are preoccupied with abuse and household dysfunction, their stress hormones, heart rate, and blood pressure remain at an elevated level for too long. This prolonged activation of the stress response system interrupts the development of the brain and other organs, increasing the risk of developmental delays and health problems later in life.

According to IowaAces360, in Iowa alone, 21 percent of children ages four months to five years are at risk for developmental, behavioral, and social delays; 19 percent of children live below the poverty line; and 10 percent of youth disagree with the statement, “I have a happy home.” Research indicates that the best forms of treatment are early intervention and Trauma Informed Care.

Trauma Informed Care promotes an environment of safety, empowerment, and healing in both physical and mental health settings. Trauma Informed Care suggests that we assume Waterloo Office Kimball Ridge Center 2101 Kimball Ave. Suite 138 Waterloo, Iowa 50702 Phone: 319-272-2080 Cedar Rapids Office Sister Mary Lawrence Community Center 420 6th St. SE Suite 220 Cedar Rapids, Iowa 52401 Phone: 319-364-7121 Dubuque Office Archdiocese of Dubuque Pastoral Center 1229 Mount Loretta Ave. Dubuque, IA 52003 Phone: 563-588-0558 most people have experienced a trauma and to approach them that way, with holistic care that is respectful.

Research has shown that teaching and building resilience in kids can counteract the effects of a high ACEs score. According to IowaAces360, resilience is the ability to thrive, adapt, and cope despite adversity. What this boils down to is that instead of looking at a child and asking, “What is wrong with them?” we stop for a minute and ask, “What happened to them?” The treatment for this is as simple, and as hard, as being non- judgmental, showing unconditional love, and being a consistent person in their lives.

Simply fostering community within churches and other communities of faith can reduce levels of toxic stress in children, by “breaking the intergenerational passage of trauma.” Churches and other communities of faith can participate in Trauma Informed Care by creating safe, nurturing environments, by practicing active listening skills, by offering support, and by destigmatize toxic stress and trauma.

Another way to help destigmatize the effect of ACEs, and other types of mental illness, is to attend a training in Mental Health First Aid. Catholic Charities has taken the initiative to have three of its counselors – Clinical Director Lynne Lutze in Dubuque, Lori Eastwood in Decorah, and Lisa Turner in Ames – trained as certified instructors in Mental Health First Aid. Mental Health First Aid “is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aidis given until appropriate treatment and support are received or until the crisis resolves.” As trainers, Catholic Charities will be at the forefront of educating others how to preserve life, provide help, promote and enhance recovery, and provide comfort and support within the Archdiocese. This training is available for individual adults andorganizations.

So what about Michael? Michael would benefit from support systems in his life who are patient and understanding and who, instead of blaming him and punishing him for his behavior, seek to understand it and work with him to succeed in spite of a high ACEs score.

For more information, or to talk to a counselor, go to www.catholiccharitiesdubuque.org/catholiccharities-services/counseling-services, or call 800-772-2758.

A Prayer for Children Taking a child he placed it in their midst, and putting his arms around it he said to them, "Whoever receives one child such as this in my name, receives me; and whoever receives me, receives not me but the One who sent me." MARK 9:36-37
GRACIOUS AND LOVING GOD, WATCH OVER THE YOUNGEST AMONG US WHO FACE UNRELENTING AND OVERWHELMING ILLNESS AND INJURY. Send your grace upon them so they will know your loving and healing presence. Give to these sick children strength, hope, and joy as they face difficult treatment and recovery. You called us to receive the children, may we provide support and care necessary for their journey to health. We look to you and your Son, Jesus Christ, as a sign of mercy and joy. We ask this through the intercession of Our Lady of Lourdes in the name of your Son, Jesus and the Holy Spirit, now and forever. AMEN.

Resources Experiences Build Brain Architecture https://www.youtube.com/watch?time_continue=10&v=VNNsN9IJkws Still Face Experiment https://www.youtube.com/watch?time_continue=1&v=apzXGEbZht0 Lamia, Mary C. PhD. Understanding Myself: A kid’s guide to intense emotions and strong feelings. Magination Press, 2011 Paper Tigers: The Documentary, 2013. (Be advised: adult content)

By Lisa Turner, LMHC
November 2018

You might be surprised to learn that stress can be a good thing. Stress is what gets our adrenaline pumping and gives us our get-up-and-go for public speaking, performances of any kind, and taking tests. Without a certain amount of stress and adrenaline, life might be pretty boring. However, there is a point at which too much stress has the opposite effect and we need a break. The holidays should not be one of those times but all too often, it is. “Stress-free” and “holiday” might seem like oxymorons to most people, but it is possible to have both.

Here are some suggestions to get you thinking about how to make this season as enjoyable as possible for everyone. It is important to have realistic expectations and to define for yourself what “good enough” looks like. Are you dead set on making a turkey with all the trimmings when half of your guests are vegetarians? You might be setting yourself up for frustration and disappointment. And a lot of leftovers. Would it be easier for you to have cold cuts and sandwich fixings and finger foods available for people throughout the day, instead of cooking? Then do it! You might be thinking, if I don’t do THIS (cook, bake, wrap, shop), what will happen? What are the consequences? Will you be disappointed? Will others be disappointed? Only you can weigh and pros and cons of these options and determine for yourself what you can and can’t live with. Can you live with the disappointment of your children if you only bake two types of Christmas cookies instead of three? You can?! Great – enjoy yourself! Other ideas might include cutting back on the gift list, scale back on décor, plan ahead, and delegate. Many families are opting for the gift of “experience” instead of “things” placed under a tree. Go skiing as a group, visit a light display, stay overnight at an indoor water park, go caroling. Children are able to understand at a young age that the holidays are not all about receiving and opening gifts. They can be helped to understand that time spent with loved ones is valuable and priceless. That is a tradition that will pay off in later years as well.

Sometimes, when we get too stressed out, our sympathetic nervous system kicks into gear. This is what creates our internal emergency response system and the fight or flight instinct. It’s why your mouth dries out when you are overly nervous, and you might experience a reduction in appetite. Conversely, when we activate our parasympathetic nervous system by turning on our digestive system, we experience a relaxation response. The holidays are a perfect opportunity to experiment with healthy stress eating (another oxymoron, right?). Again, it is possible. Anything that makes your mouth water will help you to calm down. This might be having something to drink, sucking on hard candy, chewing gum, or having a light snack. Taking a walk around the block after a big meal never hurts either.

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