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Blog posts : "ptsd"

PsyD, Soldier, Priest, Counselor, PTSD

I ask for acceptance to earn the PsyD Degree at the XXXX Institute so that I might add the final and most important professional hat to my repertoire of historically interconnected or culminating roles. First, I gave my all for my country as a soldier; then I became an Episcopal Priest. Since June of 2014, I have served as the Director of Admissions at the XXXX School Prior to this position, I served for two years as a parish priest at XXXX Episcopal Church in XXXX. The cause to which I have decided to vote the balance and hopefully by far most significant part of my professional life is that of helping our veterans to heal. My comrades have been thrust into questionable moral situations for a very long time, forced to engage in many morally questionable activities, and with all too great a frequency fall into moral decay, as a result of stress, violence, and in some cases their own moral failure. I see the Wright Institute as the best fit for my interests, an academic community in which to find support and ideas to empower and inspire me to write a doctoral dissertation on the subject of Moral Injury and how it is related to PTSD.

I look forward to many decades to come fully immersed in an exploration of the ways that Moral Injury has, in the words of Rut Gubkin: "biological, emotional, neurological and spiritual and/or existential dimensions." As a priest of ecumenical formation, I believe that I have education/training/experience that will prove to be of great value in the development of models for healing that incorporate spirituality from a diverse body of religious backgrounds with a central focus on spirituality itself, rather than spirituality as it exists within any given religious tradition. I am especially interested in first studying, perhaps even helping to perfect or contribute to the development of Moral Injury Event Scales (MIES). I am pleased that there is already an extensive body of literature with which I have to work as a foundation, helpful data regarding moral injury resulting from transgressions by others, transgressions by self, and transgression by betrayal, resulting in stress, PTSD, feelings of hopelessness, pessimism, anger and rage.

I look forward to connecting some of the dots from my own experience as a soldier, with Moral Injury Theory which suggests, for example, that those who suffer Moral Injury as a result of the transgressions of others rather than their own are especially susceptible to PTSD. I saw this to be glaringly true of the poor fellows who I interacted with in the mortuary affairs unit overseas. They are the ones who process the bodies of those killed in action. They processed both Americans and the local Iraqi population who were killed in action (KIA). It's a terrible thing to see a mother and father lying on a table next to their children, the entire family KIA. It is even worse to see this several times a day, almost every day, for long periods of time. As if this were not yet tragic enough, these soldiers were well aware that many if not most of these casualties of war that come from air strikes that are not reported on the news and sometimes not reported at all. The transgressions of others often occur by people making simple mistakes with deadly consequences; these transgressions are also the most heavily correlated with PTSD.

Transgressions of self, on the other hand, have been shown to be more strongly associated with hopelessness, pessimism, and anger. One young marine from my unit was the gunner on top of a vehicle and the driver fell asleep and lost control, flipped the vehicle, and the young marine was crushed and mangled beyond recognition. Despite the fact that what happened was an accident, the driver of this vehicle is likely to experience more trauma than would have been the case if he had fallen asleep in civilian traffic and taken a life—due to the sheer chaos and ambiguity of combat. Adrenaline, fear, and a desire for revenge can be most lethal combinations resulting in soldiers all too frequently transgressing their own sense of morality in the heat of battle, making split-second decisions that will haunt them for a lifetime, leaving the with invisible scars that are sometimes not easy to detect.

I am especially concerned with the variety of ways in which Transgressionsof Self in warfare can have deadly consequences. One suicidal young marine that I dealt with in my office stands out in my mind. He had been standing guard on a dirt road in Fallujah when a car was approaching his checkpoint. The car was not slowing down so he aimed his rifle at the driver and pulled the trigger. The bullet struck the driver in the head and the car came to a slow stop. There was a 5 year old boy in the front seat covered in his father’s blood. The young boy was crying uncontrollably as the driver was still grasping for his last few breathes. Radio communication was not working properly and the marine who pulled the trigger spent 2 hours with the young boy and his now-dead father before backup arrived. This had happened 3 months prior to our conversation. I glanced down at his boots and noticed that the bloodstains were still there.

Finally, I seek to excel in Moral Injury Theory and PTSD treatment in my research concerning “Betrayal.”  The damage that occurs from the perception of being morally betrayed is especially evident among Iraq veterans who feel strongly that they were betrayed by their government because they were required to fight an unjust war, and that the blood that has been spilled in Iraq has been spilled in vain. The struggle to recover for these veterans who suffer from a sense of Betrayal is compounded by the fact that evidence has continued to emerge that they were indeed sent to war on the basis of false intelligence (no weapons of mass destruction). Many joined the military because they felt that they were serving a greater purpose after the country was attacked on 9-11. Now they have to deal with the fact that Saddam/Iraq had nothing to do with 9-11. They are left with the unsettling question about the atrocities of war they participated in and what was it all for? 

My central objective in life has always been to serve others, first in the military, followed by the ministry; these days I mostly serve the needs of prospective graduate students. My experiences as a priest in the Episcopal Church have given me a platform for making connections with groups on every level, from the Bay Area to internationally. I have valuable connections to important people that will help me to excel, with the leaders of Episcopal Relief and Development (ERD) for example, an international relief and development agency that is currently operating in over 40 countries. This is also why I feel strongly that I am an especially good fit with The XXXX Institute since your motto is "Educating Clinicians to Society.” 10 years from now I hope to be serving as a psychologist with ERD, working on an interdisciplinary team of medical doctors, nurses and social workers.

My ideal roles and responsibilities include that of educator as well as clinician providing psychological services in the various parts around the globe served by ERD to populations that have been displaced by war, within refugee camps, and areas affected by natural disaster. As an educator I want to be a valuable resource to the leadership of ERD concerning the needs that exist for psychological services in crises areas around the globe, in addition to attending to the psychological needs of the staff and volunteers of ERD. Over the course of the last 2 years, I have come to increasingly recognize a calling to pursue a new career direction in clinical psychology, meeting twice a month with a therapist about this career change. I feel confident that I am making the right decision and have the support of my wife as well, an attorney with an established practice here in XXXX, and most certainly one of the most valuable of my social connections and human resources.

I appreciate XXXX’s commitment to diversity, social justice and equality and how you require students to be in a field placement getting real world experience each year of the program, including the first year. I want to gain as much experience as possible and I believe that getting real world experience while in the midst of academic study is an effective strategy for creative learning. The therapist whom I have worked with for over a year about my career change is a Psychiatrist and Marriage and Family Therapist and he suggested the Wright Institute. I very much admire the research endeavors of your faculty, most especially the work of Dr. XXXX and his research into anxiety disorder. A former Lutheran minister, I particularly look forward to comparing notes with and learning from Dr. XXXX.

In addition to Moral Injury among veterans, I am also looking forward to an in-depth study of the extent to which Moral Injury occurs in non-military, even non-violent situations. I want to study the history and range of both PTSD and Moral Injury in an exhaustive fashion, especially in light of ethical transgressions, attorneys who make poor life/death decisions for their clients, negligent doctors or nurses, financiers that have committed fraud; at least theoretically the possibilities are endless, hence the search for the best way to define or delimit definitions of these terms in psychology that have become increasingly important to our efforts to diagnose and cure, especially our veterans returning from the field. I thank you for considering my application. 

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Dual PHD Degrees, Psychology & Social Work, PTSD

In our community they are usually referred to as ¨neglected¨ or ¨invisible¨ African elders, aging African refugees and immigrants who have resettled in the USA, many of whom are the survivors of the trauma of war. While working at the Center for Victims of Torture, I was assigned to a project named, New Neighbors Hidden Scars (NNHS), the purpose of which is to assist torture and war trauma survivors by promoting their overall health, working to restore and strengthen their leadership capabilities, and to create networks of support that are responsive to their unique needs. Through this process, we have been able to study and disseminate successful models of community-based care. Working with this program has helped to provide me with the confidence and determination to pursue advanced study in Social Work.

When I conducted a needs assessment for the NNHS, I was struck by the numerous barriers faced by immigrant African seniors with respect to accessing services. My efforts led to the design of a model for under-resourced areas with especially high numbers of African immigrants. In these strategic areas, it has been an enormous struggle to meet the mental health needs of the rapid influxes of refugees. Over time, however, we were able to develop multidisciplinary networks of providers to improve the coordination of care for trauma survivors. What we found to be particularly effective was the development of immigrant-led support groups in housing complexes and churches, including treatment groups for refugee students, and the development of an XXXX Food Distribution Center (AFDC), providing health and social service information along with culturally appropriate food assistance. I currently have the privilege of volunteering my service as the Executive Director of the XXXX.

African seniors have immigrated to the US under vastly different circumstances; some have been brought here by their children, others were forced out of their countries due to political violence, some came as young adults. Most, however, experience acute adjustment stressors. As part of my doctoral studies, I hope to explore how migration trauma affects the wellbeing of African seniors, especially in the area of cultural bereavement and adjustment to a new society. A related direction for my research would involve the development of new analytical models for working with African senior communities in the context of existing aging programs. These new models would be designed in accordance with the culturally relevant perspectives of many African communities and apply a holistic approach to recovery strategies for post-traumatic-stress disorder (PTSD) as well as more general forms of trauma. It is hoped that this research would fill a gap in the literature since there are virtually no African-specific models in the literature on aging and there is an enormous need for additional theoretical studies concerning the implementation of aging programs in immigrant African communities. It is also hoped that this research would contribute to the development of culturally appropriate, empirically validated interventions that could serve to reduce the adverse consequences of war trauma, PTSD, and resettlement shock, thereby improving the well being of seniors who have immigrated from Africa.

 The needs assessment that I have conducted suggests that a large percentage of African seniors are struggling with mental health symptoms related to war and PTSD, often combined with other mental health issues related to aging, especially Alzheimer’s and Dementia. Furthermore, these mental health conditions are typically exacerbated by environmental factors such as isolation, language barriers, unemployment, poverty, dependence on children, the loss of status and lack of transportation. In broader terms, I am very much interested in researching the entire gambit of issues involving the mental health of immigrants, especially seniors, and Africans in particular. I hope to publish in the future concerning the development of empirically validated interventions that reduce the adverse consequences of resettlement stressors, especially as combined with mental health issues—particularly, torture, forced migration, and PTSD. I am concerned with the paucity of existing research not only concerning African refugees in particular, but immigrant senior populations in general. Thus, I also hope to make important contributions to the systematic study of migration trauma, generally speaking, and the hurdles that must often be overcome in the accessing of services upon resettlement.

 It is my intention to design studies in which African refugees and other immigrants are given the opportunity to make meaningful contributions to the design and implementation, as well as the evaluation, of the research project. This supports the University of Michigan’s mission of promoting social justice through the empowerment of the weakest and most vulnerable members of our society; and in this way I also hope to contribute to the amelioration of oppressive conditions to which they are subject. One especially salient variable in my research will be the way in which ethnographic differences between African immigrant communities are characterized by specific words or terms used to refer to specific illnesses or mental health challenges This is especially important given the vast need for culturally specific treatment models for dealing with culturally specific practices, metaphors, spiritualities, etc., thereby leading to more accurate understandings of the specific mental health and wellness challenges faced by immigrant seniors. I see this type of research is of critical importance for the development of new training models, therapeutic initiatives, and even pharmacological investigations that would be of benefit to the broader body of social work research concerned with immigrant seniors.

Growing up in Kenya, we followed a family tradition of children being sent to live with their grandparents between the ages of 7 and 11.  My parents lived in a city while my grandparents lived in the rural area. Thus, my siblings and I were sent to my grandparents to be educated in the ways of the community: culture, norms, values, customs, rituals, folklore, etc. Each story we were told had a moral lesson illustrating a societal norm. We greatly respected my grandparents, and by extension the elderly in the community for the wisdom they embodied. When the need for conflict resolution arose, we were told to take it to the “Jorieko” meaning, ¨the wise ones.¨ I date my interest in the elderly to this period, and I have been fascinated by seniors ever since. My grandmother did not like going to the city because it represented a loss of authority for her, feeling much more at home with the practice of rural customs and lifestyles. And I have often pondered my grandmother’s sentiments when reflecting upon how still very much more traumatic it would be to be forced out of one’s country and culture entirely, for political reasons.

 My central career objective is to spend the balance of my professional life developing culturally sensitive mental health delivery models for African immigrants and refugees, especially older residents, always linking research to practice. I hope to serve as a teacher, consultant, researcher, and clinician in my area of expertise. Your doctoral program will help me to become a well rounded intellectual and scholar concerning the mental health and public policy issues faced by or affecting our senior populations, especially first-generation immigrants. Since I am myself an immigrant from Africa to the US, and now embarking on middle age at 44, I feel uniquely qualified for the development of a research interest in this area since I have a well refined capacity to empathize with the stresses that immigrant families and individuals from Africa must bear, the difficulties of cultural adjustment, migration trauma, etc.  I look forward to shouldering increasing professional responsibility in my work with African immigrants and refugees, institutions of higher learning, and social work professionals: conducting research and designing culturally appropriate, integrative mental health service models. It is painfully clear to me that social service agencies lack the necessary expertise in the development and implementation of culturally specific and appropriate mental health services for immigrants and refugees from Africa, as well as other regions of the world, and I ask for the opportunity and profound privilege of devoting my life to this cause.

I am also interested in the opportunity afforded by your program to attain a dual degree in social work and psychology, since I am concerned with the mental health issues of immigrant populations and this would help to refine my capacity to perform creative, cutting-edge research in this area. As a social worker, I am interested in promoting greater levels of social inclusion for immigrants from Africa and the study of psychology would help me to understand the mental health aspects of that inclusion. I am particularly excited about the possibility of studying under Professor XXXX whose research interest is in the area of clinical gerontology and racial and ethnic variations of service delivery to the elderly. I thank you for considering my application to your program.

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