My Body, My Pain: Chronic Pain as a Women’s Mental Health Issue//Kylie Steinhilber

Image retrieved from: University of Michigan, Michigan Health, https://healthblog.uofmhealth.org/health-management/cost-of-chronic-pain-infographic

           

            Living with chronic pain can cause one’s physical and mental health to suffer. Among those living with chronic pain, nearly 70% are women (Kiesel, 2017). Unfortunately, many are left without answers either because their disorder doesn’t have many known effective treatment options or because their doctors have “gaslighted” them. Whether or not you have heard this term before, if you are a person who has any type of marginalized identity, you may have experienced an instance of gaslighting in which a doctor makes you feel as though you should doubt your (well-justified) symptoms (Booth, 2018). Doctors may even minimize your symptoms to the point where you yourself can’t tell if the symptoms are real or in your head because no doctor you’ve visited has seemed to validate them. Unfortunately, gas lighting is perpetuated by gender-based stereotypes that women are just “more sensitive” and can be traced back to the days where women received a diagnosis of hysteria. These stereotypes contribute to the dearth of research on effective treatment options for women’s chronic pain, especially chronic pain due to reproductive health issues. Moreover, research on chronic pain typically uses male populations despite the fact that women are the majority of those who suffer with it (Kiesel, 2017). Disappointingly, it takes women multiple visits to the doctor’s office over a period of months to years to get proper treatment, if any. This is a health disparity we cannot ignore.

           

            We must also consider the effects that living with chronic pain can cause for women beyond their physical health. As someone who has dealt with chronic pain, I know first handedly how it affects one’s mental health. My own perspective is just one of many unique voices of those who live daily with chronic pain. For me, chronic pain has affected two major aspects of myself: my competence and my body image. This is not an uncommon experience. Chronic pain can make one feel as though their body isn’t home, at times distrusting one’s own body not knowing what symptoms will present one day to the next. Pain can limit one’s ability to perform tasks they previously were able to do with ease, or make tasks more difficult than they are for others without chronic pain. Unlike physically visible disabilities, chronic pain is invisible and can often make it especially hard to advocate for one’s self out of fear that others won’t believe them. Especially considering that this fear is sometimes reality, as in the case of doctors who gas light women’s pain, one can feel silenced. When your voice isn’t heard, it can become easy to feel as though your voice and your needs don’t matter. As a result, one may internalize this in the process of self-silencing in which one censures their own voice for the sake putting others needs above their own and limiting the relevant importance of their voice as compared to others (Swim, Eyssell, Murdoch, & Ferguson, 2010). Self-silencing is a common phenomenon in experiences of marginalization or objectification such as sexism (e.g., Watson & Groteweil, 2016). However, self-silencing is less studied in females living with chronic pain despite their common experiences with gaslighting which rests upon sexist notions that women’s pain isn’t real or that women are too sensitive. This can contribute to the feeling of incompetence, or the lack of control over one’s outcomes, including their experience of pain, their ability to find treatment options and their prognosis.

           

            In addition to hindering competence, chronic pain can have a negative impact on one’s sense of their own body. For example, studies show a relationship between chronic back pain and distorted body perception (e.g., Moseley, 2008, Flor, Braun, Elbert, & Birbaumer, 1997). These studies provide good evidence for neurological differences in how those with chronic pain perceive their own bodies, however, studies that examine body perception and chronic pain in terms of mental health (i.e. body image) are limited. Research has found that those with chronic pain perceive their pain-affected body areas to be enlarged in comparison to how they once were or in comparison to their other body parts (Bailey, Nelson, Lewis, & McCabe, 2013). Despite this and the fact that our society promotes the “thin-ideal” among women, I can imagine how many women struggling with chronic pain and the resulting feeling of body-part enlargement may also perceive their bodies negatively.

In my experience, chronic pain has caused me to feel as though my bottom half is numb and heavy and ultimately causes me to perceive myself as larger than I may appear to others. Combined with feeling a lack of control over my prognosis and treatment options, my body image has suffered while I figure out how to treat my pain in the meantime. So, apart from what I’m doing already to treat my pain, what can I do? This is a difficult question because the answer may necessitate a paradigm shift. For me, I’ve had to redirect myself away from the notion that women’s value is based on what they look like or how much they weigh. I’ve slowly shifted to self-defining positive body image to incorporate an acceptance-based stance that there are some things that I cannot change—my pain and the associated body perception problems—yet I can do my best to avoid mental suffering over it. Acceptance-based therapies such as Acceptance Commitment Therapy has also been proven to be helpful for others who have chronic pain (Musavi, Mujembari, Abharian, & Pashang, 2018).  In this process, I’ve also attempted to emphasize and prioritize my value in having as much health and low-pain days as possible, regardless of my weight, shape or size. This is a difficult process when we, as women, are told otherwise and that message is reinforced across different domains of life. It is also difficult when our pain is not validated.

The journey with chronic pain can be difficult in ways that extend beyond the distance of our pain itself. For many, this journey can also be long. I hope to keep exploring how to positively live with chronic pain and its effect on my mental health. To those with chronic pain who may be reading this: your pain is real, your struggles with your body are important, and I hear you.

Written by: Kylie Steinhilber   

References

Bailey, J., Nelson, S., Lewis, J., & McCabe, C. S. (2013). Imaging and Clinical Evidence of Sensorimotor Problems in CRPS: Utilizing Novel Treatment Approaches. Journal of NeuroImmune Pharmacology, 8, 564-575. doi: 10.1007/s11481-012-9405-9

Booth, S. (2018, September 05). Is Your Doctor Gaslighting You? Here's What to Do. Retreived from:  https://www.health.com/mind-body/is-your-doctor-gaslighting-you

Flor, H., Braun, C., Elbert, T., & Birbaumer, N. (1997). Extensive reorganization of primary somatosensory cortex in chronic back pain patients. Neuroscience Letters, 224(1), 5–8.

Kiesel, L. (2017, October 09). Women and pain: Disparities in experience and treatment. [Blog post]. Retrieved from: https://www.health.harvard.edu/blog/women-and-pain-disparities-in-experience-and-treatment-2017100912562

Moseley, G. L. (2008). I can’t find it! Distorted body image and tactile dysfunction in patients with chronic back pain. Pain, 140(1), 239–243. doi: 10.1016/j.pain.2008.08.001

Mousavi, S.M., Mujembari, A.K., Abharian, P.H., & Pashang, S. (2018). Effectiveness of Acceptance and Commitment-Based Therapy (ACT Rehab) on Quality of Life, Severity and Duration of Pain in Women with Chronic Low Back Pain. Iranian Rehabilitation Journal, 16(1), 103-110.

Swim, J. K., Eyssell, K. M., Murdoch, E. Q., & Ferguson, M. J. (2010). Self‐silencing to sexism. Journal of Social Issues, 66, 493-507. doi: 10.1111/j.1540-4560.2010.01658.x 

The Country is in an Uproar About the Falsely Accused, But What About the Sexually Assaulted?// Emma Lathan, M.S.

Photo from People.com 

October 6, 2018 was a disappointing, and quite frankly gut-wrenching, day for sexual assault survivors and their families and friends, for those who will be assaulted in the future, and for America as a whole. Many have used Dr. Christine Blasey Ford’s powerful testimony to induce fear about what can happen to males across the country should survivors (90% female) go unchecked: at any given moment, a woman can falsely accuse a man of a crime he did not commit, and it will uproot his entire life (This belief is highly contradictory given Brett Kavanaugh’s recent Supreme Court confirmation, as Dr. Ford’s courageous testimony became nothing more than a minor inconvenience in Kavanaugh’s career). Even the President of the United States of America mocked Dr. Ford and instructed America to “Think of your son. Think of your husband,” as if all men are now in danger of being falsely accused of sexual assault. This mentality is extremely dangerous for all men, women, and children who have been and who will be victimized – it insinuates that false accusations are commonplace and encourages individuals to be more dismissive of survivors than ever before.

In reality, false accusations of sexual assault are extremely rare. Only roughly 10 to 35 percent of sexual assaults are reported to law enforcement in the first place (Planty & Langton, 2013), and of those, an estimated 2 to 10% are deemed to be false (Lisak, Gardinier, Nicksa, & Cote, 2010). According to Joanne Belknap, a criminologist and sociologist at the University of Colorado Boulder, “This puts the actual false allegation figure closer to 0.005 percent…” 

Now let’s look at sexual assault rates. Roughly 36% of women, 17% of men, and 47% of transgender people are sexually assaulted (James et al., 2016; Smith et al. 2017). This means that one in three women, one in six men, and one in two transgender people experience some form of sexual assault in their lifetime. One in four girls and one in six boys will be assaulted before their 18^th birthday (Finkelhor et al., 1990).

Moral of the story: it is MUCH MORE LIKELY that someone will be the victim of sexual violence (36.3% chance for women, 16.7% chance for men, 47% chance for transgender people) than be falsely accused of it (0.005% chance).  In fact, even for your son or husband, it is 3,340 to 9,400 times more likely that they are a victim of sexual assault than falsely accused of it.

Given the #MeToo and #TimesUp movements, women’s marches, and Dr. Ford’s courageous testimony, the country is focused more than ever on the topic of sexual assault. However, many are denying the reality of a nationwide problem by claiming false allegations to be common instead of discussing high base rates of sexual assault and providing support to survivors. Through the current platform that survivors have, I hope that we can shift the narrative around sexual assault from politically-motivated denial of a pervasive problem to focus on prevention of the hundreds of thousands of sexual assaults that occur in the U.S. each year (National Crime Victimization Survey, 2015) and best treatment and support for survivors.

Written by: Emma Lathan, M.S.

Finkelhor, D., Hotaling, G., Lewis, I. A., & Smith, C. (1990). Sexual abuse in a national survey of adult men and women: Prevalence, characteristics and risk factors. Child Abuse & Neglect 14, 19-28. doi:10.1016/0145-2134(90)90077-7

James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). The Report of the 2015 U.S. Transgender Survey. Washington, DC: National Center for Transgender Equality.

Lisak, D., Gardinier, L., Nicksa, S. C., & Cote, A. M. (2010). False allegations of sexual assault: An analysis of ten years of reported cases. Violence Against Women, 16(12), 1328-1334.

National Crime Victimization Survey, 2010-2014. (2015). Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Planty, M., & Langton, L. (2013). Female victims of sexual violence, 1994-2010. U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

Smith, S. G., Chen, J., Basile, K. C., Gilbert, L. K., Merrick, M. T., Patel, N., … Jain, A. (2017). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010-2012 state report. Retrieved from the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control: https://www.cdc.gov/violenceprevention/pdf/NISVS-StateReportBook.pdf

Intentional, Reciprocal Engagement with Feminist Mentoring//Samantha Hinnenkamp M.A.

                Photo Credit: Samantha F. Hinnenkamp, M.A.                 

There’s no doubt that feminist mentorship impacts a (feminist) psychologist-in-training’s trajectory, with positive mentors often being crucial to an individual’s success in learning (Fassinger & Hensler-McGinnis, 2005; Hollingsworth & Fassinger, 2002). In an academic setting, feminist mentoring can be utilized in clinical supervision, meetings with faculty or peers, and within the relationship between chair and student. Furthermore, there are training models devoted to feminist mentoring approaches (Benishek, Bieshke, Park, & Slattery, 2004; Fassinger & Hensler-McGinnis, 2005). However, mentoring can occur in less formal ways between individuals with varying relationships other than “teacher/student”.

Many of us who have benefited from receiving feminist mentorship may have become connected with our mentors in strange or unexpected ways. My first feminist mentor, my high school Spanish teacher, offered me texts on disability activist led movements and international labor-rights organizers after seeing me read a copy of a popular yet dated feminist text written by a White woman from the United States. This mentor was critical in pushing my understanding of intersectionality and the linkage of oppressions. I’m not sure what motivated her to connect with me, but this was beyond the capacity of her formal role as high school Spanish teacher. 

In other instances, we may actively pursue a connection with a specific feminist mentor. When I applied for graduate programs as a senior undergraduate student, I e-mailed a professor with feminist research interests. When I accepted the offer into my MA program, she became my academic advisor. The phrase “psychologists wear many caps” became real quickly, as her impact on my training spanned the realms of clinical supervision, classroom instruction, research, navigating higher education, and advocacy. Similar to previous experiences, she challenged me to push the bounds of my feminist knowledge base and advocacy interests. Beyond her impact on my life as a human being, she was formative to my developing professional identity.

In sum, I encourage you to engage with feminist mentoring. Accept opportunities that develop for feminist mentorship. If you are still a student or in training, you may find yourself in positions to be the mentor to classmates or strangers who engage you in coffee shops. This might feel natural and easy for some. For others, it might feel odd or presumptuous-try it anyway. Connectedly, seek mentorship to challenge your growth. As a feminist mentor of mine has said “the creative power and knowledge base is always stronger in a group than on one’s own”. Be sure to seek mentors who have similar views to you as well as those who diverge. Seeking mentorship may involve e-mailing, networking at conferences, or participating in mentorship matching programs. Consequently, seek opportunities to provide mentorship by building relationships with change agents and those at earlier stages of training.  

References

Benishek, L.A., Bieschke, K.J., Park, J., & Slattery, S.M. (2004). A multicultural feminist model of mentoring. Journal of Multicultural Counseling and Development, 32, 428-422. Retrieved from: https://search.proquest.com/openview/bdb1589e9e5a65889b4d3001c6785dfe/1?pq-origsite=gscholar&cbl=35948

Fassinger, R. E., & Hensler-McGinnis, N. F. (2005). Multicultural Feminist Mentoring as Individual and Small-Group Pedagogy. In C. Z. Enns & A. L. Sinacore (Eds.), Teaching and social justice: Integrating multicultural and feminist theories in the classroom (pp.143-161). Washington, DC, US: American Psychological Association. http://dx.doi.org/10.1037/10929-009

Hollingsworth, M.A., & Fassinger, R.E. (2002). The role of faculty mentors in the research training of counseling psychology doctoral students. Journal of Counseling Psychology, 49(3), 324-330. doi: 10.1037/0022-0167.49.3.324

Reclaiming Intersectional Representations in Comic Books//Abigail Walsh

https://www.bbc.com/news/blogs-trending-45331730

In recent years popular culture has shifted some focus from traditional comic book characters – male, hyper-masculine, white - to characters with more diverse identities. Black Panther broke the box office and was welcomed with critical acclaim (Coogler, 2018). In the excitement for the new Captain Marvel movie, writers have called the female character “the most powerful hero the MCU has ever seen” (Gilyadov, 2018). Marvel has also introduced a Muslim-American female superhero, Ms. Marvel, who is the first Muslim character to headline her own continuing solo series (Berlatsky, 2014). These examples of diversity in comic books is important. People tend to identify with characters who are most like themselves (Bandura, 2001; Hoffner, 1996) and it is important, especially for young people to experience this process of identification through media. We also know that exposure to diverse media can change people’s rigid and stereotypical attitudes (Browne Graves, 1999). It is essential, then, to create media and popular culture that is reflective of the diverse populations who read and consume comic culture.

Despite some of these impressive strides, some individuals and comic creators have found the representation of people with intersecting identities from marginalized communities to be stereotypical or lacking entirely. Some have noticed this and taken control. These creators are working to reclaim characters and stories in the industry that represent people from their own communities

When they can’t see themselves in the comic industry, some comic creators are writing their own stories when. Priya Dali is one such example. Dali explores themes of gender roles as a queer Indian woman. Her recent work explores these gender roles in childhood through “ghar ghar”, or playing house (Chaudhuri, 2018). There are others who do this work. Dozens of transgender writers are working to change representation and have largely been able to do so because of the increasing presence of online comics (Mey, 2014).

Other comic critiques and creators are reimagining mainstream comic book characters. Lifelong comic lover, Sara Alfageeh, became critical of the way Dust, a Marvel X-Men character, was being portrayed (Pierpoint, 2018). Dust is a mutant from Afghanistan and is written as a character with a strong cultural and traditional background, who wears a niqab. However, Alfageeh has leveed critique against Marvel’s choices for depicting a traditional Muslim character. Marvel’s portrayal has Dust in a form-fitting revealing niqab that sexualizes a character who is supposed to be wearing a full body niqab. Alfageeh has created her own illustrations to demonstrate ways in which Marvel could have created modern and interesting clothing for Dust to wear that are more representative of  the ways this character could dress. These illustrations have been getting a lot of fan support online and even attracted the interest of Zac Thompson, an X-Men writer (Pierpoint, 2018).

These creators, and others, are actively working against the historically stereotypical representations of marginalized groups and working to include identities that are often left out of comics, graphic novels, and popular culture entirely. If we have a goal as a society to create a more diverse and inclusive world, one way to accomplish this is by creating diverse and inclusive media. The more diverse voices are, the more stories get to be told.

References

Bandura, A. (2001). Social cognitive theory: An agentic perspective. Annual Review of Psychology, 52, 1–26. doi: 10.1146/annurev.psych.52.1.1

Berlatzky, N. (2014, March 20). What makes the Muslim Ms. Marvel awesome: She’s just like everyone else. Retrieved from: https://www.theatlantic.com/entertainment/archive/2014/03/what-makes-the-muslim-em-ms-marvel-em-awesome-shes-just-like-everyone/284517/

Browne Graves, S. (1999). Television and prejudice reduction: When does television as a vicarious experience make a difference? Journal of Social Issues, 55, 707–727. doi: 10.1111/0022-4537.00143

Chaudhuri, Z. R. (2018, August 31). A queer Indian artist is exploring her sexual identity through a comic book. Retrieved from: https://scroll.in/magazine/890464/a-queer-indian-artist-is-exploring-her-sexual-identity-through-a-comic-book

Coogler, R. (2018, February 14). Black Panther – the most radical superhero yet? Discuss with spoilers. Retrieved from: https://www.theguardian.com/film/2018/feb/14/black-panther-superhero-film-discuss-with-spoilers-ryan-coogler