Author Archives: Susan

APA Speaks Out About Stress

Nearly every year in recent history, the APA has taken the “Stress-Temperature” of this country on at least an annual basis. The most recent article is called Stress in America 2023/A nation recovering from collective trauma. However, even though the title of the article is about a nation recovering from the collective trauma of Covid-19, the news is not good, and recovery is not the topic of the paper. No one can argue that Covid-19 was a traumatic time and it is mostly over. But the stress of so many other crises and problems is building. The APA article points out how much higher the percentage of stress-related chronic illnesses are being seen today. To add to the growing concern about professional stress, the Louisiana Psychological Association Fall/Winter Workshop hosted Dr. Leisl Bryant, a Professional Consultant with The Trust, who spent almost the last hour of her Ethics, Risk Management and Vulnerabilities: Yours, Mine, and Ours presentation talking about stress and the need to manage it in order to remain effective therapists.

I must admit that I was getting tired of writing about stress and stress management every month and I figured the readers are getting tired of it too. However, my thoughts as I read the APA paper and then listened to Dr. Bryant were different. I realized how important it is for us all to take stress management more seriously. In other words, stop putting it off and start doing something on a regular scheduled basis. That was Dr. Bryant’s basic message.

The message of the APA article was full of data about increased and increasing numbers of people who are reporting chronic stress-related illness but denying that they are all that stressed. It is as if people do not want to admit that they are stressed.

According to the APA, adults between the ages of 35 and 44 are showing an increase in chronic illness from 48% in 2019 to 58% in 2023. The article made an important point that we all know but put it in everyday language so that it is more digestible: “Long-term stress puts the body on high alert and as stress accumulates, leads to inflammation, wearing on the immune system, and increasing the risks of a host of ailments, including digestive issues, heart disease, weight gain, and stroke.”

The APA’s yearly survey concluded that many people (81%) felt that their physical health was good even when they also reported (66%) being diagnosed with a chronic illness (high blood pressure (28%), high cholesterol (24%), or arthritis (17%). That is as close to being a river in Egypt as you can get. They also reported an anxiety disorder (24%) or depression (23%). At the same time, the data indicated that people are playing down stress. The reasons given for not
seeking treatment were: therapy doesn’t work (40%), lack of time (39%), or lack of insurance (37%). While we cannot do much about insurance costs and lack of coverage, but our field needs to get busy to change the beliefs that therapy doesn’t work and that people do not have enough time to go to therapy. We need more information into the public.

Then there is the Elephant in the room: Stress Management and how many of us really do it. There are so many ways to reduce stress. Each of us needs to spend a good half hour thinking about all the things we do to reduce stress on a DAILY basis. Make a list and really try to put it into a regular schedule. You can set your iPhone or smart watch to remind you when it is time to take a break.

I went back over the columns posted in the Psychology Times since I started writing them around 2014 and came up with so many possible ways we can pay attention to how stressed we feel at the end of the day and what we can do about it. But, as the Maharishi Mahesh Yogi, the originator of Transcendental Meditation ™ once said, “If you can’t do anything else, Breathe!” Breathing is automatic. Maharishi was not talking about mindless breathing; he was talking about breathing with intention and focus, with mindfulness.

Maybe spend 2-3 minutes every few hours to Pause, and take some slow, deep inhalations.

Louisiana Department of Health Releases Outcomes Report––Meets 91% of its 45 Goals

In a Nov. 27 announcement, the Louisiana Department of Health (LDH) released its annual Outcomes Report detailing the results of key initiatives and policy goals for FY 2023. LDH was successful in completing 91.1% of its 45 goals and 92.5% of its 253 deliverables outlined in the FY 2023 LDH business plan titled “Invest: Teaming Up for a Stronger LDH and a Healthier Louisiana.”

According to officials, goals were selected from a range of policy priorities and include addressing chronic disease; improving maternal health; expanding Medicaid policies that address environmental health risks; expanding the behavioral health system’s capacity; and improving services for citizens with developmental disabilities, among others.

LDH had five major categories designed to make measurable improvements: Improve health and well-being across the lifespan of Louisianans; Support vulnerable and underserved populations; Invest in and empower #TeamLDH; Improve performance, accountability and compliance; and Strengthen customer service, partnerships and community relations.

“Improving health outcomes for all Louisianans is critical, and the Department of Health has made tremendous progress in implementing policies that address some of the biggest health challenges facing our state, including chronic diseases, maternal health, behavioral health and overall access to quality medical care for all of our hardworking individuals and families,” said Gov. John Bel Edwards.

Childhood Experiences and executing trauma-informed care, more families throughout Louisiana can work towards being happier, healthier and readily have access to the care they need,” said Louisiana First Lady Donna H. Edwards.

“The Department’s dedication to addressing the mental health crisis in Louisiana is both commendable and essential. LDH’s involvement in the launch of the Louisiana 988, alongside the efforts of the Office of Behavioral Health, is a significant step towards ensuring Louisianans in crisis have access to the support they need,” said State Representative Laurie Schlegel, District 82.

Tonja Myles, Certified Peer Support Specialist, Set Free Indeed Ministry, said, “Louisiana 988 has quickly proven to be a critical source of 24/7 mental health support. Upon its launch, many Louisianans were unaware of this crucial resource. However, LDH has made significant progress in promoting this important tool, which is becoming more widely utilized and known during a time of mental health crisis in our state. I look forward to seeing the continued usage and promotion of 988, aimed at reaching our most vulnerable residents in their time of need.”

Our WWII Mothers & Sisters in the Military

by Rodney R. Baker, PhD
VA Psychology Historian

The reference to WWII mothers and sisters in the military in this commentary is quite accurate.  Many do not realize that women did in fact directly serve military positions during WWII and have been doing so since the Revolutionary War. I began my VA psychology historian role in the 1980s while still a chief of psychology at the VA Medical Center in San Antonio. In that historian role, I first became interested in collecting stories about women in the military while working on a research project I published with two Vietnam nurses about the military nurse experience in Vietnam. My collection of stories continued when I retired in 2004 and have grown in number. The stories have impressed me with the diversity and impact of women in the military in our nation’s wars as well as their courage and sacrifice. In my historian role I am convinced that history is all about what happened and what happened is a story. I have many stories about women in the military from our nation’s early beginning, and I am pleased to share some of them with you from WWII in this narrative.

Those of you who are reading this and have seen my letter to the editor know that I referred to the WWII Fathers’ articles in the November 2023 Psychology Times as inspiring. The photos in those stories added to their impact, and I would like to start my sharing of stories of WWII women in the military with two photos of exhibits from the Nimitz National Museum of the Pacific War in Fredericksburg, Texas. The first photo notes that nurses were among the first women to arrive at the Normandy beachhead after D-Day and assisted in the operating theater. The second photo shows a woman who served in the Women’s Air Force Service Pilots (WASPs) who ferried aircraft from the factories to air bases, served as test pilots and flight instructors, shuttled officers around, and towed targets for artillery practice.

It is estimated that 350,000 American women joined the military during World War II. They served roles as nurses, drove trucks, repaired airplanes, and performed clerical work. Some were killed in combat or captured as prisoners of war. Over 1600 female nurses received various decorations for courage under fire. As many as 543 women died in war-related incidents, including 16 nurses who were killed from enemy fire. Although U.S. political and military leaders had decided not to use women in combat because they believed that public opinion would not accept such roles, nurses were needed to provide care to soldiers in combat zones and they ignored any technical distinction between serving in combat or serving in combat zones.

The Army established the Women’s Army Auxiliary Corps (WAAC) in 1942, with WAACs serving overseas in North Africa. The WAAC was converted to the Women’s Army Corps (WAC) in 1943. Recognized as an official part of the regular army, more than 150,000 women served as WACs during the war with thousands sent to the European and Pacific theaters. In 1944, WACs landed in Normandy after D-Day with WACs also serving in
Australia, New Guinea, and the Philippines in the Pacific.

The National Archives and Records Administration reports that in September 1942, the Army Air Force (AAF) created the Women’s Auxiliary Ferrying Squadron (WAFS) and recruited highly skilled and experienced female pilots who were sent on noncombat missions ferrying planes between factories and AAF installations. Eventually, over one thousand women completed flight training in the program. As the ranks of women pilots serving the AAF swelled, the value of their contribution began to be recognized, and the Air Force took steps to militarize them. As a first step the Air Force changed their unit name from WAFS to Women Airforce Service Pilots (WASP). Thirty-eight WASPS died in accidents in their assigned duties. Women were finally recognized as a permanent part of the U.S. armed forces with the passage of the Women’s Armed Services Integration Act of 1948. However, they were not granted veteran status until 1977, and finally only became eligible for the Congressional Gold Medal in 2009.

Records at the National WWII Museum in New Orleans note that among the more than 27,000 American military personnel held as POWs in the Pacific were 77 US military nurses. The women, members of the Army Nurse and Navy Nurse Corps, would come to be known as the “Angels of Bataan and Corregidor.” Taken prisoner in the Philippines, the nurses were held with POWs in the Santo Tomas and Los Banos Internment Camps. In those critically undersupplied internment camps, they were able to provide vital professional care to all Allied POWs held there. Santo Tomas became a POW city of roughly 6,000 people The nurses helped to establish the Santa Catalina Hospital on the grounds of that camp and did their best to help stem epidemics in the overcrowded camp as well as organized a public health campaign in the most unsanitary conditions. They treated patients with minimal supplies in spartan conditions for accidents, disease, and malnutrition. The weight loss due to starvation in the camps averaged around 32 percent of an individual’s body weight. The American nurse POWs were not just waiting to be liberated, they were fighting to survive and to ensure the survival of others for whom they were proving care.

Miraculously, all 77 of the nurse POWs survived the almost three-year long imprisonment from May 1942 to February 1945, The Army nurses were liberated from Santo Tomas in early February of 1945. I have added a photo from the National WWII Museum in New Orleans that shows that the Navy Nurses, who had been moved to the Los Banos Internment Camp, were liberated three weeks later. After liberation, the Angels of Bataan and Corregidor received little recognition as military prisoners of war. But most of the nurses said that they did not do anything extraordinary, they were just doing their jobs.

I will finally note that the Military Women’s Memorial (described at
https://womensmemorial.org/) was established by a grateful nation to honor women who have served in or with the United States Armed Forces. It is unique in inviting military women to register and submit their stories, thus preserving those stories for future generations. The memorial is located at the gateway to Arlington National Cemetery in Virginia, USA. Dedicated in 1997, it is the only major U.S. national memorial that recognizes the courage and patriotism of an estimated three million women who have defended their country throughout history starting with the Revolutionary War.

Dr. Erin Richard Helps with Novel School Design

by James Glass

Dr. Erin Richard, Associate Professor in the School of Leadership & Human Resource Development and Louisiana State University (LSU) has helped pave the way for two traditional elementary schools in the East Baton Rouge Parrish School System to transform into magnet schools.

Superintendent Sito Narcisse has proposed converting two Baton Rouge elementary campuses into health care and environmental education programs. These two programs would be backed by Baton Rouge General Medical Center and LSU, according to a report in The Advocate.

Dr. Richard, who holds a PhD in Industrial and Organizational Psychology from LSU, has applied her expertise and conducted evaluation workshops on the teachers being brought on board to launch the new program in the East Baton Rouge Parish School System.

The two schools being proposed are Park Elementary and Polk Elementary. Superintendent Narcisse’s proposal noted that Park Elementary would then add a middle school and the name would change to Park Elementary Medical Academy. Polk Elementary would become a sixththrough-12th-grade school and would be renamed the Eva Legarde Research Center for Coastal Studies and Environmental Studies.

In a memorandum from Superintendent Narcisse, the Eva Legarde Research Center for Coastal Studies and Environmental Studies would be based on a phase-in approach, with 50 students per grade level or approximately 350 students. Successful participation in this program is an asset for students interested in pursuing their post-secondary studies at LSU.

Narcisse explained that professional development, both at the district level and in partnership with LSU, is a crucial component to ensure that teachers have the expertise and support to ensure that the program is implemented with fidelity.

This is where Dr. Richard’s expertise plays a key role in the successful completion of professional development. As a faculty member in the LSU School of Leadership and Human Resource Development, Dr. Richard teaches courses on work stress and health, organizational needs assessment, program evaluation, and quantitative research methods.

Dr. Richard consults with local organizations to provide services such as training needs assessment, program evaluation, leadership development workshops, and survey design and
analysis.

Her research focuses broadly on the promotion of worker well-being, with a focus on topics related to emotion, self regulation, interpersonal communication, and leadership.

Dr. Richard is currently examining how organizational leaders manage negative emotion and promote resilience in followers.

“This is a dream coming true before our very eyes,” Edgardo Tenreiro, chief executive officer for Baton Rouge General, told the board. Tenreiro said Baton Rouge General has a school of nursing that the Park Elementary program could feed into, noting there’s a shortage of nurses right now.

Christopher D’Elia, dean of LSU’s college of coast and the environment, said the college has successfully partnered for years with science-minded students at Scotlandville High and he sees the new Eva Legarde school as an opportunity to expand on that. “I’m looking for more of the same and better, and I just can’t tell you how excited we are about this opportunity,” D’Elia said.

Dr. Richard has conducted applied research funded by the Office of Naval Research in partnership with the Naval Air Warfare Center Training Systems Division (NAWCTSD), and she has collaborated on projects funded by the Educational Testing Service (ETS) and the National Institute for Occupational Safety and Health (NIOSH). She has also consulted with local organizations to provide new manager training.

Her focus is on intrapersonal and interpersonal processes related to emotion in the workplace, the promotion of worker well being, with a concentration on topics related to emotion, self-regulation, interpersonal communication, and leadership. Her research Interests include Industrial and organizational psychology, work stress and health, leadership and emotion Interpersonal emotion management, work motivation, cyber-aggression and workplace
neurodiversity.

She has published her research in academic journals such as Journal of Applied Psychology, Personnel Psychology, Organizational Behavior and Human Decision Processes, Occupational Health Science, and many others.

Dr. Richard’s publications include:

Matey, N., Sleiman, A., Nastasi, J., Richard, E. M., & Gravina, N. (2021). Varying Reactions to Feedback and their Effects on Observer Accuracy and Attrition. Journal of Applied Behavior Analysis, 54(3),1188-1198.

Richard, E. M. (2020). Promoting employee resilience: The role of leader-facilitated emotion management. Advances in Developing Human Resources, 22(4)*, Special Issue on Resilience and HRD (J. Mendy & M. Bal, Issue Eds.) Issue awarded the 2020 Best Issue Award from the ADHR editorial board.

Richard, E. M., Young, S. F., Fischer, J. J., & Giumetti, G. W. (2020). Unique effects of cyberaggression on victims’ counterproductive work behavior via rumination and negative emotion. Occupational Health Science, 4, 161-190.

Richard, E.M. Fischer, J. J., & Zhou, Z. E. (2019). Cyberbullying in the Workplace: Cross-cultural Issues. In G. Giumetti and R. Kowalski (Eds.), Cyberbullying in Schools, Workplaces, and Romantic Relationships: The Many Lenses and Perspectives of Electronic Measurement. Routledge/Taylor Francis.

Dr. Richard received her PhD in Industrial Organizational Psychology from Louisiana State University. She is Assistant Professor in the School of Leadership and Human Resource Development, in the College of Human Sciences & Education at Louisiana State University. She serves on the editorial board of the Journal of Business and Psychology, Organizational Behavior and Human Decision Processes, and the inaugural board of Occupational Health
Science. She is also a member of the Academy of Human Resource Development, the Society for Industrial and Organizational Psychology, and the Society for Occupational Health Psychology

An Ounce of Prevention

The third reason for death in the U.S. is unintended outcomes of medical treatment. A study by Martin Makary, MD, then a professor of surgery at Johns Hopkins University School of Medicine, found that medical errors–comprise the third leading cause of death in the U.S.

“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” Makary said to The Washington Post.

We know about some of these problems. When the specialists go on vacation the mortality drops. For the one out of 1,000 women saved by mammography, up to 10 healthy women will be treated needlessly. A third of FDA approved drugs have been found to later have safety issues.

However, in a comparison of age-adjusted deaths from all causes, the World Health
Organization ranks the United States last in similar countries. At the same time, Louisiana
ranks 50 of all the states.

For this report, we look at the barriers to providing prevention, rather than the expensive and dangerous treatments now provided by the medical and pharmaceutical industries.

Consider an example from mental health. Imagine that a patient with psychosis is given nutrients. She improves her quality of life to such a degree that she no longer needs yearly hospitalizations, which, along with other expenses, amounted to $500,000 of costs over a five-year period.

Dr. Bonnie Kaplan, Professor Emerita in the Cumming School of Medicine at the University of Calgary, in and expert in the field of nutritional mental health, thinks this type of prevention might save lives and money. Kaplan publishes widely on the biological basis of developmental
disorders and mental health – particularly, the contribution of nutrition to brain development and brain function. 

In her “Hospitalization cost of conventional psychiatric care compared to broad-spectrum micronutrient treatment,” in International Journal of Mental Health Systems, Kaplan points to
dramatic savings for those patients that respond to nutritional interventions. Nutrition is one of the innovations in illness prevention that has been neglected for decades. Other basic approaches include behavioral and psychological treatments for lifestyle based illnesses, equally as costeffective.

Prevention requires tools that are often unfamiliar because educational, behavioral, and social interventions, not usually considered to be part of medicine, may be most effective for many diseases,” said Hamilton Moses and co-authors in, “The Anatomy of Health Care in the United States,” in an article of the Journal of the American Medical Association.

While medical costs are driven by chronic disease, it is not due to an aging population, even though age is often cited as the cause. Moses shows that about 80 percent of the total health care cost is accounted for by those under 65, and relate to psychological, social and behavioral elements. The CDC estimates that three lifestyle factors––poor diet, inactivity, and smoking–– account for 80 percent of heart disease and stroke, 80 percent of type 2 diabetes, and 40 percent of cancer.

“Behavioral intervention is the foundation for lifestyle medicine,” writes Dr. John Caccavale, author of Medical Psychology Practice and Policy Perspectives. “Of the top four classes of medical problems in America – metabolic disorders, respiratory disease, cardiovascular disease, and mental disorders – physicians will have great difficulty demonstrating that they are improving patient health by utilizing medications as a first-line treatment for these classes of disorders,” writes Caccavale.

“I think wellness/prevention are areas where there is tremendous need in primary care,” said health psychologist Dr. Michelle Larzalere.

“For both physical and mental health, the need to work on active problems is often so high that wellness/prevention get shorted on attention,” Larzalere said.

“The health habits that most reduce the preventable component of the most prominent causes of morbidity and mortality in the US, –for example, refraining from smoking, eating a healthy diet, getting regular exercise, and limiting alcohol consumption– are behaviors that psychologists can really impact positively. Unfortunately, at least in my experience, other needs are so great that it is hard to make time for wellness/prevention initiatives unless there is a specific plan put in place.”

Author of Health Psychology, Dr. Linda Brannon said, “The division of health into mental and physical health is a false dichotomy that we need to get over. I think that many providers address the presenting problem to the extent that they do not look beyond it.”

For decades now, psychological scientists have known that behavior is the key to costs.  Larzelere explained that psychological scientists have agreed that those using an integrated care model can expect a 30 to 60 percent reduction in medical use costs.

Quality care and cost savings dovetail at the primary care level. To put this in perspective, a 10 percent reduction in medical/surgery costs nationwide –by treating the mental or behavioral
component– would exceed the entire current national mental health budget, she explained.

She is correct. Prior to Covid, CMS and The National Health Expenditure Accounts reported that healthcare spending reached $3.5 trillion in both public and private sources. This is $10,739 per person. And accounts for 17.9 percent of the Gross Domestic Product.

A ten percent savings, as Larzelere suggests, is $350 billion. Estimating savings at 30 percent could mean a savings of $1 trillion dollars.

Is all this spending doing anyone any good?

A pattern of poor health outcomes and high costs reflects the country as a whole. The United States ranks 50th out of 55 industrialized countries in a measure of life expectancy and medical care spending, according to Bloomberg, who concluded the U.S. is the “least-efficient” health-care system in the world.

Louisiana is always at the bottom. In the most recent report from America’s Health Rankings, an annual analysis of the United Health Foundation, Louisiana ranks No. 50.

The state has its challenges. Nearly 21% of the population of the state is at the poverty level or below, when only 12 1/2% of the citizens nationwide fall at this level of economic status. Over 41% of the citizens a Louisiana fall at 200% of the poverty level or below. Compare this to 29.75 percent nationwide.

Health is woven into a complex set of social and psychological behaviors, not a single cause. “Socioeconomic status is one of the most powerful predictors of all cause mortality,” says Dr. Chris Leonhard, health psychologist and Professor at the Chicago Professional School at Xavier. “New Orleans is a startling example of this,” Leonhard said. “Life expectancy at birth in the Tremé where the average household income in 2010 was about $26,000 is 55 years, while in Lakeview, the average 2010 household income $75,000, and life expectancy at birth is 80 years.”

Pre-Covid, Louisiana paid $10.7 billion on behalf of about 1.9 million Medicaid recipients, averaging about $5,694 per recipient, according to the Louisiana Department of Health.
During the fiscal year 2017–2018, about 39.6 percent of Louisiana’s population were enrolled in the Medicaid program and payments were made on behalf of 1,876,908 recipients.

However, according to an analysis by Blake Kruger and Jeremiah Brown, Louisiana spends the most on Medicare beneficiaries per capita than any other state. At the same time, we reports greater disparities in health status and death rates than other states.

Kruger and Brown investigated the associations between healthcare intensity, healthcare spending, and mortality in Louisianan Medicare beneficiaries. They defined healthcare intensity to be synonymous with the hospital care intensity index, a combination of inpatient days and physicians’ services.

The researchers found no association between healthcare intensity and spending. Nor did they find any association between spending and mortality, noting, “We also observed no association between health-care spending and age, sex, and race-adjusted mortality.” And, when they compared healthcare intensity to age, sex, and race-adjusted mortality, they could find no meaningful associations. Nor did they find than more spending made any difference in survival when adjust for smoking, inactivity, or obesity.

They concluded, “We found that no associations exist between healthcare intensity and spending, spending and mortality, as well as healthcare intensity and mortality. The lack of an
association between healthcare intensity and spending may indicate that outpatient care in Louisiana is becoming more highly utilized and thus our measure of inpatient care intensity
is becoming less sensitive. These findings may also reflect that spending more on healthcare in Louisiana may not improve rates of survival and should prompt reflection as to the role social programs play in producing more auspicious health outcomes for Louisianans.”

Healthcare is Designed by Special Interests

The sheer size and complexity of the healthcare industry would suggest that innovations would be challenging, but change may be even more unlikely because of the political power yielded by the industry. Over the last years the pharmaceutical industry, Blue Cross/Blue Shield, the American Hospital Association, and the American Medical Association were the some of the highest contributors to Congress.

Psychology and other groups have not been able to garner a place at the medical table. California Attorney David Ries of Human Capital Specialists tried to persuade federal Rule makers to include psychologists in the bonus plan for Accountable Care Organizations (ACOs) but failed. He told the Times that the final Rules were very disappointing, and said, “The broad recognition of the importance of behavioral health to overall wellness indicates that ACOs are unlikely to achieve their treatment objectives …”.

These special interests exert themselves not only through direct lobbying, but the medical-pharmaceutical-hospitalinsurance industrial complex has a firm hold on the prices and services through the “CPT Codes” and the “Relative Value Scale Update Committee” or RUC. These special interest groups decide what services are allowed and how much they are reimbursed.

The CPT codes, short for Current Procedural Terminology, control what services are allowed and reimbursed. The codes are created by three hundred “Advisors and Experts,” primarily from the American Medical Association’s House of Delegates, representing medical specialties, who attempt to influence an “Editorial Panel,” composed of representatives from medical societies, insurance companies and the government. This panel conducts secret meetings and decides on what healthcare services are paid for, and which are not.

Dr. Tony Puente, Past-President of APA, was one of the two outsiders allowed to participate in the CPT process. “Essentially,” he said, “the CPT tries to divvy it up in a way that is theoretically and empirically, and diplomatically and politically, correct.” Participants must sign a strict AMA (American Medical Association) confidentiality agreement and declare, “I will not disclose, distribute or publish confidential Information to any party in any manner whatsoever.”

To decide on reimbursement, 28 voting members on RUC, representing medicine specialties such as anesthesiology, cardiology, neurology, neurosurgery, obstetrics, oncology, psychiatry, and so on, meet and decide how much each service is worth, and how much is to be paid.

The CPT system is dominated by organized medicine. “Every seat at the table has a vested interest, mostly not supporting your proposed code,” said Dr. Travis Thompson, professor, psychologist, and leader in the Association for Behavior Analysis International. He was speaking after it took him and colleagues three years to muscle through codes for the treatment of autism.

While the CPT approval is a first leg of a long journey, another element of this behind-the-scenes influence is the panel known as AMA/ Specialty Relative Value Scale Update Committee, or RUC. Since 1991 members of the RUC establish the value or price for the CPT codes.  Somehow this is not considered price-fixing.

Control of the CPT and RUC have helped shaped health care toward high technology and high prices, less primary care, and no prevention.

A dramatic example of flawed decisions in the medical/pharma industrial complex is the opioid crisis. Twenty years after a marketing blitz aimed at convincing physicians that opioids were safe and effective, the overprescribing of this heroine-type drug has catapulted overdose deaths to the highest rate in modern times.

Despite the flood of legal opioids into the society, the CDC reported no change in pain that would meaningfully drive the prescribing: “…there had not been an overall change in the amount of pain that Americans reported.”

In contrast, the CDC did find that psychological and physical treatments for pain were beneficial (“CDC Guideline for Prescribing Opioids for Chronic Pain”). This despite the fact that these non-medical approaches are rarely integrated into
treatment programs.

And, they were often the more appropriate treatment. “It is now widely accepted that pain is a biopsychosocial phenomenon,” clinical health psychologist and Past-President of the Southern Pain Society, Dr. Geralyn Datz said, and that must be treated as such.

Conclusion

Dramatic changes are needed in the structure and function of the healthcare institutions currently used for the state and the nation. Individuals will need to be treated for root causes,
which will be more behavioral and psychological in nature than the current methods or models.

Louisiana may have the most to gain from prevention and innovations of any state in the nation. But there is a long way to go.

“A bright new future of understanding, preventing, and treating mental disorders awaits us,” writes Bonnie Kaplan.

But just how long is that wait going to be?

 

 

Bah Humbug

A review of 
by Alvin G. Burstein

The approach of Christmas stirs up memories—and a wish. Some of the memories reflect my  confusions about the holidays as a child.

Both my parents were Russian immigrants. Mother was an observant Jew. Although my father had spiritual interests reflected in his Masonic studies, he did not follow Jewish religious practices. He sold Christmas trees in the Mom and Pop grocery he ran with my mother. More- over, he donated trees to our public school classroom, and erected one in our home–no doubt provoking Russian language conversations with his wife indecipherable by us children.

And I recall a second grade experience of being excused from participating in singing a Christmas carol with the rest of my classmates. I wanted to sing, too, but I understood the exclusion to be an expression of our teacher’s sensitivity to religious difference. That motivated me to hide both my disappointment my curiosity about the meaning of the mysterious term “ronyon virgin.”

Those memories, and the imbedded feelings, may have contributed to the wish to re-read Dickens’ story, A Christmas Carol, and my viewing a couple of film versions of that tale. The 1830 story is a classic, demonstrated by its having spawned at least eight film versions and by the tale and its reincarnations continuing to shape our views and feelings about the holiday. Of the many film adaptations, I looked at two: the first a re-mastered 1935 version staring Alistair Sim, the second a 2009 3-D Walt Disney/ImageMovers’ effort.

The power of the tale lies in its being a story of a redemption, one that depends on the recapturing of Scrooge’s forgotten past, the curative effect of which is at the heart of psychodynamic therapies. The pathogenic node of Scrooge’s forgotten past is the terror of parental rejection, a potential theme that accounts for the popularity of the classic tales of abandonment and adoption from Bambi and Orphan Annie to Harry Potter.

The Dickens story starkly contrasts happy families, the Fezziwigs, that of Scrooge’s nephew and the Cratchits, with the lonely Scrooge, abandoned as a school child. That theme is deepened by the climactic adoption of a resurrected Tiny Tim by the healed Scrooge.

Though his story antedates Freudian theories of psychosexual orality, the link between being loved and being fed is manifested in Dickens’ emphasis on opulent feasts for the fortunate and deprivation and hunger for the wretched, and his depiction of Scrooge as having two selves, a mean, calculating, unloving self, and a disowned emotional one. That in his redemption the second replaces the first rather than being integrated with it may be a flaw, psycho-dynamically speaking.

That might account for a manic element in Scrooge’s “recovery:” his ebullience, his hyper-activity and his showering of money on others. Here is an illustrative excerpt from Dickens:

“I don’t know what to do!” cried Scrooge, laughing and crying in the same breath and making a perfect Laocöon of himself with his stocking. “I am as light as a feather, I am as happy as and
angel, I am as merry as a school-boy. I am as giddy as a drunken man. A merry Christmas everybody. A happy New Year to all the world. Hallo here! Whoops! Hallo!”

It may be over-pathologizing to raise a question about the durability of such an excess. On the other hand, it may be Dickens’ contribution to our contemporary demand for unmitigated happiness during this holiday, a demand that opens the door to disappointment and holiday depression.

A final comment specific to the DVDs: Both are very close to the Dickens text in the sense of using much of the dialogue from the original. The Walt Disney version is stunning in its visual effects, actually overindulging by stressing the terror of flling and eeriness, thus distracting from the more psychological issue of deprivation. It begins with a prequel in which Scrooge takes the coins from the eyes of Marley’s corpse, sniggering “Tuppence,” a scene that highlights his avarice in way that many children would find upsetting. Scrooge’s animated cartoon presentation, scrawny and desiccated, underlines his emotional starvation but lends him and the other Disney characters a one dimensional quality.

Paradoxically, Sims’ 1935 black and white Scrooge, though more dated, is more real, making it easier to empathize with his pain. In fact, this version elaborates Scrooge’s abandonment by attributing it to his mother’s having died in childbirth. Because Sims’ Scrooge is more real, this version is the one I prefer.

Ψ We Remember Dr. Tommy Stigall

Dr. Tommy T. Stigall passed away on October 15, 2023, after struggling with cardiovascular problems for several years. He was 89.

A licensed clinical psychologist, he was born in Kentucky but was a 64- year resident of Baton Rouge, where he enjoyed a complex career in psychology that included state employment, private practice, and consulting activities.

Dr. Stigall is best known for his unflinching dedication and comprehensive leadership in advancing the profession of psychology at both the state and national levels. He was there when Louisiana psychology was still a fledgling profession, he was there when it sought independence, and he was there to nurture its development for a span of fifty years.

A past president of the Louisiana Psychological Association (LPA), Dr. Kim VanGeffen, said, “Tommy was a great leader and supporter of the Louisiana Psychological Association and also of the American Psychological Association. He had great wisdom. Tommy also took the time to reach out to me and offer me guidance when I was president of LPA in 2000 and I will forever remember his kindness and support.

Current LPA president, Dr. Jesse Lambert, said, “Dr. Stigall’s passing is a tremendous loss for the psychology community. As a newly licensed psychologist, I had the privilege of meeting with Dr. Stigall to discuss the legislative history of psychology in Louisiana. His dedication and energy ultimately led to groundbreaking advances for psychology as a profession.”

Dr. Stigall accomplished a bridge between the national and the state organizations. In the American Psychological Association (APA) Dr. Stigall served on the Board of Professional Affairs, on the Board of Educational Affairs, and on the Committee for the Advancement of Professional Practice (CAPP). He served on the APA Council of Representatives for over ten years, representing Louisiana during times of change and challenge.

He was also a Fellow in APA and served as President of Division 29 (Psychotherapy) and on the division’s Board of Directors.

He served on the Board of Directors and Member-At-Large for Division 42 (Independent Practice). And he was a member of the Society of Clinical Psychology (Div 12), the Division of State Psychological Association Affairs (Div 31), and the American Society for the Advancement of Pharmacotherapy (Div 55).

Dr. Stigall served on the APA Committee on State Legislation from 1974 to 1979, and as Chair in 1977, on the Oversight Committee on Public Policy and Legislation, on the Joint Council on Professional Education in Psychology, and on the Interim Board of Education Affairs.

He served as Chair for the APA Panel on Education Standards, Quality Assurance and Enhancement for the Board of Educational Affairs, the Task Force on Marketing and Promotion of Psychological Services, as a member of the Steering Committee for the National Conference on Postdoctoral Training in Professional Psychology, and as Chair and member of the Commission for the Recognition of Specialties and Proficiencies in Professional Psychology.

He was President of the Association of State and Provincial Psychology Boards (ASPPB), served on its Executive Committee, and he was a Fellow of ASPPB.

“In all of these,” Dr. Stigall once said in a 2011 Times interview, “and in other roles as well, there were many satisfactions. But the greatest pleasure came from the personal contacts and relationships that grew out of working with colleagues across a wide range of roles and settings.

“I got to know and work with people like Ray Fowler, Mattie Cantor, Ron Fox, Pat DeLeon, Arthur Kovacs, …” and many others he explained. “Their wise counsel and dedication to advancing psychology as a profession has been an inspiration to me.”

Dr. Pat DeLeon, former APA President, said “Tommy Stigall was an extraordinarily sensitive individual who cared so much for the future of psychology and ultimately its patients and communities. Often purposefully the individual ‘behind the scenes,’ he worked tirelessly to facilitate the efforts of others in fulfilling his vision for an expanded profession. He appreciated the critical importance of state association generated efforts and often shared Louisiana’s Lessons Learned with colleagues across the nation. He was active at the national level, where he would generously educate the next generation of psychology’s leaders, while most importantly installing trust in their efforts for meaningful social change.

“It was a pleasure and distinct honor to be able to call Tommy a colleague and close personal friend. We will miss him greatly. Aloha,” said Dr. DeLeon. Dr. Stigall’s concurrent service at the state level was extensive.

He served as Chair of the Legislative and Social Issues Committee for the Louisiana Psychological Association for 14 years, from 1974 to 1988, a time that included repeal of the statutory requirement for consultation and collaboration with a physician. He served as President, Secretary-Treasurer, and as committee chair for Psychological Evaluations. He served as APA Council Delegate for eleven years, from 1990 to 2001. And, he was the Editor and Associate Editor of the Louisiana Psychologist from 1993 to 2000. His wife Connie served along side him as Executive Director during much of this time.

Dr. Stigall served as Chair, Vice-Chair, and member for the Louisiana State Board of Examiners of Psychologists, from 1972 to 1975. And he was President of the local regional group, Baton Rouge Area Society of Psychologists.

Colleague and head of psychology at the Louisiana University Monroe, Dr. Bill McCown said, “Tommy’s passing is truly sad. Tommy worked tirelessly for Psychology in Louisiana and beyond. Our profession was his passion.

“I remember Tommy saying once that psychologists underestimate their ability to help change lives. ‘We simply underestimate our skills and what our research shows we can do. We can probably do it better than most professions.’ Tommy never stopped telling that to colleagues, legislators or professionals with different training than our own. ‘That’s a task that a Psychologist should do,’ he was fond of saying,” Dr. McCown said. “That was a long time ago. Our profession has come a long way, partly thanks to his efforts and advocacy.”

Over the years, Dr. Stigall’s efforts have been acknowledged by his colleagues in both national and state organizations.

He was awarded the Outstanding Advocate for Psychology by the Association for the Advancement of Psychology. He received the Karl F. Heiser Presidential Award from APA, an honor to those who have given their time to help define and advance psychology through state and federal legislation.

The Louisiana Psychological Association honored Dr. Stigall with the award for Contributions to the Profession of Psychology in Louisiana in 1982, and again in 1984 with the Continuing Contributions to Psychology Award.

In 2012, LPA created the Tommy Stigall Louisiana Psychology Award, named in honor of lifetime contributions of Dr. Stigall to psychology in Louisiana.

He has been honored with the Award for Special Achievement, and also the award in Recognition of Outstanding Contributions to State Psychological Affairs, by the APA Division of State Psychological Association Affairs.

The National Academies of Practice named him as Distinguished Practitioner in 1991. He was awarded for Distinguished Services and Valued Contributions in 1989 and the Distinguished Psychologist Award in 1990 by the APA Division of Psychotherapy.

Dr. Stigall earned his undergraduate in Speech – Radio Journalism from Baylor University in 1956 and his masters in Counseling Psychology in 1958. Shortly after, he joined the United States Air Force. He attained the rank of Captain upon leaving the Reserves. In 1966 he earned a PhD from Louisiana State University (LSU) in Clinical Psychology.

In 2011 we asked him how it happened that he became a psychologist?

“There is a little story that goes with this answer,” he told the Times. He majored in Speech, Radio, and Journalism as an undergraduate at Baylor. But he needed a way to delay his entry into the military from his ROTC training––because of romance.

“In my senior year,” he said, “I started dating my future wife, a freshman co-ed named Connie Bankston.” He entered the Baylor masters program in counseling psychology, which gave him time to court Connie. By time for graduation, both he and Connie had their respective degrees and he was commissioned as a second lieutenant in the USAF. “We married in the summer of ’58 and I was ordered to report soon thereafter for active duty.”

After fulfilling three years in the military, he decided to apply to LSU’s doctoral program in clinical psychology, his stipend requiring that he work for the state after graduation. This led to Dr. Stigall being employed as a staff psychologist at the Baton Rouge Mental Health Center, and then he was appointed Chief Psychologist. He subsequently was appointed Manager of Psychology and Training in the Office of Mental Health and Substance Abuse, Louisiana Department of Health and Human Services.

He opened his private practice in 1983, The Psychology Group, in Baton Rouge providing services to individuals, hospitals, federal groups, and the Social Security Administration. He also served as a complaints investigator for the Louisiana State Board of Examiners of Psychologists. He also served as Medical Expert for the Office of Disability Adjudication and Review of the Social Security Administration.

He published twice in American Psychologist. For “Behavioral Science and social conscience,” he wrote, “If behavioral science, as science, is to contribute to the solution of man’s social and psychological distress, it can best achieve this objective by a technology of control which is scrupulously noncoercive, thoroughly public, and exceedingly patient.”

Dr. Stigall was suggesting caution in answer to then APA President Kenneth Clark’s proposal for a program of biochemical intervention to curb aggression in both criminals and world leaders. He was respectfully pointing out to the national psychology community the paradox and moral danger in such a viewpoint.

He also coauthored the 1993 article on “National Conference on Postdoctoral Training in Professional Psychology.” Other articles include “The evolving profession of psychology: Comment on Lowe Hays-Thomas’ (2000) “The Silent Conversation,” in Professional Psychology: Research and Practice, and “Masters vs. doctorate debate,” in The Independent Practitioner.

His book chapters include “The struggle in the states,” in M. T. Sammons, Prescriptive Authority for Psychologists: A History and Guide, and “The impact of accreditation on the professional practice of psychology,” in E. M. Altmaier’s, Setting Standards in Graduate Education: Psychology’s Commitment to Excellence in Accreditation.

With Dr. Wayne Greenleaf he authored, “Psychology and Public Law,” in The Clinical Psychologist, 1978, and also in The Clinical Psychologist, “Sunset on licensure: Are professional ethics enough?” in 1981.

Dr. Stigall retired from clinical practice in 2004 and engaged in what he called his “lifelong serious interest in photography.” He additionally served as President of the Louisiana Photographic Society. His work was accepted in juried competitions and he won two first places in the Louisiana Press Association for photos in the Psychology Times.

About the man himself, Dr. McCown said, “On a personal level, he was always there for colleagues, available for questions, consultation, or simply if you needed advice or to vent. He was thoroughly professional but also profoundly kind and empathetic. Tommy believed that people could get better and do better. He believed that Psychology offers a unique opportunity to help people be their best selves. That belief is how I will remember him.”

Dr. Tommy Stigall is survived by his wife of 65 years, Constance Carolyn (Bankston) Stigall. He is also survived by his two children Lisa Edmunds and Stuart Stigall and their spouses John and Lisa, and grandchildren Hannah and Gregory Edmunds and Matthew Stigall.

 

 

Gov. Congratulates Rep. Johnson

On Oct. 25, after more than three weeks of struggling in the U.S. House of Representatives, Louisiana Rep. Mike Johnson, a conservative from Shreveport and an LSU educated Constitutional attorney, was elected Speaker of the House.

In a press release from October 25, Gov. John Bel Edwards said, “Congratulations to Louisiana’s Mike Johnson on his election as Speaker of the United States House of Representatives. In Louisiana, despite our differences, we have found ways to work across party lines to guide our state through challenges and deliver progress for our people. I hope that Speaker Johnson can bring these Louisiana values to Washington.”

On the same day, the Louisiana Democratic State Party Chair Katie Bernhardt also issued a press release saying that Mike Johnson was a “threat to democracy,” and that he was a “radical MAGA and Freedom Caucus member.”

Johnson is the representative of Louisiana’s fourth congressional district. He is 51 years old. Born in Shreveport, Mr. Johnson is the oldest son of Jeanne Johnson and firefighter James Patrick Johnson. He has three younger siblings.
Mr. Johnson received his high school diploma from Captain Shreve High School in Shreveport. In 1995, he graduated with a bachelor’s degree in business administration from Louisiana State University. After finishing his undergraduate studies, he went to Louisiana State’s Paul M. Herbert Law Center, earning a Juris Doctor in 1998.

Mr. Johnson and his wife, Kelly, have four children: Hannah, Abigail, Jack, and Will. According to sources, Mr. Johnson is a devout Christian, has been the host of a conservative radio talk show, a columnist, a college professor, and a constitutional law seminar instructor.

 

Foods that can help fight off Everyday Stress

Any acute stressor triggers the same physical reaction to stress, like nerves before a presentation or finishing an article on a schedule. We all are subject to stresses in ordinary life. Concepts such as Acute vs Chronic Stress have been frequently discussed. The many and varied ways to reduce stress and the importance of reducing it have often been a subject of this column. Many people don’t know, however, that a varied and balanced diet can really help you deal with the physical responses your body automatically produces to daily acute stress. We all recognize the hormone, Serotonin, which is linked to our mood. But, did you know that 90 percent of Serotonin is produced in the gut – not in the brain? And, if the cells in the GI tract have access to the correct nutrients, they can produce more Serotonin. Apparently, it comes down to eating foods that contain an essential amino acid known as Tryptophan, which then produces Serotonin. We cannot make tryptophan naturally so we must ingest foods that contain it. Tryptophan can be found in food; Serotonin cannot.

The answer is not foods high in refined sugar. Such foods can actually impair brain function. Research on nutrition says that our bodies crave variety, a mix of vitamins, minerals, fatty acids, protein, and carbohydrates in order to boost levels of balancing hormones, like Serotonin.

Some foods help reduce Cortisol, which is another well-known hormone linked to stress. Cortisol increases inflammation. Fruits like blueberries are full of antioxidants and vitamin C, which reduce levels of Cortisol in the body. Avoid inflammation-increasing foods such as refined sugar, alcohol, refined grains, trans fat, and saturated fat. Some dietary experts recommend use of 100% maple syrup and coconut sugar as substitutes.

Anyone familiar with the Harry Potter books will recall that Professor Lupin gave Harry Dark Chocolate whenever he was stressed. Dark chocolate also reduces Cortisol. Dark chocolate also has compounds called flavanols which are thought to relax blood vessels, improve blood flow, and decrease blood pressure. Milk chocolate and white chocolate do not do nearly as good a job as dark chocolate.

Fruits and vegetables boost Serotonin. Bananas in particular, boost Serotonin. Spinach, Swiss Chard, pumpkin seeds, edamame, avocado and potatoes are all good sources of magnesium, which reduces Cortisol and promotes good sleep. Oranges, broccoli, sweet potatoes, peas and cucumbers are rich in Potassium. Veggie sticks with hummus work as well.

Fish, particularly oily fish as we noted last month, can reduce anxiety and increase brain function. It is the Omega-3 fatty acid that works.

In summary, this is a list of the top Serotonin boosters. Remember any food that contains the essential amino acid, tryptophan will produce Serotonin. But the other top foods are: Salmon gets top marks for boosting Serotonin. Spinach is second (that includes Swiss Chard and probably most all of the leafy greens, including Kale). Seeds and nuts and soy products are also top on the list of Serotonin boosters.

When it comes to reducing Cortisol, the list is different. Dark Chocolate stays at the top and is probably the easiest to sell. But, don’t forget seeds (pumpkin, chia, flax, and hemp), avocados, bananas, spinach, broccoli, nutritional yeast and probiotics. Many of these are high in magnesium, even dark chocolate. Oh, and nuts (walnuts and almonds) help reduce high cortisol levels.

As much fun as it is to read about good foods to help manage stress, please don’t forget that practicing meditation or mindfulness, getting good sleep and moderate exercise are essential to keep your mind and body in balance during these chaotic times.

For Veterans Day: Our WWII Fathers

They were young and they were green. Two-thirds of them had never even fired a rifle. They marched off, 16 million of them, half of all the young men in the country, to the deadliest and most widespread war in history.

They went to stop the Axis powers from carving up the world. And they did it.  They were our fathers. As the last of the WWII Veterans fade from life’s stage, we honor all our Veterans this month by sharing three stories, by psychologists, about their WWII fathers.

With some saying that we are on the brink of war, the realities of world war must not be forgotten.

In this special feature, Dr. Susan Andrews, Dr. Julie Nelson, and Dr. John Magee will share some of what they remember about those in the Greatest Generation.

Kenneth A. Ring, Jr.
Battle of the Bulge, defense of Alsace, France
Awarded Silver Star, two Bronze Stars
by Susan Andrews, PhD

My father, Kenneth A. Ring, Jr., was one of the thousands of veterans who served our country in the last days of WWII in France, Austria, and Germany. My memories of my father have always pictured him as “larger than life.” I knew he was multiply decorated (Silver Star, 2 Bronze Stars) and I guess I knew that meant that he was a hero but I don’t think the meaning really sunk in until recently. My son was telling me what he had learned about how his grandfather had earned the Silver Star, and wondered if I knew how my father earned the Bronze Stars.

Dad never talked about the war to me–or in mixed company, in general.  Unfortunately, he died in 1978 at age 53 from a brain tumor. However, my brother knew a lot of his stories from years of hunting and fishing trips with dad and other men, some veterans. In the evenings, they would sit around and trade stories. My brother has an amazing memory and shared some of what I am now sharing with you. Some of it comes from details of two books about the 42nd “Rainbow” Infantry Division (I.D.) published immediately after the war.  The first book tells the story of the 42nd I.D. while the second book details the 222nd Regiment of the 42nd I.D., which was dad’s regiment.

The 222nd was part of the Rainbow Infantry Division under the command of Major General Harry J. Collins, and shipped from Fort Bragg to Camp Gruber to Camp Kilmer to Marseilles in November 1944, and in 1945 took part in the Battle of the Bulge.

My father was a leader even before he was pressed into his role in history. He was the Cadet Commander of the ROTC at Texas A&M, in his junior year in petroleum engineering when he was called to active duty. He reported to Camp Gruber with the rank of 2nd Lieutenant.

My mom, newly married, tagged along and rented a room in a house in the little Oklahoma town of Muskogee just to be near dad until he shipped out, sometime before September 1944. I did not meet my father until the war was over and he shipped home. Mother and I lived in Dallas, Texas, where both of my parents were born and grew up a block apart.

My father was on the front lines in heavy combat for 114 days in the thick of those last days of the war in Europe. He was awarded his Silver Star for his heroic defense of Alsace France on January 24, 1945. At that point he would have been in Europe for only 2 or 3 months. Only a few months before he had been a petroleum engineer junior year student at Texas A&M.

As a 21-year-old, green, 2nd lieutenant, he was instrumental in turning the tide in the Battle of the Little Bulge, important in the defense of Alsace, France, for which he earned the Silver Star. He also earned two Bronze Stars in the short 3 or 4 months after that. Dad and his Company made raids behind enemy lines.  He found and arrested Hitler’s secretary, and many other high-ranking Nazis, who were trying to hide in the Bavarian Alps, including the infamous Butcher of Paris, SS General Von Oberg, who was posing as a private.

As the Commander of his Company in the 222nd Regiment of the 42nd I.D., they advanced 450 miles from the Hardt Mountains of France to the border of Austria, along the way capturing the towns of Wurzburg, Schweinfurt, and Furth. His was the first unit to successfully cross the Siegfried Line. Dad said that they knew the fighting was going to be intense when the men were given a steak dinner and a new pair of socks the night before. The Rainbow Division captured 51,000 German prisoners. When they were finally in the Tyrol and quartered in fancy hotels, Dad’s men found a cache of $300 million in gold and art (just like the Monument Men). He also served as the Occupational Mayor of Achensee, Austria, in the Tyrolian alps. Finally, his unit was among those who captured Munich.

One of the highest profile things my father did was to command the forces that liberated Dachau through the front gates. I never heard the stories of those days from my father. But, I accidently––at age 14 while looking for something in the attic–– found the pictures my father had taken inside Dachau. Members of my family and myself have occasionally seen captured news footage of my father that was taken during the liberation. I know I had nightmares as a teen and young adult from the photographs. In fact, I can still see the pictures as if they are burned on my brain. I feel sure that my father had more than nightmares from that experience. The concentration camps were among the true horrors of that war. However, that kind of emotional reaction was handled differently by most WWII veterans.

Finally, my father moved to Vienna and became the Aide and bodyguard for General Mark Clark, the general over Austria. Among other things, dad organized and ran the Officer’s Club in Vienna for the General until he was discharged and returned home to mom and me.

In trying to imagine what veterans like my father must have gone through, I have tried to gather as much information as I could find about what my father lived through in the first few months after landing in Europe, the events that led to his Silver Star.

His unit landed in Marseilles in November 1944. It was called the worst winter in Europe in 100 years. The temperature dropped to 20 degrees below. Our troops were not prepared for the extreme cold. The bitter cold of that winter is one reason why the Russians defeated the Germans.

The landing and deployment of the Rainbow Division into the Western Front was supposed to be kept a big secret but somehow the Germans found out they were coming and were ready, waiting and actually taunting our young, totally green troops when the Battle of the Bulge started Christmas eve 1944.

The Germans were planning the last major offensive campaign on the Western Front in Europe, called Operation North Wind (Unternehmen Nordwind). It began on December 31,1944 in Alsace Lorraine and ended on January 25, 1945. Hitler, himself, briefed his military command on December 28, 1944, three days prior to the launch of Operation North Wind. Hitler told his command that the goal of the offensive was to break through the lines of the US 7th Army and the French 1st Army in the Vosges mountains and destroy them. He wanted to liberate Alsace but more he wanted to “exterminate the enemy forces wherever we find them…destroy their manpower.” This last Battle of the Little Bulge, as some called it, was a month of some of the bloodiest fighting by the Americans in Europe. Winston Churchill called World War II’s Battle of the Bulge “the greatest American battle of the war.” Steven Spielberg impressed the 6-week ordeal on the popular imagination with the movie, Band of Brothers, which dramatized the attack on the village of Foy by three companies of the 101st Airborne Division, the Screaming Eagles. The 222nd I.D. fought alongside of the 101st.

Imagine the stress these young men were under. They have never faced combat and now they are facing two very experienced German army groups; one group was commanded by Reichsfuhrer-SS Heinrich Himmler, himself. Our young men sat in their foxholes, wet and freezing, close enough to the Germans that they could hear them being whipped up to a battle frenzy with drugs, mostly crystal meth, while waiting for dawn.

The fighting, which started on December 31,1944 was intense and our line had bulged as we retreated. The 222nd had been forced, because of casualties and the delay of reinforcements, to pull back up north from Strasbourg toward  Haguenau to the French town of Neubourg where my father set up a defensive position on the south bank of the Moder River on January 21, 1945. Thus, at age 21 my father found himself the leader of Company M (heavy machine gun platoon) of the 222nd Regiment of the 42nd I.D. He was a Company Commander because of field promotion after the death of Company M’s commander in the earlier battle.

I have seen it written about the events of those days: “Further withdrawal was being planned; had it not been for the brilliant defenses of the 222nd.”

My father was a crack shot and he had taken up a defensive position in a farmhouse basement, where he was lying on the snowy steps coming out of the basement, surrounded by sandbags with several carbines and several of his men behind him, reloading the carbine rifles and passing them up to him. It was night, about 20 degrees below; the roads were so covered with ice that men could not walk without slipping and falling.

My father ordered his men to hold their positions when the Germans penetrated the main line of resistance with a large force. The 222nd had no artillery support or tanks or tank destroyers. It was riflemen against self-propelled guns and armor. They were trapped in the basement with only turnips and schnaps to eat or drink for three days. Dad had blown three bridges that the tanks could cross on the Moder toward the Rhine. All night he lay in the snow and shot moving targets in the snowstorm. In the morning light, they saw that the enemy casualties were enormous; the Germans had withdrawn and were never able to capture the town of Neubourg.

In the final analysis, my father spearheaded a defense of what later proved to be the last offensive action ever launched by the German army on the western front in Europe.

For my father, as for so many others, he saw horrors and lived through things that we can only imagine today with the help of movies. He rarely spoke of it.  He never went to therapy or claimed any mental or emotional disorder. Most of the true heroes I have met do not ever talk about what they did to be known by others as heroes. Maybe they don’t even think of themselves as a hero. I don’t know.

My father probably had what was called “combat fatigue” when he returned home. I really do not think he had PTSD. WWII vets did not react in the same way as veterans with PTSD do now. They came home from war, drank a bit too much, had an occasional nightmare but with family support and knowing they won and saved the world, they tried to put it behind them.

They typically did not talk about it much and did not even seek out other veteran groups. They felt that people did not want to hear about it. They did not want people to feel sorry for them. They did not want to be the hero who came back troubled by what he did over there and the people that he had bombed or killed.

Only in recent years have I realized that in my growing up years, I was often afraid of my father. He would become fiercely protective when his family was in danger and I can remember him spanking me when I came home crying that some kid had hit me. He spanked me and made me go back out and stand up for myself to the bully. He later explained and apologized saying that he saw many European children not know how to protect themselves and that he never wanted to see that happen to us if some foreign power were to invade our country. In those days, late 1940’s and 1950’s, people thought it was possible that America might be invaded.

I lost my father at his young age of 53. Many of those brave men died young.  Some blame their early deaths on the amazing stress and horrors they endured and then mostly buried when they returned from the war. Although it is not easy to “re-member” the events of those days, it is with great love and honor that I remember my father; he was a great influence in my life.

Gordon Nelson
Master Sergeant Army Air Corps, 20th Air Force,
XX Bomber Command, HQ
China–Burma–India
by Julie Nelson, PhD

I don’t think my father, Gordon Nelson, had any romantic ideas about war. Like all true Irishmen he told amusing stories about his experiences, which seemed to lighten what I always thought was a more melancholy undertone. But maybe that’s just true of the Irish in general.

Dad (Gordon) was 19 when he signed up for the Mississippi National Guard. Coming from a poor, single mother family (his own father had taken off when he was small), his options for college were nil. He enlisted in November of 1940, probably knowing that peacetime draft would pull him in, because this was before Pearl Harbor in ’41. Gordon was a strategic thinker, so he might have signed up so he could change from the Army Infantry to the Air Corps (later renamed Air Force).

This now seems logical. My kid brother, Kevin, said that Gordon realized that 2nd Lieutenants and Sergeants in the Army Infantry “… were all being shipped to Europe battlefields and killed within two weeks on average. He said he was in line for that, so he switched to U.S. Army Air Corps which later was known as the Army Air Forces.”

Gordon’s letters home to his mother were significant. “Those letters,” Kevin said, “were poignant and fascinating to read. Very telling. I started seeing a change in tone in GN’s letters…something along the lines of grim acceptance that he was doomed and there wasn’t a damned thing he could do about it.”
Gordon had bomber training at MacDill Field in Tampa, Florida, and then went on to Smoky Hill Army Air Field in Salina, Kansas where he had his first experiences in B-29s. The subtext which was to color his war experiences.

In a letter home from Smoky Hill, Gordon said that he and his buddies “were all a little droopy” because of a recent crash. A crewmember had come to his office and inquired about a fellow and Gordon said, “Who, that little Dago kid? He was killed in the crash.” Gordon wrote that the crewmember “… just slumped in shock and grief because they had become quick friends and poof, he was gone, dead.”

The dangerousness of the B-29s would follow him to the other side of the world.

B-29s were the very heavy bombers that were pushed into production by Roosevelt. While considered the most advanced bombers in the world at that time, they were not fully tested by the time they were put into service. Because of their size and heavy loads, they were hard for pilots to handle. Takeoffs were risky. Boeing had rushed development and the B-29s had mechanical problems, including engines with a tendency to overheat.

Gordon served with the 20th Air Force, XX Bomber Command, at the Kharagpur Air Field, West Bengal, India. From Kharagpur, the bombers would double as transports and carry their own fuel and cargo, over the Himalayan Mountains, known as “the Hump.” There were so many crashes between India and the China air bases that pilots called it “The Aluminum Trail.”

But President Roosevelt wanted to bomb Japan and had promised Chiang Kai Shek that the U.S. would bolster the Chinese war efforts, and the B-29s were the best chance to reach the Japanese islands.

So, my father’s war stories included the occasional mission with him as a tail gunner, the highjinks of young men, living as best they could in the moment, and dealing with whose plane would be going down next. Toasting their dead and “turning down the cup” of the friend they’d all lost. The imagery Gordon could paint (he was a poet at heart) of India was, I think, part of how he coped, and also the irony he saw in things that happened.

The Japanese would strafe the airfield at Kharagpur and the men would dive into the ditches on either side of the runway, Gordon told Kevin. But, it was considered almost as dangerous to jump into a ditch because of the poisonous krait snakes and cobras that were often in the ditches.

The cobras were everywhere. They were so bad that tent members would hire a local “coolee” to bring his pet mongoose in and clear the tents before everyone went to bed.

In the latter part of the war, General Curtis LeMay took command and turned a failing B 29 program into a successful one, by flying low altitude missions that had more bombing accuracy, albeit even more risky.

My father liked and respected LeMay, and was part of the group that attended when LeMay inspected the facilities. During one inspection of the cafeteria, the General singled out my father and abruptly asked, “Sergeant! What do you think of this mess?” Gordon, confused about of what LeMay was asking but not wanting to appear inattentive, fudged and answered, “Well, Sir, I guess it’s not too good?”

LeMay cursed and said, “I knew it! Get this damn mess up to snuff for these men.” And then LeMay walked off in disgust, thinking that Gordon had confirmed that the food, “the mess,” was substandard.

At a 1986 Christmas party we held in Baton Rouge, my father came face-to-face with a piece of his past. As the young Sergeant in India, he had spent his money collecting some “stones” that he bought from Indian jewelers. He had sent one, a star sapphire, home as a gift for his baby nephew. Forty years later it had found its way into a dinner ring for that nephew’s wife.

Recounting the events, Gordon said that the other stones had “disappeared,” which he thought was due to retaliation by a tent member. Gordon had taken the tent member’s beer (he had left him “Rupees 18”). He and his buddies had needed the beer––they had drunk all of theirs–– because Baldy Van Buren was in the base hospital with the flu and they went to visit him and would never go empty handed (without liquor) to see Baldy.

“In those days we thought we would live forever,” Gordon wrote to us. “But now it seems so long ago and far away that the little stone and the lives it touched has a strange poignancy about it. After thinking about it I’m reminded of the verse from the Rubaiyat that goes: “And not a drop that from our Cups we throw/ For Earth to drink of, but may steal below/ To quench the fire of Anguish in some eye/ There hidden––far beneath and long ago./”

“Can’t you hear temple bells, Indian children calling ‘Bakaheesh, Sahib.’ I can. Haven’t thought of it for 40 years, but I can see Baldy the practical joker, in the rick-shaw race we had in Calcutta flinging handfuls of appes at the hundreds of kids running behind to bottle up the rest of us.”

“The war was winding down––or sort of,” Gordon wrote. “Some of us were being rotated back stateside to form a new 21st Air Corps and go West to Guam. Others were preparing to be flown across occupied China. To do this they flew long, long missions in the B-29s and on one of them to Mukden, Manchuria, Baldy’s plane had engine trouble and crashed.”

It was this tone, where the story ends in a minor key, that I always noticed. I do think my father was affected by the war, whether it was PTSD or Moral Injury or just the way that a young man would be affected when people around him keep dying.

He was not in regular combat like some–I believe he worked to avoid that. I think that my father flew only the required number of combat missions.
But one night, late, while he was drinking too much, he began to talk about an event I’d never heard him talk about before. While guarding a prisoner, the man escaped. Dad shot at the man’s legs to stop him, but missed, and killed him. My dad began to cry, and then he started to sob, and he didn’t stop. I was stunned and felt helpless. I said something lame like, “It was an accident.” After a while, he finally stopped, wiped his eyes and, embarrassed, told me to ignore him, that he was being “silly.” The next day he refused to talk about it and acted as if nothing had happened.

Gordon was not any sort of hero, and would candidly say that he spent most of the war scared out of his wits. He came home in April 1945 and went to college on the G.I. bill and studied journalism and Shakespeare. He married my mother and contributed four children to the baby boom and was normal, for him. He lived to 91, and was happy.

As far as I know, once he returned to the U.S., he refused ever to fly again. When my kid brother visited Ireland, Dad “treasured the vial of Irish dirt” Kevin brought back for him from Killarney, his hereditary home. Dad always wanted to see Ireland for himself, but he never did.

Warren Magee
Second Lieut., Marine Corps
“Soldier’s Heart”
by John W. Magee, Jr. PhD

My Father, Warren Magee, never once talked to me about his combat experiences in World War II as a Marine Corps bomber pilot. Not once.
Warren Magee was the third of four boys born to Johnny and Vina Magee. His father, “Dr. Johnny,” was a true country veterinarian, and, during the Depression, often took payment in fruits and vegetables, and sometimes a chicken. Vina once told me the family history was one of “country folk.” It was not an apology.

Warren wanted to be a veterinarian like his father, and a farmer like his Uncle Lamar. After high school, he started college in Pre-Veterinary and Agricultural Studies at Mississippi State University.

Warren was 20 years old, a full-time, sophomore-level, undergraduate student on December 7, 1941—the “date which will live in infamy”—when Japan bombed Pearl Harbor. He learned of the bombing that Sunday in the small country store of his uncle in Caseyville, Mississippi, less than 100 yards from Uncle Lamar’s 400-acre farm.

After the bombing of Pearl Harbor, Warren left college and joined the Marine Corps. The course of his life changed forever, as it did for most everyone in his generation, including his three brothers—one of whom joined the Army Air Corps, another who was a glider pilot involved in the fighting of Europe in 1944, and another who joined the Merchant Marines.

My uncle, W.O., was a child during World War II, but later joined the military, and served in Vietnam as a navigator on B-52 bombers during the Vietnam War. Uncle W.O. recalls my Father, Warren, as one of a group of young officers in World War II who were called “90-Day Wonders.” After Pearl Harbor, because of urgent need for officers, some were put through an intensive, condensed training period of 3 months. The term was sometimes used as derogatory, but by others with affection. Of the 90-day training, W.O. says “if you survived it, you went on.”

Warren did survive the training, and was commissioned a Second Lieutenant, and then sent to train at Corpus Christi Naval Base, where he became a pilot. Information from “The Slipstream,” published by the Corpus Christi Naval Base after the war, indicates Warren was part of Squadron 5A, one of the earlier squadrons to go through Corpus Christi. According to W.O, Lieutenant Magee, at 5 feet, 8 inches tall was the ideal height for a pilot in the smaller bomber cockpits.

Warren was sent to the Marine Corps Air Station at Cherry, Point North Carolina, with Marine Air Craft Group 11 (“MAG 11”), 2nd Marine Air Craft Wing (“MAW”), under the 1st Marine Expeditionary Force. Cherry Point had an auxiliary pilot training station at Edenton, North Carolina, a small, picturesque town on a natural harbor from the Atlantic Ocean. Warren was a flight instructor there on B-25 Mitchell Bombers for Marines who would serve in the Pacific.

It was at Edenton that Warren met my Mother, Sarah Russell, who reportedly broke a date with a Major to go out with Warren. Uncle W.O., who grew up in Edenton, said “Warren got the prettiest girl in town.” Sarah used to say she first spotted Warren in church. Although Warren probably attended her church, and she may have spotted him there, they actually first met at the USO Club. “He was so good looking,” she said of my Father, “and a good dancer.”

Sarah also told a story that Warren had said that on a specific day and time he’d fly over her family’s house. Sarah waited outside, until his bomber appeared and he dipped each wing as his “wave” to her. Warren was a young man preparing for war, but there had still been a little room for romance.
Only months after their wedding, Warren was sent overseas to Okinawa for the remainder of the war. It was from Okinawa that he and his crew flew bombing missions until the war’s end.

My Father only told me one story that had occurred while he was in the Pacific. It was a typical Warren story, and not a combat story.

Warren was leaving his plane when he saw a group of indigenous people in a circle, just off the runway. Curious, Warren walked over. The group had circled around a snake and one of them was trying to kill it with a long pole.

In college, Warren had earned extra money by catching snakes for the biology department. He had been taught that the only poisonous snake with round pupils was the coral snake. This snake was clearly not a coral snake, so Warren moved inside the circle and grabbed the snake just behind the head. The people in the circle began yelling, which Warren interpreted as undeserved congratulations.

Then, still holding the snake, he began to think more about that rule. Realizing he wasn’t sure if this was the rule for “all” snakes, or just for snakes in the U.S., he walked outside of the circle and tossed the snake into the brush. He continued to receive congratulations, and, of course, later learned the snake was indeed quite poisonous. He said he never engaged in snake-catching on the island again.

Warren separated from the Marine Corps as a Captain after the end of the war in February 1946. Uncle W.O. and other family members indicate that Warren did not talk about his combat experiences, so the number of combat missions he flew, or specific events he experienced, are unclear.

After his military service Warren intended to return to college to become a veterinarian. But Mississippi did not have a Veterinary school and out-of state admissions were very rare. An individual at a school in Alabama reportedly asked Warren for $500 as a bribe for admission, but Warren refused. He never got into veterinary school.

In 1946, he started in the oilfield business, where he worked for 39 years. After his death, I learned he quit one job when they wanted to transfer him to Morgan City because he was concerned that my sister and I would not get a good education there.

Warren grew up Methodist, and Sarah, Baptist, but my father did not believe that only one religion had it “all figured out.” When we first moved to Shreveport, my parents visited different churches, looking for the right fit. Eventually, they joined the First Presbyterian Church, and more importantly, they became part of a Sunday School Class. For years, I witnessed the importance of that class to my parents. Besides attending Sunday school, they ate together, played bridge, fished, and took trips. I still recall laughter as a regular feature of those times, even as I wondered how religious people could laugh so much.

It was some 30 to 40 years later, ten years after my father died, that I learned more about the “Sunday School Class.” In the late 1990s, I recognized one of the men from the Class and learned he was a former POW from World War II. His wife told me something that I had never known—every man in the class was a World War II veteran.

The class was like a family, and I’ve often wondered about the combat experiences of all of those other men in the class. The laughter that I heard as a child, and their obvious love for one another, means much more now, after learning about PTSD, and my 29 years of clinical experience treating combat veterans. Ironically, I know more about the combat experiences of that ex-POW than I know about my own father’s experiences in the war.

My father died unexpectedly of a heart attack at age 64, one month before his retirement, and before I had earned my PhD.

It was only after his death that my Mother told me the one combat-related story she knew, of a time when Warren and his crew almost had to ditch his B-25 Bomber into the Pacific Ocean when returning to Okinawa after a mission. She had no details other than they almost did not make it back. I think Warren would have been the same person, regardless of his circumstances. I never heard him curse, ever. He never spoke ill of others because of race, age, sex, or religion. He was honest and ethical in all his relationships.

Warren never became a veterinarian, and never had a farm. Despite many reversals of fortune, I never heard my father complain about the unfairness of life, even though his early goals in life were not realized, and even with numerous major stressors and losses involving family and finances.
I don’t think my Father had PTSD, but he had a strong sense of doing what was right and facing things directly. He transmitted to me an awareness of his expectations, whether these came from the Marines or the war, or just my Father. These included standing up for what was right, even against bullies, and even at the cost of a fight.

My father softened over the years, though he could still be tough. Somewhere along the way, the tough Marine country boy seemed different. He read poetry books I gave him, even though I know he much preferred other offerings. He did not judge me through my various phases (long hair, beard, leaving school, living with a girlfriend). He was amenable to change, even in himself.

A couple of years before his death, my father and I went fishing. I asked him about his life—it had turned out so differently from the one he had planned before World War II. He told me he was happy and had been happy, and believed things had turned out the way they were supposed to. He talked of the important things of his life—family, friends, the Sunday School Class, daily choices in life. He wondered if my sister and I would have received a good education if we had been living on a farm deep in rural Mississippi. He had once told me that you can “lose” almost anything you get in life, but not education.

After my father’s death, my Uncle Mac told me a story about Warren’s last trip to Mississippi. While squirrel hunting somewhere deep in woods unfamiliar to my Father, he and Uncle Mac separated to hunt alone. Later in the day, Mac realized he hadn’t heard Warren fire a shot all morning, and he went to find him.

Mac found Warren sitting on the ground with his back against a tree, looking up at the tall canopy of trees above, his rifle some distance away. Warren said that he had been so struck by the beauty around him that he just sat down to enjoy it, and he didn’t want to spoil it by hunting. Warren told Mac “If heaven’s supposed to be better than this, it must be some place.”

Two months later my Father passed away.

That day when we went fishing, when I asked about his earlier dreams, as he explained how he had been happy, even though he never got to be a country veterinarian or farmer, my Father also said, “Besides, try and picture your mom living way back in the woods.” I realize that Warren had his priorities right—he didn’t want to lose the prettiest girl in Edenton.

I’m sure my Father was grateful for the life he had, even if it wasn’t the life he planned. As a school boy, he chose his grandmother’s farm for the summers. As a young man, he chose to join the Marines, instead of continuing his studies. He chose not to pay a bribe to get into veterinary school. He made the choices he wanted to live with. I know he wouldn’t use the words I’m using, but I’d say he figured out what was important. Warren got the big things right, even if others wouldn’t see them as the big things.

One of the old terms for PTSD was “Soldier’s Heart.” In that time, some believed that the afflicted soldier was suffering from a form of heart-sickness for his home and family. I don’t think my Father had PTSD, but I think he had to overcome more body-blows than the average boxer, and he did so with quiet grace. Maybe for him, the term “Soldier’s Heart” would have meant more about the internal and external resources that helped him overcome life’s “slings and arrows” so he did not succumb to them.

After my father’s death, my sister Susan said that, even though our Father was often quiet, “You always knew he loved you.” I think there may be no greater inheritance to have from anyone.

The Shape of Water

by Alvin G. Burstein

My first reaction was to think of this film as a mash-up of The Creature from the Black Lagoon, with its fantastic and frightening monster, and Splash, with its mermaid romance.

But more complexity is promised by the beginning and ending epigraphs that frame it:

If I spoke about it – if I did – what would I tell you? I wonder. Would I tell you about the time? It happened a long time ago, it seems. In the last days of a fair prince’s reign. Or would I tell you about the place? A small city near the coast, but far from everything else. Or, I don’t know… Would I tell you about her? The princess without voice. Or perhaps I would just warn you, about the truth of these facts. And the tale of love and loss. And the monster, who tried to destroy it all.

And the afterword:

Unable to perceive the shape of You, I find You all around me. Your presence fills my eyes with Your love, It humbles my heart, For You are everywhere.

The opening, with its uncertain ifs and references to fair princes and last days suggest something other than facticity despite the story’s purported setting in the 1950’s cold war and space race. It implies a truth that transcends history, the truth of myth or legend.

The central characters are a striking assortment: A possibly divine monster from the deep, capable of bloody wrath, magical healing and striking vulnerability; a totally mute scrubwoman, employed at a top-secret research facility; a closeted gay illustrator, her confidant; a federal agent who combines sadism and phallic narcissism.

As the story unfolds, one striking theme is the federal agent’s figuring himself as a Samson castrated by a wily Delilah. He suffers losing two fingers in his battle with the creature, and ultimately rips off the re-attached digits in a desperate effort to avoid being defeated by the woman protecting his captive. This sub-plot includes the agent’s trying to act on his urge to sexually assault the mute scrubwoman. When she rejects him, he reacts by having rough sex with his wife and buying a fancy new car—which gets wrecked in the course of the unfolding plot.

The major focus of the film, however, is on the “princess without a voice,” the scrubwoman. During the day, she mops floors and cleans urinals. At home, she luxuriates—and masturbates—in the tub of her decrepit bathroom, and fantasies while watching television movies with her illustrator neighbor. When she encounters the captured monster, she sees past his grotesque and frightening appearance. He, beset by alien humans, recognizes her as a savior—and princess.

That brings us to the closing epigraph. Our prince and princess avoid attending to apparent externalities. They choose to bathe in each other’s love.
Amor Omnia Vincit.

Is the mythic lesson of the film that love always wins? Or that love is most important? Or is it that the real monster is not the grotesque creature, but crass and dangerous appartchik functionaries ignorant of the meaning of love?

Or does writer/director Guillermo del Toro have all three in mind?

Dr. Buckner Awarded Grants: Alcohol, Drug Abuse and Microaggressions for Blacks

Dr. Julia Buckner, Professor in the Department of Psychology at LSU and the Director of LSU’s Anxiety and Addictive Behaviors Laboratory & Clinic, has been awarded two grants, totaling over $800,000, to study alcohol and drug abuse for Black persons including the impact of microaggressions.

Dr. Buckner is also a Clinical Associate Professor in the Department of Psychiatry at LSU-Health Sciences Center and a Visiting Professor at the London South Bank University School of Applied Sciences.  She is also a licensed clinical psychologist.

The first grant is for the project, “Black Hazardous Drinkers:  Ecological Momentary Assessment of Racial/Ethnic Microaggressions.” The agency is the National Institute On Alcohol Abuse and Alcoholism and the amount is $402,835.00.

According to the project materials, “Black persons are the second largest racial minority group in the U.S., accounting for over 13% (44 million) of the population. Black persons evince numerous health inequalities, particularly as it relates to alcohol consumption and negative affect (NA; e.g., sadness). Indeed, Black individuals evince the greatest increase in average daily volume of alcohol consumed such that it is 41% greater among Black compared to White individuals who consume alcohol.

“Further, Black Americans report increases in drinking frequency and heavy drinking episodes at rates greater than most other racial/ethnic groups. And when Black persons experience alcohol use disorder (AUD), their symptoms tend to be more chronic than non-Hispanic/Latin White individuals. Minority stress-based models
of substance use and mental health outcomes tend to propose that
marginalized groups such as Black Americans are vulnerable to risky substance use via the interplay of several domains including interpersonal (e.g., experiences of racial discrimination) and individual factors (e.g., emotional symptoms). Indeed, meta-analytic data indicate that racial discrimination is positively related to alcohol consumption, heavy/binge drinking, at-risk drinking, and
drinking-related problems among Black persons. […]

“There is a need to understand the proximal and longitudinal nature of MAs [microaggressions] and alcohol use motivation (i.e., greater alcohol craving, intention to drink, and coping-oriented motives for alcohol use) and drinking (i.e., greater alcohol consumption, greater frequency of drinking, and more negative consequences from drinking) among this health disparities group.”

The second grant is for the project, “Ecological Momentary Assessment of Racial/Ethnic Microaggressions and Cannabis Use among Black Adults.” The agency is the National Institute On Drug Abuse and the amount is $419,904.00.

From the materials, “Black individuals who use cannabis use cannabis more frequently and are more likely to use riskier cannabis use methods (e.g., blunts), associated with greater exposure to carcinogens and toxins and with greater risk for cannabis use disorder (CUD). In fact, Black individuals who use cannabis are more likely to meet criteria for CUD than White or Hispanic/Latin persons. This is concerning given rates of cannabis use (including daily use) appear to be increasing among Black adults in the U.S.

“Minority stress-based models of substance use and mental health outcomes propose that marginalized groups, such as Black Americans, are vulnerable to risky substance use via the interplay of several domains including interpersonal (e.g., experiences of discrimination) and individual factors (e.g., emotional symptoms). Yet, despite meta-analytic data indicating that racial discrimination (a source of significant minority stress) is positively related to adverse drinking outcomes among Black individuals, the impact of racial discrimination on cannabis use behavior among Black individuals has received little empirical attention. […] there is a need to understand the longitudinal nature of MAs and cannabis use motivation (i.e., greater cannabis craving, intention to use, coping-oriented motives for cannabis use) and cannabis use and related problems among this population.”

Dr. Buckner’s program of research primarily focuses on: (1) psycho sociocultural causal and maintaining factors implicated in substance use disorders and co-occurring anxiety substance use disorders; and (2) development and evaluation of empirically-informed treatment and prevention protocols for substance use disorders, including treatment for co-occurring anxiety-substance use disorders.

Dr. Buckner has had over 190 publications and she has utilized a variety of methodological procedures in her research, including ecological momentary assessment, affect and craving induction paradigms, attentional processing paradigms, technology-based interventions, and randomized clinical trials.

She has been involved in several NIH grants as PI, co-PI, consultant, and sponsor and is currently Project Director on a graduate education training grant from the US Department of Health & Human Services’ HRSA. She has also received awards from organizations such as the American Psychological Association, College on Problems of Drug Dependence, Anxiety Disorders Association of America, and Association for Behavioral and Cognitive Therapies (ABCT) Addictive Behaviors & Anxiety Disorders Special Interest Groups.

Once Upon a Time in Hollywood

by Alvin G. Burstein

“Once upon a time” is a phrase signaling the beginning of a fairy tale. Fairy tales are folk tales that persist in a culture because they embody and illustrate that culture’s values. They function as parables. So the title of this film invites us to look for its moral center.

There is another interesting aspect of director Tarantino’s choice of the title. On one hand, the film is deeply rooted in a particular historical moment, the fifties and sixties. On the other hand, the tale is an odd amalgam of fact and fable. Movie actress Sharon Tate, whose tragic 1969 murder by Manson acolytes riveted the public, is a central figure in the film. But the tale the movie unfolds is an alternate history saga: what if the murderers had gone to a neighboring Beverly Hills mansion instead of that occupied by Tate and her famous husband, Roman Polanski?

That second house is owned by the fictional character Rick Dalton, played by Leonardo DiCaprio. Dalton was the star of a western bounty hunter TV series. He is struggling to upgrade his stereotyped small screen television career into a more rewarding one in big screen movies. An integral part of Dalton’s career is his relationship to his stunt double, Cliff Booth, played by Brad Pitt.

Booth is more than a stunt double. He is Dalton’s factotum, and the film makes much of their relationship, intentionally troubling us with the disparity between their rewards and social status, and the nature of their tie to each other. They need each other, but in ways that transcend convenience and utility. Part of the fairy tale element of this film is its providing an opportunity to make a moral judgment about this pair of characters. The fictional movie star owner of the opulent Beverly Hills mansion next door to Tate and Polanski is less admirable than is his stunt double and body man, an ex-Green Beret who lives in a trailer on a lot behind a drive-in movie screen.

Booth’s “roommate” in his trailer abode is Brandy, a pit bull. In a highly comedic element, Booth feeds his dog Wolf’s Tooth dog food, “Good Food For Mean Dogs.” It comes in two flavors, Rat and Raccoon. Brandy, eager and quivering with hunger, is trained to wait while Booth prepares the dog’s dinner. Not until her owner, at his leisure, gives her the signal, does she lunge slavering to her repast. Brandy later plays a key role in dealing with the misdirected home invasion by Mansonites. She is one of the most admirable characters in the film. The moral point: a creature of simple if urgent impulses, she controls herself out of attachment to Booth. In addition to the contrast between Dalton and Booth, we have a contrast between Dalton and Brandy. Dalton uses Booth and others, Brandy’s devotion is unconditional.

The film is very popular—high ratings from Rotten Tomatoes, grossing over a hundred million dollars at this point. Part of its popularity is its focus on an interesting time and place. Another element of its fascination is its look behind tinsel town glitter. It has the allure of a gossip column, a peek at what goes on behind the doors of the rich and famous. In Freudian terms, a peek into the parents’ bedroom.

Dr. Leonhard, Award Recipient, Grateful to Late Janet Matthews

Dr. Christoph Leonhard, founder and first department chair of the Chicago School of Professional Psychology at Xavier, is the 2023 recipient of the Janet R.  Matthews, Ph.D. Outstanding Psychology Mentor Award, announced by the Louisiana Psychological Association.

Spokesperson Dr. Amanda Raines, said, “This award recognizes and honors Dr.  Janet R. Matthews for her lifetime of mentoring work and the impact she had on psychologists in Louisiana. This award is given to an individual who has made significant contributions in their mentoring of others in psychology. This year we
are recognizing Dr. Christoph Leonhard.

“Dr. Leonhard is a Professor of Clinical Psychological at the Chicago School of Professional Psychology at Xavier University,” Raines said. “In his current and previous roles, he has tirelessly mentored dozens of students and chaired numerous doctoral dissertations. Dr. Leonhard has also mentored faculty within the department to aid in their transition to academia. In sum, he consistently goes above and beyond to cultivate competent and diverse professionals.”

Dr. Leonhard told the Times that he is particularly grateful for his connection to Dr. Janet Matthews.

“My first feeling about the award was gratitude toward the late Dr. Janet Matthews, whom the award is named after. When I arrived in New Orleans about a dozen years ago with the idea to possibly start a PsyD program here, folks quickly directed me to Janet. Her mentorship and support were instrumental in helping get the program started,” Dr. Leonhard said.

This is a legacy award developed by Dr. Laurel Franklin, who was mentored by Dr. Janet Matthews. Dr. Janet Matthews passed away in 2019.

Margaret Smith, PsyD, the current Department Chair/Director of Clinical Training/Professor at The Chicago School of Professional Psychology at Xavier University of Louisiana, said, “Dr. Christoph Leonhard was the founder of our program at The Chicago School of Professional Psychology at Xavier University. He worked tirelessly with our students ensuring that they would have opportunities to present posters at the Xavier Health Disparities conference as well as at the Louisiana Psychological Association annual conventions. He has mentored a number of our students to successfully publish articles and has provided guidance and mentorship to our adjunct and core faculty members over the years. He has also provided me with mentoring on administrative program responsibilities.”

Dr. Leonhard also said, “Additionally, I feel very honored that the LPA recognized me for the mentoring I do with our PsyD students. Working one-on-one with our students is the most rewarding part of my job. I feel very humbled by the award because the bulk of this honor really belongs to my mentees. The very essence of mentorship is the collaboration between the mentor and the mentee – with the heavy lifting being done by the mentee. Most of my mentoring centers around professional development with a focus on research and clinical skills. Doing research, writing proposals, dissertations, conference presentations, and publications is all done by the mentees with only sporadic input from me. Ditto for clinical skills development. I can mentor and guide all I want but ultimately, it’s the mentee who is attending that workshop, reading that book, or working in supervision to develop that new skill.”

What does he think are his most important achievements so far?

“Even if it is now unfortunately closing, my bringing a Chicago School clinical PsyD program to New Orleans in collaboration Xavier University is my proudest achievement,” he said. “We have been able to train a goodly number of much needed psychologists, many of whom represent historically marginalized  populations. And we will graduate several more as the program is being taught out. Most of our graduates are now practicing locally and are bringing much needed mental health services to this underserved area,” Dr. Leonhard said.

“With the PsyD program closing, I am transitioning to focusing on my consultation practice. For the past three years, I’ve been writing about statistical and methodological problems with using neuropsychological tests to determine whether an examinee is malingering. There are huge social justice implications of this work that I plan to pursue in the future. As luck would have it, some of my
mentees are also interested in this work,” Dr. Leonhard said.

Dr. Leonhard has a Google Scholar Ranking at Institution: 10th most productive (1,323 Citations, h-index: 12), he was named the Chicago School of Professional Psychology: Distinguished Teaching Award for Diversity and International Psychology He is a Fellow of the American Academy of Cognitive and Behavioral Psychology, Association for the Advancement of Behavior Therapy: Honor Roll, and Illinois School of Professional Psychology: Faculty of the Year Award.

He has served as Visiting professor at University of Malta, Visiting professor at Beijing Normal University, and Instructor at the Institut für Verhaltenstherapie  und Sexuologie.

His research positions include Research Consultant at Institut für  Verhaltenstherapie und Sexuologie, Nuremberg, Germany, where he worked in designing, implementing, and publishing research on the topic of mindfulness-based Self-Practice/Self-Reflection in the advanced training of CBT therapists.

He also has served as Research Consultant at “RAI Ministries-Camp Restore”, a social justice program in New Orleans East. He has served as Program Evaluation Consultant at “The Way Back In,” a residential and outpatient clinic for patients with substance abuse problems.

Examples of his publications include:

Leonhard, C. & Leonhard, C. (in press). Neuropsychological Malingering Determinations: Science or Fiction of Lie Detection?  Georgia Law Review, 58(2).

Leonhard, C. (2023) Quo Vadis Forensic Neuropsychological Malingering Determinations? Reply to Drs. Bush, Faust, and Jewsbury. Neuropsychology Review.

Leonhard., C. (2023). Review of Statistical and Methodological Issues in the Forensic Prediction of Malingering from Validity Tests: Part II: Methodological Issues. Paper accepted for publication in Neuropsychology Review.

He will be conducting a Forensic Grand Rounds organized by Alberta Hospital Edmonton and the University of Alberta via Zoom on October 11 at 10AM Central Time. The title of the presentations is Neuropsychological Determinations of Malingering: A Forensic Junk Science?. The event is free and open to all who are interested with prior registration required at
https://ualbertaca.zoom.us/meeting/register/tJYlduqgrD8vEtPq2gntqD2BDjmYiSgXIi11

Dr. Joy D. Osofsky Acknowledged for Scientific Contributions

Dr. Joy Osofsky’s achievements were recently acknowledged by the Louisiana Psychological Association when they named her the recipient of the Award for Contributions in Psychological Science.

Dr. Osofsky, clinical and develop-mental psychologist, is the Ramsay Endowed Chair and Barbara Lemann Professor of Child Welfare at Louisiana State University Health Sciences Center in New Orleans where she is director of the Harris Center for Infant Mental Health.

She has published widely and authored or edited numerous books on trauma in the lives of children. She has established an international reputation has an expert
in this area and recently testified at a congressional panel. Currently, with three  colleagues, she is editing the WAIMH Handbook of Infant and Early Childhood  Development.

Dr. Osofsky is also Past President of Zero to Three and of the World Association  for Infant Mental Health. She currently serves on the Board of Zero to Three. She  has served as Co-Principal Investigator of four Centers within the National Child  Traumatic Stress Network since 2003. She is currently President Elect of Division 7(Developmental) for American Psychological Association.

The Louisiana Association spokesperson, Dr. Amanda Raines, said, “Dr. Osofsky is  a Professor of Pediatrics and Psychiatry with the LSU Health Sciences Center and  the Paul J. Ramsay Chair. She is an internationally recognized expert in infant and  child mental health. Dr. Osofsky has published hundreds of peer-reviewed manuscripts, books, and book chapters and received support for her work  through various agencies.”

The nominating individual said, “Dr. Osofsky’s decades-long career embodies the  heart of excellence in bringing the science of psychology to the benefit of others,  through applications, education, writing and scientific investigation. She is a clinical psychologist, professor, author, researcher, and she brings her integrative thinking to the education of tomorrow’s leaders and innovators. She exemplifies what it means to advance psychology for the benefit of the larger society.”

In 2007, Dr. Osofsky received the Sarah Haley Award for Clinical Excellence in work
with trauma by the International Society for Traumatic Stress Studies. In 2010 she  was recognized with the Lourie Award for leadership and outstanding contributions to the health and welfare of children and families. In 2020, she was awarded the Translational Research Award from the International Congress on  Infant Studies and in 2021 she received the Zero To Three Lifetime Achievement  Award. Dr. Osofsky has been recognized many other times for her contributions.  These include Honorary President Distinction, World Association for Infant Mental  Health; Presidential Commendation from the American Psychiatric Association for leadership in mental health recovery following Hurricane Katrina; the Nicholas Hobbs Award by Division 37 of the American Psychological Association for contributions to public policy; the Medal of Honor by the Mayor of New Orleans;  the 2000 Role Model by Young Leadership Council, New Orleans; Best social  science reference text, American Publishers Association for the WAIMH Handbook of Infant Mental Health (four volumes), as just a few examples.

Dr. Osofsky serves as Clinical Consultant, Safe Babies Court Teams, Zero to Three, in Louisiana, Mississippi, Georgia,Arkansas, Connecticut, Nebraska, Iowa, New York, Cherokee, NC. She is the Past-President, Zero to Three: National Center for Infants, Toddlers and Families and Member of Executive Committee of Zero to Three (2000-2007); Member of Board of Directors (1986-present); Member Committee on the Board (2006-present); Program Chair, National Training   Institute (2009-present).

The Times asked her what she feels are her most significant contributions.

“I have  contributed over many years to recognizing the importance of understanding of  the effects of trauma on children and on their families, and says to help them recover and gain resilience,” she said. This includes  contributing to an understanding of preparation, response and recovery following  major  disasters including recently the intersection and inequities related to the  COVID-19 pandemic, she explained.

“I have developed one of the few programs in the country offering training to psychology interns and postdoctoral fellows and child psychiatry fellows in infant  and early childhood mental health including training in evidence based clinical practice for young children under the age of six years,” Dr. Osofsky said.

Her work has been acknowledged through numerous grants including:

Louisiana Association of United Ways/Red Cross funding for Family Resiliency Project, Co-Project Director with Howard J. Osofsky, M.D., Ph.D., 2008-2009, $554,246;

Louisiana Rural Trauma Services Center Substance Abuse Mental Health Administration. Principal Investigator, Center in National Child Traumatic Stress  Network, 2008-2012, $1,999,000 (50% time);

Mental and Behavioral Health Capacity Project for the Gulf Region Health  Outreach Program, Funded as part of the Medical Settlement following the  Deepwater Horizon Oil Spill, Co-Director, 2012-2017, $14,400,00 (80% time);

Terrorism and Disaster Coalition for Child and Family Resilience, National Child Traumatic Stress Network, Co-Principal Investigator, 2016-2022, $1999,000 (50%  time); and

Harris Foundation funding for Prenatal and Perinatal Behavioral Support for  Maternal and Infant Well-Being, (MIST Program). CoPrincipal Investigator, 2017- 2024. $630,000, 20% time.

Examples of her extensive publications include:

Osofsky, H.J., Osofsky, J.D., Hansel, T.C., Lawrason, B., & Speier, A. (2018). “Building
resilience after disasters through the Youth Leadership Program: The importance  of community and academic partnerships on youth outcomes.” Progress in  Community Health Partnerships: Research, Education, and Action, 12. Special  Issue, 11-21.

Weems, C. F., Osofsky, J. D., Osofsky, H. J., King, L. S., Hansel, T. C., &  Russell, J. D. (2018). Three-year longitudinal study of perceptions of competence and well-being among youth exposed to disasters.” Applied Developmental Science, 22(1), 29–42.

Osofsky, J.D. & Osofsky, H.J. (2018). “Challenges in building child and family  resilience after disasters.” Family Social Work, 21,115-128.

Osofsky, J.D. and Osofsky, H.J. (2020). “Hurricane Katrina and the Gulf Oil Spill:  Lessons Learned about Short and Long-term Effects.” International Journal of  Psychology.

Osofsky, J.D., Osofsky, H.D., Mamon, L.Y. (2020). “Psychological and social impact  of COVID-19.” Psychological Trauma: Theory, Research, Practice, and Policy.

Osofsky, J.D. & Osofsky, H.J. (October 2022, in preparation). “The importance of  building regional coalitions to support resilience for children and families in  response to disasters and violence.”

Osofsky, J.D., Osofsky, H.J., Frazer, A., Olivieri, M., Many, M., Selby, M., Holman, S.,  & Conrad, E. (February-March, 2021). “The importance of ACEs in an intervention  program during the perinatal period.” American Psychologist, 76.

She has produced over 70 books and book chapters and hundreds of scientific  presentations, invited presentations and seminars. Her works include:

Osofsky, J.D. (Ed) (2011) Clinical Work with Traumatized Young Children. New York: Guilford Publishers.

Thomas, K. & Osofsky, J.D (Eds) (2012). Emerging Issues in Infant Mental Health.  Zero to Three Journal., Washington, DC.

Osofsky, J.D., Cohen, C., Huddleston, J., Hudson, L., Zavora, K., Lewis, M. (March,  2017). Questions Every Judge and Lawyer Should Ask About Infants and Toddlers in the Child Welfare System (Update). Reno, NV: National Council of Juvenile and  Family Court Judges.

Osofsky, J.D., Stepka, P., & King, L.C. (2017). Treating Infants and Young Children  Impacted by Trauma: Interventions That Promote Healthy Development. Washington, DC: American Psychological Association.

Osofsky, J.D., Fitzgerald, H., Keren, M., Puura, K. (Eds) (2021, in preparation).  WAIMH Handbook of Infant and Early Childhood Mental Health, Two Volumes,  Springer Publishers.

Invited Plenary, “Lessons learned from children exposed to trauma.” Early Intervention and Education Meeting, St. Petersburg, Russia, July,  2013

Invited  Conference, “Trauma through the Eyes of a Young Child,” Hong Kong  Infant Mental Health Association, Hong Kong, March 2017.

Invited Master Lecture: “Recognizing the Effects of Trauma and Adverse Childhood Experiences during the Perinatal Period,” World Association for Infant Mental  Health, Brisbane Australia Virtual June 2021

Legacy Interview: “How to Heal Childhood Trauma,” MindinMind, UK, October 2022

What are her plans for the future?

“Currently, I continue to provide training and supervision in infant and early childhood mental health,” Dr. Osofsky said. “I initiated 4 years ago and am director of a support program with several excellent LSUHSC faculty that also has an evaluation component – Mother-Infant Support Team (MIST) for high-risk pregnant mothers at University Medical Center.”

She said she will continue to do presentations, virtually and in person, on the  effects of trauma on children and families and ways to support resilience,  including components related to inequities, in the United States and  internationally.

“I also do presentations on the impact of vicarious trauma and compassion fatigue when working with trauma and how to provide support for providers,” she said.

“I am working as lead editor with three colleagues, two of whom are international,  on the two volume World Association for Infant Mental Health Handbook on  Infant and Early Childhood Mental Health which will go to press at the end of September 2023.”