Social Psychologist Sharon Goto on the Mental Health of Asian Americans

An Interview with Social Psychologist Sharon Goto

Sharon Goto, Ph.D. is a Professor of Psychological Science and Asian American Studies at Pomona College. She specializes in Asian American psychology, cross-cultural psychology and issues of intergroup relations.

Kaylin Ong:  Thank you today for joining us for this installment of the Seattle Psychiatrist Interview series. I'm Kaylin Ong, an undergraduate student at Pomona College, and a research intern at Seattle Anxiety Specialists. We are a Seattle-based psychiatry, psychology and psychotherapy practice specializing in anxiety disorders.

I'd like to welcome with us Dr. Sharon Goto, Professor of Psychological Science and Asian-American Studies at Pomona College. Dr. Goto has a PhD in social psychology with minors in industrial and organizational psychology and quantitative psychology, and has also published several papers within the field of Asian American and cross-cultural psychology.

So before we get started, can you please let us know a little bit more about yourself and what made you interested in studying Asian-American psychology?

Sharon Goto:  Thanks, Kaylin. So happy to be here. I’ve taught at Pomona College in Asian American psychology and Asian American studies and psychological science department for over 25 years. Currently, I am chairing the Department of Asian American Studies, and I have been teaching a class called Asian American Psychology. That is one of my favorite classes to teach along with some other classes. It's been really fun to see how the field has changed across the years. I also do research and my research is generally trying to understand how bicultural individuals navigate different cultural worlds, different racial worlds, and trying to understand the psychological processes related to that. And in addition to that, I guess, let's see, my pronouns are she/her, and I have a lovely family, my husband and two daughters who are currently home right now back from college and my two adorable stray cats. So happy to be here.

Kaylin Ong:  Yeah, thank you so much. So your research explores the prominent role that culture plays in self-construal. Can you explain what this means and talk about some ways you studied this in the lab setting?

Sharon Goto:  Yeah, so self-construal is a way that people kind of define or think about themselves. So it's a series of different theories about that and there's been a lot of empirical work on it. And it's slightly different from the way that Freud, for example, would learn about them, the self and just sort of through introspective techniques, it's more empirically driven. So there are some theories that talk about the difference between the ought self, the ideal self, the actual self. There are some distinctions between the public self, the private self. What I'm really interested in is the differences in the distinction between the interdependent self and the independent self. In some ways that I studied or has been studied and I study as well is we look at, for example, just simple self-report, for example.

So, you could ask a person to measure the level of interdependent self-construal. How important is it to include other people when you're trying to make a decision for independent self-construal? It's really important for me to make decisions on my own, agree, disagree, how much agree to that. So that would be different ways to tap those using self-report measures.

And the reason why it's such a big deal to look at interdependent independent self-construal when you're looking at cross-cultural research is because it actually predicts a lot of variance in behavior and attitude. So it really turns out to be super important when you're looking internationally, globally as well as within a particular culture. And there are also more experimental ways to understand self-construal, like using electrophysiological measures and trying to understand the way the brain is processing information differently based on their cultural orientation of interdependent versus independent self-construal. So it's not alone. There are many people who have come before me. It's really, I think, a super interesting construct that has really stood the test of time.

Kaylin Ong:  Yeah, that sounds really interesting. I think cross-cultural psychology is such an interesting field and has so much depth. So yeah, thank you so much for sharing. So on that, cross-cultural research often uses the phrase collectivist versus individualist to talk about, for example, cultural differences. Can you explain what these two terms mean and also give some examples of how this might manifest itself in human behaviors and attitudes?

Sharon Goto:  Yeah, so if you're not familiar with the terms independent and independent self-construal, you might be familiar with the terms collectivism and individualism. So that's probably a more well known, maybe more interdisciplinary approach. It was probably one of the entrees into psychology about how culture was first studied. And it does look at the amount of importance the group carries over the individual. So collectivism is more cultural level and individualism is more cultural level or aggregates of people level constructs. So groups of people can be more collectivist in nature, more group oriented or more individualistic in nature or more self-oriented or individually driven. And it turns out some important things are, for example, the way that rewards are distributed. It's very interesting. It varies very much by collectivists versus individual orientation, for example, in terms of how people think reward distribution is fair or not.

So, for example, collectivists might be very happy if rewards are distributed equally within your group. So, everyone gets $5 and that feels good. Versus individualists might tend to be more what's called equity based. So, they want to earn their money, so they're really okay if some people that do more work get $10 and other people that don't do the work get $0. So, it's a different way of distributing and a different way of really defining what is fair. And it's really interesting that the very notion of what is fair is actually culturally driven and understood by collectivism versus individualism, for example.

Kaylin Ong:  Thank you. I had a quick question. So collectivist versus individualist. I think a lot of the times I've associated, for example, collectivism with East Asian cultures or just eastern cultures in general, and then Western cultures are a little bit more individualist oriented. Would that be correct or accurate to say?

Sharon Goto:  Yeah, so there have been a lot of studies that have done, starting with Hofstede’s original studies, looking at the amount of collectivism versus the amount of individualism in different nations. And you're exactly right. So East Asian cultures tend to be more collectivists and less individualistic. And Western European, North American cultures tend to be more individualistic and actually more individualistic than basically the entire world. So very much outliers. And I do want to say that although it's important to understand the idea of individualism and collectivism at the aggregate level, there's analogous to interdependent and independent self-construal at the individual level. So collectivism tends to be comprised of people that have high interdependent self-construal individualism tends to be comprised of people that have high independent self-construal. But it's also really important that you have that distinction because just because you're in North America doesn't mean that you're necessarily individualistic. You could have very strong interdependent self-construal tendencies as well. Does that make sense? So it really allows for that's not just so essentialized that you really do have a broad representation.

Kaylin Ong: Oh, thanks for the clarification. Okay, next question. So, one of your most recent publications focuses on cultural priming effects on the N400. Can you explain for our listeners what the N400 is and why it's been an essential component of your research?

Sharon Goto:  Yeah, so the N400 is like a time locked event related potential. So basically what you do is you attach these fancy electrophysiological equipment to the scalp, which people have probably seen. And based on surface level activity, you have some insight in terms of the brain processing, the neural processing that's going on. So basically, what we do is show you stimuli and about 400 milliseconds afterwards, you are getting some gauge of semantic processing, which is the amount of sense making a person is doing.

So, for example, if I were to tell you ‘The boy gave his dog a bone.’ Okay, that makes good sense. Versus, ‘the boy gave his dog a bugle.’ That's a little bit more confusing, and there's probably a little bit more processing that's going on to make sense of that. So it turns out that the semantic processing of information can vary by culture, and it's a more dynamic way to understand cultural differences, particularly for example of bicultural people who might move in and out of different cultural frames. It's also very sensitive, and that's why we have tended to use it in our lab.

Kaylin Ong:  Right. That's very, very interesting. So in your lab, do you collaborate with the neuroscience department or neuroscience students, for example?

Sharon Goto:  Yes, absolutely. So our lab is called the Cultural Race and Brain Lab, and I'm one of the professors and also Professor Richard Lewis who has an appointment in neuroscience. And our students are a combination of people that are in Asian American studies and psychological science and in neuroscience, all interested in culture and the brain.

Kaylin Ong:  Oh, great, thank you. So, you've briefly studied the role of discrimination on the mental health of students of color, and as a professor with a background in organizational psychology, how do you see your findings as being relevant today?

Sharon Goto:  Yeah, that was an interesting sort of study that I had done with a student actually as a senior thesis at Pomona College. Pomona College students are amazing. So it's been known that discrimination is a stressor and it leads to negative mental health outcomes. And what we wanted to do is we wanted to look at the mechanism for that. So we were wondering if one of the mechanisms of being in a stressful organizational setting, so either educational or workplace setting, if that would lead to more psychological distress. And if the mechanism or the reason why that might be the case would be what's called depletion of self-control.

So, the idea is self-control. There is a limited amount of self-control we have. It takes energy to maintain our self psychologically and physiologically. And whenever there's a stressor, it kind of depletes it a little bit, and one of those stressors could be consistently being in a hostile environment or an environment where you have to be wary. And what we showed empirically is that, yes, for students of color being in a psychologically stressful environment, for example, a classroom setting in a predominantly White institution can lead to psychological distress. And the mechanism for that is depletion of self-control.

So, self-control is really interesting because you could also learn to build it up a muscle, you could exercise it, but at a particular time you're using a lot of energy, if that makes sense and that's why you have the depletion.

Kaylin Ong:  That makes a lot of sense.

Sharon Goto:  So yeah, I think that's particularly relevant now with the racial tensions and it's definitely whether you're in education in the classroom or in the workplace or whoever it might be, if you're in a setting where you're thinking about these issues, you're worried about issues related to discrimination, then it's probably taking a little bit of a mental toll and cumulatively it could have a negative effect on your psychological distress.

Kaylin Ong:  And the next question I think is a little bit related to that. So why is cultural diversity important in the workplace setting? And have you done any sort of research on this topic as well?

Sharon Goto:  Yeah, so that's one of the reasons that I really got into this area, just looking at the demographics, I understand that workforce diversity, just diversity in our society in general is only going to increase. And to pretend it's not is just probably not the most productive way to go. So, counter to what some of the recent Supreme Court decisions have been that have made decisions against the role of affirmative action, there's a really long-standing tradition of empirical tradition: understanding that diverse work groups do better in many ways. They come up with more creative solutions. If you have enough time to work together, people are very satisfied with their interaction within a diverse setting. There's really fantastic outcomes that come to play. So it's really, really super important.

And although I haven't done research looking at, for example, diversity and group performance for example, I do indirectly look at it because I'm looking at how bicultural individuals might interact or be in a workplace with culturally different or racially different others. And I'm trying to work from a model where it's not necessarily an assimilationist model. So, where you have to become completely like those people in the workplace that you're seeing, shed your language, shed your cultural values and shed your cultural behaviors. But rather what are ways that those cultural differences benefit the workplace and what are ways that being different from others can be enhancing and not self depleting? So that's what I do.

Kaylin Ong:  I think especially as a student, and obviously Pomona College is a very liberal institution and it's very, very diverse and I feel very grateful to be surrounded by just such a diverse crowd and so many diverse students of color. But yeah, I think just because of the affirmative action and just the recent events, I mean, I guess surrounding that and the dialogue, I feel like it's particularly relevant today for students.

Sharon Goto:  Yeah, it's really interesting. I mean, there really is a trickle-down effect in terms of the way people think about each other and what their goals are. And so I'm really hoping that this time is a time where people just really keep the conversations and communications going.

Kaylin Ong:  So it's clear that the COVID-19 pandemic has had profound impacts on mental health across the globe and research states that Asian Americans in particular have been affected by the pandemic more than other racial groups. And so I wanted to ask you, in what ways have they been affected more and how would you potentially explain this finding?

Sharon Goto:  Yeah, so I am a little bit less interested in the comparative experiences of the COVID pandemic across different groups, but I have seen a lot of research that was looking at the effects of the pandemic on Asian Americans in particular. And you really do see faring worse during and after the pandemic. So it's really due to health related stressors, economic related stressors, social stressors, like racial discrimination and the pandemic, that physiological, everything is a stressor that has affected, in particular, some people within the Asian American community more than others. So I think those are just things that need to be looked at more carefully.

Kaylin Ong:  I think the social determinants of health in particular are very, very interesting and sometimes they get overlooked. And so I also wanted to ask a follow-up question. Do you consider, for example, historical trauma at all and in your research, or I guess what is your take on that in implementing a broader scope of history and the historical traumas or generational traumas that Asian Americans have faced?

Sharon Goto:  Yeah, I think that's something that is really so important. It's actually one of the reasons why I got into this area in the first place. I was really taken by my Asian American psych class as an undergrad that Stanley Sue taught and really wondering within my own personal family, what would be the negative impacts of internment, which my parents had both faced in terms of long-term consequences.

I haven't looked at it directly as a research question, but some people have Donna Nagata and University of Michigan, and I think empirically you're seeing it more and more in research. I would love to adopt some frameworks and some theories about it. What's really interesting is we just finished a study looking at older adults and help seeking within the Asian American community. So it's a community based sample. We're wondering about how the COVID related incidents, both due to the virus and also due to increased racial discrimination and violence really has affected older adults, and in turn, whether or not and how they help seek or not.

What was really interesting is yes, so there was some reluctance, some stigma as you might imagine, but also people would come up to us after and they would say things like, "Our community," or, "I've been through so much before that this..." They wouldn't say is nothing, but, "I know I can make it through this." So it was really personal testimony and resiliency that I wish that... Maybe it will be our next study. I thought it was so very interesting. It wasn't outside the kind of questions we're asking, but you could really see it as the strength of the community.

Kaylin Ong:  No, I think that's a very, very interesting topic because I'm also Asian American and my grandparents, they lived through the Great Depression, they're very old now. But they were saying very similar things where it's like they've been through a lot and they're very, very resilient and it's just unlike anything our generation has experienced. And so that difference in generational knowledge and generational experience and also help seeking behavior and health seeking behavior is very, very interesting to me just because I feel like there is a fine line between older individuals who are reluctant to seek help even when they may need it. And so it's just that line between they're very resilient, but at the same time, I feel like more outreach maybe needs to be done, especially because the pandemic has affected older populations, especially my grandparents and my great aunts and uncles who are still around. So yeah, it's very personal, but very interesting.

Sharon Goto:  Yeah, yeah, very personal, very interesting and really super important. So there's more people that do this kind of work. We always need more people to do this kind of work.

Kaylin Ong:  Yeah, it's very, very interesting to me. So my next follow up question, it's pretty general. What can be done to potentially address the declining mental health of Asian Americans throughout the pandemic?

Sharon Goto:  I mean, think it's about making sure that people have the resources that they need. One thing that we did find is that the older Asian Americans were likely to seek help from friends and family, surprisingly equally likely from law enforcement, just in case there were race-based situations, but much less so statistically, significantly less so for mental health resources. So trying to get the mental health resource piece together, it's been long standing in the community based on stigmatization and access and that sort of thing, but particularly stronger now. And what's interesting in our data, it suggests that when people are thinking about seeking help, the collectivism piece comes back. So thinking about how I am seeking help now from friends and family will help share my experiences so they will know what happens.

So the old adults in my sample, they were really thinking about younger people too, setting a good example. They're wondering if other people are going to be available and willing to listen. They're wondering about whether the police are going to be available, if they ask, reach out. They're also asking questions about the social norm around help seeking. That was also really big. So really looking differently than other samples that are less probably interdependent self-construal would probably look at our sample, which you would guess was very normatively driven, very collectively driven. So I think what can be done would be to do things like attack the problem of stigmatization, show role models of people who have sought help from mental health and have done better.

I remember in graduate school, for me, mental health help seeking was not something, not a tradition in my family that we really talked about. I remember there was a graduate student that was a little bit older than me that I really looked up to, was profoundly smart, had their act together so much, and then she would talk about how she would see her therapist, and I thought, "Ah, maybe that's the ticket."

So role modeling, more communication, more availability, more help to access the resources if they want to seek mental health. That would be a big step: resources. That would be a big step I think of in terms of, right, you could do now, right?

Kaylin Ong:  Yeah, I think the Asian American community especially, there is a mental health stigma and asking for help and reaching out for help. It's definitely a barrier. And it comes from a lot of personal experience, and I'm sure you've had very similar experiences as well. And yeah, I think it's cool that it's this collective experience that we have and it's something that we can overcome together through collective help and just an increase in resources, like you said.

Sharon Goto:  Yeah, absolutely. You could probably link it to one of the, again, once again, that some of the collectivist values of not wanting to be a burden on other people. If you think about a really tight group, then you know, want to try to hold your own, other people don't have to worry about you. And so, it is a little bit driven by that.

Kaylin Ong:  And then moving on to our next question. So before the pandemic, what were the biggest mental health challenges typically faced by Asian Americans?

Sharon Goto:  Before the pandemic, I think you would hear about differences or difficulties in acculturation or adjustment, immigration adjustment or acculturation adjustment, discrimination, racial discrimination, and also stereotyping. So having to live with one way or the other, the model minority stereotype is a big stressor on the community. So, I think those were things that would appear in the literature before the pandemic.

Kaylin Ong:  Yeah. Could you elaborate a little bit more on the model minority myth for listeners who haven't really heard of that term?

Sharon Goto: Yeah. So, the model minority myth stereotype is the idea that Asian Americans, and it  was originally with East Asian Americans, but also now extended to South Asian, Southeast Asian. It just is a really strong stereotype, very persistent. They are the model. They don't need anything. There's something about their culture that's special. They work hard, they don't complain. They do their work, they don't need any extra resources, they don't need any help. They figure it out themselves and they do a good job.

So on the surface, the model minority myth sounds really fantastic. "Oh, yes, I am a part of a model group." But there’s really a little bit more difficult of a read in it. So if you dig down a little bit deeper and you see when the stereotypes started to occur, I think it's not an accident. And many others think it's not an accident that it started to be more popular during the civil rights movement. So when other groups were really asking for more justice for them, so African Americans and Chicanx populations were really asking for more justice for their own situation, then, then popular media, politicians, et cetera, were saying things like, "Well, we don't need to change our structure. Our institutions look at the Asian Americans. They're doing really well." And that's really the beginning.

So, it really did then, and it does now, it really creates a wedge with using Asian Americans as a wedge group to divide people of color. Does that make sense? So, to deny that racism exists in our institutions.

Kaylin Ong:  Right. And I think that goes a little bit back to what we were talking about with affirmative action. I think there's a very interesting stratification between different minority groups now, especially Asian Americans sort of being grouped with White Americans as opposed to all other minority groups in higher education. And I think that has so many implications right now. And so it's interesting to see how things come back and things are very interconnected right now.

Sharon Goto:  Yeah, I think that's a really good point. So yeah, with affirmative action stuff now in educational settings, you have to, and it's really been a rough place for Asian Americans to continue to build their coalition among Asian Americans, because yeah, the umbrella of Asian Americans are very diverse, different ethnicities, different languages, different experiences within educational settings. And so I think particularly if you think about in workplace settings, extending that to workplace settings, and all of a sudden it's all gone in terms of the model minority and everybody and needs a little affirmative action. I know that I benefited very much from some mentorship that was based on race. Yeah.

Kaylin Ong:  Very interesting issues.

Sharon Goto:  Yes, yes.

Kaylin Ong:  All right, so just wrapping up, do you have any other advice or anything else you'd like to share with our listeners today?

Sharon Goto:  Well, Kaylin, I wanted to thank you for really doing your research, asking really super good questions and bringing this important topic out to people that might be listening or thinking about these issues or maybe wanting to know a little bit more, benefiting from a little bit more. So thank you for that. My message would be that our communities are really rich. There's a lot of strength in our communities and in our families. And so I think the best thing during hard times would be to really lean into the strengths.

So if you need help from people that have always been there for you, that would be the time also to ask for some assistance. And the flip side of the coin is if you're in a position where you're seeing someone else and they may not be asking you explicitly, but you think that maybe you could share some stuff, some time just listening, maybe some advice, some resources, or just really just being there for someone. I think that would be my best advice. Very simple, every day things, just the humanity that we have for each other, I think would be, and really relying on our cultural strengths, would be the best advice.

Kaylin Ong:  Yeah. Thank you so much. Yeah. And on that, thank you so much just for being willing to answer my questions and sharing your knowledge. And I think it's so important to be generous with our time and share stories and listen and whatnot. So yeah, thank you for joining me today, and I wish you the best in the future.

Sharon Goto:  And right back at you. Thank you so much. Appreciate it.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Certified Mental Performance Coach Lauren Becker Rubin on the Mental Health of Athletes

An Interview with Certified Mental Performance Coach Lauren Becker Rubin

Lauren Becker Rubin is a Hall of Fame field hockey & lacrosse athlete at Brown University. She is an advisor to Haverford College’s varsity teams to ensure their mental health well-being as competitive athletes.

Jordan Denaver:  Thanks for joining us today for this installment of the Seattle Psychiatrist Interview Series. I'm Jordan Denaver, research intern at Seattle Anxiety Specialist. I'd like to welcome Lauren Becker Rubin. Ms. Becker Rubin is a certified mental performance coach who works closely with Haverford College's varsity teams. She also works with collegiate and high school teams as well as individual athletes. Before we get started, can you please tell me a little bit more about yourself, any sports that you may have played that made you interested in studying mental performance?

Lauren Becker Rubin:  Absolutely. Good morning and thanks so much for having me. I've been involved in the mental performance space for about 30 plus years, and I think why I'm so passionate about it and why I love it so much is because I was absolutely the athlete that needed it. I was a collegiate athlete at Brown University. I played field hockey and lacrosse. Honestly, if you look at my athletic resume on paper, you would say, "Wow, you had a lot of success, a lot of awards, a lot of accomplishments." But my day-to-day didn't feel that way. I was often frustrated. I had a very hard time dealing with pressure and stress. I didn't feel like I was consistent, I wasn't meeting the big moments and I think mostly I had a really terrible relationship with losing.

I know most athletes don't like to lose, but I really took it personally. I would lock myself in my room after a bad game for hours in the dark and it would take me days to get over things, and it was just a super unhealthy relationship with how much pressure I put on myself, how I never thought I was good enough or never played well enough and just was really unhealthy, so this was 30, 35 years ago when I was in college. One day our lacrosse coach took us to the counseling center and we met with a psychologist who was dabbling in sports psych, which is pretty rare for the 35 years ago - it wasn't as common. A light bulb went on for me and it flipped a switch. I was like, "Wow, this could really help me and it could make me feel a lot better." And it did help me a little bit.

As an athlete, I found it late. That was my junior year, but it really changed my life. I just really got involved in mental health around athletes and mental skills coaching, mental performance as it pertains to athletes in sports just became my life's work.

Jordan Denaver:  Nice. All right, so then into our first question. In your experience, what are the mental health challenges that athletes may face during their participation in sports?

Lauren Becker Rubin:  Great, so athletes face a lot of the same mental health challenges that everybody does. It just gets ramped up a little bit because we're performing. Athletes are on a public stage, so everything they're doing is out in the open and then there's the pressure of winning or losing or playing. The mental health issues are similar. Stress, anxiety, pressure, worry, a lot of fear - fear of losing, fear of winning, fear of embarrassment, fear of getting injured, fear of losing social status, fear of losing your position - so there's a lot of fear of worry, stress, anxiety about performing.

I would say embarrassment is a big one that affects mental health. There's also injury really plays into mental health issues, not playing, being left out, being isolated plays in. I'd say a big one that really affects mental health is loss of identity. If you get injured or maybe you're not playing or maybe you're not the star anymore, athletes identify as being athletes and for their whole lives that's their number one thing and then all of a sudden it's either over or it's taken away, so struggling with identity really affects what's my next identity? What else do I identify with? Affects mental health as well.

Jordan Denaver:  Definitely, I've experienced that too as an athlete. It's definitely tough.

Lauren Becker Rubin:  Yes. I think one of the hardest things for athletes, especially the higher you get at collegiate level, pro, Olympian is when you don't play, whether that's somebody else is playing in front of you or you're injured and it's taken away from you, it's very difficult to process those feelings and it definitely weighs on your mental and emotional wellbeing.

Jordan Denaver:  Speaking to that, what are some positive mental health benefits that athletes can experience?

Lauren Becker Rubin:  There are a lot of them, and one of the biggest is social connection. I remember reading maybe 10 or 15 years ago an article from the “Happiness Lab” at Harvard that said the number one indicator of wellbeing is social connection. Being part of a team, being with people really bumps up wellbeing and mental health. The other pieces of participating in and benefits of athletics is you're part of something bigger than yourself, you're finding meaning and purpose, you're all working towards a common goal, so there's some shared humanity in that. That shared humanity when you win feels good, but also shared humanity when you lose and you have other people to work through it, and those are all really good health benefits.

The other things that athletics has shown to do is build resilience. It shows us we can do hard things. It makes us more adaptable, and because you never know if you're going to win or lose, you have to start learning how to manage emotions around that, and that's very correlated to life. There's ups and downs, there's good things, there's bad things. You have to learn to be able to manage your emotions around that and athletics really helps you do that.

Jordan Denaver:  I think one of my favorite things about working with Haverford College on the lacrosse field is being a part of that team. I love the sport, but on the other hand I love being a part of the team and being with the girls.

Lauren Becker Rubin:  That makes a lot of sense. Connection, community is just so huge for wellbeing and mental health.

Jordan Denaver:  I think we touched on it a little bit, but then on the other hand, what are some potential negative mental health impacts that athletes may encounter?

Lauren Becker Rubin:  They're there for sure. Athletes tend to be very hard driving, type A, on a mission, goal oriented, so with that comes some issues around perfectionism and not feeling good enough, not meeting moments which could lead to some issues with low self-esteem. There is the managing the emotions around stress and pressure and anxiety of games. We did touch on a little bit sometimes when you're injured or maybe you're not playing, you could feel a little bit isolated. That I think some of the other negative things that happened with athletics is maybe some shame around not performing. Then one of the biggest things that could be negative is if it's a toxic culture or toxic coach or toxic teammates and you're in that environment all the time, that really could be negatively impacting your mental health.

Jordan Denaver:  Definitely. All right, so what do you think are the mental health differences in competing in sports on a competitive level versus recreationally?

Lauren Becker Rubin:  It's a great question, and I'm not an expert on recreational sports, but I have read a ton of research and there's a lot of literature out there that about just the benefits of exercise and movement. If you're doing something recreationally, whether it's walking or yoga or Zumba or playing tennis for fun or running a 5K just to collect the T-shirts and it's something that you're doing for fun, it increases mood, it builds the positive feel good hormones. Again, there's social connection in that, and there's a lot of benefits around fun, having fun and a lot of research these days on just doing play. We play as kids and that's one of the most enjoyable parts of the day, but then as we get older, we start losing that playfulness. Doing things recreationally is play, and play enhances a lot of wellbeing, and on a physical, emotional, mental level, we just feel better.

I do want to say there are a lot of health benefits for competitive sports too, and we touched on a little bit about meeting and purpose and being part of a community, but sometimes people throw around the term like pressure is a privilege, and what's behind that is if you're feeling pressure, it means what you're doing is important to you. If you're involved in something that's important to you, there's going to be some benefits there by seeing it through, so there are health benefits of that pressure and of that competition that add to the movement, the exercise, the fun, the social connection that you get recreationally. There are benefits for both, but I think recreational athletes are enhancing mood, they're connecting, they're feeling good, they're having fun, they're playing. There's a ton of benefits there as well.

Jordan Denaver:  Yeah, I agree. I think the pressure of the competitive play definitely works into some of the mental health effects for college athletes.

Lauren Becker Rubin:  And I feel we'll talk about it, but it's how you interpret pressure, which really correlates directly to your mental wellbeing and your mental health. If you feel pressure is something that helps you, helps you get ready, helps you get your body activated, helps you focus because this is something that's really important, then it's a positive benefit. If pressure really makes you shrink and it really makes you worry and it really raises your cortisol and all the not so good hormones, then it's a negative. A lot of it comes to how you interpret what's going on.

Jordan Denaver:  Then on that note, are there any unique challenges or stressors that elite athletes face in terms of their mental health?

Lauren Becker Rubin:  Here's really interesting and what I've found in my practice working with youth, high school, college, and even professional athletes, the challenges are similar. Even the youth athletes and working with the 12 year-olds right now, they feel frustration, they feel stressed, they feel pressure, they have anxiety over performance, they worry about things, so many of the challenges are the same. I think for elite athletes, what makes them unique, and this is college, pros, Olympic athletes, is that they need to be “all in”. They need to be solely focused and it's not a balanced life.

One of my favorite people in the mental performance space right now is David Goggins. And in his last book he called it “Savage Mode”. Elite athletes have to be in savage mode all the time, and that means you have to be selfish, you have to prioritize yourself, you have to prioritize your mission or your goal. I think sometimes that puts you at odds with people in your life. Relationships suffer. I think people judge you. I think it's a little bit isolating. People don't understand you, they want to bring you down.

So I think that is a real challenge for somebody who's trying to be elite, where they just have to be all in, solely focused, very selfish. I think the consequences of that is that people don't get them, and people want to judge you and they want to bring you down or tell you what you're doing is not balanced, but I think it's very hard to be balanced and be elite. I think when you're on that path to being elite, you have to have your blinders on and be all in to get what, to accomplish what you want to accomplish.

Jordan Denaver:  I think just to tie into the pressure, I think especially on an elite level, maybe higher up college like D1 or pros, the pressure of a fan base too really plays into the pressure that athletes feel.

Lauren Becker Rubin:  I think you're absolutely right. I think social media and fans and money and contracts. Imagine an Olympic sprinter who trains for four years and then has 10 seconds to do their craft. I just think that everything we talked about, pressure, stress, anxiety, worry, isolation, just really ramps up the higher you get.

Jordan Denaver:  That ties into our next question a bit. How do you think societal expectations, performance pressure, and competition affect an athlete's mental wellbeing?

Lauren Becker Rubin:  This is a great question because this is the work, and I'm going to give you a roundabout answer to that and not direct answer only because the answer to that is it depends, it depends on the work behind how you allow that to affect you. How it affects you depends on what your skill set is, what your tools are, what your strategies are, and then this is absolutely the mental skills work or the mental performance work or the sports psychology work. It's about having skills and tools and techniques and strategies to manage societal expectations, the performance pressure, the emotions, the competitions, because at the end of the day or the beginning of the day, all those things are always going to be there. The pressure, the emotions, the adversity, the challenges, the social media, the judgment, all of that is going to be there, but if you have skills and you work on the skills and you practice and you train that part of your life or the game, then you have some techniques and strategies to work through those.

One of the things I really like to say is mental toughness and mental performance, managing the mental part of sports is directly linked to mental wellbeing. The skills translate, the more you train and develop the skills that help you perform, the more skills tool strategy you have for mental wellbeing and mental health. The work is training it and the work is doing and the work is having it be part of your daily protocol, building a platform so that when societal expectations ramp up or when you're preparing, feeling performance pressure and it's always going to be there, the adversity, the challenges, the setbacks, it's always going to be there. You have skills to help you navigate it so that it directly correlates to how it's going to affect you. The more skills you have, the more you work on it, the more it becomes part of your daily protocol, the more you can catch it and work with it. Does that make sense to you?

Jordan Denaver:  Yeah, that definitely makes sense. I think especially as you gain more experience, you just know how to deal with the mental pressures of playing at elite levels and just the performance pressure in general and societal expectations.

Lauren Becker Rubin:  And I think the more you replenish yourself, you bolster yourself up with things like breath mechanics and mindset or visualization and imagery, focus, working on resiliency, working on your belief system or limiting beliefs. All of this skill, all of these skill sets becomes part of your toolkit, so then when you're feeling that performance pressure or you're not feeling your best physically, you don't go down a rabbit hole, you go back to... I know with the team sometimes we use physical things like pound your chest, get your energy up, or maybe some EFT to bring down your stress and your anxiety. There's lots of skills and tools that you know can just proactively set yourself up to be in a better place, show up as your best version of yourself, but be able to reset quickly. All of those things weigh into how does it affect you? It affects you different ways when you have skills to counter it or to proactively set yourself up to be in a better place even before that happens.

Jordan Denaver:  Our team does love the heart tap.

Lauren Becker Rubin:  Tap your chest or get big, expand yourself, take up space to feel power. There's just lots of anchors and tools that we can use to help ourselves navigate that, those pressures, because they're always going to be there. It doesn't go away. We just get better, more adaptable and more flexible with working with it and that directly ties into our wellbeing. That's the coolest part of the mental health and mental performances are tied together. We work on skills for helping us play better, but those same skills help us feel better, our overall mental health.

Jordan Denaver:  That's very true. All right, so what role does the team environment and social support play in promoting positive mental health among athletes?

Lauren Becker Rubin:  If the team culture is good, then we're talking about community. Again, connection, fun, shared experience, being in a group, striving for something bigger than ourselves. There's so many positive environmental and social support benefits of being part of a team. There's also teamwork and leadership opportunities, trust building, all these things are great for mental health. Then the vice versa is also true. If the culture's not good, if there are toxic teammates, then the environment weighs in a negative way, but being part of groups is really a great social support network if it's a positive culture. Do you feel that way on your team? On the field stuff helps off the field stuff. We're striving to win games and win championships, but then your group becomes your social support network off the field as well, I would imagine.

Jordan Denaver:  Exactly. My best friends are the girls on my team, and I think we work really hard on building up our team culture, so that takes a lot of time to build that team culture outside of sports and outside of practice and that's why doing a lot of team activities, just like getting to know one another and building that culture and that trust outside of the field, it helps so much. Then you'll see that trust and that support play out onto the field when we're playing games and during practice. I think that's so important.

Lauren Becker Rubin:  Yep. It's bidirectional. It really is on the field, off the field. I love that you used the word trust, because trust and confidence go together. In fact, I think the root of the word confidence is an inner or intense trust, so the culture builds trust, trust builds confidence. The more you trust each other, the more confident you are, the better you play. The more you love each other, the better you play. It is really bidirectional, so culture, environmental, social support really is very entwined.

Jordan Denaver:  I remember it was a semifinal game of this past year and our coach, Coach Zichelli, she said that you need to play for your teammates. I think that speaks a lot to what we're talking about. She's like, "Play for your teammates, play for your seniors who are leaving." So I think it's a lot for just playing for each other and in that way you tend to play well because you're playing for each other. You want to boost people up, you want to show off your teammates, and I think it just all ties together very well in the field.

Lauren Becker Rubin:  I love that concept. Playing for something bigger than yourself, playing for each other really helps us step up into the moment because we don't want to let people down, we care about them, we love and it really brings out the best in us, so I love that concept.

Jordan Denaver:  All right. Next, how do you think athletes can take care of their mental health while participating in sports?

Lauren Becker Rubin:  I think this is an important question and I'm glad that you're bringing it up to the forefront because it's not always upfront. Sometimes it's in the back in crisis, what do we do? So I feel like having it upfront, making athletes know that they have resources. I think how athletes can take care of themselves is to use their available resources, teammates, coaches, counseling centers, mental performance coach like myself, know that those resources are there and don't be afraid to use them and ask for help. Don't hide it. That's another way that you can take care of yourself. We need to change the stigma around mental health, that it's a weakness and by bringing it up, it's really a strength. That means you're working on something just like we would do a physical skill. In lacrosse, if your non-dominant hand isn't strong enough, you work on it. If your mental health, if you're struggling with mental health, you work on it, you don't hide it, you don't lock it away.

And I would say one of the biggest things, ways an athlete can take care of their mental health is to be proactive. Meaning make this part of your daily protocol. Do things every day that build your foundation and get that foundation as big as possible. What I mean by that is sleep, nutrition, working on recovery, maybe meditation, watching funny movies, doing social things that are fun, having friends, going out in the sun or nature, getting a massage every now and then. Every day as an athlete you're doing a lot of things that are depleting yourself, physical exertion, mental exertion, stress, pressure around your sport. You have everything that's depleting you. Not to mention in a college setting all the academic pressure. You have to balance that out with things that replete you, replenish you, and you have to do that daily, know what those things are.

And if it becomes part of your daily protocol, then every day you're having mini wins, mini win, mini win, mini win, mini win. What that does, it adds up to big wins and it builds this great foundation of strength so that when you do have a setback or you might be feeling a little bit off or something really knocks you over the head that you weren't expecting, you're coming at it from a more replenished space. The biggest way I think to help with dealing with mental health is to build up wellbeing and make it part of your daily protocol so that when you do get whammied, you've got some resource already built in.

Jordan Denaver:  Yeah, I agree. I think having that framework is so important, so that you can fall back onto what you know and what skills you've built. Are there any strategies or interventions that coaches, trainers or sports organizations can implement to support the mental health of athletes?

Lauren Becker Rubin:  I think the biggest strategy is to normalize the conversation around mental health. Just normalize it. Just like we normalize that sports are hard and that it's going to take some effort and we're going to get knocked down and get back up. We normalize that life is hard. I think we have to normalize that there are mental health issues with athletes, and when we normalize it then we aren't afraid to talk about it. I also think that coaches and trainers can bring in resources, they can bring in a mental skills coach like myself. They can bring in counseling, they can bring in speakers, they can bring in resources like books or articles or webinars that normalize that, "Hey, this is mental health issues are part of life of being an athlete and things are going to come up and we can talk about it."

I think the other biggest strategy that coaches, trainers, or organizations can layer in is bringing fun to whatever they're doing. Just because you're training hard and you're trying to be the best version of yourself as an athlete, win games, win championships doesn't mean it can't be fun. I did read a research article about this. The best teams, the most accomplished teams over time combine two things and that is grit. Angela Duckworth from Penn has written a lot about hard work over time, perseverance over time, that's grit. You have to do the gritty work, you have to get in there and you have to do the hard stuff, but when you add it to fun, grit, and fun, that's when teams are most successful. That's when athletes are most successful, so I think in a proactive intervention besides the resources and besides normalizing, just make it fun. Make it fun, make it enjoyable, and that really helps support athletes' mental health.

Jordan Denaver:  We talked a lot on our team is bringing the fun back into the sport because I think when you're younger, that's everything that you have really is the fun and the love that you have of the sport you're playing, but as you enter the more competitive level like college, pros, you lose that fun and now you're suddenly just in this space where you're just working to win or you're working in this competitive, this nature and you lose the fun that you used to have as a child and the love that used to have for the sport sometimes. We focus a lot on trying to have fun and bringing back the love that we have for the sport because that's why we play it.

Lauren Becker Rubin:  I love that you're talking about it and that it's an emphasis, because I think it gets lost a lot in college sports where it becomes a job and you lose the fun. I think it really not only affects performance and success on the field, but it definitely affects mental health and wellbeing. I love the fact that you talk about it and that it's part of your culture.

Jordan Denaver:  All right. Next, are there any specific warning signs or indicators that athletes, coaches or peers should be aware of to identify mental health issues in athletes?

Lauren Becker Rubin:  This is a great question and it's a great thing to have some awareness around because sometimes there are no signs. Sometimes, especially for athletes, they want to suffer in silence and they're afraid of the stigma or the shame around mental health issues and the stigma or the idea that athletes have to be tough and strong and show no weakness. Sometimes there are no signs, and that's really tricky when some major mental health crisis happens, everyone says, "How come I didn't see it?" But a lot of times there aren't any signs.

Here are sometimes signs that come up that you could look for: different behavior. Is somebody who's normally social not going out and isolating themselves? Maybe somebody's drinking more or someone who used to drink is not drinking alcohol and drugs. A change in behavior, like someone who is normally loud and social, is being really quiet. Other signs might be someone skipping team functions, maybe sleeping a lot, or maybe you have a teammate that's going home every weekend, that could be a sign that something's going on. Then some of the more obvious signs is someone's just unhappy or they're appearing depressed or somebody is losing a lot of weight or gaining a lot of weight.

The signs are look for differences, somebody's acting, looking, behaving differently. It could be a sign that something is going on behind the scenes that they're not expressing outwardly, but they're trying to deal with inwardly. I would say another thing to look for is if you have a teammate, is it who's injured? I think being injured really plays into mental health and mental wellbeing for athletes because again, you're pulled out of what you identify with and what you love and it's very isolating. If you have a teammate that's injured, I would definitely check in with them and make sure they're okay and make sure they're still feeling included.

Jordan Denaver:  I can speak firsthand to that because I've been injured and I've spent time on the sidelines because of an injury, and watching your teammates play and on the field, it's really hard sometimes knowing that you can't be out there to help them or support them and that your role on the team has changed in a way, especially when the injuries are potentially season ending. It's very difficult.

Lauren Becker Rubin:  For sure. How did it affect your mental health and how did you work through some of those things?

Jordan Denaver:  It was hard. I was out for I think five, six months. I think I recognized that my role on the team was different, that I was on the sidelines and that I had to be more of a cheerleader and less of a contributor on the field, but then I think there was also a lot of hope that I will come back soon, which is also scary too, because coming back from an injury and you haven't played in six months, that's really tough too, but I think the team's very good about it. I think also making sure that you're not isolating yourself. Still maybe attending practices and just watching, still attending those games, still attending other team activities to keep yourself integrated even while injured is super important.

Lauren Becker Rubin:  Well, I want to applaud you. You used a lot of great skills and when you're in a difficult time, sometimes it's really hard to find the things that pull you out of it. One of the biggest pieces of working on mental skills, mental health, mental performance is not being stuck, not being either stuck in one place or spiraling backwards. Do we want to keep moving? And part of keeping moving is shifting out of it. I love that you said I needed to find a new role. If we can use our mindset, "Okay, I'm not on the field, but what role can I take? How else can I look at this where I can be the best teammate? Or maybe I could be a good scout or maybe I could watch film." So you're shifting your mindset to find a different role is a great skill.

And you also use the word hope. Having hope, having faith, believing in things that you don't necessarily have all the proof of yet keeps you moving forward and it keeps you on a path of, "Hey, this could work out, this could be good." So those are all great strategies to keep you from staying stuck where you were or spiraling backwards. Great job of keeping yourself working on... Using tools to get you moving in the right direction.

Jordan Denaver:  Thank you. Let's see what's next. What steps can be taken to reduce the stigma surrounding mental health in sports? I think we touched on this a little bit.

Lauren Becker Rubin:  Some of the things we mentioned about normalizing it and bringing resources I think helps reduce the stigma. I think on a broader level, I know that the NCAA is doing a lot of research and work and education on this topic where they are providing resources to colleges just to make them aware that this is an issue. In fact, I read one of the NCAA research studies they did where they found that for collegiate athletes, 24% of male athletes experienced some mental health issues and 36% of female athletes surveyed expressed mental health issues. I do know that also self-reporting is lower, so it's probably even a little higher than that.

I think education and providing resources by the NCAA would help on the collegiate level, but I really think what helps reduce the stigma is when people step up and talk about what's going on with them. Like Michael Phelps talking about anxiety and other pro athletes like Simone Biles in the Olympics, her anxiety got to her. Kevin Love in the NBA was talking about pressure and stress and some of his issues, and Naomi Osaka from the tennis world. When professional athletes step up and say, "I am working on this, I'm dealing with this. It's not preventing me necessarily from performing, I just have to manage it, influence it, control it, work on it, but it's part, it's there for me." I think it really helps normalize it and it just shows that everybody's human and it's okay not to be okay.

I want to take it into the weeds just a little bit further and say, I think the culture around this could start changing in youth sports. The message just tough it out, run through walls, get up, when someone might be having a mental health crisis is not the right message. We have to do hard things at athletes and we have to push ourselves, and getting out of our comfort zone is one of the most important things that we have to learn how to do, but I think if coaches have an awareness and players have an awareness that there could be something else going on, then there's more language around it, there's more education around it, there's more compassion around it, and it becomes more normalized as part of, this is part of sports, this is part of life, this is part of who we are and let's have some resources to work on it.

Jordan Denaver:  I agree. I think it does start younger because those messages start a little bit less, so when you're younger and they really build as you get older. I think too, having more public figures, spread awareness on it too helps people like college athletes, high school athletes recognize that they're not alone in their anxiety. That these people performing at super high levels also feel it too. I think that's really helpful. I think just spreading awareness of it will help reduce the stigma for sure.

Lauren Becker Rubin:  Right. I agree with you. Kristin Neff, who's a psychologist that specializes in self-compassion is out there with her method, which is breathing and mindfulness, but a piece of that is shared humanity. “Other people are going through this, I'm not alone.” I think as athletes, one of the most difficult things that we struggle with is being compassionate to ourselves because we're so used to being tough and strong and do hard things, but the research that doesn't support that is that when we're more compassionate to ourselves, when we don't play well, when we make a mistake, when we lose, when we're having a mental health crisis, the quicker we actually rebound and reset. That compassion piece is really important. I think the more we normalize it and the more education is out there and the more the culture changes around it, the more compassionate we are to ourselves, actually, the better we can cope with the setbacks and the struggles, because like I said, they're going to be there. That's part of life, that's part of sports. The more we normalize it and then the more we can manage it.

Jordan Denaver:  I agree. All right. Are there any notable research findings or studies that have explored the mental health impacts of participating in sports? I know you mentioned a couple.

Lauren Becker Rubin:  Yep. I mentioned the NCAA one. In fact, I went to that lecture and heard the psychologist that works with the NCAA delivered just how prevalent their mental health issues are with collegiate athletes because of the pressure and there's money and scholarship and losing your college education tied into it, so that's really high. I did read a research article from the American College of Sports Medicine recently that said 35% of elite athletes struggle with mental health issues including eating disorders, burnout, depression, anxiety, social anxiety. At the elite level there is also a lot of mental health issues. There are pros too. I've read plenty of research on what participating in sports, the positive parts, it improves psychological well being, it can improve self-esteem, it can lower depression, anxiety and stress. I read articles where participating in athletics decreases suicidal behavior and substance abuse and reckless behavior, and that piece is maybe being accountable to teammates and to the team.

There's definitely a lot of research on increasing resilience, confidence, empowerment, empathy, just because you're going through shared things. A big thing about participating is increasing healthy habits. When you are active and you're participating in sports, it bubbles over into other parts of your life. You're eating better, you're not doing substance things that you just get on a path. There is a lot of research both ways and I think the research is still developing here, and also the research around how to deal with the pros and the cons is developing as well. It's a rapidly changing space around research and interventions, both positive and negative.

Jordan Denaver:  I think having you speak to our team, I think it's almost biweekly at this point, is so helpful. I know it helps the girls and me too so much, and I think that's a big thing too. Bringing in people to speak to the team and to speak to these issues that are a little bit more stigmatized helps normalize it, because it brings you into a space where you can talk about it, where you have resources to air mental health issues.

Lauren Becker Rubin:  I agree. I think the more you talk about it, the more resources, the more... What's really cool about this space and why I think I'm so passionate about it, as you can tell I love it, is it's ancient wisdom and modern science. The people I've been talking about, a lot of these things, the ancient stoics and Buddha and a lot for years, and now modern science is catching up and the research is backing. Breathing, compassion, visualization, self-talk. All of the tools that we're using are now research-backed, so the ancient wisdom is being supported by the modern science, and I love marrying the two. Giving a concept about manifestation, put it out there the way you want it to happen, and then having research back it up. It's a lot of fun to have the two worlds combined together.

Jordan Denaver:  Actually I've used a lot of the breathing techniques just completely outside of sports. Just any anxiety or stress I'm feeling like, "Okay, I'm going to do a box breath right now." And it's so helpful. It really is.

Lauren Becker Rubin:  I love hearing that. Obviously I want you to be the best lacrosse player that you can be and be the best version of yourself as an athlete, but I really want you to be the best version of yourself as a human being. That's why mental performance and mental health directly intersect. What's so amazing about what I do and why I'm so in love with the mental performance world is because these skills translate to life. The fact that you're using it for anxiety off the field or stress or pressure or in relationships is just really satisfying. What I hope I'm doing is creating opportunities for the athletes and the teams that I work with to reach their full potential, to be their best versions of themselves on the field and off the field.

Jordan Denaver:  And as you said before, a lot of the negative mental health issues that athletes face or a lot of just normal issues that non-athletes face and it just ties more into playing sports. Those are still stressors that people feel outside and breathing techniques and even the heart tap, that helps a lot. It's completely outside of lacrosse and sports.

Lauren Becker Rubin:  Yes, for sure.

Jordan Denaver:  All right, then I think it's our last question. Do you have any final words of advice or anything else you'd like to share with our listeners today?

Lauren Becker Rubin:  The biggest piece of advice, and ironically when I'm first working with an individual athlete or a team, I often lead with this because I feel it's so important. The advice is that mental toughness, mental strength, mental mastery, mental health is not about making it all go away. It's not about making the stress, the anxiety, the pressure, the challenges, depression, fear, worry. It's not about making it go away. It's really about hanging in there long enough so that you can shift, that you can shift out of it, that you can create enough space and awareness that, "Hey, this is going on." And then start using your tools and your strategies.

If you can recognize that these things are normal, start with the premise that life is hard, sports is hard, these things are going to happen. Hang out in it long enough that you can start using your tools, your strategies, your techniques to shift out of it, to move a little bit to get on a different path. I think that's my biggest advice is hang in there long enough that you can shift. Part of that shift though is building the resources on your own with other people, using support so that you have tools and strategies to help you shift out of it, but just to summarize, the advice is don't think that it's good feel... Feelings and emotions are not good or bad, they're just information. Use all the information, hang out long enough, shift out of it. Use your tools, your resources so that you can keep moving down another path.

I think most of us want to close the gap to where we are now and where we want to be, and the work that around the skills, around mental performance, around mental health helps us keep moving towards where we want to be, but where we're now is part of it and it's normal and sometimes it's difficult. When we go in with that mindset, then we're more adaptable, we're more anti-fragile, more flexible, and having that mindset that, "Hey, we could get knocked down, but we're going to get back up. We're going to learn, we're going to grow." Like a growth mindset that we talk about a lot with the team. It keeps us moving, so my advice is build up your resources, have tools, have strategies, know that it's going to be hard, that there's going to be setbacks. Hang out long enough that you can shift out of it and just try to keep moving.

And then my last piece of advice is don't suffer in silence. Get help, reach out, use your support, use your networks. Don't think you have to do it alone. My last piece of advice, sorry, I'll wrap it up, but growth happens when we get outside of our comfort zone and that's called adaptability. Sometimes people call it anti-fragility, but when we stress ourselves, we grow, but our body and our mind, our emotions, our thoughts, all of that stuff, we don't like to be outside of our comfort zone. When we get out of our comfort zone, what happens is we adapt and that adaption keeps us on the path of wellbeing and positive mental health. Getting stretched and getting out of our comfort zone, getting knocked back, initially it's not going to feel good, but with resources and with skills, we'll adapt to it and we'll grow. Adaption and growth is mental health and mental wellbeing, so stay in the fight long enough to grow and to adapt, and that's how we can build our mental health and our overall mental wellbeing.

Jordan Denaver:  I completely agree. I think that's some great advice. Thank you so much for doing this and for joining the Seattle Interview Series.

Lauren Becker Rubin:  You bet. Thanks for having me. It was a lot of fun.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Psychologist Pam Jarvis on Attachment & Trauma Awareness in Schools

An Interview with Psychologist Pam Jarvis

Pam Jarvis, Ph.D. recently retired as an Honorary Visiting Research Fellow at Leeds Trinity University in Leeds, England. Dr. Jarvis specializes in psychological wellbeing in childhood, adolescence, families and education.

Tori Steffen:  Hi everybody. Thank you for joining us today for this installment of the Seattle Psychiatrist Interview series. I'm Tori Steffen, a research intern at Seattle Anxiety Specialists. We're a Seattle-based psychiatry, psychology, and psychotherapy practice specializing in anxiety disorders. I'd like to welcome with us today chartered psychologist Pam Jarvis. Dr. Jarvis is a professor at Leeds Trinity University in Leeds, England. Dr. Jarvis specializes in a multi-disciplinary research perspective, including psychological, biological, social, and historical perspectives. She's written several publications including the book Perspectives on Play, which looks at play-based learning in four to six year olds, and the article Attachment theory, cortisol and care for the under-threes in the twenty-first century: constructing evidence-informed policy. Before we get started today, could you let us know a little bit more about yourself, Dr. Jarvis, and what made you interested in studying attachment and trauma awareness in education?

Pam Jarvis:  Okay, so I should correct that. First of all, I'm retired from Leeds Trinity University now.

Tori Steffen:  Okay.

Pam Jarvis:  And I was a Reader, which is a particularly British term for academics in various, so just to put that on record.

Tori Steffen:  Okay.

Pam Jarvis:  And you asked how I got started, well that's an awful long time ago because I studied as a young mature student when my own children were very small and they're all in their late thirties now. And I had an idea that I wanted to sign on for a degree because I hadn't done that at the so-called right time. And I was interested in psychology and I ended up working as sort of playgroup volunteer and doing my psychology degree at the same time, so it was just a perfect kind of environment to get interested into that kind of arena. And I followed that through really throughout my career with all the other things I've done.

I've also got quite a strong interest in history, but my major thesis in that was written on a pioneer, a nursery pioneer here in Great Britain, although she was actually born in New York State, I think in America, but she grew up and practiced in London. Margaret McMillan actually grew up in Scotland and practiced in London, so it's been a thread, if you like, all the way through my career that, that is the part of psychology that I was always interested in. I would do other things because I'd be encouraged to do that, but then I'd always come back to it. My PhD was on children in early years education, but it was more focused towards their learning on play-based learning. But emotion played a big part in that too, so really it's been a sort of thread that's gone all the way through whatever I've done.

Tori Steffen:  Right. That's great. Yeah, it's nice to have so many different perspectives in your practice. And then I'm sure studying child development with kids of your own might have helped a little bit or given you some knowledge.

Pam Jarvis:  Well, yes. Because you had the theoretical and the practical going on at the same time, so yeah.

Tori Steffen:  Right.

Pam Jarvis:  In action.

Tori Steffen:  All righty. Well, getting down to basics, could you explain for the audience what currently exists in the educational environment for student wellbeing?

Pam Jarvis:  Oh, that's a big question. I think it depends on the nation. The Scandinavian nations are much better at this then we are in Britain, and unfortunately you are in the United States. A lot of it revolves around the importance really that the society accords to that period of life and the interest that lawmakers have in early years development. And in my own country it's not much and hardly any, so I think I worked with a lady for quite some time who was a professor of early years child development education at Salem State University in Massachusetts. And the way she described your childcare provision was a patchwork quilt in terms of what was available in various states. Massachusetts did quite well, I think California does reasonably well, but not quite so well.

I'm not an expert on that, but I think where you can make the judgment on Britain in terms of, well, in England, what we do in England, Scotland is slightly better and the politicians are more interested in early years education and in what I'm going to talk about later, adverse childhood experiences, particularly. The politicians at Westminster in England are not interested at all. They have a very much a kind of attitude to, well, how cheaply can you do it?

Tori Steffen:  Yeah.

Pam Jarvis:  And I think some American states have that kind of attitude when you get a, I don't want to be political here, but when you get a Democratic president, I think you get a bit more interest and when you get a Republican president, you get a bit less interest. And the same thing goes for us that when you get a Labor government, you get more interest. When you get Conservative government, you get less interest. And at the moment, we're under one of the worst Conservative governments we've ever had.

Tori Steffen:  Yeah.

Pam Jarvis:  It's a difficult situation really, but we have hoped that it might get better. Things have turned around before, so I think that we are very dependent in England on the Westminster government, where in America it's the education and it's evolved status now. And it's much more about what state you are living in, but where money's coming from the top, there is a hit on that. Sorry, the trouble with this subject is it so quickly gets into politics.

Tori Steffen:  Yeah.

Pam Jarvis:  We know what good practice is, but it's whether we can provide the lawmakers to actually do it.

Tori Steffen:  Right. Yeah. I think what's important is kind of bringing awareness to just how significant it is to provide the resources for students, so that's what we're going to get into today.

Pam Jarvis:  The Scottish government have done particularly well over the last, I suppose five years. And they've moved in a really big way to a very informed practice. But I wrote a chapter for a document that went forward to Scottish Parliament and it was very receptive.

Tori Steffen:  Wow.

Pam Jarvis:  But not in England, unfortunately.

Tori Steffen:  Yeah. Well, hopefully America and England can learn from others that have a good system in place.

Pam Jarvis:  The Scandinavians. And I think Scotland did draw a lot of its ideas from Scandinavia, although they have their faults as well, nobody's perfect.

Tori Steffen:  Right. All right. Well getting to the topic of attachment theory, could you explain the relevance of attachment theory in education for our listeners?

Pam Jarvis:  I mean the relevance for attachment theory for human beings in every walk of life is enormous. Attachment theory has gone through several stages. And the original one with John Bowlby, who was the creator of the term, had lots of faults, but there's a central core in it, which is the internal working model. And what that means is that when the child is born, it will learn from the adults who look after it how human beings act in their relationships. And where a child gets an upbringing or an environment where they feel that their cared for, that they can call for help when they want, when they feel that their needs will be addressed, they become secure and that then will develop an adult who will feel secure in society. I mean, none of us feel secure all the time. I know I've taught this for years and years to many students and a lot of them actually were parents at the time, and they would sort of come up with this idea, “Oh I'm a bad parent because I'm not perfect. I don't make my child secure all the time.”

I might have actually told them off when I shouldn't have done this type of thing. And I think the first thing to say is, none of us are perfect but we can be good enough, effectively. And it's how the child perceives really whether they're loved and whether they will get support. And then as they grow older, they will apply that model to the rest of society. They will apply it to teachers, to peers, they will apply it to romantic relationships. There are things along the way that can happen that will make things better or worse. It's not just all with, this was one of the thoughts of the original Bowlbyian theory because it was everything with the parents and after the three years, well then that's it. And that's not true, but it is important. What can happen if a child gets the message that other people are not kind and I am not lovable. This is the model of both society and themselves that they will go out with that the self is not worthy of love.

And the society is not going to help you if you ask for help, they're not going to be kind to you. And then all else transpires from that. Most of us go out with it's not an either/or. Most of us go out with something that's somewhere on a scale. This is another thing with Bowlby because it was a 1950s theory. It was very either/or, it's not really like that. But if we're just too far away from the not good enough, what we are doing with those children, you are not only creating that model but also creating an internal stress, it's much easier to stress someone who is not secure because they haven't got any help coming, so we are going to get very stressed very quickly. This is the model of the world in your mind, nobody's going to help me and this is all going wrong. Whereas somebody who is more secure is much happier to go to a colleague and say, “I'm running into trouble here, can you help?” And think that, “Yes, they're going to help me.”

Tori Steffen:  Right. Yeah, that definitely makes sense. How it would have an impact on a child's perspective on if they can reach out for help. And you brought up the stress piece.

Pam Jarvis:  Yes.

Tori Steffen:  So definitely important and very interesting topic to study, and moving kind of over to trauma. How is the topic of trauma connected to wellbeing in education?

Pam Jarvis:  Basically we'll start off with this model of the child of, basically what happened in the 21st century was that there was a lot of work done actually on stress, how stress works within the body. And then this was taken to early years in terms of some children tend to get more stressed more quickly. And what then, because the setting up of the cortisol system is done in the very early years, if that makes sense, so therefore I always cite it to my students like a central heating system that if you've got the thermostat turned up too high, you're going to make the boiler work too hard, so effectively what's going to happen if you continually work the boiler too hard is either it's just going to go poof and die or it's going to blow up. And this is the type of emotion that you've got in these children.

And in education, this does obviously impact on behavior because those children are going to be on a much sort of tighter spring in terms of behavior, they'll do things that seem unreasonable and expect things from adults that seem unreasonable. But the other issue in education is that if you've got these stress patterns running in your head all the time, you are not going to learn as well or as quickly. Because again, the way I describe this to my students is rather like you've got a computer with a finite ability to pay attention to something. And if you are always looking on the horizon for the next bad thing that's going to happen to you, then you don't have that attention or concentration to apply to learning.

Tori Steffen:  Wow.

Pam Jarvis:  So for children who are at the really far end of this scale, it's a really difficult situation. Now here in the UK, one of the issues that is a problem is poverty because this stresses a family, which stresses the child, which creates arguments, which creates insecure attachment, which creates sort of too high reactivity stress reactions. And then this is how disadvantaged children are then disadvantaged as they go along and along and along because when they start education, they're not really set up to learn. And because of the stress that they're carrying, the adverse childhood experiences, which originates in America around about the two thousands also adds some information to this.

I don't know if you're familiar with that, you could probably do a whole piece on adverse childhood experiences, ACEs. Felitti et al, that actually I think was principally studied in California and it's rather simplistic, but it sets up a series of life events that are likely to give a child high adverse childhood experiences, which creates this excess stress. And yeah, it's all related. That's what my article is about. The one that read from early years international is how we put all this together. The work that Bowlby did in the 1950s, the work that's been done in this century on the cortisol reactions and the adverse childhood experiences idea that has come from Felitti. Which is somewhat problematic because again, it rather oversimplifies, you can't just give someone an ACEs score and kind of walk away and say, “Oh, well, that's it.”

This is always the problem with this. And in school in particular, there was a school or an area I think in Scotland that started actually assessing children for ACEs and putting that on a permanent record, but where it can be used to help children and provide help for the family, it can also be used to stereotype, so teachers could go back to it and say, well, this child hasn't achieved because look at their ACEs score, so basically they stopped doing it because it was causing argument. It's something very, very difficult in education because I think in education often there is this problem, which is if we're going to diagnose something, we need to know how to treat it. And if we're going to diagnose it and not treat it, we maybe are going to cause more harm than good because child will be stereotyped, so this is where we are at the moment.

Tori Steffen:  That's a great point. Yeah, there's so many different areas that kind of go into the attachment, and education, and trauma, and the biological perspective that you mentioned, so that's great that you know, were able to take it a step further and kind of fill in some of those gaps by putting all of this information and knowledge together, so it's definitely important to know.

Pam Jarvis:  That was the purpose of the article. Yeah, it was effectively a literature review that said, there's this area of theory, there's this area of theory, there's this area of theory, but they all go together to make this picture.

Tori Steffen:  Right.

Pam Jarvis:  And then of course you are setting the scene for a lot more research.

Tori Steffen:  Yeah, and it just gives us so much more information that's really crucial to providing for those students that have insecure attachments, or trauma, or low stress management, which we're going to get into here soon as well.

Pam Jarvis:  I mean, this is something that, what I worked when I was a teacher, principally with children in the secondary phase, junior high and high school, and I ended up basically going to work to train early years professionals here. And the reason I decided to do that, well, there were so many teenagers that I would deal with who I in the end would think, well, most of the problem with you is something that probably happened before you arrive, but now I'm looking at you at 15 and our options are limited, there are options, but they're limited. Whereas if I go and work with people who work with children in early years, that will be training people to understand this so we can do better at the period where we should be doing better and have more impact, if that makes sense.

Tori Steffen:  Right. Oh, absolutely. Yeah, it's important to kind of reach these children early because a lot of the development is happening at those very young ages, so that's a great point as well.

Pam Jarvis:  There's not nothing we can do at 15, but it's so much better if we did it at three or four.

Tori Steffen:  Right.

Pam Jarvis:  Or even before birth if we work with the parents.

Tori Steffen:  Yeah, exactly, exactly. Well, why do you think is it beneficial for schools to be more aware around the topics of trauma and attachment?

Pam Jarvis:  Well, here in Britain or in England I should say, and in America there's been a sort of fad over the last 10 years for this zero tolerance idea with teenagers that if they do something very small wrong, then you come down on them really hard and sort of make them mind if you like put them in isolation. But the trouble is, if you've got children who are basically on edge all the time, if you apply a zero tolerance regime to that child, you're going to make them much, much worse because the model of themselves they're carrying in their head is, I'm not worthy. And the model of other people they're carrying in their head is they are not going to help me.

All you're doing is justifying both of those beliefs if you're going to apply a zero tolerance technique to them, so where we have trauma-informed practice instead of immediately saying, well, a punishment is going to work here. I think the lady who works in California, sorry, whose name I've forgotten, I always do this in interviews, I should have looked this up, but I've got on her says, do not say what is wrong with you to a child, say what happened to you. They may not know in fact, but that's the question the adult should ask first. If you've got a child who's always creating problems, it's not what's wrong with them, it's what happened to them to make them do that. Obviously all teenagers misbehave at some points and sometimes the reasons aren't very deep, it's just trying their luck because that's the way they are.

But if you are a reasonable teacher or if you are a reasonable school counselor or whatever, you ought to be able to tell the difference. And this is to me where the importance of training comes in. I don't think we need to train teachers to be social workers, but we do need to train them to spot the problems. And I'm honestly not sure about teacher training in the US. I think, again, it is different in different states, but in England, I can tell you for a fact, we don't train teachers like this and it's just not appropriate. They need to be trained in this, in child development effectively.

Tori Steffen:  Right. Yeah, that is a really good point. As you mentioned, maybe teachers aren't exactly social workers, but they do have a large impact on children, on their wellbeing, and it is important for them to have those tools to address issues that come up, so that's a really good one.

Pam Jarvis:  Well, they're a first line practitioner, aren't they?

Tori Steffen:  Correct.

Pam Jarvis:  They're the ones who will flag this up. No one's saying that they have to deal with really difficult cases on their own, but they know enough to flag this up. I mean, all the time I was teaching teenagers because I was a psychologist, obviously I did, but I would go to higher up to various people who would clearly have no idea, and it was so frustrating.

Tori Steffen:  Yeah, yeah, that's definitely important to have. I think that just that alone could make a really big difference.

Pam Jarvis:  It really could.

Tori Steffen:  Yeah. Well, something in your article noted that children who experience ongoing stress from an insecure relationship with adults, they can develop issues with stress management.

Pam Jarvis:  Yeah.

Tori Steffen:  How might that say a low stress management, how might that show up in an education environment?

Pam Jarvis:  It's children who are not focused on learning, sometimes they can act out, but often it's just a kind of just not focused that a teacher can tell this, that the mind is somewhere else. And also a child who's very on the edge, if they get some kind of mild admonishment from a teacher, will just flip out and create a huge amount of difficulty. And then obviously in some regimes, the punishment for that is very harsh. One of the things English schools do is often exclude children for either for a short time or if they really badly offended them permanently. But that doesn't answer our question, it just passes it on. And there's a term here in the UK, I'm not sure if it's familiar to you, which is the exclusion prison pipeline.

Tori Steffen:  I haven't heard of that.

Pam Jarvis:  Yeah, so the child is effectively back out of education and then they'll turn up in prison sometimes later.

Tori Steffen:  Right.

Pam Jarvis:  And still carrying whatever it was that happened when they were three, and nobody's tried to address it or two or whatever.

Tori Steffen:  Right, which could create issues down the road that could have been avoided from the start.

Pam Jarvis:  Well, the biggest sort of irritation to me is that is so expensive.

Tori Steffen:  Yeah.

Pam Jarvis:  It costs more to keep a child here in secure accommodation, child offenders, than it does to send a child to Eaton where Prince William and Prince Harry went, so what is the sensible thing to do? It's not just about being a woke liberal, it's about common sense.

Tori Steffen:  Right. Yeah, that's a really good point. Well, what can schools do to help students with higher stress and insecure attachment styles?

Pam Jarvis:  Well, we need trauma informed environments, so this is staff training so that all teachers are aware when to spot the signs of a child who is highly stressed. And we also need, there's endless arguments in England about exclusions that if a child is dangerous to other children, you can't keep them in the classroom. I mean obviously that's true, but the question is, is where are you then sending them? Are you sending them to an isolation booth and punishing them or are you sending them to an adult who is trained to work with them. And actually get to the bottom of what it is that's bothering them? Often, as I say, they can't say, but it's taking, if you like, I think what the adult has to keep in their mind is this child most likely has a model of themselves that is they're not lovable and they have a model of me that I'm not willing to help them, so it's starting to work on that.

Tori Steffen:  Yeah.

Pam Jarvis:  Wherever it is you are sending them. Teachers can do this too for children exhibiting sort of lower levels of stress, but that needs to run all the way through the school process. And we're really not very good at that in this country.

Tori Steffen:  Yeah.

Pam Jarvis:  With the fact Scotland has made a start on this.

Tori Steffen:  Okay, well it's good to hear that somebody out there is confronting the situation and hopefully we can learn from what works, what doesn't, so that we can kind of reap those benefits as well.

Pam Jarvis:  What we hear, the problem, I'm sorry, this is becoming a very policy oriented discussion, isn't it? But the thing is, you can't, what we hear is actually putting this kind of policy in place is very expensive, but the argument is that more children are going to come out the other end who are not going to go into prison, who are going to create family lives that are less fraught themselves for their own children. And it's that invisible saving. There was a project actually in the US called Headstart, I don't know if you've heard of this? Where children from projects and their parents were given a lot of help and care, they'd be about my age now in their sixties. And there was disappointment because it hadn't made them sort of hugely academically more able when they got to school than children that hadn't had been in the project.

But as they grew older, they were more likely to form secure partnerships, adult partnerships. Their own children were more likely to be secure, they were more likely to be employed, they were more likely to graduate high school. So all of that, even though it hadn't made them super clever or raised their IQ by a huge amount, that security in their lives had made them, if you like, better citizens, be because they had a good, we keep going back to the internal working model, don't we? Because they had a self-confidence in their own abilities, and they also had the belief that the society was a good place.

Tori Steffen:  Right.

Pam Jarvis:  Why would I contribute to a society where I think nobody much likes me, or is going to help me.

Tori Steffen:  Yeah, that's definitely important to understand how, it just sounds like it's very significant, the attachment style and the way that the child perceives themselves and others, which makes sense that, that alone can have such a big impact on educational success. And then later in life relationships, so many other areas in life.

Pam Jarvis:  And educational success doesn't just mean high grades and going to an Ivy League university.

Tori Steffen:  Right.

Pam Jarvis:  It means getting to the end of education, graduating, and maybe doing a very ordinary job, but that security to do that, to stick at it. And attachment is really, if you like, the melting pot for all this.

Tori Steffen:  Right.

Pam Jarvis:  That early part of life where we learn who we are and how other people will react to us, our expectation of ourselves and others.

Tori Steffen:  Absolutely. Well, if students are experiencing anxiety or other mental health issues, are schools able to provide any type of therapy or even just recommend that the caregivers seek out therapy?

Pam Jarvis:  Well, again, in England, and in America, I presume it again, depends on the states. In England, no, we are in terrible trouble with this. We've got huge amounts of teenage mental breakdown, which isn't only to do with the home, it's to do with social media, and to do with the experiences they went through in lockdown and COVID. Our mental health service is massively, massively overloaded. But really we could, as I say, train other professionals in the children's workforce to be able to do some of the work, but we don't.

Tori Steffen:  Right.

Pam Jarvis:  Every so often the prime minister, whoever it is this week, says, “Oh, well we are going to put more money into the mental health service.” But my kind of reaction to that is, well, that's like pushing somebody off a cliff because we've got so many families living in poverty here and sending an ambulance in the bottom. Why don't we help families at the beginning, so we don't have so many kids with mental health problems in the end?

Tori Steffen:  Right.

Pam Jarvis:  We can't really do much about social media or there are things we could do, and I have written about that. And again, we could do a lot more about family poverty, a lot more.

Tori Steffen:  Yeah, yeah.

Pam Jarvis:  We can't make all families secure.

Tori Steffen:  Right.

Pam Jarvis:  But we can raise the chances, and we just don't bother.

Tori Steffen:  Right. Yeah, why not start from the beginning versus trying to fix issues later down the road when it's going to be, you have limited options as how to help these individuals.

Pam Jarvis:  And their bigger issues.

Tori Steffen:  Yeah, and they already have that ingrained insecure attachment. Yeah, I think it would be more beneficial from the beginning, see what you can do to intervene there versus later on.

Pam Jarvis:  I mean, I haven't actually specifically written about this, but I mean logically, if you are insecurely attached, the type of trolling and bullying you get on social media is going to have a much bigger effect on you and so on.

Tori Steffen:  Yeah, yeah, because you just have less tools maybe to deal with that kind of stress.

Pam Jarvis:  Yeah.

Tori Steffen:  Yeah.

Pam Jarvis:  Well that's the thing with stress, isn't it? The actual term stress was taken from engineering, I believe originally and if you've got a bridge that's built with stress metal, you put a train on it that's too heavy and it goes pow, same thing for human beings.

Tori Steffen:  Yeah, I like the analogy.

Pam Jarvis:  If this is already cracked and you put a heavy load on it will give way.

Tori Steffen:  Yep. Yeah, that's a perfect analogy for kind of what you can expect from students. Well, what can families do on their own to help children develop a secure attachment? And if they are able to develop that secure attachment, do you think that, that would lead to a higher wellbeing in a school environment?

Pam Jarvis:  We have to recognize how hard it is for families to start with, I think, because I would hate to input family blaming because there are so many stresses on families now. But all things being equal, what the child needs in the first three years is a group of bonded adults. Bowlby said it just had to be the mother, this is not true. That's been shown again and again and again.

Tori Steffen:  Yeah.

Pam Jarvis:  What children need is a circle of adults, it could be three, five, but who take care of them and are bonded to them and what they will, who are emotionally available to them who have a focus on them. And what tends to happen is they create a main attachment and then these subsidiary attachments, so therefore it doesn't really matter. Your daily round could be to be with mom on one day, with dad on another day, with granny one on one day, granny two on the other day. That's fine, as long as that's familiar and you are bonded to those people. And out of that a main attachment will come, but the other people are acceptable substitutes. The big problem that you have with children is if they're sent particularly to daycare where the staff keep changing and then they don't have an adult in that environment who they have that bond with.

And there are ways, personally, and this is just my personal preference, I would prefer that families were at least given the option for parental and kin care within the first three years. But if there's a lady down the road who's a really experienced child minder and you're paying her to take care of the child and she's wonderful with the child, what's the problem with that? She just becomes another one of that bonded circle. Barbara Tizard who worked with Bowlby, I think she's still alive, but she'd be quite old by now. She said, well look, the way that children were cared for in the early industrial period in Britain, because women did have to go out to work when they worked in the field, obviously the children could often tail along behind them, but there was a tradition in England of paying one woman in an extended family to care for all the children, so it could be a sister, a cousin, it could even be a grandmother.

But this created, although they might have been poor or sometimes the kids didn't get enough attention, there would be a group, a kin group of children, and a bonded adult, so really, in many ways that's better than sending a child to faceless daycare. It's a really low, here across the UK and in America childcare is, the parents pay for it. If you're lucky, I think in America you are going to get a creche attached to your job, that doesn't happen in the UK, so parents pay for the daycare that they can afford, so if you've got parents in poverty, often they're paying the lowest price for daycare and that daycare is paying the practitioners the lowest possible money. And those practitioners are, they're moving in and out of those roles all the time because they're so badly paid and they'll get a better job. It really is setting up a child that, if you like, disadvantage leads to disadvantage, leads to disadvantage.

Our prime minister for 60, 30, I can't remember, about 45 days, wasn't it Liz Truss, she was children's minister of 10 years previously, and she was asked, would you send your child to this type of daycare? And she said, “Well, children do get care, obviously I'm not looking after them all the time.” And it came down to the fact she had a nanny. Well fine, they can bond with the nanny. With attachment, what I think this is something that's often missed, the disadvantage often breeds disadvantage all the way along the line because it's about how you fund your family.

Tori Steffen:  Yeah.

Pam Jarvis:  And that is often in direct sort of opposition to good attachment in that first three years.

Tori Steffen:  Right. Yeah, you can see how it could be a domino effect of sorts and it's going to have an impact on the development of the child, and especially around trauma and attachment, so yeah those are important things to think about when you're choosing care for your children. And a really great point about the bonding with a number of adults, I envision just the parents, but it really makes sense to have a larger group of adults that children can bond with.

Pam Jarvis:  Well, granny's are often very helpful in this respect, but as you know, society's getting poorer, then often the grandparents are having to go to work.

Tori Steffen:  Right.

Pam Jarvis:  It's quite worrying, I think what is happening in the current situation where we have rising fuel prices, rising inflation, and it's making families poorer and poorer. And at the bottom of all this, children are suffering.

Tori Steffen:  Yeah, yeah, absolutely. I can definitely see how that would have an impact. And let's say everything goes right and a child does develop that secure attachment. Do you think that a secure attachment leads to wellbeing in school for that child? They can accomplish it a little easier.

Pam Jarvis:  I think they have the best chance of being the best that they can be. If you send them to a really bad school, well then nobody is emotionally indestructible. You can't bank on it, but you've given them the best chance, I think.

Tori Steffen:  Yeah. Yeah, I would agree. I think you're setting them up for success in a way. Yeah, just providing a good development, so I definitely agree with that.

Pam Jarvis:  It's kind of how we see success and success in a life, well it doesn't necessarily mean you went to the best university or you had the highest paying job.

Tori Steffen:  Yeah, very true.

Pam Jarvis:  It's being comfortable to be yourself and you've got your best chance of that if you feel that people like you and that they will help you.

Tori Steffen:  Right. Yeah, just having a healthy perspective on the world, on yourself will have a big impact on what you choose to do in your life, no matter what it may be. All right. Well, Dr. Jarvis, do you have any final words of advice for our listeners or anything else you'd like to share with us today?

Pam Jarvis:  Yeah, I think we have to see children as much more important in neoliberal societies like the UK and the US than we do. They are almost pushed under the wheels of the economy and profit. And we exist in order to make money and to make profit. And in that culture, the children are the ones who suffer the most. I think particularly, we... Actually, today we've had a news article about a private company that we're responsible actually for looking after children in residential care who gave them the most appalling service because their motive was profit. Rather than the quality of the care for children. And I think we are in danger of pushing children under these wheels and just not worrying about the emotional setup we are building for their future, but the only future that any of us have is our children. And I think this is something that we just don't think about enough.

Tori Steffen:  Yep. Very good points there. Yeah, like you mentioned, it's important to just start early so that you're not spending, you have to create all these policies and put things in place for later down the line as far as social workers and wellbeing. It just makes more sense to put the emphasis on child wellbeing during development. It's going to do your children a favor and just kind of well roundly help everything else along the way.

Pam Jarvis:  The economy is for people, people are not for the economy. And I think that's especially relevant to childhood because of the development that they need and the human things that we have to give them to allow them to develop healthily. We pay a lot of attention to physical health, because we can see it. But we don't pay enough attention to emotional health.

Tori Steffen:  Yes.

Pam Jarvis:  And then very quickly, it's coming up to too late. You're going to have to do an awful lot of work to reclaim that child where if you've done it properly first off, then it wouldn't have been so difficult.

Tori Steffen:  Right. Yeah. Well, hopefully parents and teachers out there can kind of develop those tools and skills to help these young kids develop in a healthy way, so thank you so much for sharing all your knowledge today with us, Dr. Jarvis. I've definitely learned a lot and I'm guessing our listeners did as well, so thank you so much.

Pam Jarvis:  Thank you.

Tori Steffen:  Thank you so much, and thanks everybody for tuning in and we'll see you next time.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Social Worker Erin Maloney on the Innocent Lives Foundation

An Interview with Social Worker Erin Maloney

Erin Maloney, LCSW is the Director of Wellness for the Innocent Lives Foundation. She is a licensed clinical social worker specializing in trauma, addiction, ADHD, anxiety, depression, and other mood disorders.

Theresa Nair:  Thank you for joining us today for this installment of the Seattle Psychiatrist Interview series. I'm Theresa Nair, a research intern at Seattle Anxiety Specialists. We are a Seattle-based psychiatry, psychology and psychotherapy practice specializing in anxiety disorders.

I'd like to welcome with us clinical social worker, Erin Maloney, who is the Director of Wellness for the Innocent Lives Foundation. Erin earned her Bachelor Degree of Science and Psychology from St. Joseph's University in Philadelphia, and a Master's Degree in Social Work from Widener University in Chester.

She is currently a licensed clinical social worker specializing in trauma, addiction, secondary trauma, ADHD, anxiety, depression, and other mood disorders. Thank you for joining us today, Erin.

Erin Maloney:  Thank you for having me.

Theresa Nair:  Before we get started, can you please tell us a little bit more about yourself and what made you interested in studying clinical social work?

Erin Maloney:  Absolutely. I am a little bit about me. I am a mother of three. I also have a husband and a dog. I live in Scranton, Pennsylvania, like “The Office”. I have always been interested in mental health, actually since a very young age. I told my mom probably about five, six years old that I wanted to become a therapist and she just pushed me along to do whatever I wanted and follow my dreams.

I did, I entered into psychology and I loved it and I worked for quite a bit with my Bachelor's doing case management type work, but I realized I needed to further my education. While I was finished with my Bachelor's, I saw a plethora of therapists in the company that I worked for. It was a nonprofit behavioral health clinic and I saw everybody from LPCs to LSWs, LMFTs, every acronym in the book.

But my immediate supervisor was an LCSW and I found that she had the most, at the time for me, the most variety of opportunities. She could be a director of a program we might have had for behavioral health for children. Or, she could have actually done private practice type work, and I liked that because I could see a lot of settings.

That's when I decided to embark into Widener. I worked full time but got my Master's at night, and I really enjoyed finding that I wanted to keep pursuing from my Masters to license into the clinical license. That's how I got started in it. Always had an interest, always had an interest in people's minds and how it worked.

Theresa Nair:  That's great. It's wonderful when you feel like you're pursuing your purpose and even your calling.

Erin Maloney:  Yes, yes.

Theresa Nair:  For those who are not familiar with your organization, I'm wondering if you can tell us a little bit about the mission of the Innocent Lives Foundation and how it works to bring anonymous child predators to justice?

Erin Maloney:  Absolutely. I just want to say at this point, just a quick little trigger warning. My foundation does deal with trauma related to children and exploitation in any sort of assault. So just a little trigger if anybody is listening in to take care of yourself before or after. I don't think much will come up, but I always like to give that in advance.

Innocent Lives Foundation, what we do is our mission is to do that. We try to get the predators who are hiding online behind the scenes who are trying to exploit children or publish and/or share materials of, we call CSAM, Child Sexual Assault Material. That's our biggest mission is to bring to light the people hiding, to get them out of the dark and get them prosecuted properly.

Now, one of the things I always like to mention is we are non-vigilante. That is a very important part of our mission. We do not set ourselves up as young children. We do not try to entrap perpetrators. This is actually information we find on the open web. It's unbelievable what you would find on the open web, but we use what they call OSINT, which is open-source intelligence. It's basically anything any of us could find on the web, but they know where and how to look specifically for predators laying right within our children.

What we do at the ILF is we get leads and it could be come from, we have a form right on our website that people can enter. It could be a parent concerned about maybe who their children are chatting with. We might get law enforcement to say, "Hey, we could really use some good computer diving hacking skills to find out this case."

Or, it could actually come directly from somebody who might give it to us. Or, our researchers actually are doing the research and they can find a lead. Just be so maybe a username or somebody having an inappropriate photo up. We have, at ILF, different aspects that I wanted to go into because it sounds very confusing. What are you guys doing?

We have three distinct teams. We have what we call The PIT, which is Predator Identification Team, and they're our researchers and they are phenomenal hackers. We call them good guy hackers. They use their skills for good and they're all volunteers. But what they do is they are literally the ones behind the computer doing all the research for us finding this.

We have Education and Outreach Team, which those are our people who are more about putting out blogs, putting out educational materials, fundraising for us. They're really good for caregivers who might be struggling with anything like this.

Then lastly, we have a Development Team and what they do is they actually protect our PIT by developing tools that they can use to protect our PIT people from what they see. One of the big things we have is a blur tool so that our researchers are not seeing actual skin, they just see a blurred image and they can unblur it enough to maybe see a face if they need it, but it's to help them not be exposed to so much content in terms of that.

Those are our three distinct teams, and so what we do at ILF is we all work together in tandem to basically have that one common mission to help bring predators out of the light.

Theresa Nair:  That's great. I mean it's really interesting that you have the blur tool.

Erin Maloney:  Yes.

Theresa Nair:  Because I was wondering, how do you search for this without seeing all of it? So, that would be helpful.

Erin Maloney:  Yes, yes. We very much try to protect. Unfortunately, sometimes the text cases are some of the hardest because you're reading it and your mind goes there, but we still try to protect as much as can.

Theresa Nair:  Is that on the general internet or what's referred to as the dark web?

Erin Maloney:  Yes. Yeah. There is a whole dark web that we are aware of, but we actually try to leave that to law enforcement to do themselves because it is such a gray area. We keep everything above board. Like I said, we're trying to not be vigilantes, not get ourselves in trouble.

Everything people do, even our researchers do things on a device of ours so they're never caught with any sort of material or viewing. We would never want anybody be in trouble of any sort, so everything is done through a computer they have from us with tools and things like that to protect them.

Theresa Nair:  Okay, that's good. That helps to clarify how you even do something like this?

Erin Maloney:  Yes, yes, exactly.

Theresa Nair:  You spend a lot of your time working with volunteers within the organization, the people who are using their skills in order to help identify child predators. You're providing counseling services, I believe. Can you explain why it's important to provide this type of service to the volunteers, and what types of mental health impacts can result from this line of work?

Erin Maloney:  Absolutely. As this started, my CEO he realized quickly, he actually started Innocent Lives Foundation by accident. He is what they call a pen tester. His company does do security breaches for companies to help them learn how to improve the security of their companies.

In doing so, he accidentally stumbled upon child sexual assault material on somebody's device and was able to turn that into law enforcement. It was very validating and reassuring for him and he thought, "I did this so easily, why couldn't we do this as something like a nonprofit or a mission?" He started it from there, which really led to, but he knew the importance of the mental health piece. He said, "If we do this, we have to make sure we're not harming anybody in doing so."

That's how it's always been a proponent since day one. I'm part of every aspect from when they get onboarded. We have a very extensive onboarding. People go through various interviews, and one is a wellness assessment with me because again, we are trying not to damage anybody. If there's significant trauma that's maybe unprocessed or raw still, we're not going to want to have somebody in that capacity working right now with us.

By doing that now you had said, so there's the component of me meeting them early on and then I actually meet with them once a month if they are what we call The PIT, so at minimum they have to meet with me once a month. If you are in another aspect of our team like Education Outreach or Development, you only have to reach out with me once every three months because obviously they're not dealing with the content as much. Like I said, it's different timeframes for different people.

So, that's how I work with them. Now, if somebody has a already current mental health... Now remember, these people are coming voluntarily and not all of them have a psychological disorder. Not all of them have an Axis 1 diagnosis. However, some do and when they do, I make it very clear that I'm more of a wellness piece. If they need extensive work, if there's somebody that I sense needs almost weekly sessions or if they have an addiction they're struggling with or anything even more significant, then I definitely refer them out to a private therapist in their area and/or medication management or other resources.

Then I actually collaborate with any of the people they need me to collaborate with because it is such a unique setting situation. If a therapist needs a little bit of advice or what we do where we do, I'll consult with them as well. I'm involved with them quite a bit, at least once a month and I have a very good rapport with all the volunteers.

Theresa Nair:  Do you find that people may need more services the longer that they do this? Or maybe after particular incidents? Are there maybe something in particular that they find or is it steady?

Erin Maloney:  No, you know what it is? Actually, it's not the work that I notice, it's life changes that impact their volunteering with me. When I say that, we have new parents, for example. Let's say a volunteer has never been a parent, but suddenly they're a parent and they might be one of our researchers. They may not suddenly be able to stomach what they once stomached, and so they may very well say, "I cannot."

We actually have a pause program which is completely non punitive. It's something the volunteer can initiate, or myself if I really sense somebody's just not doing well, I'd encourage that. Really, up to 90 days they can just quietly stay with us. They can join meetings if they want, they can meet with me if they want, but they're not required to do any sort of minimal work for us to keep them active as a volunteer, which is nice.

Then the other option is we also have moving around. We had one PIT member who had a hard time, again with children, and almost sometimes people could actually put their child's face on a victim, which you'd never want to see happen. That is, we never want to damage anybody. So, that person actually still wanted to be with our mission so they stepped aside to Education Outreach and they write educational blogs, or they might speak publicly at a local community event for themselves.

It's really neat. You can still move around and help with that very same mission, but not damage yourself psychologically if you are struggling. I don't find the work... I feel like if people are already here in the mindset to do this type of work, then they've either been exposed to things or they're pretty prepared to compartmentalize their brain to step into this work and step out of this work.

Theresa Nair:  That's interesting because you would assume that maybe it was something that they saw. But it's interesting that it's more life changes that they might be going through.

Erin Maloney:  It truly is. Yep.

Theresa Nair:  And what they're able to view at different points in their life.

Erin Maloney:  We have a very strong level system, that when they start, they start at a very bare... it's more just finding leads. Maybe finding usernames that might be connected to something, and then there's levels. We're not going to have somebody brand new coming in exposed to something that might be very horrific.

I don't even, age is a big factor. Maybe younger children might be too difficult for them, so we're not going to do that. We're going to have them work up in levels and so that they're not really exposed to anything too much too fast because they could process with me the whole time they're doing it whether they're okay or not with that.

I'll check in on them with their case and how it's affecting them and generally fits good and they seem like they're confident with it, then they can move up in the level system, if you will.

Theresa Nair:  Sounds like there's a lot of options for volunteering.

Erin Maloney:  Yes, yes. We do not let it damage or harm anybody because they're helping us. They're volunteering for us, so we would never want to do anything that could hurt somebody.

Theresa Nair:  Okay. I know you've mentioned, and it says on the webpage as well, that you use cognitive behavioral therapy to assist your work with Innocent Lives Foundation.

Erin Maloney:  Yeah.

Theresa Nair:  Could you talk a little bit about how you use that, and then also if there's any other techniques that you find to be productive?

Erin Maloney:  Absolutely. Like I said before, my wellness sessions are typical check-ins. How are you doing, tell me what's going on in your life? But what I listen for and people know, all the volunteers know I use cognitive behavioral therapy because I'm listening for any sort of negative or illogical thoughts and they know that and they know when I can pinpoint that, what I might hear.

If I sense that somebody's really struggling with something, then we will start using cognitive behavioral techniques to see if we can figure out whether this is something more pressing, either a budding anxiety disorder. Or, if this is just something in their lives, maybe an adjustment to something that they're dealing with.

I do a lot of reframing. If I initially hear them say something negative, I might put it in a different reframe. If they're like, "Oh yeah, yeah, yeah" and they get that and I don't hear it again, then I realize they might have just been dealing with something. What I do a lot of with the volunteers is activity scheduling in terms of cognitive behavioral therapy. Because what we do is you would not be able to necessarily do this work in front of your family in the middle maybe of a work day. There's a lot of this content that cannot be exposed. We have to activity schedule, is it best to do this maybe an hour? But you don't want to do it right before bed either. Maybe there's an evening hour that this is best for. Or, perhaps you have a quiet hour in the day with nobody around you. We do that to find the best for a person to pick the time that they can do this type of work.

Role playing. If somebody's struggling with anything really in their lives, but in particular maybe wanting to switch gears in ILF, I might help role play with them. Maybe if they want to approach that with our COO and how they might be able to switch over into a different capacity.

So, I do a lot, now again, if I sense it's something more, then I will encourage them to seek out therapy on an ongoing basis so they can do real true weekly or even twice a week sessions if needed. But generally with some cognitive behavioral therapy, I could figure out if it's something more or not, and that's what I tend to do.

Theresa Nair:  Okay, and do you tend to see any increases in anxiety or depression from the volunteers when they work for maybe an extended period of time on this?

Erin Maloney:  Well, it's funny you said that. If I do sense that, then that's again where I will go into that pause option. "Hey, do you need to pause? Are things getting too much for you?" But it's funny you say that, I've actually seen it go both ways. Where I've seen it in the negative might be, again, if they have a, let's say they're starting a new job position and this is their volunteer position, they might have too much on their plate and so their anxiety's increasing and then they have guilt about not doing their volunteer work, then there's all that.

If I sense that, then we definitely encourage a pause and again, a pause could be 30 days. It doesn't have to be 90 days, but we just encourage that you take a little mental break, take a break from us and come back when you're refreshed and ready.

However, it goes on the other side where this work is very validating sometimes. Because a lot of our volunteers may either have been a survivor of assault in their past. They could have been groomed as a child themselves, or they have a family member who this maybe impacts. When they have a case that's a win, that is completely validating. It's a way to take power back from maybe where they've felt powerless in their past. It can actually be very, very good mentally as well.

The only struggle with that is the reality is we don't always get feedback from law enforcement of how our case is? We hand in a report to law enforcement, but it might not always be clear whether that case went to trial, whether that person was convicted.

We don't always get the information, and so I have to make sure the volunteer's okay with that, that we're not always going to know every win. Are you going to be able to stay motivated on cases you don't know the answer to? There's a lot of areas to poke around in there.

Theresa Nair:  That is interesting. There's that sense of empowerment, right?

Erin Maloney:  Yes, yes.

Theresa Nair:  When they're able to do something, but I'm sure it's a little frustrating when you just never know what happens?

Erin Maloney:  Yes. Exactly, exactly. But that's not our role. We don't want fame, we don't want to be associated with putting somebody away. We are really truly just totally behind the scenes trying to help. We have the computer skills to find a lot of people and we try to hand that over to law enforcement, and so we don't always get the answers.

Theresa Nair:  Do you think there's other areas of volunteer work, or perhaps other professions in general that would benefit from providing these types of mental health services to volunteers or to employees?

Erin Maloney:  Yes. It's funny you say that. We have some volunteers who are either currently or ex-military, or current or ex law enforcement. They have said many times that if they had somebody at their office to talk to, it could have made a major difference for them with some of the things that they endured or witnessed.

I know there's a lot of EAP programs for companies, but I think there is something at me being here every day for them that makes a very big difference. They just know. I get to know them very well. It's a stable, long-lasting relationship, and so they don't have to re-explain themselves to somebody new. I'm part of the team itself and employed there, so it makes a big difference I think in that consistency that they know I'm here and they could come to me at any time.

Theresa Nair:  It seems it might also be beneficial that you have a regular scheduled monthly meeting at least with everybody.

Erin Maloney:  Yes.

Theresa Nair:  Because I think sometimes in workplace mental health services, people are afraid to use them because they're afraid of being stigmatized even if somebody sees them going to talk to the person, or if the boss finds out that they're talking to the person. Do you think it's helpful just going ahead and scheduling appointments with everybody?

Erin Maloney:  Yeah, I really do. It's so funny you say that. Yeah, because I could definitely tell there's a resistance. Our team, for the most part, it is a lot of people who happen to be in cyber security type industry. When you're in that industry, you actually tend to be, not to stereotype an entire group, but sometimes you tend to be introverted and private.

Therefore, I do think this forces people a little bit out of their comfort zone and then they do realize, "Oh, this isn't so bad." Because I'm not deep diving way into their past, Freudian style. It is non-confrontational. I go at their pace and whatever they choose to talk about. Obviously, we talk about case work, but anything else they might need to address.

It gives them a huge shift if they already had a fear or resistance to therapy where it's not so bad for them after a while, once they get to know me better. Yeah, I agree. I think it's very good that it's almost forced upon them and I send out reminders and I reach out.

If they avoid me after a certain amount of time, then we have to do the whole, "Are you trying to pause? Is there something you need?" So, it's nice, but that's rare that I don't hear from somebody

Theresa Nair:  Then it's, "Well, I'm talking to her anyway. I may as well have a real conversation, right?"

Erin Maloney:  Exactly. The other thing to this is that again you mentioned, you asked about different fields. Well, law enforcement or some other heavy content type professions, they can't turn to their family or their loved ones and just spill what happened in their day, similar to this type of work. They're not going to turn and say, "Guess what this case is about?" You can't. You want to protect your own loved ones and family and friends.

A lot of our volunteers are anonymous, so this gives them a direct place to process what they need to process without feeling they're burdening anybody. Without feeling like they're going to hurt or harm anybody. It's just a safe space for them dedicated to them, and I feel like it gives them that open door.

Theresa Nair:  Then they can talk about that case work that they maybe couldn't discuss with other people.

Erin Maloney:  Exactly, exactly.

Theresa Nair:  I think that's a great model. I wish more places would do that.

Erin Maloney:  I do too. I do too. It's very nice, and I do feel like with law enforcement in particular, I think of that field and just the things that come home from, or anybody on the front lines really. After a really rough day of what you might witness or see or hear, and then you have to go home with that.

That's where I feel for people when they don't have any place to just unload that on, and making the time. That's the other thing you had mentioned. We all have a hard time making the time, and at least with this, it's mandatory so it's part of your volunteer. We ask people to volunteer if they're volunteering with us for about 10 hours a month if possible, but that includes a lot.

We have a team meeting, which is once a month. We have myself, would be an hour so that's already detracting right off their volunteer hours for us, so it helps that it's just built right in for them.

Theresa Nair:  Right, and then they don't have to take the initiative to seek out speaking to somebody. It's just a part of it.

Erin Maloney:  Exactly, exactly.

Theresa Nair:  Well, as someone who specializes in cognitive behavior techniques to support the mental health of those engaged in volunteer work, do you have any parting words of advice or anything else you'd like to share with our listeners?

Erin Maloney:  Sure. I mention this to volunteers all the time, and I would like for your listeners to know. I think balancing life is the key. You really have to balance your life, and volunteering is actually a very worthy and beneficial cause to you. This really helps fuel your soul. But if the plate's full and you just need to get rid of something, then that's generally, unfortunately some self-care things or things we do for ourselves might be some of the first things to go.

So, I just always say, "Stay balanced." But if you are realizing you can't manage everything, you can't problem solve, you're losing your focus, you don't want to burn out. Really, I always say we cannot, you do not want to burn out. Before you start, that's where, going back to the cognitive behavioral I therapy, I listen for the negative.

If I start hearing negative comments and negative thoughts that are just kind of untrue, I really try to help reframe. But if it's not possible, then we have to look at what they might have to cut out of their lives? What they might have to do to manage things? Balancing life, self-care is very important, but you need to know when you need to step back and maybe make some changes.

Theresa Nair:  That's great advice. Well, thank you so much for making the time to speak with us and participating in our interview series.

Erin Maloney:  Thank you. Thank you for having me. I just want to make sure I tell you guys that you can always go to our website, innocentlivesfoundation.com. There are great resources and tools on there. If anybody ever had to make a report of anything they were concerned with, again, it could be a parent, a caregiver, a teacher.

If somebody's concerned about maybe what a child's posting or who a child's speaking with or they're unsure of things that are online, you can always submit a report right there and we'll reach out and see what we can help investigate for you. Please use us as a resource as needed. Again, we have great blogs and articles on there and things that you might find very helpful.

Theresa Nair:  That's great, and we will also link to that website underneath our interview so that people can find it easily.

Erin Maloney:  Wonderful. That sounds great.

Theresa Nair:  Okay. Thank you so much for joining us today.

Erin Maloney:  Of course. Thanks for having me.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Professor Gabrielle Lindstrom on Maslow & Indigenous History

An Interview with Professor Gabrielle Lindstrom

Gabrielle Lindstorm, Ph.D. is an Assistant Professor in Indigenous Studies with Mount Royal University and an Educational Development Consultant (Indigenous Ways of Knowing) at the University of Calgary. Dr. Lindstrom is a member of the Kainaiwa Nation which is a part of the Blackfoot Confederacy.

Theresa Nair:  Thank you for joining us today for this installment of the Seattle Psychiatrist Interview Series. I'm Theresa Nair, a research intern at Seattle Anxiety Specialists. We are a Seattle-based psychiatry, psychology and psychotherapy practice specializing in anxiety disorders.

I'd like to welcome with us Indigenous researcher, Gabrielle Lindstrom, who is an Assistant Professor of Indigenous Studies at Mount Royal University. Dr. Lindstrom is a member of the Kainai Nation Blackfoot Confederacy. Her teaching background includes topics surrounding First Nation history and current issues, Indigenous studies, Indigenous cross-cultural approaches and Indigenous research methods and ethics. She recently co-authored the article, Reconsidering Maslow and the Hierarchy of Needs From a First Nation's Perspective.

Thank you for joining us today, Dr. Lindstrom.

Gabrielle Lindstrom:  Thank you, Theresa. [Dr. Lindstrom introduces herself in her traditional language]. Greetings, everyone. My name is Dr. Gabrielle Lindstrom, and I just introduced myself in my Blackfoot language. My Blackfoot name is Tsaapinaki and it translates to slanted-eye woman. I'm happy to be here.

Theresa Nair:  Thank you so much. Before we get started, could you tell us a little bit more about yourself and what made you interested in studying the relationship between Abraham Maslow and the Blackfoot peoples of Southern Alberta?

Gabrielle Lindstrom:  Yeah, of course, Theresa. I was born and raised on the Kainai First Nation in what is now Southern Alberta in Canada, a province in Canada. I've been doing a lot of my research in community, and a lot of my research is concerned with knowledge and with reframing how mainstream society thinks about Indigenous people, as well as offering clarity around misunderstandings of who Indigenous people are.

I've done quite a bit of research with my colleague, Dr. Peter Choate, where we looked at traditional parenting practices from a Blackfoot perspective. We've done some research with Indigenous elders, Blackfoot elders, where they've given us ideas of what traditional parenting practices look like. That's some of my research on that end.

Dr. Choate approached me and said, "This is an idea that I have around looking at the work of Maslow. We hear these tensions." I've certainly heard it as well, how Maslow was in the Siksika Nation in the 1930s, I think it was 1938 to be exact, and he spent some time there. Out of his time there, he was supposedly influenced in shaping his hierarchy of needs. Of course, I've heard the hierarchy of needs, I've seen it in multiple disciplinary contexts, used in disciplinary contexts. The opportunity to do research with an elder is something that I'm always deeply honored to engage with. That's how I started this in this work with Dr. Choate and with elder, Roy Bear Chief. Really, it was certainly eye-opening and it was very interesting. I found it a very interesting process, for sure.

Theresa Nair:  That's great, thank you. I do strongly encourage anyone watching this to go and read the article that they wrote because it is quite a fascinating article. As you mentioned, we do know that Maslow visited the Siksika Nation in the summer of 1938. That was several years before he published his Theory of Human Motivation. Could you tell us what prompted the visit and what type of research he conducted once he arrived?

Gabrielle Lindstrom:  Sure, Theresa. Maslow was sent to the Siksika Nation at the direction of his mentor, who at the time was Ruth Benedict, an American anthropologist. He was there to do his social index testing, the social personality index testing. At the time, he thought she was really onto something with that. He went into the Siksika Nation, as I said, at the prompting of his mentor. At the time as well, she was challenging this idea that there had to be some kind of competition in Western society, this inherent competition. Benedict was challenging this idea that human beings had this inherent competition within them.

She asked him to go there, and she also wanted him to go because he had some good ideas and wanted him to explore them in that context, but his perspectives were quite narrow because he had never really been and had that cross-cultural experience. That was what prompted him to go. He was really looking at that social personality index, that's what he was really interested in expanding his ideas around, and thought that going into this very diverse cultural context he could make some generalizations that would be applicable across the human experience.

Theresa Nair:  Okay, thank you. When he arrived, how was his research perceived by members of the Siksika Nation? What do we know about his efforts to follow culturally appropriate guidelines or any customs while he was there?

Gabrielle Lindstrom:  His research, he wasn't received in a very good way because he was asking questions of the community members that were perceived as being disrespectful, that were perceived as being quite inappropriate. According to the Siksika elders, he came in with an existing agenda, which for the Siksika, this agenda was socially unacceptable to them. He ended up only observing behaviors and, of course, interpreting them from his Eurocentric filter, his Eurocentric frame of reference.

While he wanted to gain more, just get a better understanding of the human experience in the context of his social personality index test, he wasn't able to engage with Siksika members because, as I said, what he was asking, he was unaware of the protocols, the Nation protocols, in terms of what he could ask, what he couldn't ask, and so he was basically left to only observe rather than ask questions.

The Siksika elders, they said, "Okay, you're asking these very inappropriate questions really around sex and interpersonal relationships." We don't talk about things like that, we don't, it goes against our social norms as Blackfoot people. They said, "You could stay," they told Maslow, "You could stay, but you can't ask those kind of questions." They tolerated him, they tolerated his presence, and he was only left to observe. He couldn't ask those questions.

I don't know what kind of effort he made to follow culturally appropriate protocols or guidelines or customs while he was there, because as I said earlier, he didn't have any cross-cultural experiences with Indigenous people in the past, so this would've been entirely new for him. I don't know really how he was prepared, what kind of background research he'd done.

But what I find interesting is, from a Blackfoot perspective, you can't really be trained on how to act within another cultural context. Either you go in there with an open mind and an open heart of coming from a good place of respect and you build relationships and you experience those relationships in authentic ways. You can't be trained in how to be a relational human being. Either you are or you aren’t, and the only way you can learn is through experience. That's anyways what the research has shown, is that he had this agenda, he wasn't prepared, didn't know what the guidelines, the protocol. So, yeah.

Theresa Nair:  That's a good point, I think you made a lot of good points, and just the importance of being respectful. Thank you for sharing that. One of the biggest questions that come up when discussing this period of Maslow's research is how much influence this visit had over the hierarchy of needs that he later published and became quite famous for. In your research, did you find any evidence of traditional Blackfoot teachings in Maslow's theory?

Gabrielle Lindstrom:  See, the thing about it is, is there's such a disconnect in paradigms between the Western and the Blackfoot paradigm. It would've been very difficult for Maslow, coming from his Western paradigm, to authentically capture meaning from a Blackfoot perspective. It would've been very, very difficult. This notion of peak experiences that Maslow describes, that's come up in our research, but what he didn't get and what he didn't appreciate, or what he didn't understand, was the nature of relationships in Siksika culture. He didn't understand that, the connections to land, the connections to each other, the complex dimensions of spirituality. Relationships aren't about hierarchies. They're about interconnections. For Blackfoot, for Siksika, these relationships are holistic and our relationship to satisfaction, our relationship to the human experience, it doesn't exist along a hierarchy. It really is about these interconnections.

He didn't understand the traditional parenting styles of the Blackfoot and he didn't understand the notion of the child as already being self-actualized when they're born, the child as already being self-fulfilled when the child is born. When the Blackfoot child comes into the world, they already have a name, they know their place in society. They're essentially sung into their relationships that have already been established in utero.

It's very difficult to say what kind of influences, because there's such this diametric opposition, but in speaking with some of our interviewees in our research, we certainly were given some insights into how his ideas were changed. He went into Siksika really this hard science sort of guy, he was very much based in the scientific paradigm and he published around that. When he came out of that, his experiences in Siksika, he developed a more humanistic perspective, where he's looking at his observations, interpreting those observations around altruistic behaviors in the Siksika.

I think that really sort of ... Well, I should say I think, but that was what we found in the research, is that that did influence him to some degree, but we have to keep in mind that everything he observed, he was essentially integrating and filtering through his Eurocentric Western/American frame of reference. That's the thing, it's pretty difficult for me to say what kinds of ideas was he able to, how much of an influence. I think there was some influence there, but then we also have to see those cultural disconnects for what they are.

Theresa Nair:  Yes, it does sound like maybe it did influence his interest in more of a humanistic approach to things, at the very least.

Gabrielle Lindstrom:  Yeah, for sure. It definitely did. He found clues about the altruistic nature of human beings through his time in Siksika. Very much in our society, and I think at the time, and this is what one of our interviewees in our research had pointed out to us, is that Maslow was very individualistic. He came into his time at Siksika and he witnessed behaviors amongst the Siksika people, where people were just helping each other, just with no benefit to that individual who's helping the other individual, no benefit whatsoever. Maslow struggled with that, because when you enter into a relationship in our society in mainstream society, you enter into it because in some way or another you're going to benefit from it.

That was what Maslow was, I think, really struggling with, at least this is what our research found, struggling to figure out why are these Blackfoot people just helping each other out like this, why are they just doing this, what are they getting out of it? What are they getting, these kinds of experiences. Yeah, I think he was influenced, but the degree to which he could authentically and meaningfully and accurately interpret what he was observing was really lacking because of the cultural disconnect.

Theresa Nair:  Maybe part of it was him trying to understand that kind of selfless helping of other people in part of the process.

Gabrielle Lindstrom:  Yeah, absolutely.

Theresa Nair:  That leads us to our next question about when he presented his theory, do you think he was trying to incorporate what he learned and maybe just misunderstood it due to cultural differences, or does it seem from your research that he was trying to present a completely different theory that he just thought he came up with on his own?

Gabrielle Lindstrom:  This is also a difficult question for me to answer, but when we think about this in psychological terms, we can see that there's an attempt to bring a Western scientific lens to relationships, that's exactly what Maslow was trying to do. He was trying to bring this lens to relationships, but that's not what they embody in their relationships. The Siksika and other Blackfoot Nations were about interconnections, interconnections with the universe and we exist within this web of relationships.

This individualized perspective that Maslow brings to the hierarchy of needs is not the way in which Siksika exists and it's not the way that we think either. Bringing in that Western scientific analysis, that lens that very much shapes the hierarchy of needs as we know it today, it's misapplied in the context of Blackfoot peoples.

It's hard to know. I think he was influenced, and our research found that he couldn't have, because we've heard this before, is that Maslow got it wrong or something, that he tried to convey the knowledge, his observations and what he saw in Siksika and tried to translate that into his hierarchy of needs, but our research finds that it was not so, it couldn't have been so, because of these diametrically opposed paradigms. What Maslow was drawing on certainly was drawing on some of his experiences in Siksika, but ultimately I think he still had his own agenda.

Theresa Nair:  He may have gone in with that agenda and maybe even looking to justify it while he was there. Okay.

Gabrielle Lindstrom:  Yeah, he had his own agenda, exactly. Our research, and in our article, we definitely talk about that, we talk about that quite a bit. The purpose of this isn't to say that Maslow's research or that his hierarchy of needs is... We don't critique it, necessarily. It wasn't to discredit it or anything like that, but it was really about trying to deconstruct that notion that the hierarchy of needs is based in Blackfoot knowledge. That's what we were really interested in doing, because there's definitely those that say that, that have suggested that there is this link that Maslow was trying to portray Blackfoot knowledge but that he got it wrong.

We concur and we agree that our research found that he was certainly impacted by his time in Siksika, but I don't think there that he, or I should say our research, we find that it couldn't have been so.

Theresa Nair:  That's a good point, thank you. I think that's an important clarification, that whether or not his theory or his hierarchy is accurate is an entirely different topic from whether or not it was influenced by Blackfoot teachings. Those are two different questions, so I think that's an important distinction. Next, I was wondering if we could discuss the hierarchy of needs and mental health. In Maslow's theory, anxiety develops when the need for safety is not addressed and depression is a result of self-esteem needs not being met. Would you say that this part of the theory is similar to Blackfoot teachings on anxiety and depression, or would traditional teachings present an entirely different perspective on these two topics?

Gabrielle Lindstrom:  Theresa, it's very different. In my own research around Blackfoot resilience, this is where my research would come in, is it's very unnatural for a Blackfoot person to be depressed. It’s not even a part of pre-colonial teaching, it's not even really ... We're so relationally oriented, within this relational paradigm. We often say this as well, our elders will say this, or even I think this too, when I'm feeling down, I remind myself that I'm never alone and we're never alone. This idea of not having your needs met, I think it's not necessarily ... I'm not saying that's correct or that it's right, but if we are trying to understand a Blackfoot way of mental health and we're trying to understand it in the context of how Blackfoot people think about wellness, it's not just mental health, we might think of it as a spiritual wellness is what it is. It's spiritual wellness.

When your spirit is well, you're connected. You're connected to your ancestors, you're connected to the land, you're connected to each other, you're connected to the universe, you're connected to your more than human relatives. You are so connected within this web of relational alliances. When you are not connected, then there's an interruption in that spiritual wellness, there's a fracturing in that spiritual wellness, so of course a person is going to feel disconnected. It's not so much depression as it is disconnection for us. That's how we might think about it, the differences.

Theresa Nair:  That's a really interesting point, because that is a completely different perspective.

Gabrielle Lindstrom:  It is.

Theresa Nair:  Yeah, the importance of being connected to something larger and that it naturally addresses depression and anxiety as well. I think that's interesting.

We've been talking a little bit about traditional perspectives on mental health. I'm wondering if this relates to modern perspectives on mental health within the community, either within the Kainai Nation or the larger Blackfoot Confederacy. Are there any specific mental health concerns within the community, and what is the view on paths of mental health treatment? Is it generally more of a traditional perspective or what is the approach to mental health now?

Gabrielle Lindstrom:  It really is, as I mentioned, it's about spiritual wellness and connection and relationality and restoration. That's really what we're talking about. I know that there's been some work within our Blackfoot Nations, around indicators of wellness, of Blackfoot wellness. What are indicators of Blackfoot wellness, how connected are you to your language, how accessible are elder teachings, how active are you in ceremonies, all of that.

See, it's even hard for me to try and wrap my head around now, as Westernized as I am. It's very difficult for me to separate mental health from spiritual wellness, spiritual connection, from physical, all of that, because it's all so interconnected. You can't just address one aspect. It's a very holistic way, a very holistic pathway. Today, we're experiencing an extreme disconnection, disconnection from our language, and this has been ongoing, but we feel it so acutely these days because it's intergenerational. With each generation, the further away from being Blackfoot it feels like we are.

Now, some of our Blackfoot health researchers, and I'll name one that I'm very influenced by, Bonnie Healy, she talks about how far away are we from being Blackfoot. Now, the focus is on creating pathways towards coming home to being Blackfoot. That includes everything, that includes access to our lands, and I'm not just talking about the small remnants of reserves that we're left on, it's access to lands, it's access to language, it's connection, all of that.

Those are the discussions that are happening in terms of addressing mental health, if we think about it in a Western construct. We're really about restoring, restoring and having that sovereignty again in terms of how we define and how we embody our connections and our relationships.

Theresa Nair:  That's a really interesting point. With the current confines and restrictions, would it be possible then to achieve the ideal of mental health? I know it's difficult to even look at mental health as something completely separate when you're looking at a more holistic approach, but would you say those obstacles are preventing people from even reaching the state of mental health that would be the goal?

Gabrielle Lindstrom:  Oh, there's always barriers. That's the nature of our existence, is there is always going to be barriers that are cropping up that are going to push us off balance. For Blackfoot, and I'm sure for other First Nations, Indigenous Nations, I won't speak on their behalf, so I'm just going to talk about Blackfoot, it's life exists, our ontological responsibilities really are around the maintenance of balance. This is even before colonization and even now.

Is it possible, you asked me Theresa, to have optimal mental health, even in today's society, even with all of these disruptions to our traditional lifestyles? I would say, yes, it is. As long as you feel connected, as long as you are connected, as long as you can hear your language, you can hear your songs, you can sing them, you can be in ceremony, those things are still alive. Our culture is still alive and we very much are a living culture.

What Maslow brought and what he thought when he went into the Siksika community very much embedded in that salvage anthropology, that he's going to observe a people that are dying. That's not the case, we are still here and we are still achieving that optimal search and balance, because that's what it's about. You're never there, you're never just optimally have this perfect mental health. It's always about finding balance. Some days were pushed off balance, other days were very balanced. This pathologizing of those who are not in balance in that moment, that's not helpful. What we need to focus on is bringing people to balance, and that's something that no pill is going to solve. That's something that Western therapies alone don't have the answer for.

It's about a person having an opportunity to express how they are already self-actualized, because we always say in our Blackfoot ways, you are already born a perfect human being, as Creator meant you to be, but it's as we're going through those life challenges that push us off balance. What ends up happening for so many Indigenous people is we're just completely pathologized in Western mainstream society. We internalize these, and these messages push us off balance and they keep us off balance. It's very difficult to try and regain your balance when you're constantly seeing these messages in media and all of that. Yeah, that's what I have to say about that, Theresa.

Theresa Nair:  You're making some great points. This has been really insightful and I appreciate you sharing this perspective on it. As an Indigenous researcher who specializes in communicating topics related to Indigenous and First Nation communities, do you have anything else you'd like to share with our audience?

Gabrielle Lindstrom:  Well, Theresa, I think I've shared quite a bit, but what my research has really led me to realize is, and it's really, for me, doing my research is really about coming home to being a Blackfoot woman, and I'm not the first to say this, but we'll see this in even in Western concepts, is in our Indigenous ways, we have our parallel concepts. Again, I learned this, these aren't just something I come up with, this is something that these are what I've learned as well, these ideas are what I've learned from the elders. It's about understanding that we can't just do things interchangeably and interchange Western concepts with Indigenous concepts, that's not what paralleling is about. It's really about experiencing relationships.

Indigenous people have experienced relationships with Western folks on the terms of Western people, that's what I'll say, on the terms of Western people, but Western folks have not experienced relationships on the terms of Indigenous people, they have not done that yet. But if they were to do that, could you imagine the opportunities for being in balance, for being in relationship?

Hopefully, if one of the messages that I leave the audience with is, is that that pathway to transformation is really about stepping out of comfort zones and experiencing relationships not only on your terms, but on the terms of Indigenous people. Our terms, they're not oppressive, they're not assimilationist or anything like that. If anything, the Indigenous paradigm is inherently inclusive. That's what I want to say.

Theresa Nair:  That's wonderful, thank you so much. I really appreciate you participating in our interview series, and both for sharing your knowledge of the historic event between Maslow and visiting the Siksika Nation, and also for sharing this perspective on mental health as well, and more the holistic perspective from this aspect. I really appreciate it, thank you so much for joining us today.

Gabrielle Lindstrom:  You bet, Theresa.

Dr. Gabrielle Lindstrom beside a picture of her paternal grandfather, Mokakin (translates to Pemmican), Pat Weasel Head.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Advocate Lauren Johnson on Environmental Justice

An Interview with Advocate Lauren Johnson

Lauren Johnson, MPH has a graduate degree in environmental science and policy, and is a Climate Corps fellow for the Environmental Defense Fund. Lauren founded the Environmental Justice Action Network at the George Washington University and specializes on advancing environmental justice.

Theresa Nair:  Thank you for joining us today for this installment of the Seattle Psychiatrist Interview Series. I'm Theresa Nair, a research intern at Seattle Anxiety Specialists. Today, I'd like to welcome with us Lauren Johnson, who has a master of public health in environmental science and policy, and is a Climate Corps fellow for the Environmental Defense Fund. During her time as a graduate student, Lauren founded the Environmental Justice Action Network at the George Washington University, which is a student-led organization working to address environmental justice issues in the metropolitan D.C. area. In her current fellowship with the Environmental Defense Fund, she focuses on advancing environmental justice through strategic planning, scientific research, data-driven project management and community engagement. Before we get started, can you tell us a little more about yourself and what made you interested in environmental justice?

Lauren Johnson:  Yeah. So, hi. My name is Lauren Johnson. I'm from Northern Virginia, the D.C. area. And I just graduated with my master of public health in environmental science and policy from George Washington University's public health school. And ever since before public health school, even, I fell in love or became passionate about environmental justice issues when I was teaching high school chemistry in Miami, Florida for Teach for America. And there, I was confronted with various systems of oppression, such as lack of literacy, deteriorated infrastructure, school to prison pipeline, and was very disheartened by seeing how our nation's most vulnerable groups of people are treated, and left with little resources and so much instability, to reach their full potential. And that's what motivated me to focus on these issues at a systemic level. And I saw that public health was an avenue of doing so. And brought my passion of environmental justice into public health school, which led to the founding of the Environmental Justice Action Network at GW.

And that was founded by me and about seven other people that were also passionate about environmental justice, but did not see an avenue of expressing it at the school. And even though there's been a lot of mentioning of it, there really wasn't organized effort for students to get involved and give back to their surrounding community, because that's also a central tenant of environmental justice, of having real impacts in communities, and especially communities that are most vulnerable. So we found ourselves in Southeast D.C. doing park cleanups, urban gardens. We also held a lot of webinars, bringing more disadvantaged speakers, such as Indigenous environmental activists or food justice activists, so that we can start elevating these intersectional issues to the forefront, and also challenge traditional environmentalism that does not have these issues in the forefront, but is so needed to us actually reaching our climate goals. So that perspective informs my career work at the Environmental Defense Fund, which I am going to be a permanent member in a couple weeks.

Theresa Nair:  That's wonderful. Congratulations.

Lauren Johnson:  Thank you.

Theresa Nair:  And so going back a little bit to when you started the Environmental Justice Action Network, what types of environmental justice issues did you see in D.C., and how did you decide what was important to prioritize?

Lauren Johnson:  Yeah, so we were starting EJAN, the shorthand for it, during COVID-19. So we were quite limited in terms of direct engagement with people, just for social distancing guidelines and guidelines that the school laid out for that, as well, that we had to abide by. But we saw there was a pressing need with pollution in Southeast D.C., Ward 7 and 8, and how a lot of people did not have proper trash pickup. So we would drive into these areas and just see trash littered everywhere. And you kind of have to keep it in perspective, well, if you don't have proper trash pickup, where are you going to put the trash? So that's when you can't blame the individual, but the system that allows these conditions to persist, and how they are inequitably perpetuated, because we saw some parks that are managed by the National Park Service that was full of trash. When you go to Rock Creek Park, you don't see that. What's the difference between the two areas?

Theresa Nair:  Right.

Lauren Johnson:  I think you can answer that in terms of income and race. So, we saw those issues most aptly and saw that that was a way to socially distance and engage in these types of work. And we also partnered with an urban garden called the Franciscan Monastery Garden Guild, that produces a lot of food to food insecure individuals by donating a lot to food kitchens and pantries. So, we saw those were the main ways we could engage in EJ within COVID-19. But other than that, our activities were virtual; in terms of meeting, holding webinars, and just trying to educate ourselves as future EJ practitioners.

Theresa Nair:  Okay. And just before we continue, I want to make sure, if any listeners are not familiar with the term environmental justice, could you explain a little bit more about what exactly it is and what it means and how it impacts different communities?

Lauren Johnson:  Yeah. So environmental justice came out of the late 1970s where... I believe it was PCB. There was this new industry being proposed to be put in a predominantly Black community, Warren County, North Carolina. And the residents organized extremely well and were able to stop those efforts by literally putting themselves on the line. You look at pictures of that protest and you saw kids laying on the ground trying to stop trucks going into their neighborhood. That's how pressing the issue is for these communities, because literally their lives are on the line, so they have to put their lives on the line to stop it.

And that's what spurred the movement. And since then, in the '80s, there was a report called Toxic Waste and Race that found that the strongest predictor of whether a pollution source is in a community is race, regardless of income is race. So again, I'm talking about systems. That is evidence of systemic racism and how these trends perpetuate all over the country. And then from then, environmental justice became this movement that kept becoming academic. What is environmental racism? Well, just dependent on the environment, you are subject to lack of clean water, polluted air, mold, pest infestations, things that, even if you control for income, affects our predominantly Black and brown populations.

And then that notion just kept perpetuating until in 2021, Biden released an executive order that was pretty much codifying environmental justice at the forefront of their priorities, because prior to that in the 1990s, there was an executive order assigned by Clinton that also recognized environmental justice and how federal agencies need to confront it. But this executive order put it to the forefront with an initiative called Justice40 that says that any Federal... I think energy and infrastructure investments, 40% has to go to disadvantaged communities. So that's really huge, right?

Theresa Nair:  Yeah.

Lauren Johnson:  Because when you want change, you need to have the capital follow with it. So basically, environmental justice captures a lot of things. It captures how people are adversely affected by the environment, disproportionally predicted by race, most strongly; very place-based in terms of the surrounding industries and factors that lead to pollution; cumulatively burden certain communities. And achieving environmental justice means upholding the principle that everyone has equal protection to environmental, housing, criminal, other such laws that affects every aspect of your life. That's the environmental part, expanding the definition of environment for everything that externally affects you. And EJ is about rectifying that.

Theresa Nair:  When we were talking a few minutes before the interview started, you mentioned how systematic engineering can help to solve some of these problems. Would you mind discussing that a little bit, and how systematic engineering could be applied in these situations?

Lauren Johnson:  Yeah, yeah. So this is a new discipline that just kind of happened. When I started working in the Environmental Defense Fund, I saw that someone was doing a similar study that I was, from a systems engineering perspective. And essentially, there are some tools available from more technical disciplines to assess the inputs and outputs of a system, and everything that takes place in the system that mediates or negotiates the resulting outputs. That can be applied to a social context where, for example, I'm doing a study on net zero and equity and justice. And I'm trying to create recommendations for my organization to uphold their equity and justice goals.

So the equity and justice goals are the output. Now, what can the input be? Well, to achieve that, you need to really have resources, meaning time and people and capital to be put in the types of projects that prioritize people-centered solutions that do not perpetuate existing injustices. But if you don't view that from a systems lens, then you could easily result to just blaming individuals, like, "We have some bad actors here. If we get rid of those, we'll be good."

Well, we know that doesn't work when, let's say, a similar issue is police brutality. You know firing a few bad cops is not going to change the system of people being systemically murdered, predicted by race. So in turn, you need to think about things in that lens, and the mental models, the different structures. Everything interacts with each other to produce a certain output. And to reach the output that you want, you need to change everything within the system and outside the system and how it's structured, to reach it.

Theresa Nair:  That's a great point, because I think a lot of times people do just want to blame one person or a handful of people, but it's so much of a bigger problem than that, that it really needs a much bigger solution. If I could do one more spinoff, just because we were talking about such interesting things before I started recording, could you talk a little bit also about the relationship between the environmental movement and environmental justice, and how those two can sometimes conflict a little bit?

Lauren Johnson:  Oh man, I was just having a conversation about this. So it helps to talk about the history. Environmental movement was spurred by... I believe his name was John Muir, who was pushing the national parks movement. And I may be getting this wrong. I also know Teddy Roosevelt was involved in the national park system, but hey. "We're concerned about the environment. It's pretty. Nature. Wildlife. Let's preserve it." Well, who was on this land before? Indigenous peoples. They lived for thousands of years, existing sustainably on the land. So prior to colonization, people are like, "Oh wow, this nature, it's so well kept." That's because people were keeping it. And we're finding now that there's some practices that are ingrained in Indigenous knowledge that we need to start doing, such as controlling fires in forests or cutting some of them down so it's not densely populated. Indigenous peoples figured that out thousands of years ago, and now we're coming around and realizing we need to do stuff like that, because we have so many wildfires now.

So there's always been this tension of people, typically white liberal, "We need to protective the environment. We need to protect our wildlife." That's true. We also need to protect the people that is in that environment. And that's the intersection that is left out, and many others. Gender, race, income, all those things factor into how much you can take care of the environment and how much the environment impacts you. And coming from an environmental justice side to that, there's a lot of tensions because like... we were talking about systems. EJ really pushes for you to confront those issues. And that makes you very uncomfortable with it.

So a lot of people, when they become uncomfortable, they'll shut down and say, "Well, that's not my focus. That has nothing to do in the environment." The environment is everything around you that affects you. So yeah, you should have a stake in all this. And if you're doing environmental work, you also need to talk about healthcare. You also need to talk about housing, the criminal justice system, because these are things that impacts everyone's environment. And we all need to be an equal stakeholder in solving it, because otherwise we can't have a systemic change that is needed to solve the climate crisis.

Theresa Nair:  Yeah, I think that's an important point. You can't really separate all of it. It's kind of the one-health approach, that everything is connected together and it all relates to each other. When you've been working with communities and residents on some of these environmental justice issues, what types of mental health impacts have you seen on the communities who are experiencing some of these disparities or discrimination?

Lauren Johnson:  Yeah, I would say I was confronted with that quite aptly when I was teaching. I decided to Teach for America in Miami, Florida, a very hot and humid place that... I read one site that says that the number one most economic risk to climate impacts. So for the students I taught, one time, I got a grant to do a hurricane disaster preparedness workshop for those students. And somehow during that workshop, we started talking about air pollution. And I ended up asking those students, "How many of you have asthma?" And over half the class raised their hand. That's not-

Theresa Nair:  That’s significant.

Lauren Johnson:  ...random. That's the system at play where you're in these conditions, like I said, hot and humid, you have a lot of mold, you have a lot of pests, you have on top of that industries near you that are affecting your health through air pollution and water pollution. And then now you're compounding that with climate change and sea level rise, extreme weather. All those things are going to heighten those existing conditions there.

And so that's kind of what climate justice is all about. And the ways that we are addressing our climate-related causes, you need to make sure that the people that are most adversely affected are uplifted in that transition because, well, one, usually they're the ones that are least responsible for causing it; just looking upon income, the more income you have, the more greenhouse gas footprint you have. And oh man, I can't even get into a large conversation about how corporations are part of that too, but-

Theresa Nair:  You can feel free, if you like. Yeah.

Lauren Johnson:  But these factors, they compound. And it causes a lot of anxiety. I even had to make a suicide attempt call to report that.

Theresa Nair:  Wow.

Lauren Johnson:  And I mean, these are environmental things, but this also controls people's behavior. If you're in this bad environment and you're also not concerned about education, even though it's a school, that's another thing, you're going to have all these things mentally impact the students that you have. And oftentimes I just had to put on my therapist hat and just be there talking to students, had some people cry on my shoulder, just know that I care about them. And if anything, sometimes that's one of the few times they even heard that, which is also really sad.

Theresa Nair:  Wow, that is.

Lauren Johnson:  Yeah, mental health is very tied into it. But one thing you need to make sure is that climate anxiety has become something very real. It's a very real thing, but that is because this might be the first time you have this existential threat to your livelihood.

Theresa Nair:  Right.

Lauren Johnson:  To keep that in perspective, that has already been a thing for many groups of people in this country, whether it be slavery, Jim Crow, migrant workers, elderly, just people with disabilities. They've already had these existential threats affecting their livelihood. So, you have to recognize your identity and your privilege when you're addressing these issues because you might be like, "Oh my gosh, you need to do something about it at all costs. Everyone just needs to get in line." Well, that's not good enough for a lot of people that's already suffering from occurring conditions. So, you just have to keep things in perspective, even when it affects you mentally.

Theresa Nair:  That's a good point that a lot of groups have been dealing with these threats for a long time. And for some people, this is the first time they're experiencing something like this, but other groups have been dealing with this on an ongoing basis.

So, when people start to feel overwhelmed and feel like these are just huge issues, where do you even start addressing it? What advice would you give for people who are just feeling overwhelmed when they think about these topics? Because we're talking about these major systematic problems, right, that I think the average person feels like there's not really anything they can do much about. So what advice do you give? Like, you seem to be able to stay inspired and feel like you can make a difference. And I think that's amazing. It's one of the reasons I wanted to interview you. This is incredible, how you stay inspired in the face of all this. But I think a lot of people look at some of these topics and they just feel frustrated. So what advice would you give for people who just look at this and they just think, "I can't change any of this"?

Lauren Johnson:  Well, first, I'll say check your privilege, because there's a lot of people overwhelmed for hundreds of years in this country. But also, I'll take a quote from one of my environmental professors at public health school: "You need to find the bubble of people and work that you can influence, and just focus on that."

So, for me, I know that I grew up in a pretty privileged upbringing. And even though I'm a Black woman, I still had a lot of opportunities and came from a two-parent household that also was very stable. So that means I've been able to gain a really robust education. Part of my skillset is talking to White people, so I'll just call that out too. And then also, just thinking about the big picture. So that's why I found that I can make a lot of impact in a big environmental organization because all those skills I had growing up, but I can also keep things in perspective and saying, "Well, I know that I'm quite privileged, but there's a lot of other people that look like me that aren't. And how about I can do what I can to level the playing field, per se, and actually make an impact in doing that at an organization that has international influence?"

Very challenging and difficult work, but I found myself on a team that is designed to do just that. And they're extremely motivated. And what keeps me going is thinking about the students I had in Miami. They are suffering in many different ways. It seems like I might have some skills that can do something about that. And that might be me getting ahead of myself and saying, "I'm going to fix everything." No, no, no. But what I can do is expand the platform I have and try to get as many people on the same page as possible so that authentic and meaningful change does happen as we're addressing the climate crisis.

Theresa Nair:  That's great. And I think you hit on one of the key points, that you work with other people who are also inspired. Finding maybe a group or an organization to work with where people are working towards a positive difference, right, I think that that can help. And then you have also the inspiration of who you want to help, thinking about your former students.

Let's talk a little bit about your work in Texas. I know last year you worked with the North Central Texas Council of Governments to develop a greenhouse gas emission reduction plan that will mitigate risk for underserved communities. Could you tell us about your work there and how underserved communities in that area are being impacted by climate change?

Lauren Johnson:  Yeah, for sure. For sure. So that project you just mentioned took place last summer. And just as a context, Texas is actually divided into all these regional council of governments, and they assist the local governments in making decisions and providing funding. Well, a collection of those local governments approached the North Central Texas Council of Governments, which is the Dallas-Fort Worth area, saying, "Hey, we know climate change is a thing. Why don't you give us this repository of strategies and tools to address it in our own communities?"

So that was the basis for the project, which is looking at all these different plans that were cultivated in Texas or the rest of the country, even some international organizations, of these strategies. Well, I'll say a lot of them are untested though, because a lot of things that we're proposing to solve climate change, they're still in a development phase. But if a government wants to do something in particular, well, then they can... Well, I hope it's being turned into an online repository. I just did the strategies. They can look at some strategies that can reduce some emissions. But like I was saying, you can't leave out the other side of the picture, that there are some people that are burdened by emissions, but more specifically air pollutants. And those are the things that are most concerned.

So I tried to position the recommendations and the strategies around those different pollutions, and know that you can both reduce emissions from these industries, but also clean them up so that surrounding communities are not disproportionally affected. And that was the level of engagement I could have with vulnerable communities with that project. But I also was able to use some GIS mapping to look at the trends of different pollution sources, so whether that be natural gas or oil, power plants or Superfund sites, and look at some data that approximated the distribution of health impacts, whether that be asthma, cancer, diabetes, and then see how the location of those pollution sources interacted with those health disparities.

It was almost very upsetting how much those health disparities aligned with where those pollution sources were. And I used something called the CDC Social Vulnerability Index  that takes into account a lot of social factors like age and race and language proficiency to measure the vulnerability of certain communities. And I found the most vulnerable were right near these pollution sources. And that could just be a highway right next to you. But some of the most burdened communities... There was one in Fort Worth. It had the lowest life expectancy, I believe in the whole state of Texas. And they were actually right across from a hospital, but because it's this really major roadway was separating them and the hospital, they were completely cut out from any healthcare access. And likely the effects of the roadway near them and a number of other pollution issues, that causes them to have ridiculous rates of different diseases, and then caused such a lower life expectancy.

So, when I talk about environmental justice, this really is a life and death matter, and should thus be treated with that urgency, because as we're trying to change our society to affect climate change, you need to make sure that there's communities already suffering, and this is an opportunity to do something about it.

Theresa Nair:  Yeah, sometimes people don't realize what a difference even just living right next to an interstate makes on your overall health, just breathing in that pollution every day. And of course it's usually wealthier people tend to live further from the interstate and aren't impacted as much, right? Something like that can have such an impact on your health.

We've been talking about these environmental justice issues that are in Texas and D.C., and we talked about Miami a little bit. Many of our listeners are in the Pacific Northwest, and they may not know what environmental issues are in their city or even how to find out about that topic. How could the average person who may not be very familiar with the environmental justice problems in their area find out more about some of the problems in their local communities and the disparities that exist?

Lauren Johnson:  Yeah, yeah. So, it's good that I've learned a lot of cities or local governments are really thinking about these issues, especially with the Biden administration setting high priorities for environmental justice and like Justice40 providing funding to vulnerable communities. So, I would say the first resource you can go to locally is check your local government website. See if they have something listing what they're doing about environmental and social issues that are affecting the area. I think that's the best way to get more local base. But if you could quickly search what local organizations are also confronting those issues, like type in "Environmental justice" and your community. You can see if there's any other organizations there that might have some local knowledge.

But there is also a lot of just national organizations and movements that are trying to put these issues into light. And that could just be some of the renowned environmental justice organizations like we have for environmental justice, the Deep South Center for ... Deep South Center for Justice ... Oh, man. I messed this up.

Theresa Nair:  That's okay.

Lauren Johnson:  But this is an organization led by Dr. Beverly Wright in the Cancer Alley area. It does a lot of work there. And even the major environmental organizations too, like I work at Environmental Defense Fund, we're also thinking about these things. There should be a decent amount of resources there to think about it. And also nationally, the EPA, Environmental Protection Agency, DOE, the Department of Energy, they're also putting out resources to think about these issues, but also mapping and screening tools to actually you can go in, type in your address, and you can see the different pollution sources or demographic issues that are coming into play your area.

So for example, the EPA, they have something called EJScreen, that you can do this. The CDC has Environmental Public Health Tracking Program, that you can do this. And if you live in California, the California EPA is really on top of these issues. And you can look to see how they're affecting you through a tool called CalEnviroScreen. So, there's a lot of resources and things sprinkled throughout here, but what we need is a more robust movement of joining forces and understanding we're on the same side of trying to figure things out, and working together to do so.

Theresa Nair:  Yeah, I think that's the important point, because a lot of times people might want to help if they know about it, but they may not even know that some of these problems exist in their neighborhoods, or where the tools are to find out about it. And I will link to some of the tools that you mentioned below this interview as well, so that people at least listening to this interview can find them.

If a person is experiencing anxiety due to living in an urban area, and maybe they're worried about things like the pollution from the interstate, if they live nearby, or heat islands, or they've noticed that they have higher rates of asthma in their neighborhood, some of these topics that we've discussed, what type of advice would you give to them?

Lauren Johnson:  Yeah. Yeah. I would say just really try to figure out what those different things are; like you said, the urban heat island, it could be a lot of allergens that you're affected by, the interstates. Just really understand how all these issues are. And then find people trying to do something about it, because there's a lot of really great local nonprofits that provide free assistance to ... let's say you're in an urban heat island and don't have good AC. Well, there's a lot of nonprofits that have programs funded for you to get that for free. And then that can intersect with healthcare as well. There's a lot of great organizations that may be local to you that can do that as well.

But really the issue isn't individually how we respond to this, the issue is our representatives, the people we elect, pushing policies that can actually do something about this. For example, why isn't it mandated in affordable housing to have AC? Isn't that a necessity nowadays, especially with heat waves and climate change?

Theresa Nair:  Right.

Lauren Johnson:  We need to petition our representatives and senators to do something about it. And if you not just send an email, but if you are able to get on the call online with someone, then I've been told by number of local legislators they will listen to that and try to do something about it, because maybe they have a ballot initiative coming up and are debating it, if you could be someone in the public forum or speaking setting to talk to these people directly. And I would advise, start at the local level too, because those are the people that really are making decisions that impact you locally. You can bring your perspectives up, and they may pivot entirely. You never know. So there are ways to stay empowered throughout this. And really just realize knowledge is power, and you do have something to do about it.

Theresa Nair:  Have you seen that happen? Have you seen someone completely drastically change their mind after being contacted on one of these issues?

Lauren Johnson:  Not directly, but I have heard offline, these are ways to really make an impression, because for example, part of the reason why I fell into EJ is I started working with a nonprofit called Catalyst Miami in Miami, Florida. And they did a lot of free training and resources to empower local residents to talk to their representatives or a city board meeting, and how to do that. A lot of it is just telling your personal stories and how things have personally affected you, and then saying a solution too. They'll be empathetic, but if you don't put anything on the table what to do about it, they probably won't get there either. So you could go there. And like I said, there was a local nonprofit that was training us to do that. And I saw people throughout that program really find their voice, encouraged to talk about these issues, how they affect them, and what is something we can do about it.

Theresa Nair:  That's an important point, because it's true, a lot of times people who make these decisions aren't in the community, and they might make decisions that wouldn't even work for the community. But if community members who are affected themselves are the ones suggesting solutions, then they know that that's the solution that would work best, from their perspective. And then they can at least consider it, whereas they may not even think about it if somebody doesn't contact them.

Lauren Johnson:  Right, exactly. It's very powerful, the storytelling really is. So, I hope people don't lose sight of that because there's been such a push to quantifying things, big data, technical. Well, I'm finding with EJ, the social dimensions of all that is being left out. So that's why I'm training myself to be a social science practitioner, where my current study, I'm talking to a lot of people through ... well, I'm actually doing my own interviews. I'm having a focus group tonight to start talking candidly about these types of issues, and what are some ways we can do them ... well, for me, as a big environmental organization, do something about it, and not leave people behind?

So, there are things. Again, we were talking about, what are things you can influence? Well, that's my sphere. I think about people in communities and try to bring them in the conversation. Well, you can figure that out for you too, whether that be from a more technical side or social side. We need everyone, all hands on deck to meaningfully and authentically address these issues.

Theresa Nair:  Yeah, you're right. That's true. Well, as a professional who's building your career around advocacy and addressing environmental justice issues, do you have any parting words or final things you'd like to share with our listeners?

Lauren Johnson:  Well, I'll say the fight is long, the fight is hard, but it's still worth doing it. And it sounds cliche, my favorite MLK quote, but this one's good, and he's also said a lot of things that are good. They're just kind of whitewashed over time. But this one is, "The moral arc of the universe is long, but it bends towards justice." So if you are fighting for something you truly believe in and truly believe in helping people and pushing us forward as a society that's more fair and equitable and just, we're going to be going to that position naturally as people.

Whether we'll get there fast enough with climate change happening is another question, but things are already moving that direction. So, if you feel like you're the only person caring about these things, if anything, people will come around to it. But the urgency is that we kind of are on a ticking clock now with how worse issues can be if we don't reach our greenhouse gas emission targets. So be urgent, know that these issues matter in our life and death, but try to remember that this fight is worth having at the end of the day, because you can truly improve lives to the better doing so.

Theresa Nair:  Right. That's a great note to end on, that it's worth fighting and that it's worth going through and worth continuing to work towards these solutions. Well, thank you so much for speaking with us today and participating in our interview series. I really appreciate you making time in your busy schedule to meet with us.

Lauren Johnson:  For sure. Thank you for having me. If anyone wants to follow up, I'm happy to put my email address there. I can send that to you.

Theresa Nair:  Okay, great. We'll put your contact information there. And so yeah, if anyone feels like they would like to contact you, we'll provide the information on how they can do so. Okay. Thank you.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.

Professor Eri Saikawa on environmental pollutants

An Interview with Professor Eri Saikawa

Eri Saikawa, Ph.D. is an associate professor and director of Graduate Studies at Emory University. She is an environmental scientist specializing in: atmospheric chemistry, environmental health, biogeochemistry, climate science, and environmental science.

Theresa Nair:  Thank you for joining us today for this installment of the Seattle Psychiatrist Interview Series. I'm Theresa Nair, a research intern at Seattle Anxiety Specialists. I'd like to welcome with us Environmental Researcher Dr. Eri Saikawa. Dr. Saikawa is an associate professor and director of Graduate Studies at Emory University. She conducts interdisciplinary research on the environment, including atmospheric chemistry, environmental health, biogeochemistry, climate science, and environmental science. Her recent research contributed to understanding and mitigating chemical contaminant exposure among children in the west side of Atlanta, including heavy metal and metalloid exposure through the soil. Thank you for joining us today, Dr. Saikawa.

Eri Saikawa:  Yeah. Thank you so much for having me today.

Theresa Nair:  To get us started, I'm wondering if you could tell us a little more bit more about yourself and what made you interested in studying environmental pollutants.

Eri Saikawa:  Yeah. I really don't know what made me interested in environmental pollutants, but I was kind of a geek growing up and I was always very fascinated by pollution. Since I was a kid in elementary school, I always wanted to work on mainly some kind of pollution, and that has kept going. So, here I am, I guess, but I was always very fascinated by air pollution mainly. I wanted to find a solution to mitigate air pollution.

Theresa Nair:  That's wonderful. I think it's a really fascinating topic and I'm sure many of the people watching this interview will agree. We all have a little bit of that geek side. I think we can all appreciate that. Your research recently led to the Environmental Protection Agency's designation of a new Superfund site in western Atlanta. For audience who is not familiar with this designation, could you tell us what it means to be a Superfund site and why it was important for this neighborhood to receive that designation?

Eri Saikawa:  Yeah. I'm not a lawyer either, but as I understand it, it is designated as a Superfund site when there is quite substantial contamination that needs clean up by the federal government. What happened in the west side is that there was a brownfield investigation at first for a smaller lot. It was about 30 lots that was considered contaminated. But then, when the EPA started investigating, they found a lot of high lead levels in those 30 lots. And so, they expanded and then it just continuously expanded. At one point, they said, "Okay, it's not possible to clean up at the scale that was happening." And so then, they needed the federal funding to come, and that's when it became Superfund sites. And now, it's including about a little over 2000 lots because of the funding that's necessary. I think that was important.

How is it considered in the community? I think it's a very different story. I believe that some of the community members are probably not excited that it is a Superfund site. It's very well known that when it becomes a Superfund site, then the value of the homes, for example, go down. And the studies also indicate that after the Superfund sites is cleaned up, then the values come back up, but it is a difficult time for other community members. They are already overburdened. We hope that it was a good step so that it's going to be cleaned up, but I'm sure the people that are actually being impacted by it, there are mixed feelings.

Theresa Nair:  Right. It's positive and negative because the site's being cleaned up but then it decreases home values in the meantime.

Eri Saikawa:  Right.

Theresa Nair:  And that's interesting, you mentioned that there was some cleanup effort even before the designation of a Superfund site. If it's a smaller site, they're still able to begin cleaning?

Eri Saikawa:  Yeah. The EPA has some funds to clean up the remedial action. If it's a small area, then they can come at the regional level and then clean up. But because the number of lots that were high in lead was so much higher, they weren't able to cover that number of lots with the amount of funding that they have. They needed to clean up over a thousand lots, then they do need the federal funding. And I guess that is necessary to be designated as a Superfund site.

Theresa Nair:  Okay, thank you for that clarification. There was an article in the Georgia Recorder from 2021 which explains that you began testing the soil in Western Atlanta for slag in 2018. Can you tell us a little bit about what slag is and what the history is that caused the slag to appear in this neighborhood?

Eri Saikawa:  Yeah. What happened was we wanted to understand the potential soil contamination because there was a lot of urban gardening going on. And then, what we found was that in some of the residential lots, we were finding pretty high lead levels that were over sometimes 2000 ppm, when 400 ppm is the standard by the EPA. And one of the residents living in the west side that brought the slag pieces, which is industrial waste from smelting. They're like rocks. It's kind of like volcanic rocks. They have a lot of pores. They're the remaining from smelting. And the slag that we are seeing is most likely from the waste from lead smelting. There appear to be about 11 lead smelters in Atlanta in the past. And so, we believe that's the remaining of that. And because of that waste, we are finding a lot of lead in those pieces. I think what happened was they were buried as foundations for the land to build the homes, but then over time, the soil was eroded. And then, what used to be the foundation is now showing up as a surface soil.

Theresa Nair:  Right. I see. Was that material originally in the foundation of the homes then?

Eri Saikawa:  Yeah.

Theresa Nair:  Oh, wow.

Eri Saikawa:  That's what it seems like. And so, what happens now is that the EPA goes to dig the soil to clean up. In some cases, they dug about eight feet down and they still found slags.

Theresa Nair:  Wow.

Eri Saikawa:  And so, that is going very deep. So, now what they found is that they cannot dig everything to take out and so they are only digging about one to two feet. And if they still see the slag, then they put the plastics to make sure that the developers that would come later on know that it is contaminated with slag underneath.

Theresa Nair:  Okay so, the plastic doesn't necessarily prevent it? It's just kind of a warning for developers?

Eri Saikawa:  Right.

Theresa Nair:  Okay.

Eri Saikawa:  Correct.

Theresa Nair:  There's contamination past this point?

Eri Saikawa:  Yeah, exactly. They don't have the funds to dig that much to clean everything up.

Theresa Nair:  Wow.

Eri Saikawa:  Yeah. Because, what's happening is that the residents stay, living in the house when the cleaning goes on. They're trying to clean up as much as possible, as quickly as possible. The priority is to take the surface soil out and then replace with clean soil.

Theresa Nair:  Is the idea then that that amount will protect the resident that's living there, that that's enough of a buffer to isolate them from exposure?

Eri Saikawa:  Yeah, that's the idea I believe.

Theresa Nair:  Okay. And is the history that you just explained, is that similar to other Superfund sites throughout the country? Is that generally how these sites have begun, that it was near a factory or some type of production that contaminated the land?

Eri Saikawa:  I think there are very different types of Superfund sites. Sometimes, it's contaminated because of the current operation, so the EPA knows who is causing the pollution. In that case, they can go and the polluter is going to be responsible for cleaning up. But, I think there are also a lot of cases like what we are seeing in the west side where the past contamination is causing problems, so then it's hard for the EPA to figure out who the actual polluter might have been. And so then, the federal money needs to come in because they cannot get the polluter to pay.

Theresa Nair:  Okay. So if they knew who it was, then they might be liable?

Eri Saikawa:  Yes.

Theresa Nair:  But if they don't know, the EPA takes over?

Eri Saikawa:  Yeah, exactly. I believe that the EPA is still going after who might have dumped these so that they can make them liable.

Theresa Nair:  Right.

Eri Saikawa:  That takes a lot of time, I think.

Theresa Nair:  Yeah. I'm sure it does. And proving liability could be a whole issue.

Eri Saikawa:  Yeah.

Theresa Nair:  There was an article published by 11Alive on March 19 of this year that quotes the EPA administrator as saying that, “The new Superfund site is located in an overburdened and underserved community." Could you explain to our audience how this issue is tied to environmental justice and any relationship that exists between the site designation and neighborhoods that have historically experienced discrimination?

Eri Saikawa:  Yeah. I think for this historic west side, it is a predominantly Black neighborhood and also the income level is one of the lowest in the Metro Atlanta area. It is overburdened in a sense that they already have a lot of issues that they're going through. And it is also an energy-burdened area, meaning that it becomes energy-burdened when you pay more than 6% of your income towards electricity.

Theresa Nair:  Oh, wow. Yes.

Eri Saikawa:  Atlanta is pretty well-known for energy burden, but this area is especially energy-burdened. If you have low income and if you are already paying so much for electricity, you cannot pay for other things. That is a very big problem. And chronic issues and the water contamination, for example, has been seen in their creeks as well in the past. It's not just the soil contamination that they're dealing with, but it used to be also a food desert, meaning that they didn't have a lot of fresh produce around where they live. And because they didn't have vehicles either, then they couldn't get the produce they needed. It's unfortunate because having this urban agriculture movement is really great on one hand, but then if there is a lot of contamination in the soil, then that doesn't solve the problem at all and creates another problem. So when you are already overburdened, then it's a really complex issue that you are going through.

Theresa Nair:  I was actually going to ask you about that because I know you mentioned earlier that you did get into this because you were studying urban gardening. And urban gardening does have a lot of benefits for increasing food independency and increasing access to healthy food, but then you have this question of soil contamination. And I know that you have done some research with focus groups, studying safe gardening practices in urban environments. Could you tell us a little bit about... For anyone who might be using urban gardens, how people can protect themselves, or how people can know whether it's safe or whether they can eat the vegetables that are being grown in these environments?

Eri Saikawa:  Yeah. So, I think the best practice is really to be cautious before you actually start it. If you are worried about it, I would highly recommend that you would test the soil. That's why we are also providing this Community Science SoilSHOP opportunity for people to test the soil for free for lead. Lead is not the only toxicant, but that can be a way to screen. And I think that's one of the most important chemicals that you want to avoid. Also, if you're now able to really test the soil, you might just create the raised beds and make sure that you are not having any potential contamination in the place where you are gardening. Because, it's the most unfortunate, I guess, consequence of this great cause that you're doing. And I believe that urban agriculture also does a lot for our mental health as well. It really improves your mental health, I read somewhere. There are really good benefits. Taking precautionary measures, I think, is pretty important.

Theresa Nair:  Okay. There are some good suggestions. So if they do think their soil's contaminated, using raised beds, putting in potting soil would help offer some protection then.

Eri Saikawa:  Yeah.

Theresa Nair:  Okay, good. You mentioned the mental health impacts of urban gardening, how there’s some benefits. I'm wondering if you could talk a little bit about the mental health impacts of lead exposure. We hear a lot about the physical health impacts. Could you talk about anything related to mental health, how it affects mood, memory, or brain development in children?

Eri Saikawa:  Yeah. I think lead exposure is really linked to the brain development of children. When you're exposed as a small kid, then that can have developmental issues. And I think what's really important is that once you're exposed, it's very difficult to go back to preexposure. Yeah, I forgot to mention, I think washing your hands if you are potentially exposed can really do a lot. And sometimes, we think that if you're growing food in your own garden, then you might not wash your vegetables or something, but that's really essential that you wash. You make sure that you are not having any contamination. And if you have pets, making sure that they don't bring in the contamination at home. That is pretty crucial too.

Going back to the brain development, I think the IQ can be impacted quite a bit. What I usually want to think about is the people that are going to be impacted by lead are also already overburdened. The distribution is not equal, and so we really need to make sure that the kids in the vulnerable neighborhood are really given the safe environment and we should do more to make that happen for those children.

Theresa Nair:  Thank you. That's a good point. One of the things I found really impressive when I was reading about your work was that you're not only a scientist researching this topic from your office, but you also joined the West Side Health Collaborative and were doing some hands-on work in the community, passing out leaflets to residents and urging them to get their children's lead levels tested. Since you were going out within the community and raising awareness, I'm wondering if you could tell us how this information was being received by community members. Were people experiencing increased anxiety or fear or depression, or were people feeling more optimistic that this was going to be a short-term problem that would be easily resolved?

Eri Saikawa:  Yeah, I don't think anybody was optimistic that I've seen. There were so many devastating, I guess, cases that I saw and that sometimes made me wonder if that was a good thing that we found contamination. For example, the partner that I work with in the community, she had a garden in her lot that was especially for children. She called it Children's Garden. And then, there were her grandkids that were gardening in that soil. And that was the spot where we found high lead levels and it was really with a lot of slag. And that was really devastating because that is somebody that I know well and she had this to do good things for her grandchildren. She was really worried obviously and she took them for blood test. And actually, I remember so well she told me that the test came back and one of her grandchildren, the level was high.

Theresa Nair:  Oh wow.

Eri Saikawa:  It was very, very devastating for me and for her. Yeah, thinking about that actual impact that it has when we talk to the residents, I think it is really difficult. How can we actually go over that, it's not something easy. Because if you're already exposed, you can always do a lot to mitigate, but that impact is going to stay. And so, the resident is asking me, "Is this child having developmental issues because of lead exposure?" And I cannot answer that. I think there is a potential that might be the case but I'm not a doctor and it's very difficult to say. And so, seeing those people, I think, struggling, what can we really do is, I guess, make that impact as less as possible, knowing that they are already very much impacted and they have to suffer from that.

Theresa Nair:  Right. I'm sure that's really difficult, especially for that grandmother who was trying to make healthy food, grow healthy food for her grandchildren. I guess the best thing you can do at that point is try to clean it up for everyone from here on to move forward. But, I'm sure that's difficult. I'm glad you were able to work with them to help them clean it up and help to find solutions. I wanted to broaden out our conversation a little bit. So far, we've been talking about the Superfund sites in Western Atlanta and the impact in that community. However, I do want to point out that below this interview, we're going to be placing a link that shows where people can find Superfund sites near them and find out if they are near any of these neighborhoods. It is that EPA's website, and that will allow everyone in our audience to check their own proximity to Superfund sites.

Since many of our audience members are in the Washington state area, I think it's important to note there are currently 69 Superfund sites listed within the state. However, when you dive into descriptions for these sites, many are listed as deleted, final, or non-NPL. Could you explain a little bit about what these designations mean and how concerned for environmental exposure people should be if they find that they're living near one of these sites?

Eri Saikawa:  Yeah, that's a very good question. The west side just got listed on the National Priorities List. NPL. NPLs are considered to be the national priorities for cleaning up. If you are living in or proximity to the NPL site, then that is one of the most contaminated sites in the U.S. And so, your exposure, I think that's something that you would really want to think about. And even if that is, I guess, you mentioned deleted... So, deleted, I think, happens after the cleanup is over. And so, hopefully, that is already when it's clean. Sometimes, not everything is going to be completely clean, but I believe that the cleanup process usually works so that it is much cleaner than how it used to be. And so, over time, hopefully, the value is going to increase and then you are going to have a better environment.

Sometimes that even though it's a Superfund site, it cannot be designated as an NPL. And that's often a political reason, it seems like. I believe that if you are in one of the, even the brownfield areas, the Superfund sites areas, you do want to be mindful of what kind of toxicants you might be exposed to. And if there is an opportunity to test for either blood test or whatever test that's available, I think you should take advantage of that.

Theresa Nair:  That's good advice. If a person is experiencing anxiety due to learning that they're living near a Superfund site, or if they suspect they may be living in an area that's undesignated but may have some environmental pollutants present, what practical steps could they take to protect their health and the health of their family members?

Eri Saikawa:  Yeah. This is so important. If you do suspect that you might be having some exposure, the data is very important. Community science, citizen science, I think that's taking a lot of power. So if you are able to find somebody that can work with you to figure out what kind of contaminants might be there, or if you already know what might exist, I think getting the data and then bringing that to the EPA, that is so important. And then, once they have the data, it is their responsibility to really look into it. I would really urge anybody, if you are finding any issues, see who you can partner with and then try to get the data that you need and bring it to either the EPA or the health organization. For Georgia, the department of public health. Georgia Department of Public Health is very interested. I'm sure there are agencies like that in Washington state that would work with the community.

Theresa Nair:  Okay, that's a good recommendation. To start with maybe something like soil analysis, would you recommend contacting the local university first, somewhere like that to start?

Eri Saikawa:  Yeah, sorry. ATSDR, Agency for Toxic Substances and Disease Registry, they usually host what's called soilSHOP. They might be willing to help figure out if there might be contamination of that soil. And then, I guess, just contacting the person that you are aware of, any scientists. It doesn't have to be somebody that you know. I'm happy to hear the concerns and then try to find the scientists near the people in your area in Washington state, for example. I think just reaching out to anybody that you find on the internet might be one step. And then, I think talking to your doctors is also important. If you're feeling some anxiety, talking through with your doctor, and then they might be able to refer to somebody else that can potentially help. I think seeking help earlier is a pretty important step.

Theresa Nair:  It's very good advice. Was there anything else before you go? Did you have any parting words of advice or anything that we didn't ask about that you might want to share with our listeners on this topic?

Eri Saikawa:  Yeah, I think I would really want to say that if you do see some problems, talking about it with your community members and then potentially testing. I think that is very important in trying to make everybody safe, especially your children. I really would like to encourage that. We don't talk enough about these potential contaminants that really affect us, so raising awareness amongst ourselves first and trying to distribute that knowledge to others, I think that's very important.

Theresa Nair:  I think this has been a very interesting discussion and I want to thank you for taking the time to speak with us and sharing such valuable information and information about resources and where people can go if they have these types of concerns. And I just want to thank you for participating in our interview series today.

Eri Saikawa:  Yeah. Thank you so much for having me.

* To check if there is a Superfund Site near where you live, click here to access the EPA’s search site.

Please note: The views expressed by the interviewee are for educational and informational purposes only, are not meant to diagnose or treat any condition, and do not necessarily reflect the views of Seattle Anxiety Specialists, PLLC.

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Editor: Jennifer (Ghahari) Smith, Ph.D.