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ACTIVE SHOOT PREP A SAD COMMENTARY

Violence—random, sudden, illogical, and lethal—has become a fact of life. Years of social and economic injustice have resulted in large numbers of people who are frustrated and without hope for the future, people to whom bravado is everything, and anything that seems the slightest bit threatening—a put-down, a disagreement, a dirty look—­demands immediate retaliation.  As I write these words, this kind of violence almost seems old school to me.

I’m not quite sure when my consciousness shifted about the kind of violence we now all face. I wonder if it was during the six year period beginning in December 1993 when the Long Island Railroad massacre occurred, followed by the Oklahoma City bombing in April 1995 and then Columbine school shooting in April 1999. The targets: public transportation, a federal building and a public school.

I think it was during that period of time when it started to sink in that something dramatically different was happening that was more than a fluke. I remember thinking, in one of my more morbid moments, that all Americans were secretly entered into a daily national lottery that wouldn’t result in fortunes gained from pooled funds, but instead in body counts delivered at the hands of deranged strangers.

And now, as two additional decades have unfolded, churches, synagogues, concert halls, nightclubs, workplaces and more have been added to the pantheons of mass murder.

This past Election Day, during our annual staff development day, I participated in an Active Shooter Preparedness Training at North Shore Child and Family Guidance Center. It was presented by police officer Ken Murray and paramedic Rich Husch from Nassau County Police Department Homeland Security division. The training was engaging and informative.

Before 1993 I don’t believe I could have imagined participating in such a workshop. Today it is essential for workplaces, schools and houses of worship.

In a staff development day just few years earlier, the theme was mindfulness. Mindfulness, originally a Buddhist concept founded centuries ago, refers to a practice of paying attention and staying in the present, moment-by-moment, to feelings, thoughts, bodily sensations, and surrounding environment without being judgmental. Mindfulness is often taught as a meditative approach to calming or soothing oneself.

After the active shooter preparedness training I thought about the commonalities and contrasts of the two, both of which emphasize paying attention to the environment, one to luxuriate in the richness of what might otherwise pass one by and the other to be hypervigilant to threats and escape routes.

Mindfulness is taught for the benefits of stress reduction, improved focus and reduced emotional reactivity. Active shooter preparedness is taught so that, In the midst of chaos, anyone can play an integral role in mitigating the impacts of a potentially deadly incident.

On reflection, I’m struck by the emotional flexibility required to absorb both into one’s consciousness, requiring fluidity and many-sidedness.  Robert J. Lifton is an American psychiatrist and author, chiefly known for his studies of the psychological causes and effects of wars and political violence.

In a review of Lifton’s book, The Protean Self: Human Resilience in an Age of Fragmentation, the reviewer sums up the concept of the protean self by stating that “life is not a straight line. Instead, it is, and ought to be, experienced as a collage.”

The sad reality today is that the collage is becoming overcrowded by images of carnage that more sensible gun regulation can go a long way to changing.

Published in theislandnow.com: https://theislandnow.com/opinions-100/kids-first-preparedness-mindfulness-and-the-protean-self/

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org. 

EVERY FIGHT NEEDS A VOICE

When tragedy strikes, the grief can be overwhelming. One way that some people choose to deal with their pain is to try to make something good come out of a horrible situation. That’s what the parents of Timothy O’Clair did when their 12-year-old son died by suicide on March 6, 2001 after mental health benefits provided by their insurance company ran out.

The O’Clair family fought tirelessly for years for New York State to pass a law requiring health insurance policies to provide access to timely and affordable mental health care in the same way they cover physical illness. The legislation, called Timothy’s Law in honor of their son, was finally signed in December 2006.

Timothy’s Law helped to blaze the trail for a much broader federal law that passed two years later which requires health insurers to provide access to mental health care on par with medical and surgical care.

Now, what would you think if I told you that despite these hard-fought state and federal laws, in New York State national insurance companies are continuing to prevent children like Timmy O’Clair from accessing care and that New York State regulators are assisting them in doing so?

This is precisely the case. As health law expert Brian Hufford stated, “Timothy’s Law appears effective. In 2009, the state reported an increase of 4.5 million people with plans promising comprehensive mental health coverage. But that number is almost certainly a mirage.” Hufford goes on to say that New York’s insurance regulator, the Department of Financial Services, has a shallow history of enforcement that suggests it lacks the interest or resources to adequately protect New Yorkers.

One year ago North Shore Child & Family Guidance Center issued the results of a groundbreaking study known as Project Access, which surveyed 650 people across Nassau and Suffolk Counties.

The results revealed conditions similar to what the O’Clair family fought against in the early 2000s and showed that discrimination against people living with mental illness and substance use disorders persist.

An immediate follow-up to the Project Access study exposed the reality: the New York State Department of Financial Service is stonewalling demands to further investigate this civil rights issue.

In a letter to DFS Commissioner Mary Vullo citing the Project Access study, state Senators Todd Kaminsky and Elaine Phillips requested a thorough investigation into the persistent problem New Yorkers were experiencing when trying to access timely and affordable mental health care.

Almost five months later Scott Fischer, executive deputy superintendent for Insurance, a division of DFS, responded in writing to the senators.

Fischer wrote: “DFS’s review of the various networks has confirmed that each of the insurance companies in Long Island exceeds the standards for mental health and substance use providers, for the purpose of the commercial products sold outside of the New York State of Health,” the official health plan marketplace.

In other words, this DFS official is stating that there is no problem and nothing more to do, which is contrary to the evidence.

Fischer’s response belies the reality that DFS does little if anything to verify reports from health insurers indicating that they have adequate networks of providers available to their beneficiaries.

I had the privilege of meeting Timothy O’Clair’s dad Tom at a National Alliance on Mental Illness event in Albany in October.

Tom was the driving force behind the passage of Timothy’s Law. We shared a stage in recognition of our mutual efforts to advocate for effective and enforceable parity laws so insurers do, in fact, cover mental health care the same way they do physical illness.

We spoke briefly. I told him that although I never met his son, I keep Timothy close to my heart in the continued fight. He responded, “Keep doing what you’re doing.”

Although it was only the two of us in this fleeting interchange, I’m sure that Tom’s entreaty was meant for all people of good will that know firsthand the devastating impact of untreated mental illness and addiction. We all must keep fighting so Timothy’s Law is a reality and not just mere words on paper.

To find out how you can join this effort, contact Andrew Malekoff at (516) 626-1971, ext. 302, or email amalekoff@northshorechildguidance.org.

Published in theislandnow.com: https://theislandnow.com/opinions-100/kids-first-every-fight-needs-a-voice/

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org

FIGHTING BACK FROM CHILDHOOD SEXUAL ABUSE: KAYLA'S STORY

By Andrew Malekoff

I recently attended a seminar led by Dr. Cynthia Kaplan, Director of Trauma Training & Consultation within the Child and Adolescent Services at McLean Hospital of Boston. Dr. Kaplan addressed the issue of childhood sexual abuse (CSA). She incorporated the story of a young woman, Kayla Harrison, a survivor of CSA and a two-time Olympian Gold medalist in judo for the United States.

Many years ago CSA was only heard about in whispers as opposed to in depth reports by investigative journalists. Today, reports on CSA perpetrated by what seem like otherwise model citizens – religious leaders, coaches, teachers, seem commonplace.

Dr. Kaplan made a strong point about how we caution children in the strongest terms to “stay away from strangers,” yet 90 percent of children and adolescents, who are sexually abused, know their abuser.

Kayla’s book, Fighting Back: What an Olympic Champion’s Story Can Teach Us about Recognizing and Preventing Child Sexual Abuse - and Helping Kids Recover,  co-authored with Drs. Kaplan and Aguirre, contains excerpts from Kayla’s personal journal. She wrote about her experiences throughout the course of her abuse, including about how she was groomed by her coach.

“By the time I was 9 or 10 I started traveling with the team to local tournaments. At night when the whole team would watch movies I would snuggle up next to him. He would put a blanket over us and then one day things went further and he guided my hand to touch him.”

About one in 10 children will be sexually abused before their 18^th birthday. The impact of CSA can be felt by survivors throughout their lifetime. According to Dr. Kaplan, what complicates the healing is that CSA is not visible, not transparent. Consequently, survivors may not get the support they need and are often left to struggle and mourn alone.

When film director Steven Spielberg created the Shoah Foundation, which strives to capture the testimony of Holocaust survivors, he discovered that many of them had never told their stories before. They often avoided doing so because they had a deep sense of shame and distress which they often believed could or would not be understood by others. After the filming they reported feeling a sense of relief at finally having told someone. They finally felt heard.

Being truly heard requires another person to bear witness. Living with the hurt in silence can compound traumatic stress and lead to destructive and even fatal behaviors including drinking, drugging, self-harm and suicide.

Disclosures of CSA require professional support. When survivors lose their ability to control disclosures, the emotional impact can be devastating. Even in the best of circumstances, says Dr. Kaplan, following disclosure individuals often feel more distressed and have trouble managing emotions. They may begin to lose faith in the world and can feel re-traumatized by the disclosure experience itself.

It is significantly more likely that a child will disclose if they know they are likely to be believed and do not feel blamed and also if they are helped to anticipate the potential legal repercussions of breaking their silence. 

Believing that they will be protected by the adult they disclose to goes a long way. Particularly when they are able to maintain at least some control over the disclosure process, preserve their anonymity to the extent possible and sustain a level of confidentiality.

Surprising as it may seem, children also need to feel free to express their concerns about what will happen to the offender, as it is a complicated relationship with the victim having mixed feelings that survivors need time to process.

There is hope. As Kayla said, after many years and support from her new coaches, parents and mental health professionals, “I began to see my way out of the darkness and towards the light until I could again see the flame of the Olympic torch shining with my very own eyes.”

Published in Blank Slate Media’s TheIslandNow.com, Oct. 23, 2018, link: https://theislandnow.com/opinions-100/kids-first-fighting-back-from-childhood-sexual-abuse-kaylas-story/

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.  The book Fighting Back can be found at: https://www.guilford.com/books/Fighting-Back/Harrison-Kaplan-Aguirre/9781462532971

END RAPE CULTURE

by Andrew Malekoff

In the 1980’s I held a part time job as a psychiatric crisis counselor for an emergency room nearby my home in Long Beach. I carried a beeper and was on call nights and weekends. I handled some of the crises over the phone. Many calls required my presence at either the ER or, in some cases, the police station.

The calls involved people with thoughts or actions related to suicide; substance use issues; family conflicts; or people with mental illness experiencing disturbing symptoms such as hallucinations or delusions.

Sometimes crisis calls were more benign. They included people seeking advice or referrals, or people who simply wanted to make human contact in the middle of the night to combat their loneliness.

A few of the crisis calls have not escaped my memory. One of them involved a young Black woman who told me that she had been raped. She said she came to the ER to request an  examination.

In the course of my intervention in the ER I asked the on duty nurse if the woman was given a “rape kit,” a sexual assault forensic exam to preserve potential DNA evidence and receive important medical care. The nurse said she had not. When I asked why not, she gestured with her head towards the chief emergency room physician and rolled her eyes.

I approached him and asked him the same question, “Why not?” With no change of expression he said matter-of-factly, “Because she’s crazy.” I said, “What has that got to do with it.”  He did not respond.

I returned to the woman and asked her again, “Would you like to be examined?” She nodded yes.

I circled back to the doctor and said, “If you’re telling me that you are refusing her a “rape kit,” I am including that in my crisis note which will be read by government officials that support this hospital. I will state that the patient reported being raped, requested a rape kit and that you denied her the examination.”  He appeared surprised to be challenged and finally said, “I’ll give her a kit but don’t ever question my authority again.”

As I was following the proceedings leading up to the most recent Supreme Court nomination and the protests led by women, I found the term “rape culture” popping up repeatedly on social media.

Emilie Buchwald, author of Transforming a Rape Culture describes rape culture as “a complex of beliefs that encourages male sexual aggression and supports violence against women. A rape culture condones physical and emotional terrorism against women as the norm.”

Women Against Violence Against Women (WAVAW) Rape Crisis Centre in Vancouver, BC, Canada further states that “rather than viewing the culture of rape as a problem to change, people in a rape culture think about the persistence of rape as just the way things are.”

Perhaps the most disturbing aspect of rape culture is that, to a large extent, it is accepted as inevitable when, in fact, it is an “expression of values and attitudes that can change.”

Parents can teach their children not to condone sexual violence in everyday language and reject the sexual denigration of women and girls. Schools can teach comprehensive sex education that includes values and attitudes. The justice system can punish rapists and not their victims.

And, medical personnel who perform forensic exams can be properly trained.

Published in Blank Slate Media’s TheIslandNow.com on Oct. 9, 2018, link: https://theislandnow.com/opinions-100/kids-first-end-rape-culture/

   

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

BEYOND WORDS: TRAUMA AND THE ARTS

by Andrew Malekoff

Powerful images that depict disturbing events in ways that literature alone cannot can be illuminating and healing. Following are three descriptions of different media that capture recent man-made disasters still very close to the surface for many of us.

The first, Please Stand By, is an example of cartoon art in the aftermath of 9/11. The second, The Last Lockdown, is about a sculpture created after the mass school shooting in Parkland, Florida. Both illustrate the fear-inducing paralysis of traumatic events. The last, Memorial Rock Garden, describes bereaved children painting stones to memorialize their deceased dads.

Please Stand By

In the immediate aftermath of the September 11, 2001 terrorist attack on America, several artists joined together to produce a soft cover book entitled 9/11: Artists Respond.  It is a collection of art, sequenced to showcase the artists’ response to the terror that befell the world.

One nine-frame piece entitled “Please Stand By…”, by Jeph Loeb and J. Scott Campbell, features a girl of about eight years old watching cartoons on television. By the third and fourth frames, the image on the screen changes to a live feed of the Twin Towers ablaze.

As the little girl stands transfixed, stuffed animal in hand and her face less than 12 inches from the screen, the commentator announces, “We interrupt this program to take you live…”

The little girl turns away and cries out, “Mommy!” The next three frames begin with her mother dropping a basket of laundry. Then, with her face contorted in anguish, she embraces her daughter to shield her from the unrelenting televised images.

The final frame is a close up of the little girl asking, “Mommy, when are the cartoons gonna come back on?”

The Last Lockdown

The next image is a haunting statue, as described by journalist Josh Hafner, of a “small girl cowering beneath an open school desk, clutching a leg as she gazes into the distance with a look of fear in her eyes.”

The sculpture was created by Manuel Oliver, an artist who lost his 17-year-old son Joaquin in the Parkland, Florida, mass shooting earlier this year. As Oliver said, “It’s too late for us to save Joaquin from gun violence, but through art my family and I are making sure that we protect the rest of the kids out there.”

“Talking about the trauma is rarely if ever enough,” advises noted trauma expert Bessel van der Kolk. He points to the Holocaust Memorial in Jerusalem and the Vietnam War Memorial in Washington, D.C., “as good examples of symbols that enable survivors to mourn the dead and establish the historical and cultural meaning of the traumatic events to remind survivors of the ongoing potential for communality and sharing.”

Memorial Rock Garden

          In 2002 at North Shore Child & Family Guidance Center, a group of boys and girls who lost fathers in the attack on the World Trade Center decorated stones to be placed in a memorial rock garden.

The kids in the bereavement group sat together around a table covered with newspaper. In front of each of them was a large smooth oval-shaped stone. They decorated the stones with unique designs of paint and glitter, each one a personal remembrance of their fathers.

“Mine is painted gold,” beamed Mack. “I painted it gold because my dad is like gold to me.” A heart framed Jenny’s design, “because my dad will always be in my heart.” On Seth’s stone were two intertwined hands, a small one and a larger one that showed “me and my dad were best friends.” Victoria painted a fire hat and said, “My dad is my hero.”

We might do well to remember that when funding cuts threaten to decimate arts programs in schools there is more at stake then we might imagine. The impact of the arts is not measured by standardized tests and its value is incalculable.

Published in Anton Media's Long Island Weekly, Oct. 23, 2018, link: https://longislandweekly.com/beyond-words-trauma-and-the-arts/ 

Bio: Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

SEEKING HUMANE SOLUTIONS FOR YOUNG REFUGEES

By Andrew Malekoff

In a recent story in the Albany Times Union, reporter Mallory Moench paints a different picture about juvenile asylum seekers as compared to recent stories about caravans purportedly composed of gang members and Middle Eastern terrorists.

In the report we meet Rosa, who left El Salvador as a young adolescent after being targeted by a gang intending to prostitute her. To prevent becoming sexually exploited, she left her parents and crossed the border. She has been living in the Capital Region of New York for the past two years.

Rosa, now 17, is undocumented and is seeking special immigrant juvenile status that would enable her to apply for a green card which permits a foreign national to live and work permanently in the U.S.

Rosa understands that she could be denied and deported. More than 12,500 undocumented young people have participated in immigration court this year alone. For those without a lawyer, the odds of deportation are much greater.

According to the Albany Times Union report, “If juveniles [under the age of 21] have a relative who is a U.S. citizen or green card holder, they can apply for a family-based petition. If they are victims of trafficking, domestic violence or another crime they can apply for crime victim visas. If they’re fleeing persecution like Rosa, they can apply for asylum. If they’re missing one or more parents they’re eligible for special immigrant juvenile status.”

Attorney General Jeff Sessions has taken measures to fast track deportations. Consequently, many juveniles may be sent back to their homelands—and the dangers and threats that await them—before legal proceedings are implemented.

Many of the young people living in New York’s Capital Region, ages 12 to 19, came from El Salvador, Guatemala, Honduras or Mexico after being confronted with gang violence. The profile and numbers of refugees on Long Island is similar. It is ironic that with the incendiary political rhetoric of the day, many asylum seekers have been labeled gang members, when it is gangs that they are trying to escape from. 

Many young migrants endured trauma in their passage to the U.S. They faced starvation, violence and abandonment.

There are only two immigration courts in all of New York. One is located in New York City and the other is in Buffalo. For many asylum seekers, the cost for transportation to court hearings prevents them from following through. For example, for those living in the Capital Region, a bus ride can be as much as $100 and more than $500 for private transportation. This is especially daunting when they are living in poverty.

Furthermore, there is a cap on the number of visas given each year and also each month. This contributes to inordinate delays in court.

For most of these juveniles the fear and anxiety of being deported as they await a final legal determination can be unbearable and impacts their ability to heal from the traumatic journey to the U.S.

Immigration laws do need to be enforced as open borders with endless flow of refugees is unsustainable.

The challenge is how to enforce the law, dial down the divisive and hateful rhetoric, demonstrate compassion and seek humane solutions for young migrants simply looking to live without fear.  We’ve strayed from that ideal. I hope we can find our way back.

Bio: Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

WORDS REALLY DO MATTER

Andrew Malekoff

Words matter. Today, this is no more evident than in the incendiary rhetoric – spoken and tweeted - that has contributed to American citizens being pitted against one another.

There is a growing sentiment that the mass shooting in a Pittsburgh synagogue that took the lives of 11 congregants was fueled by hate speech that ignited the shooter’s growing rage.

Although that subject is being abundantly covered in the media, it is the words associated with another kind of shocking death that I wish to draw attention to here. 

When someone takes their life they are most frequently reported to have “committed suicide.” Commit is a word that connotes a criminal act. Yet, suicide is not a crime.

Desiree Woodland, a mom who lost her son to suicide shared her experience in a NAMI (National Alliance on Mental Illness) publication. “My son did not commit a crime. He believed the only way to end the unbearable pain was to end his life. He died because he didn’t have the words to express the deep psychological/biological turmoil he was experiencing.”

If not a crime, is suicide an immoral, depraved or sinful act? It isn’t if it is the consequence of mental illness, unbearable stress, or trauma.

Nonetheless, family members who are survivors of suicide loss report the experience of others speaking in hushed tones around them. Some people refer to suicide as a selfish act, the result of poor parenting, a deficit in the family or all of the above.

At the same time that there is a growing demand to tone down divisive and hateful rhetoric in order to prevent interpersonal violence, there needs to be discussion about mental illness and suicide. 

According to Denver psychotherapist Dr. Stacy Freedenthall, “If changing our language can help suicidal people to feel safer asking for help, then changing language can save lives.” 

In academic journals there appears to be an inclination to use the term “completed suicide.” However, committed and completed are terms that advance the stigma and shame related to suicide and should be avoided.

Increasingly there is preference to the expression “died by suicide” which avoids the judgmental undertone of “committed suicide.” 

Perhaps a contributor to The Mighty, a digital health community created to empower and connect people facing health challenges and disabilities, said it best: “By shifting our language around suicide, we have the power to reduce some of the massive shame carried by survivors of suicide. If you feel scared or helpless about what to say to someone who’s lost someone to suicide, take comfort in knowing that, by changing your language about suicide, you’re offering an act of kindness.”

To be published in Blank Slate Media’s – TheIslandNow.com

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org. 

A FROZEN MOMENT

Andrew Malekoff

Three years ago on a bright September morning, my wife Dale phoned me at my office in Roslyn Heights to tell me about something disturbing that had just happened to her. It was a few days before the Jewish New Year when our family comes together.  

Dale and I both grew up in New Jersey. We relocated permanently to Long Island after we were married in 1980. We raised our children here. She has been teaching art to high school students at the Hebrew Academy of Five Towns and Rockaway, a Yeshiva in Cedarhurst, for close to 35 years.

This is the story she told to me.

She had been shopping at King Kullen in Island Park, about a mile-and-a-half from our home in Long Beach. She was standing in a checkout line unloading a shopping cart full of groceries on to the conveyer belt.

A large man stepped up to wait in line behind her. He had only a few items in a smaller hand-held basket. He seemed agitated; she said she thought it was because he’d have to wait.

Trying to be helpful, she pointed out to him that a cashier had just opened another register just a few aisles away and that there was no one standing in that line.

The man didn’t react. He just stood there, muttering under his breath, appearing to be dissatisfied with the pace of the transaction in front of him.

In my wife’s basket were a number of items for cooking and baking traditional foods for the holidays: brisket, chicken, soup greens, matzo ball mix, and so forth.

Also in the basket were four Yahrzeit candles that we light each year at this time to remember our parents, three of whom died in the 1990’s, all well before their 80^th birthdays. My mother-in-law Ida was the only one who made it past the age of 80.

The man continued mumbling under his breath and, finally, he said out loud: "You know the ovens are still open."

It was a frozen moment. The checkout girl and Dale just looked at one another. It was one of those surreal moments that can leave one feeling momentarily numb.

There was no physical altercation, no yelling, no overt anger. But, in my view, it was every bit of a violent moment.

As she recounted her experience she said, “I wish you were there with me.” I thought about that. Had I been there I’m not sure what I would have done. Initiated a physical confrontation?  Shouted him down? Assessed him as mentally disturbed and ignored him? Calmly asked him, “What do you mean by that?” I’ll never know for sure. 

What I do know is that anti-Semitism is alive and well.

My wife’s disturbing experience, on the eve of our High Holy Days was a fleeting yet indelibly shocking moment and reminder of how close to the surface anti-Semitism is, particularly in our increasingly divided nation our children are inheriting. 

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visitwww.northshorechildguidance.org.

For publication in Theislandnow.com

REACH OUT AND REMEMBER

Andrew Malekoff

In the aftermath of the 17th anniversary of 9/11 I offer a remembrance of several groups of people – all Queens, NY court personnel - whom I spent a day with in their courthouse, just three days after the 2001 terrorist attack.

The people I met with included individuals with missing relatives or friends, individuals with relatives or friends confirmed dead, individuals who were in the World Trade Center complex during the attack, individuals with family members who barely escaped, and individuals who witnessed the attack and collapse of the Twin Towers from courthouse windows. All were deeply affected. Most were in a state of shock and disbelief.

When I arrived at the courthouse after getting off at the Jamaica stop of the Long Island Railroad, I learned that I would be meeting with three groups of 8 to 12 people each. I was called in by an official from an Employee Assistance Program to offer a supportive group experience. We met in a vacant courtroom. I arranged chairs around two adjacent prosecution and defense tables.

As I awaited the first group a court officer said, “Today should be interesting.” I asked him what he meant. He said, “It’s foreclosure Friday.” He explained that every Friday they have an auction of foreclosed property and, typically, about 200 Arab-Americans participate in the auction, signaling a sense of mounting unease with people of Middle Eastern descent.

I greeted the first group, and one by one the participants revealed signs and symptoms of trauma and stress. These included numbness, shock, headaches, loss of appetite, aches and pains, frequent trips to the bathroom, sleeplessness, flashbacks, startle responses to loud noises (especially airplanes), helplessness, gruesome nightmares, anger, uncertainty, guilt and fear.

Fear was a powerful theme. Many felt that the courthouse was unsafe. During the final group meeting a female court officer walked in unannounced and searched for explosives, explaining that there had been a bomb threat.

At least one or two people wept openly in each group, women and men. In each group at least one person left the room to compose themselves and then came back. More than one person said, “I can’t stop crying.” And more than one said, “I can’t cry.”

Anger was a prevailing theme. There was anger at the government. “How could they let this happen?” they asked.

Many shared feelings of disbelief, saying how surreal it all seems. One said, “I am in a semi-daze; I feel like I am not even here.”

Guilt was prevalent, especially about going on with mundane day-to-day activities. A court officer said he felt insignificant, like “a grain of sand.” He said he felt helpless and wondered if he was going crazy.

The loss of innocence was best expressed by a group member who lamented, “Aren’t our children entitled to the life we enjoyed?”

One group participant’s son escaped from the 78^th floor. He took the stairs. His co-workers waited for the elevator. They didn’t survive. The son’s story was retold by his mother through sobs. When he emerged from the building, she shared, he witnessed “flaming bodies falling from the sky.” Two others held her hands as she told the story.

In each group people reached out to comfort one another through physical touch and understanding words. In one group a woman who said she couldn’t understand why she hadn’t cried was brought to tears by another’s pain over a missing sister.

In closing, the participants in one group agreed that “it’s good to know you’re not alone,” and “it’s good to know you’re not going crazy.”

I found the intensity of that experience and the participants’ ability to reach out to one another moving.

Although I was there to facilitate, my role was to bear witness. It confirmed for me what I was already feeling; when facing incomprehensible tragedy and overwhelming grief we must push ourselves to forgo isolation and reach out to one another.

Another September to reach out and remember.

Bio: Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

Published in the Long Island Weekly, September 12, 2018:  https://longislandweekly.com/reach-out-and-remember-september-11/

                                                                                                        

RESPECTING THE DIGNITY OF THE WORKING PERSON

Andrew Malekoff

By now I imagine you’ve heard all about The Cosby Show actor Geoffrey Owens who was job-shamed for working at Trader Joe’s. If you haven’t heard or just to refresh: A customer recognized him, snapped a few unflattering photos of him bagging potatoes and sold it to a tabloid news outlet that gave it a derisive can-you-believe-what-he’s-doing-now hook. If you are a parent, this is a great story to share and discuss with your kids. If you are a young person still in school it is an important lesson to absorb, store away and preserve so you can come back to it. You might find that you will need it one day.

Although the Yale graduate Owens admitted to feeling humiliated by being exposed in such a disdainful manner, he said that he was not embarrassed about having a side job at Trader Joe’s and that many working actors need to supplement their income to help support themselves and their families. Social media picked up his cause, which led to myriad media appearances and a viral social media presence. He used the opportunity to give voice to the dignity of work.

Here is what he said about that in a September 4 Time Magazine video interview: “The fact that I, as the guy from The Cosby Show, was shamed about working at Trader Joe’s, that story is going to move on, that’s gonna pass. What I hope doesn’t pass is this new recognition, this current sensitivity people are feeling about work and about people working. I hope what continues to resonate is the idea that one job is not better than another. A certain job might pay more, might have better benefits and might look better on paper, but essentially one kind of work is not better, superior to another kind of work and that we re-evaluate that whole idea and we just start honoring the dignity of work and respecting the dignity of the working person.”

Ironically, Owens’ job shaming experience led to thousands of tributes on Twitter, a new acting job with producer-director Tyler Perry and offers of cash gifts from celebrities like rapper Nicki Minaj, all of whom were so moved by Owens.

I found the story to be personally uplifting; and, not because Owens benefited with renewed notoriety and a promising new acting job, but because of his humanity and the dignity he displayed in representing working stiffs all across America, regardless of their stripe or station in life.

Bravo Geoffrey Owens. Well done!

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org. You can see the Time interview with Geoffrey Owens here: http://amp.timeinc.net/time/5385842/geoffrey-owens-cosby-show-actor-grocery-store-speaks-out?__twitter_impression=true

This article will appear in TheIslandWeekly.com

LOOK AT WHERE WE HAVE COM

By Andrew Malekoff

If you haven’t been initiated just yet, the twitterspere is a fascinating place on the Internet populated by all kinds of people, from your neighbors to local shopkeepers to your long lost cousin to your favorite film actress to world leaders.

By Twittersphere or Twitterverse I refer to postings made on the social media website Twitter, considered collectively.

At any given moment in time postings might include news of the day, personal reflections, political leanings and gleanings, conspiracy theories, calls for social action, fond memories, jokes and riddles, aphorisms, recipes, links to music, film and book reviews, humorous gifs (animated or static images) and much more.

Some posters have millions of followers. Others have less than 10. Anyone can participate by posting or just by scrolling and reading.

If you wish you can respond to posts. You can approve or disapprove of what someone else wrote. Or simply add your own voice to a discussion.

If you do decide to post, beware: there are trolls in the twittersphere. Wikipedia defines a troll as “a person who starts quarrels or upsets people on the Internet to distract and sow discord by posting inflammatory and digressive, extraneous, or off-topic messages with the intent of provoking readers into displaying emotional responses whether for the troll's amusement or a specific gain.”

Fortunately, not every person who responds is a troll. Many are thoughtful and respectful and only interested in expanding a conversation.

Just the other day I was on Twitter and found a discussion about the beginning of the school year. The opening tweet was written on August 22 by a mom from Las Vegas who goes by the handle, @CandaceToddLV: “It’s the 8th day of the school year & I just received a call from my daughters high school informing me they arrested a child with a loaded 9mm gun on campus this morning. I am now standing in my kitchen sobbing. I should not have to live like this. @MomsDemand ”

Candace’s post drew a significant response. Almost 90,000 people “liked” her post and more than 1,700 people responded. One response was written by @marci6687 from Florida who replied, “While absolutely not as scary as your situation, in our 8th day as well we are on our 4th written threat and 5th day of controlled or alert campus.”

Another response was sent by @rememberpink1: “My heart bleeds for you. I had two nephews & a niece at Sandy Hook. As an aunt the pain & fear & anger was unexplainable. It STILL is. And I wasn’t their mother. I stand strong w/ you. I fear every day my kids are in school. We shouldn’t have to fear. THEY shouldn’t have to fear.”

Many of the responses, which I will not share here fed into a debate on gun control, politics and the NRA.

One guy @joe1lane1 wrote, “My wife (school teacher) was in bed when I got home. Asked, “rough day?”  She said they had to do training on stopping wounds, suicides and other things. It wears her out emotionally. Educators are true “Heroes” in this country and get nowhere near the credit they deserve!”

My wife is a teacher as well. As I’m writing this she is on her way to her second day of school. She too will be participating in a similar training today. This has become the new normal.

In a few weeks at my agency North Shore Child and Family Guidance Center our staff members will be participating in an “active shooter” training.

Look at where we have come.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visitwww.northshorechildguidance.org. You can also visit: momsdemandaction.org, a grassroots movement of Americans demand reasonable solutions to address our nation’s culture of gun violence, that Candace tagged @MomsDemand in her opening tweet.

Published in TheIslandNow.com August 31, 2018 - https://theislandnow.com/opinions-100/kids-first-look-at-where-we-have-come/

VERSE BY MALEKOFF

VERSE by Malekoff, Politics-plus ... All original free associations.

Melania tells children, "Be best"
The nation answers, "Surely you jest"
So side splitting
Must be kidding
C'mon First Lady, give it a rest

Somehow we made it through Watergate
That darkest of times sealed Nixon's fate
And now there's Trump
That treasonous punk
True patriots cannot allow his escape

Fast food burgers make me sick
Meat is gray and grease is slick
They make me gag
And my belly sag
Where's the the john, I gotta go quick

24 hours of stations to choose
The never ending hum of cable news
Look at the talking heads
Including retired feds
Riling me up or making me snooze

Can barely recall her mother's face
ICE police caged her up in this place
Five-sixty-five
Is mine alive?
Or has she gone missing without a trace?

Rudy Guliani said, "truth is not truth"
America's mayor is long in the tooth
So full of crap
Needs a long nap
Or a quick dip in the fountain of youth

The King of Twitter lost his mind
Left all rational thought behind
Croaks like a frog
Lies like a dog
Regarding morality he's totally blind

The base is under Donald's spell
They do not know him very well
Hypnotized
Mesmerized
As dogs reacting to Pavlov's bell

Michael Cohen has copped a plea
Soiled his pants and took a pee
He's gonna burn
Unless he turns
The tables on President DJT

Madonna co-opted the Queen of Soul
Now Ciccone is paying a toll
Despite all her cash
Huge fan backlash
When Aretha arrived they broke the mold

The ladies of Salem have arrived
To tell us Agent Orange conspired
That twisted runt
Declared "Witch hunt!"
Thou protesteth too much - So you're  fired!

From, I'd take a bullet for my boss
To, I'd like to throw him under the bus
Michael Cohen is in deep shit
Agent Orange needs to quit
It's justice served or democracy lost

A tribute to Heather Heyer
Who stepped straight into the fire
To humanity's friend
Love the world sends
Your memory won't cease to inspire

A baby blimp flew high overhead
Bopping in time with Grateful Dead
The queen feted Trump
The orange-haired lump
"A stable genius, I am," he said

If stomach-turning Hannity
Were eaten by a manatee
There'd be such glee
That a windbag like he
Was turned to waste in a tropical sea

The children of Flint drank lead
Poison then went to their heads
No one took blame
Michigan's shame
Tap water that brings only dread

To our nation's enduring disgrace
Is prejudging according to race
Bias by skin
Our original sin
Diversity we should all embrace

That guy with the orange cheeks
Moscow should be where he sleeps
He rants and he rages
And puts children in cages
But with Vladi he acts like a sheep

Mike Pence is like a mannequin
Standing beside the sultan of sin
That frozen smile
Is code for "Sig Heil"
He's Charlie McCarthy's next of kin

Agent Orange is selling us out
Sowing the seeds of eternal doubt
Vladimir's pet
Has no regret
Unprincipled lying treasonous lout

Bone spur orange dodged the draft
Misleading congress is his craft
Oh me, oh my
That boy can lie
And republicans cover his ass

"No collusion" is not really so
Agent Orange is America's foe
He cheats and he lies
Gives comfort to spies
That sorry sack of s*** must go

What leads to a meaningful life?
A career, a husband, a wife?
It's not what you'd guess
You see, life's a mess
Cannot be smoothed by a butterknife

Agent Orange is straight from hell
Take a close look and you can tell
It is not "if" or "maybe"
He's Rosemary's baby
No doubt he's profoundly unwell

He joined him alone in a room
Saw Vladi and started to swoon
His heart is so hollow
He started to swallow
One infamous Monday at noon

If Cheech & Chong met Don & Vladi
Think they'd toke some wacky tabacky?
From phony gladness
To reefer madness
The key to peace might just be a fatty

Do you feel a nagging itch
'bout the guy who's Putin's bitch
Orange face
Huge disgrace
Women beware, bring your mace

He fancies himself as Narcissus
He’s really much more like pertussis
Spreading his germs
Making us squirm
With thousands of lies so outrageous

Mar-a-Lago for golf with Vladi?
Nunes will serve as their caddy
Should be a thriller
Bare-chested killer
Asking 45: to "Who is your daddy?"

Don't be deceived my dear friends
Putin sees America's end
45 in his pocket
Nuclear tipped rocket
A missile of death he will send

Shady old Paul Manafort
Is headed to criminal court
He'll do the time
Lest he drop a dime
From 45 there'll be no support

Be prepared to get out the vote
Take a car, a train or a boat
We have a choice
Amplify your voice
Grab your coat, keep freedom afloat!

For all of the POTUS's vanity
And transparent acts of insanity
FOX is his lair
That vicious broodmare
Sowing his seed with Sean Hannity

If you're ever feeling hell-bent
Don't you bitch, instead dissent
Make some waves
Not rants & raves
Stand up, speak out & represent

When a football player takes a knee
He's excercising free speech you see
Peaceful protest is patriotic
Shutting it down is idiotic
Take a knee for Emmett Till, Rosa Parks & MLK

There's something about adolescents
They're brooding or effervescent
What is it with teens
That live in between
Darkness & blinding incandescence?

I just had surgery for a hernia
By the Ancient Order of Hibernia
They closed up the hole
And charged me a toll
So now one might say I'm superbia!

Michael Cohen has 45 on tape
Fancies himself as a hero in a cape
But it's not really so
He's just another schmo
An attorney on paper but in truth a great ape

On Friday there'll be a blood moon
July 27 coming real soon
Eclipse of the heart
Adrip in the dark
Prophecy or marching dragoon?

I sleep with someone that snores
So loud it rattles the doors
My eyes are wide shut
I lie still like King Tut
Can't sleep so I get up & do chores

Migrant kids' psyches we're battered
On US soil dreams were shattered
Came to escape
Violence and rape
To 45 none of it mattered

When Agent Orange disappears
Many folks will stomp and cheer
That won't hide
The great divide
Racial strife will remain my dears

Religion can be good or evil
One's morality strong or feeble
Feed the poor or
Take for yourself more
A generous heart or deceitful

We teach our children not to lie
Yet POTUS says sea is sky
Up is down
Flat is round
Truth means nothing to this guy

Mayor Giuliani has run out of time
America's Mayor swims in slime
At a great cost
Integrity lost
Trading it all for a spot on prime time

Big boss is under the gun
Mueller has got him on the run
Now I can see
Him taking a plea
Quiet as a mouse, cat got his tongue

Let's not sugar coat the truth
Trump committed child abuse
At the border
He did murder
Thousands of souls with no excuse

Whose the greatest fraud of all
Orange cheeks mean and cruel
Has a base
With no taste
Sells false hope to hordes of fools

I don't like glaring at Kindle or Nook
I like the delicious feel of a book
Turning the pages
Paper in cages
I'll take a hardback by hook or by crook

Give me liberty or take my breath
Free speech or spiritual death
Who is this guy?
A Russian spy?
King of s*** mountain or dime store Macbeth

Sleepless days & sleepless nights
Freddie Fender go fly a kite
Country twang
Purple gang
These pants look good but man they're tight

On the way to kingdom come
I chewed a piece of bubblegum
Bazooka Joe
Eddie & Flo
Pearly gates and bottle of rum

Agent Orange is a lying pig
Separates families, takes the kids
Not my prez
I hereby sez
Crushing human rights is his gig

The folks at the rallies are odd
Pretending 45 is a god
They live by mob rule
And stammer and drool
Then bow to a fake, a phony & fraud

Ivanka got the poor to stitch
Stuff but not Abercrombie & Fitch
Paid pennies an hour
Held court in Trump Tower
Starved still they did as she got rich

POTUS slammed the great LeBron
A man of character, Don's got none
He's helping it seems
To fulfill kids' dreams
As POTUS tears families apart by the seams

When Donald Junior was a tot
He dreamed about a Russian plot
It took all he had
To dig dirt for dad
And soon he'll have a prison cot

Suffering from our collective amnesia
Still fast asleep from the anesthesia
It still isn't too late
To escape this cruel fate
Need a stiff shot of Milk of Magnesia

Agent Orange says: "Stand & Salute"
Bellowing orders from an empty suit
Anti-minority
No moral authority
Players who kneel he cannot uproot

Mueller will indict a Stone
Poor Roger too late to atone
Sneaky guy
Gonna fry
Prison next and final home

Our system of justice he demeans
Many in congress will not intervene
The future is bleak
Acting like sheep
Kissing up so pathetically obscene

Agent Orange despises black & brown
Vituperation spins his world 'round
How did this creature
Became such a feature?
His sense of omnipotence makes the earth frown

Forty-five thinks the Earth is flat
On global warming he smells a rat
Ridiculous putz
Ideas so nuts
Fancies himself an aristocrat

Sharp Objects is a funky show
Southern gals on the down low
Camille feeling torn
Since she was born
Her mama Adora drinking bordeaux

In a mid-morning tweet monologue
Forty-five called Omarosa a dog
She said he's corrupt
Wants his ass whupped
In a White House that's stuck in a fog

Raging parents in the Sooner State
Threatening a trans teen to castrate!
Diversity be damned
Hatred's in their hands
Stand up, speak out & demonstrate!

Brennan's clearance taken away
With 45 it's watch what you say
Attack free speech
The right to preach
Unless your willing to pay to play

Omarosa, she has some gall
Got Agent Orange by the balls
She's not hoarding
Lots of recordings
Setting the table for a great fall

Trump is tainting the jury
To the constitution's fury
Rule of law
In his craw
Their verdict won't end this story

Copyright Andrew Malekoff 2018

Some of these appear under my friend @feministlimericks account on Instagram

A MESSAGE TO ASPIRING AUTHORS for Social Work with Groups Journal

A message to aspiring authors from Andrew Malekoff[1], Editor-in-Chief, Social Work with Groups, a journal of community and clinical practice    

I have been reviewing manuscripts for Social Work with Groups since I became editor in1990. During that time I’ve noticed some trends in the types of articles that were not accepted for publication, particularly those articles that address direct practice. I want to describe those trends, that continue to this day, and what my thinking is about them. Such discussion will help define the kinds of articles about group work practice that I want to encourage in this journal.

          Broadly speaking, two kinds of articles about direct practice are most prevalent among those not accepted for publication in the journal. First, there are articles that describe the needs and dynamics of a particular population group - those who have been abused or persons with a particular illness, for example. While such delineations are often informative, too frequently the reference to groups and group work practice in such articles is minimal and seems to be appended reluctantly and uneasily to qualify the article for consideration in this, a journal on work with groups. The portions of such articles that refer to group work practice are not an integral part of the authors’ presentations and seem artificial.

          Second, there are articles that describe a group and its process, be it a particular kind of group or a group with a particular population, with which the author worked. While such descriptions are often interesting, too frequently their purpose was unclear. In these articles, the practice described is not examined conceptually and therefore the applicability to other groups of the work depicted is never made clear. Given the complexity of groups, of individuals, and of situations, articles that are solely descriptive, that do not look critically or analytically at work that is being presented, are not helpful to their readers.

          With respect to both kinds of paper, population-oriented or purely descriptive, I have found practice illustrations to be too general to capture the essence of the work described. Illustrations that capture the true nature of group, bringing to life the interaction among the members and between the members and the worker, are too often absent.

          What I would like to see included in Social Work with Groups are articles that bring together the doing and thinking of group work practice. In articles that emphasize knowledge of the needs of a particular population, implications for and illustrations of group work practice based on such knowledge need to be integral. In articles that portray practice through presentation of descriptive vignettes and examples, the rationale that underpins the practice, the thinking behind it, and the implications for future practice with groups are crucial elements.

          I recognize that writing can be a painstaking and tedious endeavor. To complete a work after several drafts, only to have it rejected by journal editors, can be discouraging and demoralizing. My feedback here is not meant to discourage, but just the reverse. My aim is to encourage all with interest in work with groups to share their ideas and experiences. I hope that increased understanding of the reasons that articles are rejected for publication will result in an increased number of articles that are accepted for inclusion in this journal.

More details about submission: www.tandfonline.com/wswg There is a drop down menu with “instructions for authors” or go to: http://www.tandfonline.com/action/authorSubmission?journalCode=wswg20&page=instructions

---

[1] Andrew Malekoff, Editor-in-Chief, Social Work with Groups, c/o North Shore Child and Family Guidance Center, 480 Old Westbury Road, Roslyn Heights, NY 11577. Email: Anjru@aol.com

LESSONS FROM THE FIELD

By Andrew Malekoff

In recent years I have written about concussions in youth sports in this space, with a special focus on Chronic Traumatic Encephalopathy (CTE), a progressive degenerative disease of the brain that is the result of repetitive brain trauma. This was something I knew nothing about in my teenaged years. As a high school and college football player in the 1960s and ’70s, using one’s head as a battering ram and shock absorber was expected.

Beyond the discovery of CTE and what it has generated in the way of much-improved player safety, August never fails to evoke memories of twice-daily summer practices when guys like me went to “training camp” before school started. Training camp lasted about two weeks. It was usually hot out. They were two weeks that felt like a year. Those were the make or break days of my youth. No one was cut from the team as long as they showed up, but many did not last.

The rawest depiction of a brutal summer football camp can be found in the book The Junction Boys by Jim Dent. The subtitle of the book is: How Ten Days in Hell with Bear Bryant Forged a Championship Team. Although I never went through anything quite like the Junction Boys did, it seems that all high school and college football players have similar war stories about summer camp.

I’m not about to rehash what I’ve since learned since the discovery of CTE and the need for protective measures or share stories from my summer football camp days. However, at the risk of being cliché, there are some important lessons I learned from playing football.

As we round out another August, I thought I’d share a few of those lessons here. Most have served me well. Some have a downside. Here goes:

1.     Punctuality. As the saying goes, showing up is half the battle. But don’t just show up; be there on time. In football there were serious consequences for being late, but losing the respect of one’s peers eclipsed them all.

2.     Hard work. Know that when you are working hard, there are others working just as hard and others who are not. Push yourself to surpass your opponents and inspire your teammates.

3.     Stoicism. Keep your head up. Push through disappointment and injuries. This is mostly a good trait, but it can also prevent you from seeking the support you need when you really need it, physically and emotionally.  Vulnerability is not a lesson I learned in football.

4.     Dependability. It is essential that others who are pulling with you toward accomplishing a goal know that they can always count on you. There is a brotherhood that forms on a football team that demands dependability.

5.     Humility. Enjoy success but don’t be boastful. Have gratitude for all those who helped to support your success.

6.     Perseverance. Never give up. It is what your adversaries expect. By pushing through missteps and setbacks you learn what it takes to succeed and that your capacity to overcome failure is greater than you anticipated.

7.     Resilience. As the legendary coach of the Green Bay Packers Vince Lombardi said, “It’s not whether you get knocked down; it’s whether you get up.” To survive playing football, resilience is essential. 

Fortunately, these lessons can be learned in many places other than the football field. Any group activity that requires teamwork, sacrifice and shared goals generate important life lessons. Make sure the young people in your life put down their cellphones and other tech gadgets and take up a sport, join a club or get involved in the arts, to name a few possibilities.

They’ll grow into better people—and with no head-butting required.

Andrew Malekoff is the Executive Director of North Shore Child & Family Guidance Center, which provides comprehensive mental health services for children from birth through 24 and their families. To find out more, visit www.northshorechildguidance.org.

Published in Long Island Weekly, an Anton Weekly publicaton, August 27, 2018 - https://longislandweekly.com/lessons-from-the-field/