Omar Reda, MD

6 Lessons From a Tragedy

Slideshows

There are beautiful things that you can only see in the dark.

For the most part, the field of psychiatry has looked at organized religions with suspicion, however, a majority of sacred texts have paid particular attention to emotional wellness and holistic health.

I have used my religion and my Muslim background as a grounding and healing tool for myself, my family, my small community, and for clients who requested to use God’s words (the Noble Quran) and the authentic teachings and traditions of Prophet Muhammad (peace be upon him) as part of our therapeutic relationship.

It is usually much easier to introduce religious themes with terminology like spirituality and tending to the soul. Youth in particular seem to have a difficult time reconciling the religious aspect of their personality with societal expectations. I have queried Muslim youth and their caregivers, but my understanding from Jewish and Christian friends and colleagues is that there are similar themes in all 3 monotheistic religions. However, most of the Muslim community’s negative feelings around 

 organizations and places of worship comes from a heavy legacy of trauma, caused mainly by the culture of the leadership and from the out-of-context quoting and misinterpretation of a sacred text.

Psychiatrists can bridge gaps between the community and religious leaders through 

 education that targets stigma, which in turn helps with opening channels of communication and building bridges of trust.

For instance, look at some of the most widely criticized areas of Islamic centers:

1. A lack of trust between the community and its leaders.

2. A lack of demographic diversity and representation, especially in positions of leadership.

3 .Systemic exclusion of certain sects of the community.

4. A lack of attractive alternatives to the mainstream culture, especially for the youth.

5. Gross violations of the rights of some worshippers, like those with mental disabilities.

6. A lack of transparency and a culture of secrecy.

8. A culture of competition, rather than collaboration.

9. Poor interfaith and outreach to the larger non-Muslim community.

10. A lack of flexibility of policies and procedures.

11. Harsh approaches in providing and receiving advice and feedback.

12. An underestimation of the role of women.

13. Not taking advantage of the talents, skills, and expertise of most worshippers.

14.Poor sustainability of programs and resources.

15. Reactive, rather than proactive, response to issues.

16. Spreading a punitive message of despair, rather than advocating for hope and beauty.

17. Weak societal impact, possibly stemming from the attitude of “going back home one day.”

18. Rigid adherence to a certain style or school of thought.

19. Rare access to new blood and young leaders who speak the cultural language.

20. Poor understanding of the American cultural norms, laws, and systems.

22. Misusing religion to justify dysfunctions like domestic violence and child abuse.

23. Double standards when treating men and women, and boys and girls.

24. Minimal representation of Muslims in the media and in politics.

I have been blessed to earn the trust of both the Imams and the Muslim community in Portland, Oregon, and it is now common to hear discussions inside the house of God about family dynamics, self-care, emotional intelligence, trauma healing, suicide prevention, and many other psychosocial topics that were otherwise censored.

In Islam, the relationship between the Creator and His creation is a personal and intimate one; the face of God can be seen not only in the mosque, but in every beautiful act of kindness toward others. Ultimately, the best way to worship is to serve humanity.

is a practicing psychiatrist for Providence Healthcare System, Portland, Oregon.

Articles

Psychiatry and spirituality have many things in common, including family dynamics, self-care, emotional intelligence, trauma healing, and suicide prevention. 

Reflecting on Psychiatry’s Role in Religion

FIRST MAN: We should defend ourselves. An eye for an eye, a tooth for a tooth.

TEVYE: Very good. And that way, the whole world will be blind and toothless.

- From 1970 script of the play “Fiddler on the Roof” and often attributed to Mohandas Gandhi

“The three ingredients for healing relational wounds are safety, truth, and reconciliation, and in that order.” - Alisha Moreland-Capuia, MD

Achieving peace in the Middle East is a monumental task that seems to be ever evasive, daunting, and out of reach. A cease fire is welcome, but a far cry from what we want to achieve—lasting Middle East peace. The violence is also spilling over into increased conflict between groups in the United States. Muslims and Jews are subject to worrisome degrees of Islamophobia and Anti-Semitism. The Palestinian-Israeli conflict is an extremely complex tangle of issues to resolve, but a solution is possible, and imperative.

Both sides and their supporters need to abandon ultimately futile and self-defeating acts of violence and retaliation. Instead, they must embrace a more comprehensive and humble vision that takes into consideration the historical, geographic, religious, and cultural context of two cousin tribes that have wounded each other over generations. It is like a longstanding family conflict in which family members stop talking to one another and replace talking with hatred, necessitating therapeutic family interventions. Despite the reservations that some psychiatrists have on entering the social conflict sphere, these are, in fact, areas of psychiatric expertise.

As psychiatrists we know group dynamics. We know our tendency to scapegoat “the other”. We know how the powerful can divide and conquer less powerful groups. We know how to analyze leaders. We know the temporary but necessary pain of revealing and processing the truth. We know from Abraham Maslow, PhD’s pyramid of psychological needs that safety and security must be fulfilled before higher levels needs can be completed. We know that often deeper levels of traumatic causation need to be processed and dealt with before healing can meaningfully occur.

This is not a naive proposal by any means, though it may seem so to some. Inevitably, many will disagree with any Middle East analysis. Rather, it is a plea for change because doing the same thing over and over again, expecting different results, is the very definition of insanity. Constantly suspecting each other’s motives has not moved this protracted struggle even an inch out of square zero. As good as prior endeavors were—that is, things could have gotten even worse—they have not been nearly enough.

There are many intricate political and psychosocial dynamics that come into play to make this mission look impossible; however, fighting parties in other parts of the world have managed, for the sake of their children, to reach some kind of compromise that benefits all involved. Children in the blessed land should not continue to pay the price of our ignorance, false pride, and generational bigotry.

As Muslim, Jewish, Christian, Hindu, and Sikh psychiatrists, in a bio-psycho-social-spiritual model we sense this is a moral and spiritual crisis. We support peace among nations, safe and secure homelands, and opportunities for all. This is not at its essence a fight between Muslims and Jews, or between Arabs and Israelis. This is an ideological and practical war that often intentionally feeds cultish misinformation, especially via the internet, which artificially arouses emotions, leading to relieving emotional tension by ever-increasing violence. Peace-loving civilians lose their lives, while extremist groups and fear mongers run rampant.

Unfortunately, the media usually chooses to focus on the negative events occurring in the Palestinian-Israeli conflict, and ignores equally dispiriting, yet equally important, inter-ethnic tragedies taking place in places like Kashmir, Myanmar, China, Syria, Yemen, Iraq, and elsewhere around the globe. This disproportionate attention to one particular locale in the Middle East only enflames matters more. It leads the public to believe that this is a unique situation, when it is a tendency of human nature that needs to be overcome everywhere. Despite our paradoxically doing so in this paper, we include other examples and intend to address them more in the future.

Perhaps we can learn and apply a few lessons from countries like South Africa, Rwanda, and Bosnia, where warring tribes have seemingly learned to live together. The Truth and Reconciliation Commission was especially effective in helping to bring South Africa out of apartheid without a bloodbath. 

Big problems get resolved only when broken down into small pieces. The use of dialogue can—and should—start in our households, small intra- and inter-faith circles, and cultural communities. A group of international and interfaith psychiatric caregivers have come together to create a community of care and have produced two requested, well-reviewed books that can be used as tools towards healing: 

From these sources, here are some ideal prescriptions to start with:

- Dignity for all, established by working together respectfully for a common end

- Humiliation for none, which means hearing each other out

- Apologies by all, as saying “I’m sorry” and meaning it begins the healing of many wounds

- Gifts to the others, such as sharing assets and promoting each other’s strengths

- Neutral peace-maker(s), or the calling in of trusted third parties, which may ideally need to include mental health experts

- Teaching tolerance to children, both by parents and educators

- Addressing intergenerational trauma, which includes that affecting political decision-makers

Also, as psychiatrists, we know very well that an illness cannot be cured unless we address its root causes, and similarly we have the moral obligation to call for the immediate dismantling of bigoted and violent ideologies, dictatorships, and all structures and systems that support them. They are so damaging to the body, mind, heart, soul, and spirit of so many of the people.

These are simple, though not simplistic, aspirational goals. They are meant as an antidote to the common lament about how complex these situations are, so often leading to excuses about what cannot be done and what cannot be tried. Prayer and mourning must be supplemented with action.

We need a few small steps in addition to this manifesto. Some that could be taken by SPIRIT and like-minded groups include: joint business projects, a student exchange, common textbooks (especially in the early grades), shared vacation spots, media consultation, and joint research. We must look towards innovative and out-of-the-box solutions.

Members of SPIRIT are available for consultation and discussion. We welcome other like- hearted psychiatrists of any religious background, as well as those who are agnostic or atheist, to join our SPIRIT.

is practicing psychiatrist in Providence Healthcare System, Portland, OR. He has provided psychiatric and humanistic care to trauma survivors around the world.

is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. He has recently been leading Tikkun Olam advocacy movements on climate instability, burnout, Islamophobia, and anti-Semitism for a better world. He serves on the Editorial Board of

is Clinical Professor and Chair of Psychiatry and Behavioral Science at the University of North Dakota School of Medicine and Health Sciences.

is an associate professor of psychiatry at Harvard Medical School and a Fellowship Site Director for Brigham and Women's Hospital.

is Professor Emerita, Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

is a Professor of Psychiatry at Cooper Medical School of Rowan University. He is active in several national and regional organizations and published and presented on International Medical graduates, culture, religion, family psychiatry, gender issues, etc.

serves as Assistant Dean of Clinical Education at Charles R. Drew University and Chief Medical Officer of Kedren Health Systems Inc.

is Medical Director of Child and Adolescent Psychiatry Clinic and Multidisciplinary Autism Program at ChristianaCare, Delaware.

is an assistant clinical professor of psychiatry and behavioral sciences at Icahn School of Medicine at Mount Sinai, New York, NY.

is a psychiatrist, the author of more than 300 peer reviewed papers, founder of Critica, and board member of the Social venture Fund for Arab Jewish Equality in Israel.

is Professor Emeritus in Psychiatry at the University of California at San Diego, as well as the author of more than 100 professional articles and 6 books.

interested in exploring the intersection between childhood political trauma with immigration stress. She has been recently offered a full-time research appointment as a Visiting Researcher at Harvard University, in Cambridge, Boston.

is a doctor working in frontline psychiatry for the National Health Service at South London and Maudsley NHS Foundation Trust in the UK.

is a Clinical Associate Professor of psychiatry at the Stanford University School of Medicine where she is the Director of the Stanford Muslim Mental Health & Islamic Psychology Lab, and the Director of its community organization: Maristan.org. She also serves as the Associate Division Chief for Public Mental Health and Population Sciences as well as the Section Chief of Diversity and Cultural Mental Health in the Department of Psychiatry and Stanford.

1. Moffic HS, Peteet J, Hankir A, Awaad R. 

Islamophobia and Psychiatry: Recognition, Prevention, and Treatment

https://www.springer.com/gp/book/9783030005115

2. Moffic HS, Peteet J, Hankir A, Seeman, M. 

Anti-Semitism and Psychiatry: Recognition, Prevention, and Interventions

https://www.springer.com/gp/book/9783030377441

A cease fire is welcome, but a far cry from what we want to achieve—lasting Middle East peace.

An Interfaith Psychiatrist Prescription for Middle East Peace

Perhaps you have heard the saying, “even your shadow leaves you in the dark.” There are many ways this metaphor can be understood. Some individuals might encourage you not to depend on others, because even your own shadow will leave you when you lose your light. Others might assure you that you are never really alone when things get dark, and that at least your shadow will certainly be there when the light is turned on.

I would like to take this further and ask you to befriend your shadows. Your literal shadow will likely leave you in the dark, but this is when your metaphorical shadows come out, the memories of traumas that are always with you, though sometimes unseen.

Walking alone on a dark path is scary and heartbreaking, yet it is a common experience for many survivors of trauma. When they try to listen for the sound of comfort, it is only the voices of uncertainty and self-doubt that they hear. When they try to look for a source of light, it is only the shadows of trauma that they see.

The shadows of trauma can keep us in a chronic state of hypervigilance even when it is no longer dark. It is important therefore to befriend our trauma stories.

How can you befriend something as ugly and as frightening as trauma? You do that when you practice self-compassion. Edward Smink, PhD, in his impressive book, 

The Soul of Caregiving: A Caregiver's Guide to Healing and Transformation

, referred to our reactions to trauma as 

 As caregivers, when we are depleted, he invites us to notice our shadows and embrace them with compassion. We should know that we will meet our shadows both in times of distress, and also when things feel relatively safe. Sometimes we encounter a moment of deep insight through a painful psychodynamic interpretation in a therapy session, and sometimes that light is illuminated by our support or faith system.

Without self-love through self-care, these shadows can cast darkness on the way we interact with our clients and our loved ones. As a healer, I urge you to pay attention, be attuned to what is stirring within, focus on the current moment, observe difficult feelings with curiosity, and welcome your shadows as brief guests.

That is not at all an easy task. Bruce Perry, MD, PhD, in his new book,

 What Happened To You?: Conversations on Trauma, Resilience, and Healing

, eloquently wrote, “trauma leaves you shipwrecked. Part of the rebuilding is to sit through the wreckage, looking for what remains, seeking your broken pieces.”

 Michael Hollifield, MD, asked that at the end of that search, “celebrate the pieces you find and mourn the rest.”

These are dark and difficult times we live in. Look for light and beauty within the individuals you serve and those you love, but mainly look for that within yourself. The world can be a dangerous place, full of shadows. Befriending them might bring us a little closer to our light source, or at least get more comfortable with the darkness.

Your shadows might be the light source you are looking for. Rumi elegantly reminds us that “only in the dark cave can we find the light. At the end, pain is what leads to love. There are beautiful things that you can only see in the dark.”

What Happened to You?: Conversations on Trauma, Resilience, and Healing

3. War Survivors Institute. Our Team. Accessed May 7, 2021. 

4. Schimmel A. Rumi: Sufi mystic and poet. 

https://www.britannica.com/biography/Rumi 

The Wounded Healer: The Pain and Joy of Caregiving

Walking a dark path alone is a common experience for survivors of trauma. 

Befriend Your Shadows

The Muslim community in Texas was shaken to its core by the news of a murder-suicide of a whole family on April 5, 2021.

Apparently, 2 young Muslim boys decided to kill their parents, their sister, and their grandmother, before killing themselves. One of the brothers left a chilling and troubling note listing some of his reasoning for committing such a horrifying act. He mentioned feeling empty, that life had no meaning; he talked about depression as a lonely and alienating experience, that having a supportive family can be a protective factor, but only to an extent. He even briefly described gun control in America as a joke—getting access to lethal weapons was not that difficult for him.

Religious leaders and mental health professionals have been quite vocal about showing moral and material support for the local community, especially the youth. They are also using this incident as both a learning curve and a teaching tool for the larger Muslim community, with the hope that lessons learned might help the future design and delivery of culturally appropriate services and resources, an approach that might help prevent or at least reduce the odds of having similar incidents in the future. This is an emergency that the Muslim community needs to urgently and immediately address.

Spirituality can be a protective factor against suicide. Like any other religion, Islam is practiced on a spectrum. With a population of more than 1 billion Muslims, there are diverse reactions and responses to challenges within the Muslim community. Some of the research I came across showed that the overall rates of suicide were lower among Muslims than non-Muslims, but there are many factors that come into play here, like cultural cohesion, familial bonds, and social support, which are highly valued components of the Islamic faith. Talking about religion needs to be tactful when approaching the topic of depression and suicide. Those with mental illnesses should not be judged as having weak faith or a poor relation with God; rather, we need to extrapolate using examples from the Quran and the life of Prophet Muhammad that focus on self-care, the reward of mending broken hearts, and bringing healing to injured souls.

Imam Yasir Qadhi, PhD, a prominent scholar in Dallas, Texas, gave a heartfelt talk to help shatter taboos about mental health and emotional wellness, and to address misconceptions that are quite prevalent in the Muslim culture, despite having nothing to do with the authentic teachings of the religion that encourage stress management, emotional-expression, and speaking up. Here are some of the points that sheikh Qadhi covered in his 

1. As written in the suicide note “who knows, some good might come” out of this tragedy. Hopefully there will be more education and awareness about the prevalence and magnitude of the issue of depression in Muslim teens.

2. We need to show sensitivity and respect to the family. We are in no position to pass judgment, as the “fate of those involved will be determined in the divine court.”

3. In some form or another, everyone who died was a victim. This is not to justify the homicidal or the suicidal act, but rather to try to understand the bigger picture from a trauma-informed perspective.

4. Humans tend to try to process and make meaning out of suffering. Sometimes it is difficult to comprehend the reason or “the divine wisdom” behind such traumatic events.

5. These community discussions can feel awkward, but they are essential and overdue.

6. We need to aggressively advocate through educating community members that mental disorders are as tangible as physical ones. When afflicted with cancer, broken bones, or bleeding wounds, patients are rushed to the emergency room; emotional injuries should not be treated any different.

7. Desperate people do desperate things. When they reach a point where life becomes meaningless, they might become unreachable. Hopelessness and loneliness are awful feelings. Try to be a light source, mend broken hearts, show up for others, tell those around you that “maybe I do not understand your pain, but teach me, I am here for you.” A simple act of kindness like a smile or eye contact might brighten someone’s day—or even save their life.

8. People cannot just snap out of depression. The mental box is different than the spiritual one, and both boxes need to be filled. Prayers are wonderful, but they are one tool of many.

9. Adults should not shut down or dismiss pleas for help. Many parents do not know how to talk to their teenage children. Although there is a lot of silence in Muslim household, this is not a Muslim-only phenomenon—youth depression and suicide are invisible global pandemics.

10. Tragedies such as this one should serve as a wakeup call and motivate the community to act. Mental health staff and religious leaders need to come together to address short- and long-term solutions, as well as action steps. Bottled up emotions should not be the norm. Our children are our top priority. Muslim homes and houses of worship should be seen as a refuge, not a prison, and should always feel like places of safety.

The 13th century Persian poet Rumi eloquently wrote that “there are beautiful things that you can only see in the dark.” There is always some good that comes out of trauma—the Muslim community is forced now to have difficult, but honest and healing conversations.

There are culturally humble and responsive services and resources that are made available for the community. Here are few examples:

is a practicing psychiatrist, Providence Healthcare System, Portland, Oregon.

A tragedy has rocked the Muslim community. How can psychiatry try to help prevent further tragedies from occurring? 

More Than a Murder-Suicide

For the most part, the field of psychiatry has looked on organized religions with suspicion, even though majority of sacred texts have paid special attention to emotional wellness and holistic health.

Coming from a Muslim background, I have used my religion as a grounding and healing tool for myself, my family, my small community, and for clients who requested to use God’s words (the Noble Quran) and the authentic teachings and traditions of Prophet Muhammad (peace be upon him) as part of our therapeutic relationship.

It is usually much easier to introduce religious themes with terminology like “spirituality” and “tending to the soul.” The youth in particular seem to have a difficult time reconciling the religious aspect of their personality with societal expectations. I have asked questions to Muslim youth and their caregivers, but my understanding from Jewish and Christian friends and colleagues is that there are similar themes in all 3 monotheistic religions. However, most of the Muslim community’s negative feelings around Islamic organizations and places of worship comes from a heavy legacy of trauma, caused mainly by the culture of the leadership and from the out-of-context quoting and misinterpretation of a sacred text.

Here are 25 of the most criticized attitudes and practices when it comes to Islamic centers:

1. Lack of trust between the community and its leaders

2. Lack of demographic diversity and representation, especially in positions of leadership

3. Systemic exclusion of certain sects of the community

4. Lack of attractive alternatives to the mainstream culture, especially for the youth

5. Gross violations of the rights of some worshippers, like those with mental disabilities

6. Lack of transparency and culture of secrecy

7. Double standards when treating Muslims and non-Muslims

9. Culture of competition, rather than collaboration

10. Poor interfaith and outreach to the larger non-Muslim community

11. Lack of flexibility of policies and procedures

12. Harsh approach to giving and receiving advice and feedback

14. Not taking advantage of the talents, skills, and expertise of most worshippers

15. Poor sustainability of programs and resources

16. Reactive, rather than proactive, response to issues

17. Spreading a punitive message of despair, rather than advocating for hope and beauty

18. Weak societal impact, possibly stemming from the attitude of “going back home one day”

19. Rigid adherence to a certain style or school of thought

20. Rare access to new blood and young leaders who speak the cultural language

21. Poor understanding of the American cultural norms, laws, and systems

23. Misusing religion to justify dysfunctions like domestic violence and child abuse

24. Double standards when treating men and women, and boys and girls

25. Minimal representation of Muslims in the media and in politics

Psychiatrists can bridge gaps between the community and religious leaders through psychosocial education that targets stigma, that in turn helps with opening channels of communication and building bridges of trust. I have been blessed to earn the trust of both the Imams and the Muslim community in Portland, Oregon, and it is now common to hear discussions inside the house of God about family dynamics, self-care, emotional intelligence, trauma healing, suicide prevention, and many other psychosocial topics that were otherwise censored.

In Islam, the relationship between the Creator and His creation is a personal and intimate one, you can see the face of God not only in the mosque but in every beautiful act of kindness towards others, the best way to worship the Lord is to serve humanity.

is a practicing psychiatrist, Providence Healthcare System, Portland, OR.

One doctor shares his experiences with religion’s role in the practice. 

What Does Psychiatry Have to Do with Religion?

Many psychiatrists seem to have accepted, and are content with, the narrow scope of practice imposed upon them. For myself, however, I refuse to reduce the unlimited potential of psychiatry to merely prescribing psychotropics. Medications can be quite effective, even lifesaving, but they are not the only tool we can offer our clients.

I have been reflecting on the psychosocial impact of the COVID-19 pandemic, especially on our youth, and would like to share few thoughts that might provide hope for these beautiful, little creatures.

This writing is not intended to be a naive generalization or an over-simplification; I have used an easy language here with the goal of having these tips shared with clients, especially parents and caregivers. I hope they can also help you when taking care of your family and community, and even serve your own self-care and healing.

The wounds of trauma are, for the most part, invisible. They can scar our bodies, minds, hearts, and souls. There are many hormones and chemicals involved in responding to adversity, especially protracted stress like the current pandemic. I will briefly mention 5 of those.

The hormone adrenaline (also known as epinephrine) is commonly known as the emergency hormone. It helps anticipate and prepare for threats, or activates fight or flight responses. That is helpful, and even critical short-term, but can have long-lasting negative consequences if we remain in a state of arousal, fearing an actual or a perceived threat. One way we can help children and those around us cope is to calm our mind and manage our anxiety. This can be done in many ways like meditation, mindfulness, and engaging in activities that are physically and mentally cathartic.

The hormone cortisol is commonly called the stress hormone. It helps us respond to stress, but it can also be harmful in the long run. One way to balance cortisol levels is to be kind to our bodies through mastering consistent healthy eating, sleeping, and lifestyle habits.

I want to focus now on 3 other chemicals, collectively known as the happy hormones. Dopamine (also known as the thrill hormone) is not only involved in addiction, thrill-seeking, and impulsivity, but is also a vital hormone for our emotional wellbeing. When it comes to children, we can give them a dopamine boost by simply paying attention to them. Children thrive when they feel noticed, therefore we should take every opportunity to let them know that they are seen, heard, and felt. Youth who feel safe seem to blossom, and start to believe in, and express, their beauty.

Serotonin (commonly known as the happiness hormone) is not only involved in depression, but it is also a chemical that is released when we feel valued. It is important to show appreciation to young people. When they trust in our unconditional love, they will start to believe in their own abilities, which boosts their self-esteem.

And lastly oxytocin (the love hormone) is released when children feel loved. One way to boost this hormone is to express affection towards them. Simple acts of grace and gratitude can work like magic. These can include eye contact, safe touch, smiling, kind words, and spending quality time with them.

I am a big fan and an outspoken advocate of taking care of young bodies, minds, hearts, and souls. When it comes to children, we would literally die to protect them from assaults and shield them from insults, yet many of us engage in verbal attacks and acts that verge on being abusive or neglectful towards them. I know that we are all trying our best given our circumstances, but when it comes to our loved ones, we can always do better.


To prescribe the hormones of happiness, try the Triple-A Approach:, pay attention, show appreciation, and express affection towards the people who matter most. Small moments can make all the difference.

is a practicing psychiatrist in Providence Healthcare System, Portland, OR.

One doctor gives his recommendations for attending to children’s happiness.  

Moral Duty Beyond Prescribing Medications

I have, maybe even more than my children, thoroughly enjoyed watching the Pixar Animation Studios’ film 

. Per Disney, “Soul is what makes you…YOU.” 

 is not only about finding your own passion, but also helping others find theirs.

Soul is a mysterious concept. It is more than just our heart, psyche, or spirit; it is the deepest and most intimate part of who we are. Soul is what makes us humans.

The year 2020 launched a brutal attack on our souls. The invisible scars of moral fatigue and the soul ache we are left with are constant reminders that caring comes at a cost. That is why, as a caregiver, I urge you to tend to your soul.

Find out what makes your soul sink. This can be unhealthy coping styles, unhelpful beliefs, and dysfunctional behaviors. Many caregivers act as if their feelings do not matter, as if they should ignore their needs, deny their pain, brush off their trauma, wipe away their tears, and just get up and keep going. The culture of caregiving is rampant with dark secrets, toxic stress, and silent suffering.

But that does not have to be the case. Caregiving can and should bring joy, not only pain. It brings joy when we look for and celebrate what makes our soul sing. This can include selfcare, social bonding, and engaging in deep kindness. I found family, faith, practicing gratitude, and performing acts of service to be extremely helpful in nursing my wounds and healing my compassion fatigue. One of my New Year’s resolutions is to show more appreciation to my loved ones and the things I take for granted, and to engage in activities that help people find meaning, healing, closure, and beauty.

My request for you is to do the same. Practice love, mend broken hearts, speak up for the voiceless, bring people out of the shadows, listen to the suffering behind closed doors, but also make sure that you tend to your soul.

The recent Disney Pixar film has a doctor contemplating what makes us all unique, and how we can care for ourselves. 

Tend to Your Soul

There is a common saying that if the care we provide our clients is not culturally sensitive, then it is not trauma-informed.

I am a big believer in meeting our clients’ cultural needs, and in respecting and celebrating the beauty of their traditions. However, we need more than superficially pleasant interactions with individuals from diverse backgrounds, individuals who we label as “different than us” because of the way they look, talk, or practice their culture or religion.

Trauma sensitivity alone, I believe, is not enough. We need culturally responsive and effective care. I will give an example here, then expand on how to put this concept into action.

I recently walked into the inpatient unit where I work to find that my staff had called security and were about to inject or seclude a large, agitated black man. I asked if I could try to talk to him. As I listened, he asked that he only work with staff of color, asked for a menu fit for a Muslim man who only consumes halal/kosher meat, and asked if he could talk to an imam to learn how to pray again. We ended up not needing restraints or antipsychotics after all; all he needed that morning was human connection. I happen to share aspects of his cultural background, and that made him feel safe enough to open up to me.

It is not going to be possible to have non-white staff assigned to him all the time, but on this particular day that plan worked best.

There are 4 things to remember when bearing witness to individuals in distress:

1. Authenticity. Our clients will quickly discover if we genuinely care.

2. Curiosity. Show interest in them as humans, not only the labels assigned to them.

3. Flexibility. We must be ready to adjust our way of thinking, and in doing so, we can better meet their needs.

4. Humility. Maintain the attitude of a student, keen to learn from each encounter.

Psychiatry is not only a field of suffering or an industry of pain; there is also a lot of joy that we should get out of caregiving. If you are not looking for beauty in every interpersonal encounter you have with those you serve, then you have not yet touched the soul of medicine. By listening to and meeting patients’ cultural needs, we all win.

Sometimes the best medicine is understanding. 

Rx: Meeting Cultural Needs 

 interviews Omar Reda, MD, about international medical graduates (IMG) and his own personal and professional journey. In this podcast he discusses:

1. His childhood and medical training in war-torn Libya

2. The challenges facing immigrants who want to become doctors in the United States

3. How his colleagues, and the American medical establishment at large, can help IMGs realize their dreams

Podcasts

In their quest to become American doctors, international medical graduates face formidable obstacles. A psychiatrist from Libya explains how his colleagues can help them along the way. 