Omar Reda, MD

In this series, Holiday Traditions, we asked clinicians to share their favorite holiday traditions from both past and present. Here’s how they answered.

The holiday season, for the most part, is a reason for joy and celebration. For some, however, it is a time of grief and heartbreak. As a psychiatrist, but mainly as a human, I need to notice and honor the impact of holidays on people around me. With the widespread of trauma and its subsequent dysfunctions, I am aware of how lonely and depressing these times can be.

From a diversity standpoint, not every religion or culture is represented in the major US holidays. For example, in my faith, Islam, I celebrate the end of Ramadan (the sacred month of fasting) and the end of Hajj (the holy pilgrimage to the house of God).

In Islam, like with other faiths, people view holidays as a source of light and beauty. The word light is mentioned 33 times in the Quran. Allah described Himself as the light of the heavens and the earth, Prophet Muhammad is described as a lamp that is spreading light, and the Quran is viewed as a source of guidance when things get dark.

Everyone has light, so help people rediscover and reignite theirs.

Blowing out someone else’s light will not make your light shine any brighter.

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

Dr Reda is a psychiatrist in Colorado. He is the author of 

The Wounded Healer: The Pain and Joy of Caregiving

Do you have a favorite tradition or activity that you enjoy with your loved ones during the holidays? If so, write to us at PTEditor@MMHGroup.com for a chance to be featured in our Holiday Traditions series.

Articles

Acknowledging the impact of holidays on others, and what to do when things get dark.

Be a Light

On November 12, 2022, I had the pleasure of giving the keynote speech at the launch of the Muslim Mental Health Institute of Canada in Winnipeg, Manitoba. It was quite a beautiful gathering where a dynamic group of thought leaders from Canada and the United States engaged in powerful and honest, yet difficult conversations about issues that are not commonly talked about in the Muslim community—topics like domestic violence, addiction, sexual orientation and gender identity, religious trauma, and suicide.

The stigma surrounding mental health is not unique to the followers of Islam. In fact, it stems from the cultures and backgrounds individuals come from rather than from the religion itself. Both the teachings of the Quran and the traditions of prophet Muhammad encourage individuals to speak up, express their emotions, and engage in healing dialogues no matter how “uncomfortable” they might be.

I have asked colleagues and youth from different faith backgrounds about topics that lead to heated discussions and even unnecessary family conflict, and the 4 issues that keep coming up as causing the most distress for our children are the same that make us the most anxious and defensive. In my opinion, this should be a reason to engage in, rather than shy away from, these discussions.

The 4 themes that I have identified as sources of internal struggles for youth and external struggles with their parents are the 4 Ss:

Spirituality: Children are curious, and they have the right to ask questions about God. For the most part, however, they are told that God is a “red line” and that they should not question any aspect of their religion, faith, or spirituality.

Sexuality: Children might have thoughts, feelings, and behaviors that have to do with them trying to explore and figure out who they are. Some might act on impulses that can get them into trouble with their parents. Sexual education is not usually a topic of conversation between family members, and any reference to puberty or normal human attractions often lead to awkward and angry interactions between children and their parents.

Substance use: Many children, especially in their teenage years, might try using alcohol and/or other substances out of boredom or curiosity, due to peer pressure, or in an effort to fill an emotional void. They will likely then get punished by their family or penalized by the system that failed to provide them with other healthy and attractive alternatives. Individuals usually “act out” because of either missing a basic need or lacking a crucial coping skill. It is better to work through these issues than it is to ignore or criminalize them.

Suicide: This is the worst outcome of human despair, and it can devastate or break down the family unit. When our children feel that they have no choices and no resources, they might see no other exit out of their misery than to resort to self-harm. The problem with suicide is that it is a permanent “solution” to suffering. No parent wants to bury their child, but suicide is a topic that is seldom discussed in the family context.

If we do not make our homes safe for our children to talk about issues that weigh heavily on their minds, hearts, and souls, we might lose them. I urge you to love your children; equip them with healthy and safe tools so they can face these challenges with confidence and grace; and let them know that your door is always open for them and that you welcome them as they are. We love our children unconditionally.

It takes a whole village to keep its children safe. Parents, teachers, and religious and community leaders will serve these young souls well if they collaborate with psychosocial workers and mental health clinicians to normalize these discussions at home, in schools, and in places of worship.

I urge you all to not neglect your children or push them away, because you might otherwise end up attending their funeral. That is why initiatives like the Muslim Mental Health Institute of Canada are very important, because this cycle needs to be broken.

 is a psychiatrist in Colorado. He is the author of 

The importance of normalizing discussions about the 4 Ss with children.

If You Have Children, Talk to Them

Youth, for the most part, are viewed collectively as a vulnerable group. Many young adults are referred to as “at-risk youth.”

 is difficult to define. According to the United Nations,

 youth is the period of transition from the dependence of childhood to the independence of adulthood. There is no consensus as to what age group represents that period. YouthPolicy.org

 as those under 25 years of age and categorizes them into 3 stages: early adolescence (under 14 years), middle adolescence (15 to 17 years), and late adolescence and early adulthood (18 to 24 years). Individuals are, therefore, considered youth when they are between the ages of 14 and 25 years.

Youth do not live in a vacuum, and their issues should not be viewed, or addressed, in isolation of the bigger familial and societal contexts. Most human suffering happens due to ruptures in interpersonal relations, and most human healing takes place when ruptures are repaired through healing the relationships. This is not an easy task, but to change the current status quo of family dysfunction and human disconnection, it is important that youth be viewed as part of the solution—not only as part of the problem.

What does “Youth empowerment starts with you” mean? It means that you, me, and all of us—parents, teachers, caregivers, and all who are entrusted with the wellbeing of these young souls—have a moral responsibility that we need to take very seriously. We need to lean in and look within because the solution is not 1-size-fits-all, and it is not a model or a toolkit. The solution is all of us. It takes the whole village to care for its youth.

To empower the youth, we need to empower all circles of support around them—their family, their peers, their school, their house of worship, their doctor’s office, and beyond—and we need to respect and celebrate the unique communal and cultural dynamics that they hold dear.

Under the umbrella of Untangled, a movement that I founded in 2011 to break the cycles of dysfunction caused by trauma, I am proposing that youth empowerment be reimagined through:

 making sure that youth speak up about what they need, express their feelings in safe and healthy ways, and use the trusted adults in their life for support

 establishing a foundation of safe home through opening channels of communication and building bridges of trust, and refusing to see family dysfunction as the norm, because there is nothing normal about family breakdown

 teachers serving as role models for their students and advocating for everything they need to fulfill their students’ trust, as teachers are like second parents

 normalizing discussions about youth and family mental health and emotional wellness and paying attention to the caregiver’s own needs and boundaries, as burnout is a real threat to the caregiving field

 making religion, faith, and spirituality serve as tools for healing the youth and their family, and making sure that faith leaders are not the reason that youth are running away from the house of God

 empowering safe and healthy peer relations and providing tools and skills for youth who are engaging in risky and self-destructive habits and behaviors, as peers are very important as identity anchors and support networks for this age group

For more about Untangled and my youth empowerment initiative, visit my website: 

 is a psychiatrist in Colorado He is the author of 

1. Definition of youth. United Nations. Accessed October 17, 2022. 

https://www.un.org/esa/socdev/documents/youth/fact-sheets/youth-definition.pdf

2. Definition of youth factsheet—United States. YouthPolicy.org. Accessed October 17, 2022. 

https://www.youthpolicy.org/factsheets/country/united-states/

How can we reimagine youth empowerment in order to break the cycles of dysfunction caused by trauma?

Youth Empowerment Starts With “You”

On my most recent flight home (I know, I usually end up writing a new article every time I fly), I sat next to a middle-aged woman and her father who seems to be struggling with some kind of cognitive impairment, possibly 

. I was very impressed with how, throughout our 2.5-hour long flight, that she was quite attentive to his every need and kept him both engaged and entertained. She did that through asking questions and sharing pictures saved on her phone that seemed to fill his soul with joy.

Very few of us pay attention to our parents when they grow older, especially those with dementia. We seem to either take them for granted or get easily frustrated with them. Some of us even abandon them and then we wish for a different outcome when they are no longer with us.

I lost my mom in 2016. She was diagnosed with dementia during the ugly civil war in my home country, Libya. I do strongly believe that her memory quickly deteriorated because of the many times her heart broke losing loved ones to that nonsense. I was lucky to spend the last week of her life with her; I was holding her hand when she passed. She might have not remembered who I was, but I know deep in my heart that she felt I was there. I would have never had it any other way.

 before his death too. I remember him passing by my grandma’s room who died before him and him asking, “Where is the lady who used to be here?”

Maybe I am projecting my own fears about this ugly disease given that both my mom and her dad died of dementia-related complications. There is nothing I can do right now to change my genes or reduce my risk, but here are a few things I will do and encourage you to reflect on if one or both of your parent(s) is/are still alive:

1. Enjoy the current moment. Even if they do not have factual memories, create emotional memories for and with them, through moments of bonding, care, and tenderness.

2. Repair any damage in the relationship. Heal old wounds if there is room for healing. Forgive old ruptures if you can.

3. Focus on your spouse and children. Be emotionally available for them, so together you create long-lasting memories that they can cherish when they miss you.

4. Refuse the dysfunctional status quo. There is nothing normal about family breakdown.

5. Show respect, love, and compassion to the old people in your life and those around you. Not only your parents, but also your grandparents, uncles, aunts, older siblings and relatives, neighbors, and all seniors in your community. The global pandemic showed us how painful isolation is. The best cure for 

 is to build bridges and be a source of safety and solace for others.

6. And finally, do not forget to take care of yourself. Caregiving can bring joy, but can also lead to burnout if your neglect your own needs and boundaries.

Dementia is a mental health condition that can make or break families. Remember that behind the difficult behavior is your loved one—a human who deserves to be found, held, comforted, and tended to with the utmost love and compassion.

 is a practicing psychiatrist with Providence Healthcare System in Portland, Oregon. He is the author of 

A reminder to cherish your parents and the older adults in your life.

Dementia: A Social Death Sentence

If anyone thought that trauma was settling down in the Middle East and the US, this weekend belied that assumption. Though these events otherwise seem separate and are of great social psychiatric concern in their own right, all occurring over the weekend may be more than coincidence. They are:

-After a year of relative “quiet,” rockets were launched from Israel to the Gaza Strip and from the Gaza Strip to Israel.

-The fourth Muslin man to be ambushed and killed in Albuquerque over the past 9 months occurred on Friday.

-Saturday night and Sunday was the Jewish commemoration of Tisha b’Av, an annual fast and study day related to several disasters in Jewish history.

-Saturday August 6th was “Hiroshima Day,” the day in 1945 when the first atomic bomb was dropped on Hiroshima.

In canvassing the members of SPIRIT, who have previously written about such traumas for 

™, there was a great diversity of opinion about whether it was the right time to respond, and what could we say of value, yet still be respectful of the mourning associated with these tragedies.

Then there are also the silent international traumas, such as in Lebanon. Two of our members recently visited Lebanon. Plagued with hunger and a lack of social services, they reported a sense of powerlessness, helplessness, resignation, and psychotic-like “zombies” walking the streets there. It seems that we in psychiatry have to avoid feelings of learned helplessness in reacting to these traumas.

Although hundreds of women dressed in white with their mouths taped shut marched in protest in downtown Chicago on Sunday, the invasion of Ukraine continues, with less attention by the media, psychiatry, and public.

Of course, the powers in the situation are beyond formal mental health, including the survival of countries and people. Oil money and politics are a major influence.

Nevertheless, we in psychiatry know how to sit, listen, and help address the harm we humans do to one another. Our trauma stories can be the source of wisdom, resilience, growth, and transformation. Our children and the continued intergenerational transmission of trauma is at stake. Trauma to children, regardless of whoever is responsible, is a psychiatric and global mental health issue.

We hope to make further comments in the near future and are always available to help and contribute our knowledge. In the meanwhile, we bear witness to these psychiatric tragedies of war and other violence.

is an award-winning psychiatrist who has specialized in the cultural and ethical aspects of psychiatry. A prolific writer and speaker, he received the one-time designation of Hero of Public Psychiatry from the Assembly of the American Psychiatric Association in 2002. He is an advocate for mental health issues related to 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 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. 

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

 serves as Kathleen & John Bricker Chair, Department of Psychiatry, LSUHSC. He also is chairman of the Board of Trustees of the Cobb Research Institute and is the 113th present of the National Medical Association. 

 is a clinical social worker, a visual storyteller, and a creativity consultant.

All these events that occurred over the weekend bear social psychiatric weight. 

SPIRIT (Social Psychiatry Interested in Recovery from International Trauma) Voices Some Current Concerns

Here in Oregon, for environmental reasons, you do not pump your own gas. When you go to a gas station, someone fills your tank for you.

The other day, I was waiting for the attendant to serve me, but he was rather busy flirting with a customer. He started grooming her by saying how much he liked her car, and then he commented on her looks. I could see how uncomfortable she was when he proceeded to insist on getting her number. He did not stop before he made sure she called his cell phone so he could save her contact information.

This is not at all uncommon. Many women get harassed while performing even the simplest of daily tasks that should be risk-free. I made it clear to the attendant that he was intrusive, his behavior was unethical, and he likely had violated her personal boundaries. He brushed me off by saying that I should take it easy. I told his supervisor that such behavior should not be condoned or tolerated, and the supervisor promised me he would talk to him.

The attendant took the woman’s reluctant agreement as a consent, not realizing that in such relationships, there is power inequality and many female customers might indeed not speak up when someone in a position of power takes advantage of their needs.

I think, morally speaking, it is an extremely low act to abuse a position of influence to exploit others. We have heard stories of teachers, doctors, and preachers taking advantage of those entrusted to their care—but as the gas station incident showed me, women are not safe anywhere they go.

It is a communal responsibility to change that. Women need to be empowered to speak up, and men need to speak up for them. It is not enough to roll your eyes or shake your head when you bear witness to such violations. Changing the status quo requires all of us to take an active stand.

In the hospital where I work, we use the acronym “CUS” to encourage staff to speak up. C stands for 

 (“I am really concerned to be observing/hearing this”); U stands for 

 (“this is making me uncomfortable”); and S stands for 

 (“I want you to immediately stop”). And, of course, no one should risk their life or safety when defending others. We have seen people die while standing up against oppression, including the 3 individuals who were stabbed inside a train here in Portland while trying to protect women from a bigot.

I see any female as my mom, wife, sister, or daughter. What I dislike for my loved ones, I dislike for all other women. I am inviting men to take responsibility, to become role models themselves, and to raise their boys to respect and protect women. This cycle needs to be broken.

Women deserve better. They deserve to feel safe inside and outside their homes, at their places of employment, in their houses of worship, and wherever they might be—including my local gas station.

“Changing the status quo requires all of us to take an active stand.”