The Express Tribune hi five - December 20

Ms DECEMBER 20, 2015

ISSUE NO. 183

Protecting our children How trauma counselling can help their growth

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Section In-Charge: Dilaira Dubash Sub-Editors: Amna Hashmi Nisma Chauhan Designer: Umar Waqas Feedback: women@tribune.com.pk

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The buzz

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

By Zohaib Amjad

All through this year, Pakistani media has been rife with incriminating news regarding the treatment of children within the country. The grim memories of the attack on Army Public School (APS) in Peshawar last year had barely settled when the stories of child abuse in Kasur flared up. Over 400 videos of nearly 280 children being forced into pornography surfaced. Considering this, it is hardly suprising that Pakistan has witnessed an increase of nearly 17% in the number of childhood trauma cases recorded over the last decade, as claimed by experts from the Essentials of Child and Adolescent Psychiatrists Practice in Peshawar. These, coupled with crippling poverty and other related social issues, make it necessary for us to incorporate childhood trauma counselling services into our curriculums and healthcare.

Dr Amanat Mohsin, a psychiatrist at the Gulshan Psychiatric Hospital in Karachi explains why providing timely trauma care is of utmost importance, especially for children. “Young minds are particularly sensitive to the environment around them which affects their development in the long run,” he explains. “Children’s minds are continuously growing along with their bodies, with connections between the different regions in the brain evolving.”

These connections heighten the senses, rendering children more receptive to the environment. Hence, all kinds of frightening images, loud noises and fast or violent movements can affect them adversely and overwhelming incidents can rekindle nightmares and fears. As children are yet to be able to distinguish between cause and effect, they begin to believe what they feel or think is reality.

“Traumatic events can make any individual feel harrowed and threatened on both, a physical and psychological level. This makes it hard for them to move through life,” states Saba Shabbir Sheikh, a consultant clinical psychologist at the Hameed Latif Hospital in Lahore. “Some experience life-changing events once in their lives or more than once. It could be a car accident, the sudden death of a loved one, a broken family, medical illnesses, natural disasters or simply neglect from someone they love.”

The effect is only aggravated in the case of repetitive exposure to the traumatic

event, such as one would assume happened in the Kasur scandal. Saba explains that the encounters serve as ‘re-experiences’ wherein images, thoughts and flashbacks occur in a child’s mind and naturally, upset them. Scientifically speaking, these are called ‘triggers’ which perpetrate feelings of anger, frustration, depression and anxiety. At times, one might even feel a certain hollowness in their chest without really becoming aware of its underlying reason — an example of repressed memories. “This feeling of hollowness runs the risk of translating into severe mental disorders like PostTraumatic Stress Disorder (PTSD), personality issues, depression and even suicidal tendencies,” says Ayesha Fakhar, a legal psychologist at the Research Society of International Law Pakistan.

“Often, children grow up to develope a reliance on short-cut routes to relieve their feelings, with substance abuse leading the way.”

In fact, research proves that children who undergo traumatic experiences have compromised functioning in the frontal cortex of the brain — the region responsible for thinking, awareness, language and memory. Another part that is vulnerable to stress is the limbic system which processes emotions and impulses.

Exposure to traumatic activity actually over-activates the system, making the individual suspect a threat when there may be no such thing.

Ultimately, these mental handicaps culminate in an inability for children to control their feelings and emotions as they grow older. Thus, providing them with sound medical assistance at the right time is imperative. Lack of focus and control can become a hindrance in their daily lives, steering them from studies and impacting their social relationships, amongst other things. Because of these factors, they might receive fewer opportunities in life and so, begin to feel isolated or inferior to others. “To put it simply, traumabearing children are more likely to distrust others and hold a negative set of beliefs,” explains Ayesha. “The child’s capacity to sustain significant attachments will become hampered this way. There is also a possibility of them passing it on to their own offspring via genes.”

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

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Identifying a child suffering from PTSD can be tricky as in most cases, the symptoms persist long after the trauma has occured. However, according to the ‘Diagnostic and Statistic Manual of Mental Disorders’, the following changes in behaviour can help one recognise it: 1. Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and nightmares 2. Avoidance of places, people, and activities that hold reminders of the experience and emotional numbness 3. A child may no longer trust parents or guardians. He or she may also have a negative self-attitude and perception of being a potential victim to something that may happen in the future 4. Struggling to get grades at school or socialising with people 5. Increased arousal, such as difficulty sleeping and concentrating, feeling jumpy and being easily irritated and angered.

Of course, some children are better at coping with or adapting to different situations than others, but those who are not tend to get sucked into a vortex of negativity and lose direction. Irsa Usman, a behavioural therapist at the Institute of Behavioural Psychology, presents an interesting take on the matter. “As trauma can mean different things to different people, their experiences are different and their outlook is very different too.” This is indicative of the wide scope the concept encompasses.

Based on each child’s respective needs, experts prescribe one of two main treatment options to help them come to terms with their trauma. There is, unfortunately, no set time period for the recovery but both options have proved successful in most cases.

These include:

This is an intervention-based technique designed to transform negative thoughts into positive ones. “The counselor changes the perceptions of the patient overall, particularly how they feel about the incident that caused them so much anguish in the first place,” explains Irsa. CBT incorporates other therapeutic practices like exposure therapy and relaxation therapy where the patient is made to recall their trauma in a controlled, meditative manner. At times, narrative writing is also used to help the patient express themselves.

The main aim of EMDR is to alter the images, sounds and thoughts a child is hit with when they are reminded of their traumatic experiences.

“Along with these methods, support from family and friends is crucial for the child and helps prevent a relapse,” adds Irsa. Hence, parents are often counselled along with the child so that they may learn how to speak and deal with the youngster correctly.

To make trauma counselling accessible to minors across the world, perhaps the ideal place to start from would be their schools and education institutions. The idea has been pitched during a seminar held at Ibadat Hospital in Nishtarabad in the wake of the APS attack but is yet to be implemented, seeing how Pakistan just has a handful of trained therapists to offer. According to Sarah Ahmed, an English teacher at the Beacon Light Academy in Karachi, the problem is by and large left in the hands of regular teachers such as herself. “If any student is having to cope with the loss of a loved one, for example, we encourage them to speak up and address their grievances,” shares Sarah. “We also ask the senior students and class monitors to give them extra care. However, we are not familiar with the practice of proper trauma counselling at all.”

Arguably, the reason for this ineptitude could be how mental health is perceived within Pakistan on the whole. It is unfortunate that consulting a psychologist for any reason is still assumed to be something out of the ordinary and for ‘crazy’ people. Children are still discouraged from pursuing a career in the field of psychology as it is deemed unlucrative by their parents. Child psychology remains particularly unsaturated, comprising just 0.01% of 4,000 Pakistani psychologists, as indicated by the Journal of the College of Physicians and Surgeons. Due to these dire circumstances, professionals from all over the world had to be flown in to help children who survived the attack last December. It was only afterwards that the government of KPK promised to introduce a child trauma centre as part of the Psychiatric Department in Lady Reading Hospital Peshawar.

In an ideal world, there would be no children experiencing trauma at all, since potentially detrimental incidents would be prevented. Unfortunately, the times we live in are far from ideal and people will be faced with things they are not equipped to handle emotionally.

But we can always try! To prevent permanent damage, we must do away with our preconceived notions of psychology and safeguard the emotional and cognitive health of our children. Only then can we identify, address and cure their suffering completely.

Zohaib Amjad is a scientist with majors in molecular pathology. He tweets @infectiousuni Design by Hira Fareed

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En vogue

Indulge yourself in elegant new formals from Suffuse Designer: Suffuse by Sana Yasir Photography: Stop Style Productions Jewelry: FANAS Hair and Makeup: Shoaib Khan Model: Saheefa

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

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Lifestyle

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

By Nisma Chauhan With the winter sale season going on, many of us have been buying way more than our allotted expenses. If you are a shopaholic or a bargain hunter, you will understand what we mean. Retail stores profit tremendously on our impulsive purchases but we often get stripped of our savings.

But with these ultimate shopping tips, you can become a smarter shopper. MsT has got the best advice from popular bloggers to help you learn how to do your homework before hitting the shops, build a strategy to get what you want and even save money while at it!

Know what’s already in your closet According to surveys, most people wear as little as 20% of the clothes in their closets.

As a result, there is probably plenty there you may be overlooking. In fact, we could most likely create much more storage space if we de-cluttered our wardrobes every now and then. According to blogger Natasha Kundi, of Natasha’s London blog, extra things clutter the house and take up space we can use for something more useful. “Ask yourself one question, ie do you really need it?” says Natasha. “Almost 99% of the time, the answer will be a ‘no.’” So you should begin by disposing off what you no longer need and so shop with a focus on what you do.

You can even earn extra money by selling the extra stuff online!

Browse the websites of your favourite stores, inside and out Knowing when the sales will be means tracking your favourite stores’ websites and social media pages closely. Most companies typically share coupon codes and special news on these platforms first which can help you snag the items you want before they sell out. “Sometimes, online shopping can be fruitful in terms of saving money and time,” explains Haseeb Sultan, the blogger and editor of young adult magazine Existmag. “Make sure to bookmark the top pages and sign up for newsletters to be aware of what’s going on in the corporate world,” he adds. You should also double-check your lists to ensure you are getting the best deals and while you are at it, bag in a discount coupon code. If you can combine coupons with semi-annual or seasonal sales, then you enjoy the privilege of paying lesser on already discounted items.

Be on the lookout for the words ‘with any purchase’ on your coupons. Haseeb’s secret mantra is to do a quick browsing session online before heading out. “It will save you the hassle of going from shop to shop. This way you’ll know where to go. In fact, most stores advertise their new collections and sales online a couple of days before they hit the stores so you have ample time to be mentally prepared,” adds Haseeb.

Shop when no one else is shopping This may be a little troublesome but shopping in the wee hours of the day when stores have just opened is great to get your hands on fresh inventory as it arrives. During sales, the chance of getting your hands on the most discounted items is much higher in the mornings as well. Make sure you keep yourself abreast with your favourite shops regularly so that you know when they open and will be hosting sales next.

Try them before you buy them All too often, the clothes we have fallen in love with at first sight turn out to be a disaster when worn. The only way to stop this is to make that much dreaded trip to the trial room and see for yourself. If you don’t want to be running in and out, just take at least five or six items in together. This will prevent you from spending too much time inside the dressing room and make more time for other stores. At times, you might even be able to find the same outfit at a cheaper price online and buy it without gambling on its material and fitting. “I always browse online before going out to a store to shop,” informs fashion blogger, Farwa Aamer. “In fact, don’t forget to go through your favourite blogger’s posts too as their splurge vs steal sections can offer a great insight,” she adds.

If you’re really determined, be ready to wait You may have a wardrobe burgeoning with wonderful clothes which may still not be enough. But to be able to stock it with things that you don’t later feel guilty about, you must learn to wait. Postpone your plans till a good bargain comes around, for instance — even if that sometimes results in your items going out of stock. After all, would you rather let a few items go and get great deals on everything else than to pay full price for all of it? No, right? We thought so. Hence, it’s important to be patient because shopping should make you feel happy, rather than guilty.

Nisma Chauhan is a subeditor at the magazine desk. She tweets @ChauhanNisma

Design By Maryam Rashid

Domestic goddess 7

THE EXPRESS TRIBUNE, DECEMBER 20, 2015

Christmas Cake

Tis’ the season for some sweet indulgence! This year, give your guests a special Christmas treat by serving these deliciously warm holiday desserts. They’re easy to make and ideal for cosy Christmas parties with family.

By Ryan D’Souza

Ingredients • • • • • •

Butter (unsalted) 800 grammes Sugar 1000 grammes Flour 1000 grammes Eggs 18 Baking powder 4 tbsp Mixed fruits and nuts (dates, orange peel, almonds, walnuts, etc) • Cake masala 2 tsp • Caramelised sugar (for colour) • Vanilla essence 1 tsp

Method • Combine the butter, sugar, egg yolks and vanilla essence in a large container, making sure they mix thoroughly.

• In a separate bowl, mix together all the dry ingredients.

• Begin preparing the cake batter by adding small quantities of the dry mix to the other, stirring slowly throughout.

• Caramelise about two cups of sugar until it becomes a liquid, dark brown or blackish in colour. This will add colour to the cake. Once the desired consistency has been achieved, add the sugar to the batter slow. Be mindful that that the sugar solidifies very quickly and must be folded in immediately lest it become lumpy.

• Beat the egg whites until they are fluffy and add them to the batter.

• Fold in mixed fruits and nuts of your choice.

• Pour the batter into a cake pan and bake at 180° Celsius for about an hour or so.

Sweet Puffs

By Arooj Waqar

• Flour 4 cups • Butter 1 cup (divide into 4 portions and keep it chilled) • Water as needed

For the dough: • Mix flour and water to make a hard dough. Roll and give it a round shape. Apply one portion of chilled butter on it and fold the dough to make a square shape. Freeze it for 15 minutes. Roll the squareshaped dough , now apply second portion of butter on it. And fold again into a thick square. Freeze for 15 minutes. Repeat these steps two more times until you utilise all four portions of butter.

• You can freeze this dough and use whenever you like.

For sweet puffs: • Take some dough and roll it in a rectangular shape that is half inch thick. Lift and fold it from the right side and repeat the same step from the left side to make it a thick rectangle. Sprinkle some granulated sugar on it. Now lift from the right side and double it.

Sprinkle granulated sugar on top and press sugar a bit so it sticks well with the dough. Cut rectangle into 10 equal pieces and place in an ovenproof tray.

• In a preheated oven place the tray and bake on 70o Celsius for 2540 minutes until its golden brown from the base.

Woman of the week 8

On a recent ho liday.

Posing away as always...

Bag designer Love to pose!

The winter breeze has finally set sail and we can now flaunt our favourite looks of the season. This year, large, plaid, blanket scarves have become all the rage. Not only do they look great, they can keep you warm and be worn in several different ways!

We have shortlisted some of the easiest styles you can try out to create four different looks with the same scarf.

The belted-poncho: Fold the scarf into a triangular shape and throw it on your shoulders like a cape. Tie it close with a thin belt across your waistline, pulling out just enough of the cloth to keep you covered without adding bulk to your waistline.

The standard: Put the scarf around your neck like a dupatta and then take either ends from your back and throw it across.

The pull-through: Fold the scarf horizontally.

Wrap it around your neck and pull the ends inside the loop from the front. This style is ideal for extremely cold weather as it wraps your neck with two layers.

The loop: To achieve this classic look, just hold two ends of the scarf and gently wrap them around your neck twice. Make sure that the front isn’t too put together — loosen it up a little and you are good to go.

SOURCE: COSMOPOLITAN.COM

Design by Eesha Azam