Summer is not over yet according to the calendar. But by the bags of candy corn and pumpkin-shaped chocolates and cackling witch dolls I passed by along the shelves of the candy aisles at CVS today, you’d think next week was Halloween and that now is the time to finalize Christmas plans. (Which maybe it is for people traveling but it still seems too soon). Regardless of the fact that Starbucks started serving up pumpkin spice lattes in the middle of August (because boiling hot pumpkin drinks are fun in August?) it doesn’t feel like fall yet. The air outside is a roasting ninety-nine degrees and as I type these words I am wearing a bikini and nibbling on my third grape Popsicle of the day and sucking back ice water as if I’m walking through Death Valley. So while the idea of baking my first loaf of pumpkin bread of the season and turning on Hocus Pocus sounds nice and fun, I can’t accept that Summer is over. What it feels like instead is that weird, still-too-hot-outside (at least for Southern California) in-between place that is both an ending and a beginning. The ending of the lavish heat and long, yellow days of summer, and the beginning of the colder, crisp months that usher in the holidays and are punctuated by the promise of a brand new year.
When summer comes to a close, it stirs up my hunger for simpler times. Like the first days of grade school and kicking up crunchy leaves with my Keds on the walk home from the bus stop with my friends. It makes me miss my mom’s house and the street where I grew up playing tag and hide-and-seek and trick-or-treating with my big brothers. It makes me miss the beginning of my youth — when every experience felt like a “first” and life felt novel and new, even in the hard times. Despite the nostalgia that it evokes, in many ways, the end of summer is a relief — it makes me happy. But it also makes me want to pause and be still and quiet and step outside my life for a moment to examine and process this thing we call “time” and how swiftly and relentlessly it passes — with no apology for the experiences that it cements into our consciousness as memories often before we realize they’re over.
As I have gotten older I have come to realize that less things in life are as certain as I once thought — things like relationships and love and what is be true about them. These things are constantly evolving with time and circumstance. And it’s not something I can control. The first part of my twenties helped me learn that. I can’t stop people and love and relationships from growing and shifting and taking on new shape any more than I can stop the trees from shedding their leaves and the grasses and flowers of June from shedding their summertime color. Life rolls on and we have no choice but to be roll along with it, welcoming new seasons and bidding adieu to the old whether or not we are ready to. But for now, I like this place — this in-between moment where it feels less like summer but not quite yet like fall, dressed in the dull glow of the September sun — a moment that can’t make up it’s mind as the days lead us up to pumpkin carvings and costumes and soft sweaters and spiced pies. These are the days that aren’t sure of what they want to be. And that’s sort of where I am in my late-twenties, not in the way of uncertainty but in the way of being in the “in-between” and shedding the skin of a long summer that taught me a lot about myself, mostly things I thought I had already learned.
Life is like that sometimes. It has a way of flipping us onto our heads and re-writing the script we thought we could trust in and changing our course entirely, and never with our permission. I like the experience of being in the “in-between” in the seasons of my own life for the reprieve it offers, by allowing us a chance to survey the past and scrutinize it in a way we can’t while we are living it, and we forget to after too much time has passed.
Every year around this time I tend to retreat inward and embed myself within my thoughts as I strain to understand them. There is something about the change from summer to fall that forces this in me. Perhaps because in order to fully savor and appreciate the dawn of that first perfectly crisp and apple-sweet autumn day, we must grapple with summer’s end and the reality of another year being almost over. This has never been easy for me, but I take solace in knowing that that is what this time in the “in-between” is for: reflection, reverence, and realizing what has past and what I want, and need, to come. This is what helps make the passing seasons work in harmony with one another. Because it is the transitional and trying moments that give meaning and life and harmony to the flow of the seasons — a kind of harmony that I don’t think happens by accident. An orchestrated harmony that, in my belief, God has designed for a purpose. I don’t know what that purpose is entirely, but what I do know is that it is because of this harmony that I am able to look back at my life and discern and decode patterns and trends for how and why certain things happened in the season that they did.
The natural seasons work in harmony to bring life and growth and rebirth as the earth needs. And in our own lives, I think the same is true. So as these “in-between” days continue to pass until fall’s exuberant arrival, I will choose to be thankful for the long summer that has reached it’s slow end, and the anticipation of the fall — where the air grows wild with leaves and the sun sinks below the horizon earlier, inviting the cold and the quiet of autumn as the earth takes it’s time in shedding it’s summer skin, giving us all a chance to in some way, start over again.
I’m ready for that. And it’s good that I am, because whether or not I am ready, it will happen anyway.
Because that’s just how life works. No matter the season, or where you are in the in-between.
I woke up feeling sad this morning for no reason. It is a curious thing when this happens. Last night I went to bed feeling just fine and well and with a belly full of popcorn and happiness leftover from an evening full of laughs on the phone with my best friend and a quiet nighttime walk with my dog. Then today I woke up and the sun felt too bright and alive and bold — and it wasn’t even out — it was hiding behind a thin cotton sheet of stone-colored clouds. But I knew it was there, waiting to show it’s sultry, hot face. I wanted just two more hours of night before morning. I wanted just a little more rest and a chance to collect myself before being fired out like a cannon into another week of long and chaotic workdays. I wanted to feel glad and grateful for being alive and having a job and a home to come home to. But that seemed too lofty a goal. I could hardly peel myself from my bed-sheets.
When these moments happen, I think about my friends and family and dog and husband. I have to be stable and on point and joyful for them — I tell myself. I have to wear a smile and rejoice over the good things to be the strong one. I have to act and look like I have bold faith and the wisdom required to take on what is hard. But the truth is…that’s not me all of the time. The real me has moments where I question why I am here, taking up space on this planet. The real me wants to throw an expensive dinner plate at the sky hoping it hits God right in the face so He might wake up to see how much pain I am in sometimes.
“Take that God!” I’d shout after flinging said plate into the sky like a Frisbee.
The real me knows how pestilent and childish that attitude is but no matter how hard I try, some days I can’t seem to shake it. I want that dinner plate and I want to chuck it something or someone that I can blame. God is usually who I go after. He’s an easy target — being way up there in the sky and all.
Eventually I got myself up and started coffee and made breakfast. I assumed a good dose of caffeine would give me the kick I needed to shake my sour temperament. But three hours later after bee-lining it out of my office to go and cry in my car, I was unconvinced that coffee could help, and utterly convinced that not much could. I felt hopeless and lost and tired. So I cried and asked God for some help, and apologized for wanting to throw a piece of china at Him. I was desperate to know He was listening. That’s where the work of faith comes into play: here I am wailing like a baby and talking to a God that I can’t see or touch and I must choose to believe that He hears me.
I didn’t want to call a friend to talk. There wasn’t much to say except, “I am sad today and struggling to stay in tact,” which would invite a round of questions that I didn’t want to answer, or that had no answer at all.
So what do I do? I asked myself.
The answer is never easy and rarely the answer I want. But in that moment, it was the answer I needed.
Don’t give up. This is life and you’re going to feel this way sometimes and have really, really terribly dark and exhausting and bleak days that make you feel meaningless. But broken things and messy feelings prove that you at least are living life. And sometimes these messy things are how we figure out who we are and what our story means. Because the messy things are sometimes the only things that seem true and to know the truth and tell the truth is in a way, an act of moving closer to God. You need that. You are ruined on your own. So don’t give up.
Okay, I can try and believe these things, I say to myself.
I got out of my car and went back to work for the day, knowing it would be tough, and not really wanting to, but doing so anyway.
I cried again a couple hours later. And then a little more an hour after that. But I continued on clinging to the Grace that has seen me through these sorts of days before. And tried to maintain my grip on some of the more beautiful things that I know to be true. Things like:
I am worthy of love.
I may not have some of the things that I think I need, but I have enough to survive today and tomorrow and most likely, the day and week to follow.
God has not given up on me. He is not sitting up in heaven rolling his eyes at my behavior and scoffing at my existence while wondering “why exactly did I create her again? What a total disappointment.”
Suffering can make you great if you allow it to. Or it can make you bitter, and age you beyond your years and cause people to not want to be around you. The choice is ours to make. And I’d rather be great than callous and bitter. Though most days I suck at making this distinction.
I was not a mistake. Everything that has happened to me and is currently happening has a purpose that my puny little brain can’t comprehend right now. I must focus more on that purpose, and less on the pain.
Some days will be hard for no reason and that’s just that. Welcome to adulthood.
This will get better. Maybe not today or tomorrow or next month, but eventually, it will.
After work I went to the gym to burn off some energy and mentally sober up. A few miles on the treadmill distracted me and helped me remember to breathe. Once I was finished I grabbed my gym bag and headed towards the exit. When I opened the door to leave I was shocked by what I saw in front of me in the parking lot.
Rain was falling from the sky. Rain. I could hardly believe it.
It was the first time I had seen it in about six months. California has been in the worst drought of it’s history which has been frightening and dangerous for the state. I didn’t think I would see rainfall for a long time and certainly not yesterday. But there it was.
I stood outside the gym and watched the water dripping from the sky and collecting in puddles and small pools in the corners and crevices of the parking lot. My first and only thought was this: God had heard me. He was listening. And He’s not given up on me. His Grace is real and is extended to me even when I don’t know why I’m sad and angry at the world and don’t really want to get out of bed. And His Love doesn’t stop or run dry when I mess up or want to throw dinner plates at His face for being a bad God. Rather, it is in that place that His love begins — in my brokenness and mess. He shows up in His own way and on His own time and when we least expect it. And some days all that looks like is a little bit of rain — the kind of rain that reminds you to stop and pay attention and be alive. Even when it hurts, and even when it looks like our lives are nothing more than a mess.
“I do not understand the mystery of grace — only that it meets us where we are and does not leave us where it found us.”
― Anne Lamott
This is the first time I have featured a story not written by myself or anyone I know here at everydaydolce. But this topic pulls at my heart and is deeply important to the mental health conversation — particularly in the context of gun violence in America. As someone who understands the devastating nature and harrowing reality of mental health conditions like PTSD, there simply is no room to be silent when there are environments in our country that are creating and/ or exacerbating the chances for a young child to become afflicted with a condition that they are helpless at preventing simply because of the neighborhood and level of poverty that they were born into.
This is Airena’s story.
Thousands of Americans in high-violence neighborhoods have developed post-traumatic stress. 24-year-old Aireana and her children are among the few who’ve been able to get treatment.
by Lois Beckett
for ProPublica, Sep. 5, 2014
(This story was co-published with Essence magazine. It is not subject to ProPublica’s Creative Commons license.)
Last October, Aireana and her boyfriend were driving through Oakland when a man on the street opened fire on their car. Her two children, ages 6 and 1, were in the backseat. Aireana, who asked to be identified only by her first name, remembers feeling something slam into her jaw and hearing a sound like a firecracker popping in her head. Her boyfriend hit the accelerator and swerved down the street. He and Aireana turned at the same moment to check on the kids. They were safe. Then her boyfriend looked at her and saw blood spurting from her neck. “Oh, my God,” he said, panicking, and crashed into a parked car.
In the shock after the crash, Aireana had only one coherent thought: I cannot die in front of my kids. They cannot see me die. She unbuckled her seat belt and pushed herself out of the car. As she stood, she felt dizzy and closed her eyes. But the thought of her children propelled her forward. They can’t see my body lying here dead. Still dazed, she walked away from the car. She could hear her daughter screaming behind her, “My mom’s dying!”
Earlier that afternoon, Aireana had gotten her kids ready to go to the park. She had taken meat out of the freezer to thaw for dinner. Her life, at 24, finally felt on track. That year had been hard: She had been unemployed for the first half of 2013 with no stable place to live. After scoring a new office job that summer, she moved into a two-bedroom apartment with her kids. She remembers feeling pretty as she looked at herself in the mirror on the way to the car.
A bullet had smashed through her front teeth, grazed her tongue and broken her jaw. In the emergency room, the surgeons repaired her tongue. Later, they wired her jaw shut so that it could heal. Aireana stayed in the hospital for more than a month. When she went home, her face was still puffy and swollen, and she had a hard time talking. Fragments of the bullet were still lodged in the side of her neck.
“You’re so lucky,” her friends kept telling her. “Why are you still so sad? You’re okay—you’re alive.” But Aireana couldn’t stop thinking about the shooting. She felt guilty, as if it were her fault that she had been hit. Why hadn’t she lifted her arm to block the bullet? Why hadn’t she ducked? The shooting played over and over in her dreams. Sometimes, reliving it, she remembered to duck, and then the bullet passed over her and hit one of her children. She’d wake up in a panic, soaked in sweat.
Every day at 3 p.m., Aireana paused at her front door. She knew she should go out and meet her daughter, who would be walking back home from school just around the corner. But the busy street overwhelmed her. Sometimes she would make it down to the end of the driveway in front of their apartment and then turn back.
In the aftermath of the shooting, she struggled to pay her bills. The phone company cut off her cell phone, but she didn’t care. She didn’t want to talk to anyone. Instead, she spent most of the day asleep. When she became tired of lying in bed, she’d curl up on the living room floor.
In America, violent crime is down significantly since 1993, when the nation’s gun homicide rate hit its peak. But there are still neighborhoods in cities like Oakland, Detroit, New Orleans, and Newark, New Jersey, where shootings are a constant occurrence and where the per capita murder rates are drastically higher than the restof the country. Some 3,500 American troops were killed during the eight-year war in Iraq. Within the same time period, 3,113 people were killed onthe streets of Philadelphia. According to FBI data, between 2002 and 2012 Chicago lost more than 5,000 people to homicide—that’s nearly three times the number of Americans killed in action in Afghanistan.
Over the past 20 years, medical researchers have found new ways to quantify the effects of the relentless violence on America’s inner cities. They surveyed residents who had been exposed to violence in cities such as Detroit and Baltimore and noticed symptoms of post-traumatic stress disorder (PTSD): nightmares, obsessive thoughts, a constant sense of danger. In a series of federally funded studies in Atlanta, researchers interviewed more than 8,000 inner city residents, most of them African-American. Two thirds of respondents said they had been violently attacked at some point in their lives. Half knew someone who had been murdered. Of the women interviewed, a third had been sexually assaulted. Roughly 30 percent of respondents had had symptoms consistent with PTSD—a rate as high or higher than that of veterans of wars in Vietnam, Iraq and Afghanistan.
Aireana’s son, now 2, looks out from a playground set in Oakland, California. (Don Feria/AP Images for ProPublica)
Experts are only now beginning to trace the effects of untreated PTSD on neighborhoods that are already struggling with unemployment, poverty and the devastating impact of the war on drugs. Women—who are twice as likely as men to develop PTSD, according to the National Center for Post-Traumatic Stress Disorder—are more likely to show signs ofanxiety and depression and to avoid places that remind them of the trauma.
In children, PTSD symptoms can sometimes be misdiagnosed as attention deficit hyperactivity disorder (ADHD). Kids with PTSD may compulsively repeat some part of the trauma while playing games or drawing, have trouble in their relationships with family members, and struggle in school. “School districts are trying to educate kids whose brains are not working the way they should be working because of trauma,” says Marleen Wong, Ph.D., the former director of mental health services, crisis intervention, and suicide prevention for the Los Angeles Unified School District.
Men with PTSD are more likely to have trouble controlling their anger, and to try to repress their trauma symptoms with alcohol or drugs. Though most people with post-traumatic stress are not violent, PTSD is also associated with an increased risk of aggression and violent behavior, including domestic violence. The Atlanta researchers found that civilians they interviewed who had PTSD were more likely to have been charged with a violent crime and incarcerated than other people of similar backgrounds without PTSD—but the cause and effect behind this wasn’t clear.
For some people, PTSD symptoms may have contributed to their involvement in the criminal justice system, while others may have developed PTSD later. “Neglect of civilian PTSD as a public health concern may be compromising public safety,” the researchers wrote.
Despite the growing evidence of PTSD in civilians, little is being done to address the problem. Hospital trauma centers often provide adequate care for physical wounds, but do almost nothing to help patients cope with the mental and emotional aftermath of trauma. A 2014 ProPublica survey of 21 trauma centers in the nation’s most violent citiesfound that only three—in New Orleans, Detroit and Richmond—routinely screened victims of violence for the disorder. Trauma surgeons said they were aware of the burden of post-traumatic stress on their patients, but it was hard to get hospitals to spend moneyon new programs or staff to deal with PTSD. Even Chicago’s Cook County Hospital, where researchers found that 43 percent of injured patients showed signs of the condition, has struggled to raise funds to support a new program. Doctors said they also worried about the scarcity of mental health providers, especially for low-income patients without insurance. Some said they were reluctant to screen patients for PTSD because they could not be sure they would get treatment.
What’s more, many doctors and nurses assume that shooting victims—especially young Black men—are responsible for what happened to them, says John Porter, M.D., a trauma surgeon in Jackson, Mississippi, which has a higher per capita homicide rate than Chicago’s. The line of thinking is It’s their own fault, so who cares? We’ll save their life, but who cares? But post-traumatic stress doesn’t distinguish between “innocent” and “not innocent” victims. Researchers have found gang members are just as likely to suffer from post- traumatic stress as anyone else.
The burden of post-traumatic stress on low-income communities of color gets very little attention. What public recognition it does receive is often sensationalized: A TV reporter apologized this spring after a segment on young people dealing with trauma in Oakland referred to PTSD as ” hood disease.”
“Someone in the community has to stand up and say, ‘Because of all the gun violence, we have a lot of traumatized people—and it’s not just the people who are being shot and shot at, it’s the people who are witnessing it, the vicarious trauma,’” says Arthur C. Evans, Jr., Ph.D., the commissioner of Philadelphia’s Department of Behavioral Health and Intellectual Disability Services. With the support of Mayor Michael Nutter, Evans has pushed Philadelphia to treat trauma as a major public health issue and to develop a comprehensive approach to PTSD. Over the past eight years, city officials have worked with hospitals, community mental health clinics, pediatricians, schoolteachers and police officers to increase awareness of the disorder and make sure residents are connected with treatment professionals. “We have to stop telling our kids they just have to live with this,” Evans says.
The city has paid to train local therapists in evidence-based PTSD treatments and has launched a Web site—healthymindsphilly.org, which allows people to screen themselves for the symptoms of PTSD anonymously—as a way of reaching people who might be reluctant to visit a mental health clinic. Philly has also partnered with local faith groups to train leaders about mental health resources, because “in the African-American community, people often go to their faith leaders before they will come to a treatment professional,” Evans says. Philadelphia’s police department is educating its officers about mental health and the effects of trauma. “People who have untreated trauma are highly reactive, and it doesn’t take much to set them off,” Evans says. Crisis intervention training helps officers discern between someone who is being obstinate and someone who “might have some other issues that are driving the behavior,” Evans says. The training also helps officers learn how to de-escalate a situation, rather than react with force. Philadelphia’s broad approach to PTSD includes a technique that’s already being tried in other cities: reaching out to victims of violence in the immediate aftermath of a shooting and bringing trauma education right to their hospital bedsides.
When Aireana was lying in Oakland’s Highland Hospital last fall with her jaw wired shut, one of her visitors was Rafael Vasquez, an intervention specialist with Youth Alive!, the nonprofit group that founded the nation’s first hospital-based violence intervention program in 1994. Tall and solidly built, Vasquez sometimes has to reassure patients he’s not an undercover cop. His goal is to ensure that victims of violence stay safe after they leave the hospital and that they never come back under similar circumstances.
Over the winter, Youth Alive!’s licensed marriage and family therapist, Nicky MacCallum, visited Aireana at home to conduct therapy with her daughter. For people who have grown up in violent neighborhoods, the traditional 50-minute therapy session is not always right for them. “Many times young people would walk out not having connected with the therapists, not feeling they could relate to them,” Vasquez says. “They were overwhelmed by the whole experience.” MacCallum has held sessions in coffee shops and parking lots and even on basketball courts while clients shot hoops. By bringing therapy out of the clinic and into the community, Youth Alive! has seen an increase in the number of patients engaged in active therapy: from about 5 percent of its clients to 35 percent.
MacCallum taught Aireana’s 6-year-old how to calm herself down with deep belly breaths. She talked to the girl about trauma in age-appropriate ways, asking if she ever felt like a turtle, hiding in her shell, or a prickly porcupine. Sometimes MacCallum and Aireana’s daughter would sit on the living room floor and draw together as a way to express emotions difficult to put into words. Aireana started by sitting off to one side and watching the sessions. When the therapist told her, “Adults can draw too,” she then picked up a marker herself. This led to Aireana finally sitting down with MacCallum for a session of her own. They started by talking through a list of trauma symptoms: sleep problems, anxiety, fear of going outside. “I’ve got that,” Aireana remembers saying. “That too.”
MacCallum diagnosed Aireana with PTSD. “Nicky helped me,” Aireana says. “She was the first person I actually talked to who believed it was real, that my feelings were real.” MacCallum and other therapists say PTSD is the best diagnosis they can give in these instances—but that it’s not a perfect fit. For clients who live in violent neighborhoods, the trauma that they’re dealing with isn’t really “post.”
“People in our community are constantly retraumatized,” MacCallum says. The street where Aireana was shot was only minutes away from the place where she had witnessed her first drive-by shooting when she was 8. She had been at a block party near her aunt’s house in East Oakland and thought she heard fireworks. She has a vivid memory of what she found instead: a car, in the middle of the road, with the driver slumped over, already dead, and blood running out of the car. A few weeks after Aireana came home from the hospital last winter, a young man was murdered on the street in front of her house. She remembers seeing his last heaving breaths and his friends yelling and no one around to help. She broke down. This is happening all over again, she thought.
There’s no Department of Veterans Affairs to coordinate care for Americans repeatedly exposed to violence and trauma in their own neighborhoods. One of the first steps in addressing community PTSD, says Evans, who is leading Philadelphia’s trauma response, is to “get people to come around the table. Get a few mental health professionals, a few pastors and a few human services people who are seeing the impact of this to come together and have a conversation. That’s what we did.” Community members who want to learn how they can help loved ones struggling with PTSD or other mental health issues can sign up for Mental Health First Aid, an eight-hour course run by the National Council for Behavioral Health that can also assist community groups with setting up their own training programs. The National Center for Post-Traumatic Stress Disorderand the National Child Traumatic Stress Network also offer resources for PTSD caused by community violence.
Over the summer in Oakland, Aireana’s children were terrified by the sound of fireworks. They kept thinking they were hearing gunshots. This past Fourth of July, Aireana decided she would try to help her kids adjust to the sound, rather than shutting it out. As her neighbors set off firecrackers in the street, she kept her kids at a distance. She pointed to the lights: “That one’s cool.” A purple explosion: “Oooh, nice.” Gradually, they walked closer. Later, she gave her kids sparklers and watched them run around making glowing scribbles in the dark. She had always loved fireworks. It was good to see her kids not being afraid and enjoying them, too.