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‘Take a Seat’- A sit down with a Marriage and Family Therapist

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Saleha Qureshi​ has a double Master’s in Human Development and Family Studies and graduated from the University of Connecticut. She has been a licensed Marriage and Family Therapist for the last 10 years. Here is her interview about her work as a Marriage and Family Therapist. 

Please give us an overview of your role as a Marriage and Family Therapist? 

Saleha Qureshi: ​I am a Marriage and Family Therapist and I have been in this profession for more than 10 years. I have my own private practice and currently I am doing virtual therapy sessions with my clients. My specialty is trauma and couple counseling, but I also see individuals with depression and anxiety related issues. I enjoy working with clients from diverse backgrounds. A good number of my clients are European-American. Many of my clients have reached out to me via my profile on Psychology Today. 

American society has evolved into a more individualistic society while marriage has a lot to do with sacrifices. As a Marriage and Family Therapist, how do you deal with this? 

SQ: ​It is true that the mainstream culture today is a little self-centered and materialistic in its approach. The pursuit of personal happiness in order to live the American dream is considered the epitome of success. As someone from a South-East Asian background, I come from a very collectivist culture and have strong moral values. So, I bring my values to the therapy room as well. 

There is a term called “therapist assisted marital suicide”which means that when a therapist is affiliated to a very individualistic culture, he/she actually steers the couple in a direction to end the marriage if they are not finding personal happiness with each other. In other words, without saying it directly, they put the burden on the couple. So, this way, they are defeating the purpose of being a therapist that is focused on saving the marriage. Clients are looking for a therapist who understands them and their values and will help them retain the marriage rather than break it. So, this is where my religious values, cultural values, and my training as a Marriage and Family Therapist come together and I try my best to help the couple save the marriage if possible. 

How do you evaluate underlying conditions a couple may be suffering from while providing therapy and how do you provide a solution? 

SQ: ​When I see couples, I evaluate them individually to understand their life histories, family of origin experiences and the impact of any negative life experiences and trauma. I also look out for mental health issues that can impact the couple relationship. It has been my observation that early childhood trauma or emotional neglect can cause depression or narcissistic/borderline tendencies in individuals. These issues, unless treated, can impact the couple relationship in negative ways. Of course, there is a genetic component to mental health as well. Once I identify such issues, I try to have an open conversation with the clients about it. I also alert the other partner because they would be the first ones to bear the brunt of it. Mental health problems related to personality disorders are difficult to treat unless individuals are sufficiently motivated to seek help even if it is for the purpose of saving the marriage. I also help the other partner (mostly women) to make the best decision to protect themselves and their children if they are also witnessing domestic violence episodes as well. 

These are severe cases, but mostly it doesn’t get to that level. In normal cases, my whole intention is to make the couple focus on having realistic expectations from each other and take ownership for the role they play in the marriage as a spouse and parent, while also exercising the right to pursue individual happiness. From a moral standpoint, the goal is to help them understand that marriage is a commitment that needs to be taken seriously and every effort needs to be made to save it even if it is for the sake of the children. So, I am definitely pro-marriage while also recognizing that some things should not be allowed to continue in a marriage such as physical and emotional abuse, as there cannot be peace where there is injustice. 

AN: The American Association of Marriage and Family Therapy doesn’t have the word Morality or any of its derivatives in its code of ethics. Why do you think that’s the case?

SQ: Professor​ William Doherty, director of Marriage and Family Therapy, has pushed the idea that one of the goals of MFT should be moral responsibility towards clients. However, in my opinion, the reason it is not included in the code of ethics is because everybody has different values and principles of morality. Some moral values could mean one thing for one person and totally different for the other. We have some specific injunctions in our code of ethics governing the professional behavior of therapists. For example, a therapist cannot have dual relationships with his/her clients; a therapist is not supposed to exploit the clients for personal gain and can only treat them if he/she thinks she is competent to do so. So, all these things imply that there is a moral binding in this profession. But it is difficult to define morality in this society, as it can have different meanings based on one’s religion, cultural influences, moral upbringing etc. These days, there are so many societal ills and so many different perspectives as well. For instance, there are several different forms of intimate relationships other than heterosexual. Some of these relationships would be acceptable for one person and totally unacceptable for the other. Thus, it is hard to establish something as morally appropriate or distasteful them as it will generate another controversy. 

There are a few things in this profession where the therapist is required by law to protect clients by breaking confidentiality as it relates to certain situations, such as child or sexual abuse, offensive crime, or suicidal behavior. So, there are guidelines on how to behave in such situations that endanger the safety of a person. In the end it depends on the therapists and how they bring up morality in their work. Since issues of social justice often require taking a stand on moral issues, a culturally sensitive therapist will be well equipped and competent in this regard. 

In your bio, it is said that you have a very therapeutic style of providing therapy, and it’s warm, compassionate and yet direct. Tell us a little bit more about it. 

SQ: ​ The therapeutic relationship is considered the most important factor (about 75%) in achieving overall positive outcomes in therapy. People come to a therapist when they are hurt, wounded, distraught or feeling hopeless. So, I try my best to make my clients feel welcome and supported by giving them a safe confidential space where they are accepted unconditionally. 

As human beings, we want to be seen, felt and heard. If I am able to attend to my clients in a way, they feel this connection with me, they begin to trust me. This trusting bond then helps them open up to me even more and gradually they will be receptive to any insight and recommendations I share with them even if it feels uncomfortable at first. This is what I mean when I say that I have a more direct approach. 

I feel that my role as a therapist is very rewarding in a spiritual sense as well as ‘Service to humanity is service to God’. 

Any message for the budding Marriage and Family Therapists: 

For young budding therapists, I would suggest Psychoeducation can be a good start. Similarly, I think if you are considering MFT as your profession, then try to get out of your cultural bubble. It is important to understand the nuances of other cultures and be curious and open minded. There are several books and trainings available that can help increase your knowledge. There is a mandated requirement for licensed therapists to complete a cross-cultural training every year to stay updated. Neutrality over issues of social justice can result in oppression for certain ethnic minorities. Marriage and Family Therapists can be very instrumental in playing a huge part in restoring equality for all if they continue to advocate for the ones whose voices are not being heard.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

Health

UN World Food Program Lowers Aid in South Sudan

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The United Nations World Food Programme (WFP) recently decreased aid services in South Sudan, a major blow for the Central African country where over two-thirds of the population faces food shortages and hunger. 

“Faced with increasing humanitarian needs and insufficient funding, we have taken the painful step to suspend food assistance to 1.7 million people,” said Adeyinka Badejo-Sanogo, WFP Acting Country Director in South Sudan. Instead of assisting an estimated 6.2 million people in the country, the WFP will now only provide aid for 4.5 million. 

Large floods over the last three years have destroyed farms and homes across South Sudan, displacing hundreds of thousands of people. This year, UN officials anticipate more flooding, which will put around 600,000 people at risk of displacement. Violence in South Sudan has similarly forced many people to leave their homes, placing them in vulnerable situations. According to Ms. Badejo-Sanogo, “So far this year, we have seen 200,000 people newly displaced as a result of conflicts.”

South Sudan’s people are in a dire situation, and the international community must make greater efforts to send humanitarian aid to the country. Unfortunately, the Russia-Ukraine War has already diverted many countries’ focus, and nations are struggling with their own economic problems.

But ultimately, even if aid to South Sudan can be increased, it is only a temporary solution. Developing the infrastructure to combat flooding and quelling violence in the nation will create more sustainable long-term solutions.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

The End of Roe v. Wade Has Dangerous Consequences for Women’s Health

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When the Supreme Court overturned Roe v. Wade, they did not just steal bodily autonomy from women, but also their future health. By overturning Roe, the Supreme Court has now put pressure on physicians prescribing life saving medications to women.

Abortion has now been banned in six states, and that number is likely to rise swiftly to 16 states. Twelve states have passed trigger laws. Some states have not completely banned abortions, however they have implemented gestational age limits on abortions. While other states have not decided whether or not to ban abortions, the courts and lawmakers will be deciding the fate of women. Only 20 states have abortion protections in place.

These new bans have also brought into question the future of birth control. Will states begin restricting or even outlawing birth control? Although Republicans have dismissed concerns about banning birth control, Democrats have been warning that it is a distinct possibility. Indeed, after Missouri’s strict new ban on abortion went into effect, one major hospital system in Kansas briefly stopped providing emergency birth control, even to victims of rape. 

But the potential healthcare ramifications of these laws do not end there. Many drugs cause birth defects in pregnant women, which raises the question: If women cannot legally terminate a pregnancy, can these drugs legally be prescribed to women of child-bearing ages in states with abortion bans?

“I believe that prescribing is going to become much more defensive and conservative,” rheumatologist Mehret Talabi told Medscape. “Some clinicians may choose not to prescribe these medications to patients who have childbearing potential, even if they don’t have much risk for pregnancy.”

Teratogens are medications which can cause birth defects. Many teratogenic medications include treatments for acne, cancer, rheumatoid arthritis and psoriasis.

“Doctors are going to understandably be terrified that a patient may become pregnant using a teratogen that they have prescribed,” Talabi said. “While this was a feared outcome before Roe v. Wade was overturned, abortion provided an escape hatch by which women could avoid having to continue a pregnancy and potentially raise a child with congenital anomalies.” “

Other physicians also shared their fears that doctors would now be wary of prescribing many medications, some of those with little data on pregnancy. 

Dr. Megan Clowse, a Duke University rheumatologist who works with women who are or wish to become pregnant, told Medcape: “Women who receive these new or teratogenic medications will likely lose their reproductive autonomy and be forced to choose between having sexual relationships with men, obtaining procedures that make them permanently sterile, or using contraception that may cause intolerable side effects..”

Dr. Clowse noted that many drugs commonly prescribed to patients with rheumatic diseases, including methotrexate, mycophenolate and cyclophosphamide, are linked to birth defects and loss of pregnancy.. 

“I am very concerned that young women with rheumatic disease will now be left with active disease resulting in joint damage and renal failure,” she said.

One of these drugs, methotrexate, is an effective cancer treatment and many rheumatic conditions, but has also been used to cause abortions. “If legislators try to restrict access to methotrexate, we may see increasing disability and even death among people who need this medication but cannot access it,” Dr. Talabi said.

Mayo Clinic gastroenterologist Dr. Sunanda Kane told Medscape she feared that several of the teratogenic medications used in her field to treat viral hepatitis, constipation and inflammatory bowel disease, would now be affected. While she said doctors in her field generally only prescribe medications with high teratogenic potential to women of childbearing age when they use multiple forms of birth control to prevent pregnancy, she noted that doctors may be less likely to prescribe such drugs if abortion is not available as a legal option. 

“The removal of abortion rights puts the lives and quality of life for women with rheumatic disease at risk,” Dr. Clowse added. “For patients with lupus and other systemic rheumatic disease, pregnancy can be medically catastrophic, leading to permanent harm and even death to the woman and her offspring. I am worried that women in these conditions will die without lifesaving pregnancy terminations, due to worries about the legal consequences for their physicians.”

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Daily Brief

Children Under 5 to get Covid-19 Vaccine by Next Week

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A child gets the Pfizer–BioNTech COVID 19 vaccine
  • The FDA’s outside vaccine advisers finally approved Moderna’s two-shot vaccine for children under age 5. The panel is also set to vote on whether Pfizer’s three-shot series is suitable and safe for this age group.
  • This is the last remaining group in the US to get vaccinated and many outside experts agree that the benefits of Moderna’s COVID-19 vaccine outweigh the risks for children under 5.  If all the regulatory steps are cleared, vaccines can be available by next week.
  • Dr. Joy Portnoy of Children’s Hospital in Kansas City, MO, also a  panel member, stated “there are so many parents who are absolutely desperate to get this vaccine and I think we owe it to them to give them a choice to have the vaccine if they want to.”
  • FDA reviewers stated that both brands appear to be effective and safe for children as young as 6 months, and the most common side effects, which are fever and fatigue, appear to be less common than seen in adults. 
  • Although the two vaccines use the same technology, the shots have not been tested against one another.
  • Once the FDA approves the shots, the CDC will decide on a formal recommendation. Pfizer’s vaccine will be available to children 6 months to 4 years, while Moderna’s vaccine will be for 6 months to 5 years. 
  • Pfizer’s shots are 1/10 of the adult dose, while Moderna’s shots are ¼ of the adult dose. 
  • Moderna is also seeking regulatory approval outside the US for younger children as well. 12 countries already vaccinate children under 5 with other brands.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Society

Monkeypox could be sexually transmitted disease – WHO

Monkeypox virus is caused by skin to skin contact and may be a sexually transmitted disease, warns the World Health Organisation.

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The World Health Organisation (WHO) has started its research on the reports that the monkeypox virus is present in the semen of patients. 

This presents a possibility that monkeypox could be sexually transmitted from one patient to their partners.

It is reported that most cases are in men who have sexual relations with men. 

The WHO has said that the main transmission of the rare disease is through close interpersonal contact.

In Italy and Germany, scientists say that they have detected viral DNA in semen for a small number of monkeypox patients. The virus found in the semen was capable of infecting another person. 

The WHO monkeypox incident manager in Europe, Catherine Smallwood said during a press briefing “this may have been something that we were unaware of in this disease before.”

“We really need to focus on the most frequent mode of transmission and we clearly see that to be associated with skin to skin contact,” she added.

The monkeypox outbreak is now considered a global outbreak. In more than 30 countries there have been more than 1,600 with over 500 cases in the UK. 

A vaccine of monkeypox is available and the WHO has recommended that close contacts and healthcare workers should be vaccinated first. 

WHO’s regional director for Europe, Hans Kluge said “Europe remains the epicentre of this escalating outbreak, with 25 countries reporting more than 1,500 cases, or 85% of the global total.”

Regarding the race to stockpile vaccines, he added “once again, a ‘me first’ approach could lead to damaging consequences down the road.”

“I beseech governments to tackle monkeypox without repeating the mistakes of the pandemic – and keeping equity at the heart of all we do.”

In the current outbreak, so far no deaths have been reported. But experts warn that every year monkeypox causes deaths in some countries, where the disease exists as endemic. 

The WHO is also considering changing the name of the Monkeypox virus. Consideration came after 30 scientists wrote letters to the WHO that it is not correct but rather discriminatory to give the name of the rare disease as African. 

Some of the Scientists has suggested hMPXV as new name of the virus to address the “urgent need” for a “non-discriminatory and non-stigmatising” name for the virus.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Monkeypox: Something To Be ‘Concerned About’ Says Biden

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On Sunday, President Joe Biden, in his first public comments on the disease, said that recent cases of monkeypox that have been identified in Europe and the United States were something “to be concerned about. It is a concern in that if it were to spread it would be consequential.”

During the President’s first trip to Asia he was asked about the disease as he spoke to reporters at Osan Air Base in South Korea – “They haven’t told me the level of exposure yet but it is something that everybody should be concerned about,” Biden said. As for the vaccine, Jake Sullivan, Biden’s national security adviser, told reporters that the United States has a supply of “vaccine that is relevant to treating monkeypox. We have vaccines available to be deployed for that purpose,” he said. 

Monkeypox is a virus that originates in wild animals like rodents and primates, and occasionally jumps to people. Most human cases have been in central and west Africa, where the disease is endemic. 

According to CDC’s website, Centers for Disease Control and Prevention, Monkeypox was first discovered in 1958 when two outbreaks of a pox-like disease occurred in colonies of monkeys kept for research, hence the name ‘monkeypox.’ The first human case of monkeypox was recorded in 1970 in the Democratic Republic of Congo during a period of intensified effort to eliminate smallpox. Since then monkeypox has been reported in humans in other central and western African countries.

A detailed investigation of the outbreak in Europe, including determining who the first patients were, is now critical, says Shabir Mahdi, a professor of vaccinology at the University of Witwatersrand in Johannesburg.

“We need to really understand how this first started and why the virus is now gaining traction. In Africa, there have been very controlled and infrequent outbreaks of monkeypox. If that’s now changing, we really need to understand why.”

WHO reports about 3,000 monkeypox cases a year in Nigeria. Oyewale Tomori, a virologist who formerly headed the Nigerian Academy of Science, said that outbreaks are usually in rural areas when people have close contact with infected rats and squirrels.

Monkeypox typically causes fever, chills, rash and lesions on the face or genitals. Luckily, to date, no one has died in the outbreak. The estimation by WHO suggests that the disease is fatal for up to one in 10 people. The infection typically lasts two to four weeks and usually clears up on its own.

Britain’s Health Security Agency reported 11 new monkeypox cases on Friday, saying “a notable proportion” of the infections in the U.K. and Europe have been in young men with no history of travel to Africa and who were gay, bisexual or had sex with men.

Dr Susan Hopkins, the Chief Medical Adviser for the U.K.’s Health Security Agency stated that “the evidence suggests that there may be transmission of the monkeypox virus in the community, spread by close contact. We are particularly urging men who are gay and bisexual to be aware of any unusual rashes or lesions and to contact a sexual health service without delay.”

Monkeypox spreads when someone comes into close contact with another person, animal or material infected with the virus. The virus can enter the body through broken skin, the respiratory tract or through the eyes, nose and mouth. Monkeypox is not generally considered a sexually transmitted disease, though it can be passed on during sex. Health authorities stress that we are not on the brink of a serious outbreak and the risks to the general public remain very low.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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Health

Oklahoma’s Anti-Abortion Bill: The Newest Development in the United States’ Abortion Controversy

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This Thursday, Oklahoma legislators passed what many have deemed as the most restrictive bill banning abortions in the U.S. The bill prohibits all abortions, except those that are required to save the mother’s life or are the result of rape/incest. The draft law is likely to be ratified by the state governor, Kevin Stitt, and further limit abortion access in the state.

Oklahoma’s measure has garnered national attention for a multitude of reasons. For one, the bill bans abortions immediately after fertilization; this is in stark contrast to pro-abortion laws across the U.S., which permit abortions up to 24 weeks of pregnancy. In September 2021, Texas passed a similarly restrictive abortion law, but even that measure enables abortions up to six weeks of pregnancy. Moreover, the Oklahoma measure comes right after the recent Supreme Court leak draft, which shows that the majority of the court is in favor of overturning the landmark Roe v. Wade ruling. If Roe v. Wade is overturned — which could happen as soon as late June or early July — many U.S. states (including Oklahoma) stand poised to immediately prohibit access to abortions. 
Oklahoma’s bill, along with the SCOTUS leak, highlights how abortion rights in the U.S. are contingent upon the 1973 Roe v. Wade ruling and subject to change suddenly. Indeed, the recent discussions surrounding abortion shed light on the American judicial system and how volatile landmark rulings can be. Looking ahead, Americans must see whether or not the Supreme Court overturns Roe v. Wade. If so, abortion laws across the country will change drastically, and Americans will have to familiarize themselves with dozens of new laws and restrictions. If not, the legal systems of the U.S. will have been examined and questioned nonetheless.

All views expressed in this editorial are solely that of the author, and are not expressed on behalf of The Analyst, its affiliates, or staff.

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