Speaking from the heart about Palestinian Mental Health

On 8/18/25 I was honored to speak at MCC about "Mental Resilience Under Occupation: Action Steps for Palestine." I shared what I witnessed and learned as part of a mental health delegation that traveled to Palestine 3 months ago. We had met with Palestinian organizers, activists, academics, and medical providers, all of whom risked their lives to meet with us. It was a moving experience for me to speak from the heart, about the personal and professional, and I hope that it does those I met with justice.

You can watch it here:

I Left My Heart in the West Bank

This Friday, July 18th, I’ve been asked to give my presentation "Mental Resilience Under Occupation: Action Steps for Palestine," in-person at MCC in Pleasanton, CA, as well as live online.

Join us for an impactful discussion with Shereen Khan-Amrikani, a community member who recently returned from the West Bank, as she shares her experience as part of a mental health delegation that met with Palestinian organizers, human rights activists, academics, and medical professionals.

She will also share strategies for sustaining mental wellbeing while we continue to advocate for justice in Palestine during these challenging times.

Friday, July 18 | 7 p.m. to 8:30 p.m. | MCC Conference Room | Join in person or watch live at mcceastbay.org/live

Sponsored by the Soul of My Soul Exhibit, JVP Bay Area, Eyewitness Palestine, USA Palestine Mental Health Network, MECA, & MCC East Bay.

Questions? events@mcceastbay.org

About the Speaker:

Shereen Khan-Amrikani is a Licensed Marriage and Family Therapist in the San Francisco Bay Area, CA, who specializes in trauma/abuse, chronic illnesses, reproductive and maternal mental health, neurodiversity, and grief/loss. In addition, she conducts immigration psychological assessments for refugees and immigrants at risk for deportation who are seeking permanency. 

Shereen is the daughter of Pakistani immigrants and is married to a Palestinian American whose grandparents were forcibly displaced from Palestine during the 1948 Nakba. In April, Shereen joined 19 other healthcare workers as part of a mental health delegation to Palestine, where she met with organizers, activists, academics, and medical professionals. She joins us to share what she witnessed and learned, as well as concrete steps we can take to support Palestine. 

Conversations in Health Justice

On July 9th I was honored to present to healthcare workers about health justice, social determinants of health, and current challenges in Palestine. There were Family Medicine Residents and providers of various specialties.

It gives me hope to know that Contra Costa Health has this "Conversations in Health Justice" series available to their staff and it is sparking important discussions about social justice issues and how healthcare providers can make a difference. These are discussions that are sometimes glossed over in healthcare settings, and I'm happy to hear that CCH is highlighting inequity and injustice, giving these matters their due consideration regarding the marginalized, underserved, and oppressed. 

Mental Resilience Under Occupation: Action Steps for Palestine

Everything that has been happening these past 20 months takes a mental toll on us all. We can all learn from Palestinians who have been dealing with occupation for over 77 years on how to better manage our mental health.

🕊️ Mental Resilience Under Occupation: Action Steps for Palestine

Join us for a powerful conversation with Shereen Khan-Amrikani, MA LMFT, as she shares insights from a recent mental health delegation to the occupied West Bank.

📅 June 28 | 4-5:30 pm

📍 Arab Cultural and Community Center, San Francisco, CA

Together we’ll explore how to sustain mental well-being while continuing the fight for justice during these challenging times.

*Please note that this presentation is NOT appropriate for children.

➡️ RSVP required: tinyurl.com/ResistWithCare

$5 admission fee donated to Middle East Children's Alliance (MECA)

Cosponsored by Soul of My Soul Exhibit (SOMSE), Eyewitness Palestine, USA Palestine Mental Health Network, JVP Bay Area, and Arab Cultural and Community Center

#Palestine #MentalHealth #ResistWithCare #FreePalestine #JusticeForPalestine #CommunityCare #EndOccupation #MentalResilience #BayAreaEvents

Starvation as a Weapon of War

Come hear me speak about what I witnessed this past month in Palestine!

Starvation as a Weapon of War

Sun, May 18 | Doors open at 2:30pm, speakers start at 3 | FCCB, 2345 Channing Way, Berkeley, CA

For more than 60 days, Israel has prevented any food from entering Gaza. As of May 5th, 65 children have been killed by starvation and 70,000 children are suffering from severe malnutrition with 250,000 malnourished.

- Join us to learn how starvation has been used to oppress Palestinians and a tool of control — past and present.

- Hear a psychotherapist's recent experience with Palestinian children and families in refugee camps, hospitals, and schools, contending with human rights violations and traumatic stress while living under occupation.

- Listen to live testimony from a med student in Gaza

- ⁠Participate in Silent auction and Raffle

- Support vendor tables

- Bring flyers with your org events and actions to share with the community

- ⁠Donate to Bukrah Foundation, a non-profit org started by a local doctor, that continues to provide food aid in Gaza despite the challenges.

Donations welcomed, not required.

Echoes of Resilience: Palestine Delegation Report Back

Our mental health delegation's Report Back from Palestine is scheduled for Tues, 5/20/25. It will be online. We spent 10 days in Palestine and met with organizers, activists, academics, and medical professionals. It was an intense, extremely moving, and life changing experience.

Register at this page.

https://www.zeffy.com/ticketing/d75-report-back-echoes-of-resilience-mental-health-under-occupation

Introducing Brainspotting as a Service

This month, I was excited to join fellow clinicians to get trained in brainspotting. I had been interested in learning about this for some time, but had been busy with seeing clients. Even as therapists, we have to sometimes remind ourselves to slow down and take time for our own learning and growth. So when I saw the training and that it was offered exclusively to BIPOC individuals, I decided to take the plunge. I was in for amazement witnessing this effective technique demonstrated and having an opportunity to hone my skills in facilitating it.

So, what is brainspotting?

This is a trauma-informed practice that facilitates an individual honing into their inner resources to heal from distress. It locates points in the client’s visual field that help to access unprocessed trauma in the subcortical brain. These eye positions (brainspots) are where trauma, anxiety, depression or behavioral problems are held in the brain. Locating brainspots allows the brain to process from the inside out and from the bottom up. Brainspotting is a therapeutic tool that allows the therapist to locate, focus, process and release a wide range of emotionally and bodily-based conditions that talk-therapy alone cannot access. Brainspotting bypasses the conscious, neocortical thinking of the client, to access the deeper, subcortical emotional and body-based parts of the brain. It has been shown to be an effective technique, shortening the time it takes to process distressing events or topics, and reducing the level of distress one feels. This process can also be enhanced when using biolateral music.

What can brainspotting be used for?

Brainspotting can be used for emotional and somatic conditions. It can heal underlying trauma that contributes to anxiety, depression, and other mental health conditions. In addition, it is used to enhance performance and creativity.

How can we get started?

If you believe you could benefit from brainspotting, please contact me to get started with therapy. I would to love to assist you in your healing journey.

Introducing Virtual Healing and Resistance Circles

Join me for a virtual bi-weekly Healing and Resistance Circle support group for Muslim and/or SWANA individuals and anti-Zionist Healthcare Workers / Organizers.

Free

4 Sessions on Wednesdays, 11:30am-12:30pm PST:

• 4/24/24

• 5/8/24

• 5/22/24

• 6/5/24

Register Here.

Many thanks to HEART'S Inaya Care Fund for sponsorship.

Ramadan, Gaza, Islamophobia, and Mental Health

On March 14th, I had the pleasure of being interviewed by Chef Zana of South Africa on her Ramadaan Around the World show, about the psychological impact of the genocide in Gaza, covering vicarious traumatization, survivor's guilt, compassion fatigue, and PTSD, including how to mitigate the symptoms. We discussed the rise of Islamophobia in the US, as well as concrete steps we can take to support Palestinians in crisis. Click below to watch our interview.

View this post on Instagram

A post shared by Zana Alvarado (@chef_zana)

Now Providing Immigration Psychological Evaluations!

I have some exciting news to share! I just completed advanced training on creating immigration evaluations and am thrilled to announce that I am expanding my practice to provide this important service to refugee and immigrant individuals and families within California. This is a dream I have had for a number of years, while providing psychotherapy services to immigrant families, and I am so excited that I will now be able to provide a service that can be so impactful towards the outcome of immigration legal cases.

I will provide psychological evaluations for the following types of immigration cases:

• Asylum Cases - assessing for signs of psychological distress for an individual who is part of a targeted social group.

• Extreme Hardship Cases–Identifying unique factors contributing to a client’s psychological distress such as: illness, disability, professional, financial, or academic hardship, or adverse home-country conditions that would affect the petitioner or their family members.

• VAWA Cases– detailing psychological symptoms which are common for domestic violence victims of any gender.

• U Visas - for victims of certain crimes.

Please visit my Services page to learn more about the types of services I provide. Visit my New Clients page to get started, and feel free to contact me if you’d like to ask any questions!

"I Gave Birth – Now What?”: Navigating the Postpartum Period

The time after giving birth can be a joyous time filled with marveling at one’s baby, but it can also be a period of quite an intense and overwhelming adjustment to this new addition to the household. You may wonder what to expect after coming home and how to traverse the new (and everchanging) norm.

Coming home from the hospital:

The post-childbirth period can be a challenging time of navigating one’s own healing post-delivery, while also providing care to one’s newborn (and other family members). You may have thoughts and feelings associated with the delivery, for example you may feel scared or disappointed if you intended to have a vaginal birth and instead needed to have a cesarean section, or if your baby arrived prematurely and required care in the NICU before being ready to come home. You may need support from your partner with managing your pain medication schedule initially when you arrive home following a c-section delivery since it is easy to lose track of time while caring for one’s newborn on little sleep. If one’s baby lost 10% of their birth body weight at discharge, you may be asked to bring your baby to multiple follow-up medical appointments during their initial 2 weeks of birth to monitor their weight, and you will be asked questions about their feeding and toileting schedule, which will all need to be tracked (another task to seek support from your partner towards tracking). If one’s partner is unable to provide this support, you may need to track this information using paper logs, or electronically on your phone for easy reference during these appointments, as well as set reminder alarms on your phone. Immediately after bringing baby home from the hospital, you may find that there is literally no predictable routine, with baby feeding every 2-3 hours or sometimes cycling through rapid cluster feedings, resulting in you being quite sleep deprived. Lactation difficulties during this period can be particularly stressful and lead to tears—for both baby and mother—until a solution is devised, whether through lactation consultations to support latching and feeding, breast pumping, and/or the decision to utilize formula to bottle feed baby. It takes time to develop a plan and new routine, and oftentimes that routine needs to be adjusted, sometimes multiple times throughout the course of those initial months following birth. It is important to not feel guilty if you are unable to produce sufficient breastmilk to breastfeed exclusively, or if your baby is unable to latch well; remember that you are doing everything in your power to keep baby healthy while also maintaining your own wellbeing as a mother, and you are not a failure. If able and choosing to pump exclusively, which can be very time intensive, it can be useful to ask one’s partner to feed the breastmilk bottles to your newborn, since infant feeding times may not always sync with the periodic and frequent pumping times required to build up a consistent milk supply.

Postpartum worries:

As a parent of a newborn, it’s not unusual to have some worries arise. Some first-time mothers feel a sense of panic when discharged from the hospital, wondering how they will care for their newborn on their own. The responsibility for caring for a delicate, tiny human being who is utterly dependent on you can be stressful. You may doublecheck the car seat straps multiple times to ensure that your baby is secure. You may find yourself standing over your baby’s bassinet in the middle of the night to verify that they’re breathing normally. You may worry that the milk bottle temperature is too cold or too hot. You may rightfully worry about your baby becoming ill from contact with well-meaning visitors who are eager to share in your joy and celebrate baby’s entry into the world, and you may need to tactfully communicate boundaries. You may fret that in their excitement, your older child is a little too “rough” when engaging with their newborn sibling, or you may worry about your older child’s poor adjustment to their newborn sibling. You may feel guilty about now having to divide your attention between your older child and your newborn, and you may even grieve the 1:1 time you had with your older child.

It is also typical to second-guess yourself at times, particularly if you are a first-time mother and you are offered a plethora of differing advice from well-intentioned individuals. There may be moments of feeling competent and other moments when one is feeling quite insecure as a parent. It may take time to “learn” your baby—to differentiate between their differing cries and translate their needs, to understand their preferences, and to adjust accordingly. There may be moments when you think you know exactly what works to soothe them, and suddenly they change, and you must adapt anew. It is not always easy to “go with the flow” or try to follow baby’s lead and cues, especially when one’s baby is sending some mixed, disorganized messages, but try your best and trust your instincts. And if there are times when you miss things or get things wrong, try not to beat yourself up about it. Your baby is and will be OK.

The emotional ups and downs:

Maternal emotions fluctuate moment to moment, and this is normal. You may go from feeling such intense joy, marveling at your newborn’s beautiful eyelashes while they’re peacefully sleeping, to feeling quite overwhelmed and frustrated in response to their high-pitched cries when hungry or needing a burp for the fourth time during the night, wondering why they just won’t sleep. You may shift from seeking to hold your baby continuously, cradling their perfect body in your arms, to desiring to hand them off to your partner or placing your baby in the bassinet, in order to take a much-needed break. These emotions and desires for connection and separation are quite normal and should not be taken as an automatic sign of disconnect or failed attunement to one’s newborn. Be gentle with yourself and remind yourself that you are doing your best and it’s also OK to ask for help and take a break to recharge. Everyone needs a break!

It takes a village:

Leaning on a support network during this time is critical. For parents who are accustomed to being independent and self-sufficient, it can be difficult to be vulnerable, and to accept one’s limitations and need for assistance. If you are accustomed to being the giver and caretaker in relationships, it is an adjustment to learn to ask for and accept receiving support. If you are someone whose needs weren’t always met in a consistent and predictable manner as you were growing up, it can also be difficult to trust that others will dependably come through for you and that you don’t need to “do it alone.”

For others, the challenge is not so much about asking for or accepting help, but rather, the physical distance from family and friends poses a barrier. It may be a good idea to ask if extended family and close friends can visit and stay with you temporarily after you give birth, and to stagger their visits, providing some direct care for you and your family over extended time. However, if far away from you and unable to visit, there may still be things that family and friends can do to support you—e.g. they can send gift cards for meals and diapers, ship needed items to you, call or send a quick message of support, etc. If you can afford to or budget for it, it may also be a good idea to hire help or outsource tasks, for example utilize a cleaning or laundry service, at least temporarily, until you are back on your feet and can take it on. It may be a good time to subscribe to a meal delivery service. Finally, it may be helpful to let go of unrealistic expectations during this period, such as maintaining a tidy home, making homemade meals, or keeping up with laundry, if these are tasks that you cannot get support from others within the household to complete. In time these are tasks that one may be able to fit in during baby’s nap times, but during the initial postpartum period there may be little breaks to prioritize such tasks, and that’s perfectly acceptable.

Baby Blues versus Postpartum Depression (PPD)/ Postpartum Anxiety (PPA):

Following birth, mothers go through hormonal changes which contribute to their mood fluctuations. It is not unusual to experience changes in one’s mood, including irritability and sadness, during the stressful postpartum period, especially when sleep deprived. “Baby Blues” are common during the initial postpartum adjustment period, and are transient, not requiring medical or psychological treatment. This feeling of sadness typically resolves within 1-2 weeks post-birth.

In contrast, Postpartum Depression (PPD) and Postpartum Anxiety (PPA) persist longer than 2 weeks after giving birth, and include mild to severe symptoms, requiring professional treatment. According to Postpartum Support International (PSI), 1 in 7 mothers and 1 in 10 fathers suffer from postpartum depression. They can include the following symptoms: frequent crying, mood swings, irritability, extreme fatigue, difficulty concentrating, sleep challenges, loss of sexual interest, pervasive anxiety, appetite changes, negative fearful thoughts, feelings of inadequacy, ruminating, hopelessness and despair. In addition, you may be experiencing thoughts of suicide and feelings of anger, rage, shame and guilt. If so, it is critical to inform your healthcare provider and to seek therapeutic support. Help is available and with treatment these symptoms can resolve.

Take it all in:

As you transition home and adjust to your new life with your newborn, take in the bliss of your beautiful baby and celebrate this blessing. Know that you will be undergoing hormonal changes and there will be stressors as you adapt to your new norm, and your mood may fluctuate as a result. Be kind and patient with yourself. Remind yourself that you’re doing your best and it’s good enough. Seek support as much as possible, and if you experience lasting symptoms of depression and/or anxiety, seek professional care.

How to Provide Support Following Pregnancy Loss

Pregnancy loss can be extremely devastating for a mother, couple and family. However, it is a loss that isn’t always recognized as such, or through the culturally-specific rituals following death, depending on how far along the mother was in the pregnancy. In this post, I focus on how to offer support to a grieving mother following the loss of her baby (or babies, if she was pregnant with multiples). The following is a list I’ve compiled of 12 ways to support a mother following this loss, particularly if she had been undergoing infertility treatment, which further complicates this loss:  

Help coordinate commemorative events. Know that with very early miscarriages, there may not be a burial or funeral service. However, with later stage miscarriages or stillborn babies, if you are an immediate relative or close friend of the parents of the deceased baby, help them to logistically coordinate the funeral or commemorative ritual events to honor the deceased. Coordinating between a hospital, county officials, funeral home, religious authority, and cemetery staff can be a confusing and overwhelming process and it can provide relief to the grieving parents to not have to deal with these logistics (but definitely consult with them about decision-making so they can honor their deceased baby in the way that they would like to). Sometimes the financial cost of these events is prohibitive, and if comfortable offering, ask if you can contribute financially. The mother may want to invite relatives and friends to the funeral, but not have the emotional capacity to directly make the phone calls to do so, so offer to make the calls to relay the news.

Show up. Attend the funeral or commemorative ritual events to honor the deceased and as a way to show support to the family. If the event is soon after the death, as is particularly the case for Muslims, know that the mother may be physically exhausted (and still healing physiologically from a medical procedure such as a D&C, induced delivery, emergency C-Section, etc.). She may seem emotionally numb or be flooded with grief that she openly displays, and may be unable to hold a conversation. Your presence alone can offer comfort that words do not. If you are a religious individual, offer prayers and participate in the religious rituals to honor the deceased and their family. Offer during the months to follow, to accompany the mother as she visits her baby’s grave at the cemetery (and she will let you know if she wants to do so alone). Visiting her baby’s grave is another way to demonstrate that you are legitimizing her loss, even if her baby wasn’t full-term.

Call. Reach out to the mother as soon as you hear about the loss; keep in mind that a text message may be deemed by her as inadequate given the multitude of the loss, so do the “old fashion” thing and call. If the mother isn’t ready or available to talk yet, you can leave a voicemail and it may offer comfort at a later time as she listens to it. Though it’s not always logistically possible to visit the mother, a phone or video call can be a source of connection and comfort during this difficult time. Keep calling in the months following the loss, not just right after the event. Grief is a process that takes time and it helps to know that there is ongoing emotional support for as long as one needs, not just at the moment death occurs. For the individual grieving during the months following the death, this can be an isolating time during which one interprets that everyone has moved on and is unavailable emotionally. If you know what would have been the expected delivery due date, call the mother on that date and commemorate it, as this may be a particularly emotionally challenging time for the mother because she is reminded of her loss.

Listen as the mother grieves. You may feel uncomfortable and not know the “right” thing to say and that’s ok, but do not offer platitudes that bypass the loss, such as, “Just be positive. I guess it wasn’t meant to be. God will give you more. You’re young and can quickly get pregnant again. Be grateful that through this loss God may be protecting you from a future calamity.” Women contending with infertility (whether male or female factor infertility, or both) do not have the luxury of quickly or easily becoming pregnant again; if it’s even possible it usually comes at a huge financial, emotional, and physical cost and sometimes there are additional losses along the way before there is a viable pregnancy. Don’t ask personal and triggering questions such as when she will try to get pregnant again. It’s ok to cry and demonstrate your grief at their loss, but do not make it about you to the point that they are left having to take care of your emotions. If you can sit with the mother and listen as she processes her loss, and validate her experience, she can focus on expressing her own grief and not feel alone.

Spend time in silence with the mother. There may not be words that provide comfort, but sometimes sitting in silence and being in company can help the mother not feel alone. Providing tissues, holding her hand, or offering a hug can be supportive through her tears. Know that grief comes in waves and do not be shocked at her display (or not) of emotions.

Ask what would be helpful. Respect the mother’s boundaries and don’t assume that what you think may be helpful actually is. The mother may not yet know what she needs but would likely appreciate being asked.

Give the mother space. Not all mothers want company following such an intense loss, and they may need to withdraw for a time and process what they have just experienced. Do continue to invite them to events, but don’t be disappointed if the mother needs to cancel attending social engagements for a time, particularly occasions such as children’s birthdays and baby showers that can be triggering. Sometimes the mother simply cannot tolerate the triggers or being expected to smile through the pain. Show compassion by being understanding and not displaying your disappointment or guilting them for their lack of attendance. Their withdrawal is a self-protective measure and not a measure of how they value your relationship. Don’t personalize their absence. They will resume social engagement when and if they are ready, and do not be disappointed if they can only tolerate your social event for a short time and leave the event early. Don’t be surprised if they forego baby showers completely and instead opt to mail you a gift; it doesn’t mean they don’t care about you or are unhappy or unsupportive of your pending motherhood.

Offer support with food and completing chores. Creating a “meal train” may be helpful and a concrete way to support the family (ask if they have food preferences or any allergies) through the initial weeks following a loss. The mother may not have much of an appetite but at some point she will. Offer to complete chores such as doing dishes, laundry, cleaning the home, cooking, dropping off their children to/from school, or taking their children out on playdates, particularly if the mother is still physically healing from a medical procedure and limited in terms of what she can physically handle. Some mothers may, however, not require such support and may instead throw themselves into household and parenting tasks as a means to cope with their loss, so offer specific tasks and wait for their response in order to respect their boundaries. Do not jump into caregiving that may be unnecessary and deemed as overstepping boundaries.

Send flowers and cards. It’s common in some cultural traditions to send flowers and cards. Flowers can be helpful to brighten up an environment during a bleak time. Cards with thoughtful messages can offer comfort and be helpful keepsakes for the mother long after the flowers are gone. Sometimes commemorative items such as a mom-baby necklace, or physically comforting items such as a weighted blanket and scented candles/incense can be soothing.

Provide distraction. When consumed with death and loss, it can be helpful at times to have distractions shift one’s thoughts temporarily away from the death. Don’t start with talking about your own life because that would be a misstep and can be perceived as being self-involved, mis-attuned or insensitive towards the grieving mother’s needs, but if the mother elicits those details, indulge her desire for a temporary distraction from her pain. Sometimes laughing about humorous shared memories can provide temporary relief. Sometimes taking a walk together outside of her home can be helpful to give her some fresh air and a temporary change of scenery.

Don’t treat the mother like she is fragile. You don’t need to walk on egg shells around her or completely avoid the topic of her baby’s death, which is clearly her reality. Your avoidance of the topic can actually cause more harm. Avoiding mentioning her miscarriage, for example, may result in her interpreting it as a lack of acknowledgment of her loss as real or legitimate, or demonstrate to her that you cannot get past your own discomfort to offer emotional support to her. She may also think that you clearly cannot tolerate her emotions or the topic of death/loss, and then she is left with the burden of caretaking your emotional needs, which is a role reversal. Mothers who have experienced the harrowing loss of their babies are incredibly strong and resilient, and it doesn’t help to treat them like they are broken or will break at any moment.  

Connect the mother to resources. It takes time to grieve and there is no concrete timeline for processing it, but if it’s clear that the mother is having extended difficulty functioning in her day-to-day life at home, at work, or in her relationships, it may be helpful to ask her if she needs additional support, and to provide her with a list of referrals to support groups or therapists who can provide informal and professional support. Please see my Resources page for supports related to infertility, grief, and loss.

Re-Launch and Transition to Telehealth Services

If you had asked me a year ago if I’d ever consider providing teletherapy (video-based mental health services), I would have emphatically said “no.” Fast forward 1+ years into COVID-19, and a lot has changed.

I continue to hold the traditional view and preference for in-person mental health services, when possible. There is so much gathered from in-person contact, so much that gets noticed and can be addressed in the moment when meeting in a room with a client. I have avoided providing teletherapy services in the past because I did not want to potentially miss the nuances that are picked up through in-person sessions, and the possibility of missed opportunities or connections. I also think that it is challenging, to say the least, and could be developmentally not indicated, to provide telehealth services to infants and young children (ages 0-7).

That said, after over a year of seeing telehealth provided to clients, despite the barriers mentioned, I have altered my perspective and now feel more comfortable stepping into this new format of therapy provision. I have witnessed how teletherapy services make mental health services potentially more accessible for many individuals, including those who may have barriers related to transportation or locating a culturally-matched provider in their region. I have experienced how convenient it is to simply log into a secure, video-based platform with the click of a link, and to connect virtually. I have seen platforms get upgraded and technological issues get resolved, to support seamless services without many interruptions. I have noticed clients also become more adept with the “new norm” of technology and video-based sessions with their providers. This is the new direction of mental health services and I am ready to be on board!

After taking a temporary leave of absence during 2020 mainly due to COVID-19, I have relaunched my private practice to provide exclusively teletherapy-based services. I have also now paneled as an in-network provider with Kaiser Permanente (and have maintained being paneled in-network with Blue Shield of California). It has always been my goal to provide culturally-attuned services to clients, and this new shift in my practice will allow me to reach more clients in California, and support their access to mental health services. I am looking forward to this new path!

Introducing the Muslim Moms Together (MMT) Support Group

Call to find out more about the Muslim Moms Together (MMT) support group at Early Childhood Mental Health Program (ECMHP) in Richmond, CA, that started this week…

Rumi's Poem: The Guest House

This being human is a guest-house

Every morning a new arrival.

A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.

Welcome and entertain them all!

Even if they’re a crowd of sorrows,

who violently sweep our house

empty of its furniture.

Still, treat each guest honorably.

He may be clearing you out

for some new delight.

The dark thought, the shame, the malice,

meet them at the door laughing,

and invite them in.

Be grateful for whoever comes,

because each has been sent

as a guide from beyond.

• Rumi

This is one of my favorite poems because it reminds me to be vulnerable and welcome mine and my clients’ emotions. When I meet with new clients, especially those who may be participating in therapy for the first time and are unfamiliar with the experience, they sometimes hesitate to openly and directly express emotions or share experiences. They are unsure if it is acceptable to do so. They are scared to be vulnerable. They fear judgment and being ostracized. They have been socialized that it is impolite to be so open, or in some cases, even dangerous to be so revealing. They are unsure if I can tolerate their emotions and experiences. They may have had negative experiences in the past of the listener not holding them well emotionally, and are unsure how I will react to them. They also worry that if they open up the floodgates to their emotions, they will be not be able to contain them and will become overwhelmed.

I like to think of my office as The Guest House, where I welcome clients as they are. I often wonder with clients, how can we welcome our whole range of emotions and experiences? Rather than suppressing emotions, can we be open to them all? Can we build awareness of and reflect on our emotions, sit with them for a while, and then let them pass without judgment of ourselves for feeling them? What can we learn from them? Can we be open to experiencing them all, even if it takes a lot of energy? Can we be that brave? Rather than avoiding, can we reflect on our emotions and thoughts that we suppress? Can we hold them up and examine them? Can we recognize that there are value and meaning in these thoughts and feelings? That we may have something to learn from them? Like Rumi says in his poem, can we invite them in and be grateful for them, knowing that they are sent for a purpose? I believe it takes a lot of courage, but we surely can!

How to Emotionally Support One’s Family During The Current Political Climate

The inauguration of Donald Trump as President of the United States, his reported intent to build a wall along the US-Mexican border, and his recent ban on refugees and immigrants from 7 Muslim-majority countries have ignited a sense of fear and hopelessness in marginalized communities such as African Americans, Muslims, Latinos, immigrants/refugees, and the LGBTIQ population. The far-reaching impact of policy changes on these communities is still to be seen, as events continue to unfold and Trump issues Executive Orders and restructures the government. Without a doubt those most vulnerable right now are children, who may not fully understand the nuances of current political events, but are keenly perceptive of the emotional climate within their households, schools, and communities. This article has been put together to address how to support children and families impacted by the current political climate.

Many families that have immigrated to the United States from war-torn places and/or poverty-stricken communities with hopes of building a new, safe life in the United States are no longer feeling secure. The current “Muslim ban” and discussion of borders and walls may be especially traumatizing for those individuals who have already been exposed to trauma or loss. Even individuals that have lived in the United States for generations and may be United States citizens may be feeling a sense of vulnerability and anxiety related to feeling insecure in one’s status and future stability. Research demonstrates that the rise of Islamophobia is damaging to the mental health of Muslims. Several studies indicate that anti-Muslim discrimination has been linked to higher levels of depression (Amer and Hovey, 2012; Hodge, Zidan, & Husain, 2015), anxiety, and post-traumatic stress (Abu-Ras & Abu-Bader, 2009). Many families are currently being torn apart due to travel restrictions, students are unable to return to their educational institutions, and individuals are being forced to discontinue their employment. Lives are in limbo and families are wondering how to support each other. The following are some tips for how parents can support their children:

Firstly, Consider Your Child’s Socio-Emotional Development:

Developmentally, young children neither have the mental capacity to understand all events, nor the communication skills to verbally articulate their emotions and thoughts at the level of adults. Children’s emotions may instead be demonstrated through their play, school refusal, behavior, or changes in sleeping and/or feeding patterns. Older children are better able to verbalize their fears, but still need much emotional support. Current questions and fears that children and adults may currently experience are as follows:

-       Am I and my family safe?

-       What will happen to me?

-       Who will take care of me?

-       Will we be deported?

-       Does our President and everyone hate us?

-       What do my neighbors really think of me?

-       Will we be placed in internment camps?

-       Will our overseas family still be allowed to visit us? Can we still visit them?

-       Will my classmates bully me?

-       Will my friends no longer like me?

-       How could someone so mean become president?

-       Will my religious institution be bombed?

-       Will I be stripped of my civil liberties?

Facilitate Family Discussions:

Family discussions are an important way to check in with your child and to make decisions as a family. It is important to factor in your child’s developmental stage. Use simple and clear language that your child can understand. It is important to validate your child’s emotions. Normalize that it is okay to have and express emotions and help your child label what emotion he or she is experiencing, be it fear, anxiety, anger, or sadness—or all of the above. It is okay to show your own emotions as a means of normalizing the sharing of emotions and thoughts, but do not place on your child the burden of being your emotional support. The focus of the discussion should be your child’s thoughts and emotions, rather than your own. You can let your child know that you are also experiencing those emotions, but you should stress that you are available to protect and support them. It is important to reassure your child about his or her safety, even if you are uncertain what the future holds during these unpredictable times. Know that youth and adults alike may experience a sense of alienation/isolation, a sense of helplessness or hopelessness, believing that they are insignificant and do not belong in a country that they have considered their home. Reassure your child of the goodness of society. Prompt your child to identify supportive individuals in his/her life. If your child cannot do so, provide examples for your child. For older children, consider discussions related to safety in the community and at school.

Create an Action Plan:

As a family, create an action plan for emergencies. Instruct your child to travel in groups, particularly if your child wears hijab (the Islamic headscarf). Role-play with your child how to seek assistance in various settings (i.e. home, school, community). Designate a relative or trusted family friend to care for your child if something sudden were to happen to you. Know your rights regarding how to respond in a situation when your civil liberties may be threatened. Maintain a readily-accessible resource list that includes health services, social services, legal resources, etc.

Connect with Your Child’s School:

If you are not already communicating with your child’s school, this may be a good time to do so to advocate for your child’s needs. Meet with your child’s school administration to learn about what steps they are taking to support students. Be aware of support services they may offer, such as psychologists or therapists who can meet with your child in the school setting, if needed. Be aware of the impact of Islamophobia, particularly in the form of bullying in school settings, on your child. A 2013 survey conducted by the Council on American-Islamic Relations (CAIR), demonstrated that 10% of children surveyed in California had been bullied because of their Muslim identity, and 55% of surveyed Muslim students reported experiencing at least one type of bullying (physical, verbal, or cyber bullying) (CAIR, 2013). Speak to your child about bullying, how to seek support at school if he or she is being bullied, and how to be an ally to those who may be victimized in school and other settings. If your school does not have curriculum in place for staff to address bullying, Islamic Networks Group (ING) can provide anti-bullying presentations and information to schools. The Council on American Islamic Relations (CAIR) also provides booklets for youth related to bullying and civil rights. 

Maintain Your Routine:

In times of uncertainty, it can be easy to get thrown off one’s routine and to also want to keep one’s child close. It is instinctive for a parent to want to protect one’s child, and in doing so, that parent may be tempted to keep his or her child from attending school, which can in turn be disruptive. Instead, try to maintain your family’s daily routine, as that will provide a sense of predictability and stability, thereby reducing your child’s anxiety.

Limit Your Child’s Exposure to Media:

Media (i.e. television, social media, radio stations) can provide alarming and confusing images and information. Your child may not have the capacity to process or understand this information on his or her own. It is highly recommended that you limit your child’s exposure in this area.

Connect with Your Community:

Staying connected to your local support network is critical. Visit your extended family and friends regularly and provide positive opportunities for enjoyment and bonding. In a climate of hate crimes against religious institutions, you may feel uneasy attending your local religious or community center. You may want to contact your local mosque board and learn what steps are being taken to address your safety concerns. If you are religious or spiritual, your faith leaders or faith community may provide you with a sense of reassurance, and you may also notice that engaging in your religious rituals (e.g. attending prayer services) could alleviate your fear and anxiety. Also, connecting with the larger community will help you and your family see that there are allies and advocates ready to assist you. You may experience that attending a demonstration or peaceful rally can instill within youth and families a sense of hope and belonging, thereby reducing isolation, fear, and despair. When doing so, you may need to limit how long you participate in such a rally; notice the impact on your child and if your child is feeling hungry, tired, or anxious, it is time to address your child’s needs by taking a break or returning home. You can also model for your child civic engagement by writing letters to your state representatives and sharing your concerns. Also, you may experience that serving others through volunteering your time and efforts within your local community can foster a sense of accomplishment, improved self-esteem, and connection with others.  

Report Hate Crimes and Seek Legal Consultation:

Report hate crimes with your local authority and seek legal and immigration support from legal and civil liberties advocacy groups. Organizations to consider contacting are as follows:

-       American Civil Liberties Union (ACLU)

-       Council on American-Islamic Relations (CAIR)

-       Asian Law Caucus

-       Southern Poverty Law Center

-       American Arab Anti-Discrimination Committee (ADC)

-       National Lawyers Guild

-       Arab Resource & Organizing Center (AROC)

-       Bay Area Legal Aid

Seek Professional Therapeutic Support:

Finally, if you notice that your own or your loved one’s emotional distress or behavioral challenges are persistent, professional psychotherapeutic services may be helpful. There are trained professionals available to support your psychological well-being. For Muslims in the San Francisco Bay Area, consider visiting the Bay Area Muslim Therapists website to find a therapist who can provide culturally competent services to meet your needs, and to access a community resource list. 

References:

Abu-Ras, W., & Abu-Bader, S. H. (2009). Risk factors for depression and posttraumatic stress disorder (PTSD): The case of Arab and Muslim Americans post-9/11. Journal of Immigrant & Refugee Studies, 7(4), 393-418.

Amer, M. M., & Hovey, J. D. (2012). Anxiety and depression in a post-September 11 sample of Arabs in the USA. Social psychiatry and psychiatric epidemiology, 47(3), 409-418.

Council on American-Islamic Relations [CAIR]. (2013) Growing in faith: California Muslim youth experiences with bullying, harassment, & religious accommodation in schools. http://ca.cair.com/downloads/GrowingInFaith.pdf

Hodge, D. R., Zidan, T., & Husain, A. (2015). Depression among Muslims in the United States: Examining the role of discrimination and spirituality as risk and protective factors. Social work, swv055.

About the Author

Shereen Khan-Amrikani is a Licensed Marriage and Family Therapist (LMFT) in the San Francisco Bay Area who has been working in the mental health field since 2007, providing community-based services to at-risk and emotionally disturbed youth and families. Her experience includes working with at-risk youth and families involved with the child welfare system suffering from intergenerational trauma, domestic violence, substance abuse, chronic homelessness, and/or placement within the foster-care system. As a Muslim, person of color, and daughter of immigrants, she is especially interested in topics such as spirituality, social justice, immigration and acculturation, and multicultural issues. She currently serves youth, adults, couples, and families. For more information about her services, please visit www.ShereenMFT.com.