Essays

The Origins of Ancient Rome Reveal Incredibly Sexist Social Structures

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by Namal Fiaz, March 29, 2022

The birth of the Roman Republic, which would soon transform into a vast empire with a monumental legacy, has brutal origins all beginning with a rape victim. It’s no secret the Romans were excellent storytellers; the proof is longevity. Roman myths, passed down for generations, outlived their society and continue to echo off the tongues of modern storytellers. 

The story of Lucretia is a mythological and historical tale that has survived since the early origins of Roman history, over two thousand years since its believed origins in 509 BCE. It was narrated and criticized in several different versions of works by prolific Roman writers such as Livy, Ovid, and Dionysius. Gaining popularity immediately after her death, Lucretia became a legendary symbol of beauty, virtue, and chastity. Subsequently, Roman society encouraged women, and especially young girls, to view her as a matron for model behavior. 

As the victim of the story, the glorification of Lucretia’s story after her death reveals deeper insight into the sexist roles women were expected to conform to in ancient Rome.

In Book 1 of Ab Urbe Condita, “From the Founding of the City,” Titus Livius, or Livy, a Roman historian whose works are largely viewed as reliable historical sources, recounts Lucretia’s story. Livy narrates the events leading up to the climax of her rape, as well as the aftermath and her impact on the founding of the republic. The story begins with Lucius Tarquinius Collatinus, Lucretia’s husband, and his companions drinking at the house of Sextus Tarquinius, son of the king Tarquinius Superbus, one night. The men drunkenly argue on the subject of wives, each man praising his own, and Collatinus decides that the mere sight of his wife at such late hours would put an end to the debate altogether. They mount their horses and head to Collatia, a Roman town governed by Collatinus, and into the quarters where Lucretia resides. Upon entering, Lucretia is seen weaving wool by herself by the lamplight with only the company of slave girls, unlike the other wives who had spent their night mingling and drinking with each other. This alone is meant to portray her legacy as a woman of the utmost chastity and virtue. Lucretia wins “the prize of this contest in womanly virtues”1 for her devotion to her husband and home. Sextus, intrigued by her beauty, is “seized by wicked desire”2 to conquer her modesty. 

A few days later, he returns to Collatia again, this time without Collatinus. His motives unsuspected, Sextus is welcomed to dinner in their home and is provided guest chambers for his seemingly innocuous visit. Late into the night, he enters Lucretia’s room while she is asleep. A knife in one hand, Sextus holds her down while clasping onto her breast with the other, and threatens her to comply with his wishes, otherwise he would lay the dead naked body of a male slave next to her corpse and frame her for adulterous acts. Sextus then rapes her. 

Afterwards, Lucretia, frightened and upset, sends a message to her father and Collatinus to return home with trusted companions so that she can recount all of this. All of the men are enraged by Sextus’ actions. They reassure her that “it is the mind that sins, not the body.”3 This part of the story is particularly interesting as it challenges the norms in Roman society by unexpectedly diverting blame onto the perpetrator rather than the victim who was raped. In the end though, Lucretia deeply fears that her virtue has been “ruined” by Sextus and does not wish to be an “impure” example to Roman wives. She admits that although her heart does not hold any guilt, and that she absolves herself of blame from the rape, she still cannot free herself from punishment. Lucretia reveals a knife she hid under her dress and thrusts it into her chest out of shame as Collatinus, her father, and their companion named Junius Brutus bear witness. Just before committing suicide, she urged the men to decide Sextus’ fate. It is evident she herself prefers to die before being seen as a role model to unchaste women. 

Lucretia’s rape was also the impetus of political revolution in Rome. Collatinus and Brutus led the overthrow of Sextus’s father and exiled the Tarquins from Rome. A new form of government was established in 509 BCE, with Collatinus and Brutus serving as the first pair of consuls of the Roman Republic.

Lucretia’s suicide was socially viewed as honorable by Romans, and she was subsequently immortalized as a heroine. Given that her story serves as thematic for proper behavior for women in Rome, it further reveals incredibly sexist ideals present in Roman society. Lucretia’s position as the embodiment of pudicitia, a term used to describe virtuous women, would only grow after she died. Sexual ethics were deeply conceptualized in ancient Rome; there were several intricate terms to describe one’s social as well as physical position regarding male and female sexuality. Pudicitia was a distinctly feminine descriptor of one’s character, predominantly in relation to morality and sexual fidelity. 

It is important to recognize that the male equivalent of this quality did exist in the form of virtus, meaning virtue, although not nearly to the same extent women were judged. Pudicitia was not praised as a positive ideal in men, rather, it was viewed as a neutral trait for males, and could sometimes be simply reduced to whether they acted in the dominant role in sexual relations with other men.4 Much of the explanation as to why a woman’s chastity held so much value in ancient Rome was due to the fact that it ensured they were kept “pure” for men until marriage. Lucretia’s virtue and sexual modesty was promoted as a feminine ideal through “deeply conservative and patriarchal impulse.”5  It is important to address the emphasis on virginity as men were certainly not scrutinized to the same standards. Roman girls were purposefully married young, the legal age twelve, to “ensure an undefiled body and mind.”6 This view alone amplifies the misogynistic logic used by the ancient Romans to control female sexuality and restrict freewill. 

As expected, Roman societal structures continued to subjugate women throughout the longevity of the republic and empire. The specific reasons for this perceived inferiority of women thrived on their generalization as “fragile and fickle, therefore in need of protection.”7 A plausible explanation for these rigid social structures is the historical dichotomy of men as “protectors” and women as “childbearers.” Additionally, it was a widespread belief that women were “emotional, irrational, and intellectually less capable than men”8 to the point where objections to such beliefs were controversial. In a speech written by Livy, capturing the thoughts of Cato says: “Our ancestors decided that women should not handle anything…they should always be in power of fathers, brothers, husbands. If once they get equality, they’ll be on top.”9 In contrast, Musonius, a Stoic philosopher, argued that women possessed reason and logic, were inclined towards good virtue just like men, and that “men should have as high a standard of sexual virtue as women.”10

Marriage was beyond a sufficient reason society deemed it unworthy for girls to continue their education, instead prioritizing domestic tasks and tending to the wishes of their husbands. It is also dire to address the fact that the majority of the available information about the daily lives of Roman women is provided through the lens of men, often incidental in orations or letters or poems.11 It is clear the ancient Romans did not prioritize women’s education nor urge them to contribute to literature or philosophy. The already lacking information about the daily lives of women is focused on upper class women, with scarce information about common women. In the study of classics, a field that has traditionally been dominated by men, studying the lives of ancient women was an academic priority until recent feminist perspectives concerning historical analysis emerged.

It is known that Roman women were established as subservient to men in all aspects of life; their names were technically not even their own. A Roman woman’s name was the feminine form of her father’s gentilicium during the early republic, which was passed down to all of the sisters, and also shared with aunts and cousins on her paternal side.12 Marriage was largely an social and economic proposition for both parties since the Romans rarely married for happiness and romantic love; the latter was usually reserved for extramarital affairs.

 Additionally, women had limited citizenship status, meaning they could not vote or run for public office, and in many cases their properties were under control of their father and eventually husband. Specific terms evolved for circumstances of marriage: cum manu, “with the hand,” and sine manu, “without the hand.” A woman who was married cum manu was no longer under her father’s authority, but under the legal control of her husband.13 This meant that she was under potestas, “power,” of her husband rather than her father. If she was married cum sine, which was common in the late republic, she remained under her father’s control. She needed his approval to make important financial transactions, and “might have her marriage ended by him even against her wish.”14 In a divorce, which women were allowed to bring forth under legally valid conditions, children were no longer left to her, but rather to her husband’s family. 

A woman’s influence was not acknowledged in the public sphere; they were restricted to domestic matters concerned with running the home. Such partially demonstrates why Lucretia was glorified above the other wives from the moment Collatinus and his companions found her tending to her weaving, historically one of the most domestic chores, instead of away socializing with other women. A “virtuous” Roman wife influenced by the precedent of Lucretia behaved modestly, felt great devotion to her husband and tended to his needs, and most importantly valued her chastity, and in this legendary case, above her own life.

The widespread idealization of Lucretia in ancient Rome provides insight into the way Romans viewed the social structures of gender, family life, law, and marriage. Often portrayed as a docile victim, it is clear Lucretia embodies the submissive traits women were expected to display in order to fit the status quo. Although in modern times her story is often regarded as a mere puzzle piece in the larger image of ancient Rome, it continues to raise questions regarding the position of women in a society where they were severely oppressed.

References

  1. “Titus Livius (Livy), the History of Rome, Book 1 Benjamin Oliver Foster, Ph.d., Ed.” Titus Livius (Livy), The History of Rome, Book 1, chapter 57. Accessed December 8, 2021. http://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.02.0151%3Abook%3D1%3Achapter%3D57
  2. Livy, Chapter 57.
  3. Ibid, Chapter 58.
  4. Noreña, Carlos F. “Hadrian’s Chastity.” Phoenix 61, no. 3/4 (2007): 296–317.
  5. Noreña, 301.
  6. Clark, Gillian. “Roman Women.” Greece and Rome 28, no. 2 (October 1981): 193–212. https://doi.org/10.1017/s0017383500033313.
  7. Ibid, 207.
  8. Ibid, 208.
  9. Ibid, 207.
  10. Ibid, 208.
  11. Ibid, 194.
  12. Ibid, 202.
  13. Ibid, 203.
  14. Ibid, 204.

From Criminals to Celebrities: How Women’s Fascination with Serial Killers Reflects Their Perception of Romance

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by Ayesha Azeem, March 25, 2022

People have always been interested in learning about influential people’s lives — through both gossip and the media. Whether we’re learning about Jennifer Aniston’s new fling, Kim Kardashian’s pregnancy, or Harry Styles’s secret vacation, we often interest ourselves with other people’s lifestyles, namely celebrities, because we feel as if we personally know them through our powerful admiration and devotion. We see celebrities as heroes; people we aspire to be like. But why are we so drawn to the lives of villains as well?

Recently, women have developed a strong obsession with true crime, a literary and film genre in which the author examines an actual crime and exposes the actions committed by real people; specifically, there has been a sudden fascination with serial killer crimes. This infatuation with evil reveals our desire to uncover the secrets and truth behind those who commit the horrific acts we abhor. Perhaps it fascinates us that these famous perpetrators hold such obvious disregard for morality and societal values; we feel obligated to witness the dramatic scenes unfold as a means of “preparation” for any real-life danger. 

From Ted Bundy to Charles Manson, women often find themselves deluded into romanticizing famous serial killers. We find it hard to accept that attractive people are just as capable of committing grotesque crimes as ordinary people. Recently, the Joker movie played by Joaquin Phoenix, though fictional, has captured the attention of young girls infatuated with his depressing life story and motivation to commit heinous crimes that are similar to real killers. Though women are more likely to be victims of a major crime, for some reason they feel increasingly attracted to the vile and twisted side of history, intrigued to learn about the ways in which they can face danger.

Psychologists conducted a 2010 study at the University of Illinois to investigate the relationship between gender and the true-crime audience. Psychologist R. Chris Fraley and their team discovered that women wrote 70% of the true-crime book reviews on Amazon, while men felt a greater connection to war books, writing  82% of reviews (Yates). The researchers hypothesized why women may feel an increased inclination to read more true crime and suggested that such stories can provide useful information that may help readers avoid or escape potential attacks such as murder or rape. To investigate this claim, the psychologists reviewed the summaries of the books most often reviewed by women. Further study revealed that women were more likely to read a true crime book if the victim used a clever ‘psychological trick’ to deceive and escape from their perpetrator. Unsurprisingly, women also felt attracted to true crime books with female victims. Thus, evidence strongly suggests that women tend to read more true crime books with clever female survivors because they provide a ‘guide’ of instructions as to how to avoid deadly encounters in real life. If women consume as much violence as they can in art, maybe they can escape the true violence that unfortunately lingers in our reality. 

Recently, the producers of All Killa No Filla, a British podcast dedicated to exploring the lives of serial killers, found that roughly 85% of listeners are female (Woman’s Hour). BBC Radio 4’s Woman’s Hour considered why their listeners consisted mostly of women, and invited Dr. Gemma Flynn, a criminologist at Edinburgh University, and Rachel Fairburn, co-host of the famous podcast, to explain their theories. Dr. Flynn believes that a major explanation for female true crime listeners includes women retaining an extensive fear of crime. According to Fairburn, “women love true crime because pretty much from the time that we’re very small, we’re told to be careful, look after ourselves, watch out for bad people, make sure we get home safely” (Woman’s Hour). The host suggests that society constantly attempts to protect women from danger, instilling in their minds that as long as they’re alone, they can be attacked. Thus, women tend to leave their house with a constant target on their back and safety on their minds, attracting them to true crime out of self-preservation. With the stereotype and widely held belief that women cannot walk alone at night because of possible attacks, women feel the need to protect themselves as much as possible, consuming true crime stories at the top of their list. 

The constant fear society holds regarding women as potential victims of brutal crimes stems from the media’s infatuation with blood and murder. According to a 1992 study conducted at SUNY Oswego, mass media “serves as the primary source of information about crime for up to 95% of the general public,” with approximately 50% of news coverage devoted exclusively to crime stories (Mann). With this extensive reporting on crime and violence, Americans fall victim to their availability heuristic, a mental shortcut that relies on immediate examples that come to a person’s mind when thinking of an idea or event. Because of the increased attention presented towards crime on-air, Americans may not believe that the crime rate has actually decreased over the years since all they hear about is murder, rape, and violence when they turn on their televisions. While murder rates decreased by 20% from 1993 to 1996, reporting on murder on television rose by 721%. (Mann). This affects women especially as the constant fear perpetrated by the media regarding crime and murder may be a key reason in females’ attraction towards true crime media. 

Now that we understand why women tend to reach for books labeled with the true crime genre, the compelling question needed to be answered is why women romanticize these vile human beings. After the release of Extreme Wicked, Shockingly Evil and Vile, a film on the life of Ted Bundy based on the perspective of his girlfriend, viewers went to Twitter to express their newfound admiration for the ‘misunderstood’ villain. Ted Bundy was portrayed by attractive and talented Zac Efron, only attracting more fans to the Ted Bundy “fandom,” a group of teenage girls infatuated with the killer (Donaldson). Some tweets include: “Love that conservative masculinity #TedBundy,” and “Ted Bundy is so hot… wish he killed me” (via Twitter). The women who romanticize serial killers like Ted Bundy and Charles Manson can be described as having hybristophilia, or sexual arousal “over someone committing an offensive or violent act,” as described by Dr. Katherine Ramsland, a forensic psychology professor at DeSales University. These women admire the idea of being the ‘exception’ for a damaged person; they feel the need to ‘nurture’ and ‘protect’ their powerful and evil lovers. These women fantasize about “changing” the broken part of serial killers; they want to “fix” them; usually, women who admire such behaviors have trouble with conventional relationships due to insecurities. If she dates a serial killer in jail, at least she’ll know where he is all the time (Psychology Today). Additional research indicates that women feel attracted to masculinity and may interpret serial killers’ unchecked aggression as ‘protective’ or ‘manly.’ Women may feel that these attributes will keep them safe and secure, and thus may prefer more violent mates (Perrett).

Whatever may be the reason behind women’s fascination with serial killers, this infatuation proves fatal. When Charles Manson and Ted Bundy awaited death, thousands of female fans lined up, expecting to marry these vicious men, refusing to believe their crimes simply because of their attractiveness (Sutton). The never-ending fame of attractive serial killers depicts the true danger: our inclination as human beings to automatically trust and like attractive people, simply because of their looks. Many women fell prey to Bundy and Manson’s traps simply because they might’ve misjudged them for being kind, respectable people because of their beautiful smiles or bright eyes. Though Netflix and other entertainment providers may attempt to raise awareness of real tragedies, it is important to also consider the danger of awareness. Today’s generation may be too infatuated with Zac Efron’s looks and appearance in Extreme Wicked, Shockingly Evil and Vile to realize that his charm was what allowed many to overlook his apparent misogyny and objectification of women: “Women are possessions… Beings which are subservient, more often than not, to males. Women are merchandise” (Wyman). The tales of these serial killers should serve as a warning to many women, rather than favorable romantic heroes; we really don’t know what people are like behind closed doors. We need to remind ourselves who these serial killers actually are: vile, immoral men disguised as educated, charismatic professionals; they are not compassionate or need protection – they do not feel. We must not grieve or sympathize with men that never existed.

Works Cited

Donaldson, Kayleigh. “The Sexy Killer Fandom Wars: No, Fancying Ted Bundy Is Not the Same Thing as Fancying Venom.” SYFY WIRE, 11 Feb. 2019, www.syfy.com/syfywire/the-sexy-killer-fandom-wars-no-fancying-ted-bundy-is-not-the-same-thing-as-fancying-venom.

Mann, Stephen, et al. “Crime and the Media in America.” OUPblog, 3 Apr. 2018, blog.oup.com/2018/04/crime-news-media-america/.

Perrett, David I., et al. “Effects of Sexual Dimorphism on Facial Attractiveness.” Nature, vol. 394, no. 6696, 1998, pp. 884–887. doi:10.1038/29772.

Ramsland, Katherine M. Confession of a Serial Killer: the Untold Story of Dennis Rader, the BTK Killer. ForeEdge, 2016. 

Schildkraut, Jaclyn. “Crime News in Newspapers – Oxford Research Encyclopedia of Criminology.” Oxford Research Encyclopedias, 18 Apr. 2018, oxfordre.com/criminology/view/10.1093/acrefore/9780190264079.001.0001/acrefore-9780190264079-e-32#acrefore-9780190264079-e-32-div1-1. 

Sutton, Candace. “Inside Serial Killer Charles Manson’s Deluded Fan Club.” NewsComAu, News.com.au, 9 Jan. 2017, http://www.news.com.au/world/north-america/inside-the-deluded-world-of-serial-killer-charles-mansons-fan-club-and-the-fiancee-who-says-hes-innocent/news-story/364fe75d235055d38186b3e84347d035.

Tuttle, Kate. “Why Do Women Love True Crime?” The New York Times, 16 July 2019, http://www.nytimes.com/2019/07/16/books/review/kate-tuttle-true-crime-women.html.

“Woman’s Hour – True Crime: Five Reasons Why Women Love It.” BBC Radio 4, BBC, http://www.bbc.co.uk/programmes/articles/5BQCFMQd3mPqj7YT4hlvdCL/true-crime-five-reasons-why-women-love-it.

“Women Who Love Serial Killers.” Psychology Today, Sussex Publishers, www.psychologytoday.com/us/blog/shadow-boxing/201204/women-who-love-serial-killers.

Whyman, Tom. “The Myth of Ted Bundy as a Charming Guy.” The Outline, The Outline, 5 Feb. 2019, theoutline.com/post/7043/ted-bundy-netflix-efron-handsome?zd=1&zi=godwptow.

Yates, Diana. “Women, More than Men, Choose True Crime over Other Violent Nonfiction.” ILLINOIS, 15 Feb. 2010, news.illinois.edu/view/6367/205718.

Islamophobia in the Digital Age: The Rise of a Global Mental Health Crisis

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by Farah Hasan, March 22, 2022

My phone lies face down on the table beside me, buzzing sporadically, but insistently. I ignore it, fanning myself against the mid-July heat as I attempt to concentrate on an assignment for my summer class. I drum my fingers against the desktop and whisper the words aloud to myself, trying to make sense of the convoluted sentences of the essay as the buzzing continues. What do they want? I think exasperatedly, assuming my friends are simply spamming me with memes from Instagram and funny Tiktoks. As I finish the reading passage and move on to the multiple choice questions that accompany it, I decide to spare a glance at my phone. Expecting to see Instagram direct messages (DMs) and text messages headed by my friends’ familiar usernames and contact names, I am shocked to instead see hundreds of Instagram comment notifications from unfamiliar usernames, all beginning with the common header “[Instagram user] mentioned you in a comment.” My heart racing in anticipation, I open the Instagram app and quickly scroll through my notifications. I had left a comment criticizing France’s April 2021 ban on hijabs (headscarves worn by women for religious reasons) for Muslim women under the age of 18 on a post advertising travel to the Eiffel tower, and now I see that all these comments are in response to mine. Some of them back me up, but others range from applauding France’s actions, to blatantly calling Islam backwards and incompatible with Western civilization, to attacking me as a young Muslim woman myself. I exit the app without bothering to respond to anyone and close my eyes for a second, my heart still pounding as the hate words flash through my mind repeatedly. Like me, young Muslims everywhere are exposed to Islamophobic rhetoric on the social media sites they use most, and chronic exposure to such hate inevitably takes a toll on their mental health. Online hate is not given the same coverage or attention that street-level hate crimes get, but the effects of the former may be exponentially more profound due to the wide reach of users that are present on online platforms. Actions should be taken to limit such hate speech on public platforms like social media to preserve the mental-wellbeing of users that are targeted by these remarks, even if it means limitations on the First Amendment right to free speech. 

In a case close to home, a Muslim student recently graduated from my high school in the summer of 2021 and was chosen to deliver a speech at the commencement. In her speech, she advocated for the need for understanding and peaceful coexistence during difficult times, and briefly mentioned the ongoing conflict between Israel and Palestine. This part of the speech incited infuriated outcries from the audience, rude remarks shouting at her to “go back to Pakistan” as she walked off the stage, and the creation of a Facebook group as a space for angry parents to vent and express mildly Islamophobic sentiments. Due to the convenience and ease of access, social media is frequently defaulted to as a platform for these polarizing conversations. Certain social media sites, such as Twitter, are “better-designed,” in a sense, to perpetuate hate speech and to facilitate radicalized expression. Dr. Nigel Harriman, professor at the Harvard T.H Chan School of Public Health, and a group of researchers found that 57% of students that actively used the social media sites Youtube, Instagram, and Snapchat had come across hate speech, and 12% had encountered a stranger that tried to convince them of racist beliefs (this was especially common on Youtube). Additionally, exposure to hate messages was significantly correlated to Twitter use and Houseparty use (Harriman et al., 8531). Twitter is a particularly convenient hotbed for such rhetoric, as victims that come forward to tell their stories to Twitter are simply told to block the hating account or delete their own account. In 2014, Twitter issued a statement claiming that it “cannot stop people from saying offensive, hurtful things on the Internet or on Twitter. But we can take action when content is reported to us that breaks our rules or is illegal” (“Updating Our Rules Against Hateful Conduct”). Twitter more recently updated its rules against hateful content in December 2020:

In July 2019, we expanded our rules against hateful conduct to include language that dehumanizes others on the basis of religion or caste. In March 2020, we expanded the rule to include language that dehumanizes on the basis of age, disability, or disease. Today, we are further expanding our hateful conduct policy to prohibit language that dehumanizes people on the basis of race, ethnicity, or national origin.

(“Updating Our Rules Against Hateful Conduct”)

Although Twitter has taken some necessary steps to limit hate speech, this form of harassment nonetheless still exists on this and countless other platforms, and more action must be taken to counter this.

As someone that frequents social media sites like Instagram and Facebook, I understand how detrimental the algorithms themselves can be to one’s self-esteem, but coupled with exposure to hate speech, mental health for those targeted is more likely to plummet. Although I ultimately ignored the hate comments on Instagram under the post about France, the occurrence bothered me for several days afterward, leaving me anxious, unsettled, and dealing with mild sleep difficulties to the point where I deleted Instagram for a few months. Research by Dr. Helena Hansen at NYU Langone found that victims of online hate speech are found to have elevated levels of the stress hormone cortisol, leading them to exhibit a blunted stress response as well as higher rates of anxiety, sleep difficulties, and substance use (Hansen et al. 929). Dr. Brianna Hunt at Wilfrid Laurier University found that exposure to Islamophobic rhetoric is also a predictor of social isolation and loneliness, particularly among Muslim women in Waterloo, Canada. Furthermore, the dehumanizing aspect of hate speech also incites conflicts of identity in Muslim women of color, who feel that neither their religious nor their racial ingroups accept them fully, calling for the need to address mental health for more complex cases of intersectionality as well (Hunt et al.). 

In an effort to mitigate the destructive effects of hate speech on mental health, individuals have advocated for limiting such speech, but opponents of these limitations have expressed their concerns and dissatisfaction with this movement. In the 2017 case Matal v. Tam, the Supreme Court of the United States ruled that hate speech, like regular speech, is protected under the First Amendment under the justification that “giving offense is a viewpoint” (as long as it does not directly incite violence) (Beausoleil 829). Thus, individuals opposing limitation of hate speech on social media argue that doing so would be an infringement on their First Amendment right. There is also the danger that limitations of this sort would be a step in the direction of mass surveillance and abuse of power, ultimately resulting in a power dynamic of large digital companies﹣and potentially the government﹣in stifling any and all dissent (Beausoleil 2124). Other supporting evidence includes the notion that some exposure to counter speech is needed for the development of stable mental health and that various studies have shown that limitation of hate speech does not correlate to improved social equality (Beausoleil 2125). In fact, Dr. Stephen Newman of York University points out that expression of this sort of dialogue may be integral to human personality development, and that exposure to robust forms of speech may actually improve societal dynamics by influencing democratic policy (Newman). Lastly, there is limited existing literature proving that hate speech limitation is beneficial, as regulations of this magnitude have not been implemented anywhere yet. Thus, this argument is largely based on studies that have shown the harmful effects of hate speech. 

In a growing digital age, where social media use is a part of daily life for adolescents, young adults, and even middle aged individuals, chronic exposure to hate speech such as Islamophobic rhetoric cannot be tolerated. The longer online sites and social media platforms delay addressing such sentiments, the more widespread and normalized they will become and the more detrimental the effects will be on affected individuals’ mental health. In regards to opponents’ concerns over First Amendment compromise, the First Amendment cannot be applied perfectly to the digital age, which allows for unprecedented and unanticipated reach of communication across borders, continents, and time, as posts can always be viewed and interpreted so long as they are not deleted (Beausoleil 2127). Restrictions on the right to free speech are warranted in this case, where the mental health of countless targeted individuals on a global scale are at stake. To limit the likelihood that these companies abuse their extended powers of speech limitation, restrictions should be placed on the companies’ extent of power as well (ie. restrictions should be placed on the restrictions). Rather than immediately deleting all posts and comments including hateful rhetoric (which may be impractical), social media platforms should specifically aim to disband or deactivate groups, chat rooms, and accounts specifically devoted to or frequently posting Islamophobic﹣and other hateful﹣rhetoric. On particular posts where the comment section becomes overwhelmingly belligerent and hate-fueled, social media platforms should either delete the post, delete the inflammatory comments, or disable the comment section entirely. Lastly, these social media platforms should issue public statements against hate speech like Twitter did, include them explicitly in their terms and conditions of use, and send automated warnings to users who violate conduct rules multiple times with the intent of suspending their accounts if hateful activity continues. 

Ideally, the extent to which media companies can regulate inflammatory speech should be overseen by the federal government. However, complications may arise due to matters of jurisdiction: for example, the US government may have limited say on regulation of content posted on the social media platform TikTok, as this company was founded in China. Thus, for the time being, regulations should remain on a company-to-company basis. In the short-run, it can be expected that consumer use and feedback will let companies know how effective and acceptable their policies are. 

Though many praise the advent of cyberspaces and the beginning of the digital era as a way of bringing the world closer together with connections never known before, it is difficult to fathom how connected we really are amidst the divisive and discriminatory rhetoric that is often perpetuated on the very same platforms. Hate speech is present in several different forms, including anti-Semitism, racism, homophobia, gender discrimination, and prejudice against disabled individuals. As a Muslim woman, the recent increase in Islamophobic sentiments on social media have made me realize how pervasive their effects on young Muslims’ mental health are. Therefore, I strongly encourage social media platforms to limit hateful speech and promote civil and constructive dialogue instead using the methods outlined above, even if it means a slight compromise on First Amendment rights. By merely limiting and not completely eradicating hate speech, the extent of social media companies’ power is kept in check and the potential societal benefits of exposure to antagonistic speech mentioned previously may still be experienced. Taking actions such as deleting the Instagram post about France with the barrage of inflammatory comments would be steps in the direction of greater coexistence as the Muslim high school graduate’s speech earnestly called for and promoting the benefits of global connection that the digital era originally promised.

Works Cited

Beausoleil, Lauren. “Free, Hateful, and Posted: Rethinking First Amendment Protection of Hate Speech in a Social Media World.” Boston College Law Review, vol. 60, no. 7, 2019, pp. 2101–2144.

Hansen, Helena, et al. “Alleviating the Mental Health Burden of Structural Discrimination and Hate Crimes: The Role of Psychiatrists.” The American Journal of Psychiatry, vol. 175, no. 10, 2018, pp. 929–933, doi:10.1176/appi.ajp.2018.17080891.

Harriman, Nigel, et al. “Youth Exposure to Hate in the Online Space: An Exploratory Analysis.” International Journal of Environmental Research and Public Health, vol. 17, no. 22, 2020, 8531, doi:10.3390/ijerph17228531.

Hunt, Brianna, et al. “The Muslimah Project: A Collaborative Inquiry into Discrimination and Muslim Women’s Mental Health in a Canadian Context.” American Journal of Community Psychology, vol. 66, no. 3-4, 2020, pp. 358–369, doi:10.1002/ajcp.12450.

 Newman, Stephen L. “Finding the Harm in Hate Speech: An Argument Against Censorship.” Canadian Journal of Political Science, vol. 50, no. 3, 2017, pp. 679–697, https://doi.org/10.1017/S0008423916001219.

“Updating Our Rules Against Hateful Conduct.” Twitter.com. N.p., n.d. Web. 26 Sept. 2021.

The Ugly Truth Behind Beauty

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by Iman Shah, January 20, 2022

Women and men across the world use eye pigments, blushes, lipsticks, eyeliners, and lip liners as a way to express themselves, enhancing their natural features. From a little pop of glitter in the inner corner of the eye to make the eye look bigger to a hint of shiny blush to give the cheeks a fuller look, glitter is a fundamental ingredient in a lot of makeup products. But how does the $500 billion makeup industry manage to shine all that glitters? The answer lies in a mineral found in nearly every continent, mica. Mica is utilized in makeup, but it is also used in the automotive, medical, and defense industries, making it a widely used inexpensive ingredient. The mica industry is forecasted to be worth over $700 million by 2024, yet the workers who mine and dig as a group all day in some of the poorest states of India can only hope to collectively make two dollars per day in total (Schipper and Cowan). This contrast is possible because some of these states, namely Jharkhand and Birpur, have indigenous communities living in the outskirts of the city who sieve through mud and dirt all day in the hopes of finding as much of the shiny rock as they can, and it is their only source of income. Geographically these communities live remotely and have limited access to job opportunities, basic services, schools, and businesses. Agriculture used to be another source of income, but due to increasing infertility and drought-prone soil, the only viable option is to work for long hours, digging and mining for mica and that too without any safety equipment. The conditions have irreversible consequences on adults, yet children accompany their elders to provide a helping hand, leading to a systematic cycle of poor health and poverty. Since it is the only way to earn bread and butter, an estimated 20,000 children have to work to support the multi-billion dollar industry (Schipper and Cowan). However, the problem of child labor can be significantly improved with awareness which will then promote the proper implementation of laws, economic growth, and education. Therefore, when it comes to survival and child rights, child rights should be chosen not only because it is morally right but also because in the long run, it will prove more beneficial. 

Child labor has effects that are cyclical and long-lasting. However, one of the most effective ways to combat this issue is through awareness. Awareness through different means, especially social media, can be helpful in terms of putting pressure on governments to acknowledge issues, put light on issues, and create fundraisers and donations for important causes. Makeup gurus, some of whom have millions and even billions of followers, have the immense potential to start the change. Realizing there is an issue in the first place is what will initiate the change because as a beauty influencer remarked after finding out the truth about the deadly industry, “I’m very embarrassed to only be finding out about this now” (“The Dark Secret Behind Your Shiny Makeup”). A study on social media found out how the “Red Cross received eight million dollars in donations directly from texts” in two days, illustrating the power of social media (Gao 10). Although Makeup gurus can use their influence to raise donations for these children, they can also use it to simply show their viewers how the most important ingredient in many makeup products is supplied. Influencers hold a lot of power as proven by a survey conducted by Statista which reported how “58 percent of the brand strategists and marketers surveyed report that influencer marketing will become integrated into all of their forthcoming marketing activities” (Stubb and Colliander). Makeup products that are used every day, wasted, redesigned thousands of times, without considering how this ingredient ends up in almost every makeup product. However, by simply informing viewers of the way these things happen, people can become more conscious. 

This consciousness can then in turn help pressurize companies to trace the supply chain. A major reason why child labor and abuse that is utilized to supply Mica is virtually undetected is that traders can legally get licenses to sell the mineral (Bliss 21). The supply chain goes from miners, collectors, traders, processors, exporters (Bliss 25). Therefore, since the mineral is technically purchased legally from the exporters, the rest of the process that happens behind it goes unseen. A lot of companies report that tracing the supply chain of the mineral is hard and ambiguous, but the truth is that these companies are simply not interested in tracing the origins of the chain. However, if awareness is raised amongst people, then consumers can demand greater supply chain transparency and traceability. A local activist in Jharkhand urges consumers to “Write to them [companies] and request that they disclose the source of their mica… after all, if they manage to procure the specific grades of mica required for their various products, they should be able to find out who is extracting it” (Zuckerman). Makeup buyers can usually find out if Mica is being utilized sustainably in specific products by reading the ingredients or by searching online for the brand’s sustainable-sourcing policies. Consumer awareness can make companies realize that it is worthwhile for them to start a due diligence trajectory specifically for Mica. Tracing the whole chain is difficult since these companies are not sourcing directly from the mines, but if companies and NGOs collaborate on working to end child labor, it can drastically improve the situation. 

The supply chain of Mica poses its hardships, but there are alternate resources companies can resort to which makes the eradication of child labor more possible. L’oreal, for instance, has taken an initiative to source Mica from only “legal” and “fenced” mines (Bliss 29). Similarly, other companies have resorted to Mica mines in more developed countries such as America, which comes with a higher price but a transparent supply chain. Moreover, there is also synthetic Mica, which is developed in labs. Lush, the British cosmetics company, proudly presents itself as the leader of supplying its ingredients ethically; however, in 2016 it “discovered natural Mica in a range of mica pigments it had been told were synthetic” (Bliss 30). Therefore, the development of synthetic Mica is a field that requires further research; however, it can still prove to be worthwhile putting efforts by the billion-dollar companies as it can eliminate the need for natural mica in the first place.

Awareness is imperative because it will then bring attention and aid to all the other things that need drastic changes. People will be more conscious of their actions, and they can also donate. Furthermore, NGOs and other organizations can come to these poverty-stricken areas to better the situation. One of the ways this can be achieved is through improving the traditional ways of livelihoods, specifically the agriculture system. A sustainable agriculture system ensures food security and environmental safety; it provides livelihood by providing a source of income. Given that the farming situation in these areas has suffered due to drought and ineffective and primitive techniques, NGOs can initiate a change by teaching non-traditional farming techniques which will not jeopardize the availability of the resources for future generations and still provide an alternate source of income for the villagers. These change initiatives could include innovations on water scarcity, multiple-use schemes or other community resilience, extreme water vulnerability mapping in the area, and technical options on water demand management. These initiatives can equip farmers to effectively mitigate droughts, stop using urea and DAP fertilizers, and teach methods like crop rotation, so the same nutrients are not drained from the soil throughout the year. The revival of these lands might seem unworthy; however, a UNEP report has found out that “for 42 countries of Africa the benefit of intervening to conserve is 3-26 times greater than the cost of inaction,” and those interventions came through the help of NGOs (Kumar). NGOs are very prominent and effective in implementing sustainable agriculture programs, but, on the other hand, governments can also play their role by implementing state-led land reform programs and buying crops from the local farmers at a fair price. State-led land reforms take a big piece of land and assign sections to different farmers; this leads to greater independence and possible profits for the individual farmers, avoiding the monopoly of one person controlling the lands. Government buying crops at a certain price will ensure that despite any other inconveniences that might occur, such as price drops or crop failures, the crops the farmers were able to produce are sold at a predictable and fair price. 

Eradication of child labor cannot be achieved only through the improvement of farming techniques but also through the implementation of laws and regulations. India already has laws that forbid children under the age of eighteen years from working in mines, and it is also against the UN Child Conventions (“Act now: end child labor!”). Awareness of the abuse of children in these states will urge governments to go beyond simply stating these laws in law books and implementing this law. One law that can potentially prove beneficial in this case is the legalization of mining Mica, which was made illegal in 1980 under the Forest Act. Mica is a forest resource and in efforts to conserve the environment, this law made it illegal to extract this mineral. 24,000 people who once relied on a stable source of income were left jobless (Bliss 24). Repealing this law will not only enable to formalize something which is already happening but also regulate the sector thus addressing the issues related to working conditions, minimum wages, and protective equipment. Enforcement of this law should include setting a minimum age for the mineworkers through proper documentation processes like unique identification numbers or birth certificates. The legalization of these mines would also mean that the workers do not have to work in fear of being caught all the time and illegal operators will not be holding control of the mines. Villagers get forced to work under these operators because they depend on unlicensed lenders when they need money for medical treatments or other reasons (Zuckerman). The only way to pay off the loan is by agreeing to work in these mines; hence, people get stuck in an intergenerational cycle of poverty. Furthermore, deaths in these mines usually go unreported and people are compensated with “blood money” (Makower). Therefore, the legalization of this law could also mean that deaths will be reported as there will be less fear of pursuing illegal activities under illegal operators who assert their dominance through force and brutality. However, these resolutions can only potentially occur if the law is properly enforced. 

Eradication of child labor cannot be achieved only through the implementation of laws but also to create alternate sources of income. Besides agriculture, supporting small and medium scale enterprises (SME’s) through soft loans or micro-credits (on the model of Grameen Bank in Bangladesh), promoting local cottage industries, and local, national, and international tourism can be some examples of job creation and economic activities. Skills the indigenous people already possess can be utilized to their advantage. Research conducted found that women in Jharkhand possessed skills such as “sari-making”, painting mud houses, “sewing”, and “tailor-making” (Dagar 6). However, Suyamukhi, one of the indigenous women, remarked “These items don’t sell for much” (Dagar 7). This is where awareness can be used so these products are sold on a national and international scale. Furthermore, NGOs and the government can provide further assistance to this marginalized group by teaching ways for starting a business, applying for microcredits, and navigating the market. Supporting such potential small local businesses will lead to gradual independence from the dependence these people have on mining Mica as their only source of income.

In addition, the government also needs to play its role by providing facilities to these citizens. Citizens and governments have social contracts whereby each has roles and responsibilities. If it is expected that citizens will abide by the law, then the government is responsible for providing them not only safety and security but also sources of income and provision of social services. Besides health and education, water supply and sanitation, infrastructure development particularly farm-to-market roads and broader connectivity with other parts of the state and country are important ingredients in fostering this vertical social cohesion. It would be highly recommendable that the government look into this with a different lens i.e. not only provide these services but also use it as means to create jobs for youth and unemployed persons from various strata and skills sets. Consumers and the international community can play their role by urging the government to abide by their side of the social contract so villagers then do not need to resort to unlicensed lenders or other such resources. 

Education is another imperative aspect that would again need the government’s attention and involvement to truly support the eradication of child labor. Besides traditional education, vocational and technical education needs not only to be promoted but also attractive. This can include incentivizing through free education, free books, and perhaps stipends for the students who attend and perform in their respective educational areas. However, Dr. Kumar, who researched education in Jharkhand, concluded that “doling out some incentives does not do much” (9). It is true that only providing incentives will not eradicate the overall issue of lack of education; on the other hand, there have been instances that have illustrated the effectiveness of incentives. Anjali Sinha, a researcher who has been to Jharkhand sites to collect data, witnessed in 2014 how some of the villagers willingly converted to Christianity for incentives such as certain amounts of food per month (Sinha). It is important to note though that this conversion is not only because of the incentive but also because these people want to escape India’s brutal caste system. Additionally, research in Nicaragua on poverty eradication illustrated how “school breakfasts were implemented to attract children,” which after three weeks resulted in “all eligible children” attending “school” (Blandon et al. 5). Therefore, incentives can become a channel that makes children less desperate to leave education and earn money instead. Simply providing children with a school will not solve the problem, children need to be taught in their mother tongue, at least in the primary years, in efforts to keep dropout rates low. Respectful and sensitive teachers, who are patient towards the first-generation learners, are needed. Awareness needs to be raised amongst the villagers to assure parents why sending children to school, especially girls, is beneficial for them and it will become a chief way to break the cycle of poverty. It is both in the government’s and villagers’ interest to pay attention to this aspect as education has proven to be “essential to a country’s development” (Kiross et al. 10). Many studies have proven how literacy has “been a major determinant in the rise or fall in other indicators” such as “growth rate, birth rate, death rate, and infant mortality rate”(Kiross et al. 10).

Awareness of the child labor situation in these mines has the potential to create a platform which in turn will result in consumer awareness, urging companies to either resort to alternative resources or trace the supply chain; additionally, consciousness regarding this matter can also urge government and NGOs to provide these people with different sources of income, by, for example, improving the agricultural state, and overall the government should be pressurized to play its role by providing proper facilities. However, these are all long-term initiatives that require enforcement and solving the problem from the very root. The main concern that can arise against such potential implementations is that the eradication of child labor “could increase the cost of commodities, harming the economic “comparative advantage of countries with cheap labor” which will eventually negatively impact the “poor people” (D’Avolio). Nevertheless, it is important to realize that the overall problem of child abuse in this area is complicated and deeply rooted; hence, it is going to take time and in the short term it might seem futile to pursue these actions. On the contrary, not initiating a change will keep these neglected groups of people fixated on a meager lifestyle. 

Child labor is so easily utilized in India because poor children are vulnerable and easily exploited. Children cannot form unions, go on strikes, demand breaks, and set minimum wages because children are not meant for such pursuits. They are meant for school, for playing. They are not meant to worry about whether they will be able to see tomorrow or will there be enough food on the table tomorrow. India and the global community have a responsibility to give this oppressed group of people and their children their basic rights, facilities, and resources; furthermore, the international community should not lose sight of this cause till these goals are fulfilled. The situation of this problem is difficult, deeply rooted, and complex; however, through awareness, the right resources and resolutions can be passed so the rights of the children can be chosen without hindrance by this neglected group of indigenous people.

Works Cited

“Act now: end child labor!” World Day Against Child Labour, United Nations, 2021, http://www.un.org/en/observances/world-day-against-child-labour.

Blandón, Elmer Zelaya, et al. “Breaking the Cycles of Poverty: Strategies, Achievements, and Lessons Learned in Los Cuatro Santos, Nicaragua, 1990–2014.” Global Health Action, vol. 10, no. 1, Jan. 2017, p. N.PAG. EBSCOhost, doi:10.1080/16549716.2017.1272884.

Bliss, Susan. “Child Labour in India’s Mica Mines: The Global Beauty Industry.” Geography Bulletin, vol. 49, no. 3, 2017, http://www.gtansw.org.au/files/geog_bulletin/2017/3_2017/05_GTANSW%20Bulletin%20_Issue%203%202017_Indias%20Mica%20%20mines.pdf.

Dagar, Preeti. “Vocational education and training for indigenous women in India: Toward a participatory planning approach.” International Journal of Training Research, Aug. 2021. doi:10.1080/14480220.2021.1959379.

“The Dark Secret Behind Your Shiny Makeup | Undercover Asia.” YouTube, uploaded by CNA Insider, 1 May 2021, http://www.youtube.com/watch?v=LS_CR7UwhRs&t=411.

D’Avolio, Michele. “Child Labor and Cultural Relativism: From 19th Century America to 21st Century Nepal.” Pace International Law Review, vol. 16, no. 1, 2004. digitalcommons.pace.edu/pilr/vol16/iss1/5. 

Gao, Huiji, et al. “Harnessing the Crowdsourcing Power of Social Media for Disaster Relief.” IEEE Intelligent Systems, vol. 26, no. 3, 2011, pp. 10–14. doi:10.1109/MIS.2011.52.

Kiross, Girmay Tsegay, et al. “The Effect of Maternal Education on Infant Mortality in Ethiopia: A Systematic Review and Meta-Analysis.” PloS One, vol. 14, no. 7, 2019, e0220076. doi:10.1371%2Fjournal.pone.0220076.

Kumar, Anant. “Universal Primary Education among Tribals in Jharkhand: A Situational Analysis.” Xavier Institute of Social Service, 25 Mar. 2008, files.eric.ed.gov/fulltext/ED500704.pdf.

Kumar, Pushpam. “Restoring Natural Capital Can Help Reduce Extreme Poverty.” United Nations Environment Programme, 5 Aug. 2016, http://www.unep.org/news-and-stories/story/restoring-natural-capital-can-help-reduce-extreme-poverty.

Makower, Joel. “Inside Beautycounter’s quest to transform its mica supply chain.” Greenbiz, 5 Oct. 2020, http://www.greenbiz.com/article/inside-beautycounters-quest-transform-its-mica-supply-chain.

Schipper, Irene, and Roberta Cowan. Global Mica Mining and the Impact on Children’s Rights: Executive Summary. The Centre for Research on Multinational Corporations [SOMO], Mar. 2018, http://www.somo.nl/wp-content/uploads/2018/03/NL180313_-GLOBAL-MICA-MINING-EXEC-SUMMARY.pdf. 

Sinha, Anjali. Personal Interview. 25 Sep.2021.

Stubb, Carolina, and Jonas Colliander. “‘This Is Not Sponsored Content’ – The Effects of Impartiality Disclosure and e-Commerce Landing Pages on Consumer Responses to Social Media Influencer Posts.” Computers in Human Behavior, vol. 98, Sept. 2019, pp. 210–222. doi:10.1016/j.chb.2019.04.024.

Zuckerman, Jocelyn C. “Is Your Makeup the Result of Child Labor?” Marie Claire, 17 Oct. 2018, http://www.marieclaire.com/beauty/a23722189/mica-in-makeup-controversy/.

Hijras

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by Zarya Shaikh, December 31, 2021

Spending time between Pakistan and the United States as a child, I have learned about different receptions to the LGBTQ+ community in two cultures. I thought that the first time I met a transgender individual was as a 14-year-old in America. After reading Jeffrey Gettleman’s article “The Peculiar Position of India’s Third Gender,” I realized I have met transgender individuals as early as age 8 (and possibly even earlier) in Pakistan. Similar to the Fa’afafine in Samoan culture, Hijras are individuals in Pakistan’s and India’s Muslim history who do not subscribe to a single identity as male or female.1 “Hijra” in Hindi translates to eunuchs, who are sexless individuals. They are castrated to eliminate the desire for love or lust and are meant to be sexless beings who are sexually receptive to men.1 It is important to note that not all transgender individuals in India identify as Hijras. Hijras are an entity that exists under the umbrella identity of transgender.1 During my visits to Pakistan, my family would donate money to Hijras whenever they stopped by our home or knocked on car windows. Gettleman finds that the identity of Hijras stems from a Hindu myth that Lord Rama, a Hindu god. Gettleman describes that Lord Rama “was exiled from Ayodhya and his entire kingdom began to follow him into the forest.” Lord Rama told men and women to leave him and regroup in Ayodhya.1 Hijras were known for their loyalty as they awaited Lord Rama’s return for 14 years in a folktale.1 Scholars of Hindu mythology discount the anecdote, claiming it is not in early versions of ancient Hindu texts. Regardless, the devotion of the Hijras demonstrated by the folktale is a significant characteristic of the Hijra identity.1 Before Britain’s colonization of India, Hijras were “revered as demigods.”1 Britain stripped Hijras of their identity upon colonization and enforced the binary gender system of female and male by suggesting they existed against the “order of nature” and thus criminalized “carnal intercourse.”1

In the modern-day, Hijras dress in sparkly saris and makeup while dancing and offering blessings in the streets. Indians perceive Hijras as beings with the power to bestow blessings or curses on those they meet. Radhika, a 24-year-old Hijra, shared that they were uncomfortable with resigning to a single-gender while in school. Her mother condemned these thoughts and told Radhika to “stick to” the gender binary.1 Soon after this interaction, Radhika’s parents split and her mother died. With no one else to turn to, 8-year-old Radhika met an older sex worker who made her a sex worker in a park.1. Radhika continues sex work today, as there is no other source of income. Hijras are still essential to the hierarchy of harems, which often operate like street gangs. They rely on gurus, also Hijras, who “fulfill the hybrid role of den mother, godfather, spiritual leader and pimp.”1,3 Beneath Hijras in the pyramid are chelas (disciplines) who are used to increase cash flow to the guru. For Hijras, there is not much social mobility due to restrictions placed on education and employment.2 Their rights as humans are often violated; these factors contribute to the cycle of being exploited through sex work and facing humiliation through castrations and social isolation.1 For a majority of the time following colonization, there were no modes of medical care that are easy to access. Countless deaths occurred as a result of the castrations by unqualified individuals.1 In recent years, however, India has recognized being transgender as another gender. Hijras can now undergo gender-affirming surgeries in some hospitals and access government benefits including welfare.1,2 Although this is a step in the right direction, Hijras are still considered inferior oddities who are not respected. The attitudes of society on their roles as sex workers have yet to change.

References

1 Hylton, S., Gettleman, J., & Lyons, E. (2018, February 17). The peculiar position of India’s third gender. The New York Times. Retrieved from https://www.nytimes.com/2018/02/17/style/india-third-gender-hijras-transgender.html 

2 UK Essays. (2021, August 12). The khawaja sara and hijra: Gender and sexual identities formation in post-colonial Pakistan. UK Essays. Retrieved from https://www.ukessays.com/essays/society/the-khawaja-sara-and-hijra-gender-and-sexual-identities-formation-in-post-colonial-pakistan.php?vref=1 

3 Stief, M. (2016, November 22). The sexual orientation and gender presentation of Hijra, kothi, and Panthi in Mumbai, India – Archives of Sexual Behavior. SpringerLink. Retrieved from https://link.springer.com/article/10.1007/s10508-016-0886-0#:~:text=Hijra%20are%20androphilic%20(sexually%20attracted,networks%20that%20are%20hierarchically%20organized

Music Therapy: The Art of Psychological Treatment

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by Sanjana Sankaran, December 20, 2021

Nearly 800,000 people die from suicide every year (Suicide Data). Approximately seventy percent of the American youth that struggle with depression requires treatment (The State). People with depression have a daily battle with themselves to prevent those feelings of despair and loneliness from taking over. Those living with mental health disorders may develop effective coping mechanisms to deal with their issues. Music therapy, a method of therapy and a de-stress technique for which the positive effects are not yet highly known, involves “the professional use of music and its elements as an intervention in medical, educational, and everyday environments with individuals” (Wang and Agius 595). Music therapy not only involves listening to music but also consists of thinking, analyzing, and playing it. Many people view music as a means of amusement and frivolity for those involved. Both mental health issues and the fine arts are often stigmatized in our society. In regards to mental health, several people feel the need to downplay their problems since many illnesses do not manifest with obvious physical symptoms. Hence, society issues out old cliches, suggesting that people need to learn how to ‘deal with their problems.’ In actuality, mental health can affect not only one’s mind but also one’s body and, if left untreated, can severely affect one’s quality of life. Over recent years, many have come to view the fine arts as an impractical endeavor since several jobs in this field may not lead to a stable job or income. Historically, humans have always turned to the arts to express their feelings, through music, visual arts, or the written word. Music can have a profound effect on the biochemical as well as the physiological aspects of the brain. More and more researchers today find that psychotherapeutic drugs are not as effective in treating mental health patients as they used to be, partly due to  drug tolerance. As a society, we must alter  our mindset away from  treating psychological problems exclusively through psychotherapy and drugs and must instead leverage the nontraditional method of music therapy for those  who experience daily stressors and mental health disorders.

The standard practices of mental health treatment today involve two significant methods –  psychotherapeutic drugs and psychotherapy –  both of which, given the statistics of how the rate of mental health diagnosis is accelerating, are not enough. People with mental health disorders nowadays have a lot more options as to how to treat themselves: psychotherapy, medication, case management, hospitalization, therapy groups, alternative medicine, electroconvulsive therapy, and peer support (Mental Health Treatments). In the early- to mid-1900s, methods of curing mental health ailments involved lobotomies and shock therapy. Even with all of the progress made today, a recent study shows that approximately 10 million adults in America have suicidal thoughts,  have not been able to seek treatment or have experienced both. In the past six years alone, the population of youth (ages 12-17) with depression has gone up by 4.35%, and two million kids now have major depressive episodes and need to seek treatment (The State). A team of neuroscientists from Naples, Italy found that antidepressant drug treatments are mostly ineffective for major depressive disorders. (Fornaro e. al. 494). Inefficacy can be attributed to tolerance, an anomaly that occurs when depressive symptoms reappear after previous treatment with antidepressants” with the return of depressive symptoms of MDD occurring in 9–33% of patients across published trials” (Fornaro et al. 494). Drug tolerance can build over time as the body requires higher doses of the drug  in order to have the same effect as the initial dose once did, ultimately resulting in other biological side effects. Many antidepressant drug trials tend to last shorter than 52 weeks, contributing to the  lack of understanding as to how effective these drugs will be long-term. The National Institute of Mental Health stated that 25% of 103 patients had depressive episodes. Further these patients were found to have 43 out of 171 following depressive episodes and experienced drug tolerance after a 20 year follow up (Fornaro et al. 496).   

In the book, Music Therapy in Mental Health for Illness Management and Recovery, written by Michael J. Silverman, the director of the music therapy program at the University of Minnesota, he states that “ even when medications are effective in alleviating the symptoms of mental illness, they do not necessarily facilitate psychiatric recovery as pharmacological treatments do not contribute to the development of knowledge and skills necessary for a successful transition back to the community” (Silverman 55). The state of mental health is worsening – therapies previously used for decades are now proving to be not enough in curbing  the rampant increase in prevalence of depression and other  mental health disorders. Psychiatric treatment needs to implement  a new type of therapy, like music therapy, that includes psychological interventions to analyze how people’s behavioral and thought processes have improved over  time. By seeking new methods of treatments, specifically music therapy, society will move closer towards respecting rather than ostracizing mental health patients. 

Music therapy was developed post World War I and II as a way to ease the minds of many soldiers with PTSD (Craig). Since then, this field has led to a wide range of studies, all seeking to answer the questions of how music therapy works and its purpose. If we have many different types of psychotherapy, why are neuroscientists and psychologists seeking more holistic treatments for their patients that are not guaranteed to work? Let us start with what precisely music therapy is and the basis behind it. Music therapy includes two main facets: psychoacoustics and the appreciation and hearing of music. Psychoacoustics refers to how someone perceives and comprehends music. In contrast, the brain’s mechanisms of appreciation and hearing of music is something that is developed across an entire lifespan and is influenced by many environmental factors (Craig, para. 19-20). 

There are two main methods of music therapy: listening and active playing. When  listening to music, therapists will put on music for the patient, recommended by medical experts who know about the patient’s specific case (Craig, para. 41-42). Some therapists will go down the more analytical route of listening to music. Therapists may ask questions that evoke personal thought analysis and insight. Some may also follow the Bonny method of guided imagery and music. Bonny methods consist of a patient listening to a song and seeing an image. This leads to the therapist asking specific guided questions that lead to the patient talking about their thoughts and emotions (Craig, para. 43-44). Music therapy can change a person’s attention, emotion, memory processing, behavior, and communication. A combination of all of these changes can result in  changes in neural processing that can  effectively change the biochemical state of depressed minds and improve their lives 

  Many studies prove that music therapy has been effective in treating people with mental disorders. In a  study done by Sergio Castillo-Pérez MD and his team, he states that “depression remains a major health problem and, despite using pharmaceutical agents, patients continue to report high levels of unrelieved depression” (Castillo-Perez et al. 390). This group of researchers decided to study a group of low to medium depressed people receiving  psychotherapy treatment compared to music therapy. A group of 79 patients between the ages of 25 to 60 years old were split into the two groups of therapy. The subjects chosen have never taken any psychotherapeutic drugs or have any other neurophysiological problems.  All subjects were asked to self-report their level of depression with a well-known survey known as  the Zung depression scale (Castillo-Perez et al. 387). The subjects self-reported how they were feeling age week for eight weeks. The music therapy itself involved a 50-minute self-administered music session, and once a week the participants would have a group session with doctors and other patients to provide a comfortable environment. The study controlled for stressful environmental variables that may occur such as sudden noises, changes in temperature, any environmental change or trigger (Castillo-Perez et al. 389). 

The psychotherapy administered in this study was standard conductive-behavioral therapy (CBT). At the end of the tests, the researchers quantitatively analyzed the patients’ progress with the Hamilton scale (another type of depression scale) based on their behaviors  and their self-reported scores of the Zung scale. The people with significant improvement meant they had to have a Hamilton scale of 0 to 7. The Hamilton scale was used after the 3rd, 5th, 7th, and 8th weeks. After only three weeks, within the music therapy group,  one person improved; however, none improved within the psychotherapy group.. By the end of the study, 29 subjects improved with music therapy, and only four did not. For psychotherapy, only 12 subjects improved with 16 people showing little to no improvement. These data from the Zung and Hamilton tests were also cross-referenced with the Friedman test, and showed to be statistically significant with a p-value as little as 0.0356 (Castillo-Perez et al. 389).  

As we can see, psychologists and neuroscientists today are doing more and more research regarding music therapy. Castillo-Perez’s study is just one of many examples in which music therapy has proven to improve the quality of life for people with depression more than psychotherapy. The three main methods of treatment for depression today are psychotherapy, antidepressants, and electroconvulsive therapy for severe cases. However, Perez and the rest of his team say, “Pharmaceutical treatments […] make no difference in the odds ratio of suicide attempts” (Castillo-Perez et al. 387). That is what needs to fundamentally change in how we treat and understand therapy for depressed patients. Pharmaceutical drugs will not influence the likelihood of someone committing suicide because there can be many sudden environmental circumstances and triggers. Musical therapy, on the other hand, aims to help depressed patients by trying to invoke the mesolimbic system, which correlates to positive and rewarding thoughts. As people living in  the 21st century, we can understand that there is something special about listening to new music by our favorite artists, or dancing and singing to a high energy song that can affect our minds positively. Songs can reflect how we feel and can heighten our current emotions, and this is something that medicine and therapy at a certain point cannot do as effectively as initially administered. 

As with many people who learn music from an early age, I found that playing a music instrument helped me relax and de-stress, especially after a long day of school and tests. After my piano lessons on Sundays and six-hour days at high school, I would hop on that leather bench and play Emile Pandolfi and feel my heartbeat slow down and my cheek muscles tense from all the grinning. Playing the theme from Harry Potter on the piano was my mode of artistic expression and relaxation. It is easily accessible, then, to imagine how music can help those who have severe emotional or mental disorders. To the parents of kids with mental health disorders, understand that music can be an outlet for kids to release their emotions and can have a tremendous effect on their functioning and behavior; to the kids who never seemed interested in playing music, that is okay. Part of music therapy merely involves passively listening to music in a relaxing setting. Society needs to alter its perspective on music from being misconstrued as a way of wasting time to a way of elevating one’s moods and taking a mental break.  

To truly get an insight on a student’s perspective of music and its effects on mental health, I interviewed a bandmate of mine from high school who has been playing trumpet since the fifth grade. Her lifelong appreciation of music started when she began taking piano lessons in the second grade. She then began taking trumpet lessons and joined the band in the 5th grade and has continued primarily with trumpet since then. When I asked her about her mental health, she said, “As someone who has depression and anxiety, a part of me is always anxious, and the daily fight is not letting it become a 100% of me, and using coping mechanisms to get out of it.” She had to move 350 miles for college and said that it was a difficult transition due to the workload and having to meet new people, making it difficult  to find time to relax. Being a part of the wind ensemble at her college allowed her to ease into the transition of a college student.  When asked how music has helped her with her mental state and journey, she stated, “playing music was definitely a double-edged sword. Although I had stress and anxiety from the responsibilities that came with being on the band e-board, the intrinsic joy I got from getting together with people I cared about and playing amazing music was amazing” (Anonymous). She found that listening to music gave her a sense of solace and tranquility. It allowed her mind to focus on just the music,  and in the process,  she forgot all of her anxieties and elevated her mood. The lyrics, instrumentation, and many other aspects of music therapy can reflect the emotions we feel and can elevate how we feel. Music can alter the state of chemical neurotransmitters in our minds and change our emotions – this is something drugs and psychotherapy cannot do as effectively.  

Due to social media today, music has become much more prevalent in students’ lives and has influenced the way college students handle stressful situations.A significant reason explaining  music therapy’s lack of usage is because there are many misconceptions about the way music therapy works. Music therapy Director of University Minnesota Dr. Silverman, discusses the ill-conceived notions of music therapy, stating that “a common misperception of music therapy is that it is used exclusively to treat musicians” ( 55). Silverman emphasizes that music therapy was always used to help treat people with a broad range of neurological and psychological issues among a variety of adults, children, and seniors. Another common misconception is  that music therapy is not as effective because it is merely the act of passive listening to pre-recorded music. However, music therapy is not just listening to music. Director Silverman says that in a study done comparing two groups of depressed patients who underwent passive music therapy and active music therapy, the active music therapy patients stayed throughout the sessions. Active music therapy involved lyric analysis, recreation music playing, and percussional music therapy (Silverman 55). All of this active participation served as psychological interventions that helped alter the person’s mood, behavior, and mindset.   

In a survey I administered to fellow Stony Brook Students and my fellow high school alumni who have taken part in music since a young age, I discovered their opinions on the use of music in a therapeutic way.  Of the 57 people who responded, 79% played an instrument, 22% of people said they listen to jazz or a variety of orchestral or classical music while studying, 80% of people listen to music when stressed out, and 73% of people found music to be therapeutic overall (“Music As Therapy”). 28% percent of the people I surveyed have mental health disorders such as anxiety, depression, and eating disorders. Even though the  majority of people surveyed did not have disorders, 80% of the people who deal with everyday environmental stressors choose to listen to music to cope. When asked on a scale of one to five (five being complete improvement in mood and one being mood unchanged), 31 people said they felt better after listening to music when they felt anxious, sad, depressed, or other negative emotions. 12 people say their mood completely changed for the better (“Music As Therapy”). Although these results are biased because many of these people have played an instrument, they show that a majority of students understand that music has therapeutic qualities and utilize it as a coping mechanism or a tool when experiencing stress, anxiety, or depressive thoughts. Music is a type of escapism that allows people to avoid focusing  on their current troubles and gives them the ability to focus all of their energy on one thing only – music.  

Having said all of the above, why do people still believe that conventional treatment methods are effective and do not want to change? Discussions of new treatment methods lack because people only know what is largely acknowledged in society. Mental health was and still is stigmatized because it affects one’s  mind and does not often manifest with physical symptoms like cancer. Only in the past few years has the topic of mental health been brought to the forefront. If many Americans do not wish to discuss their mental health problems, then how can new and more productive methods of treatment be used? Therein lies the existing problem that needs to change. Currently, in the time of self-quarantine, anxiety can run high even with people who have not been diagnosed with a  mental health disorder because we live in a time of uncertainty. In a time when the fear of virus spread is high and ‘stay at home’ orders are strict, quarantine serves as an obstacle for people who need weekly in-person therapy sessions. People need to utilize resources at home that are easily accessible to cope with their anxiety, like  music resources. If people are privileged enough to have access to the internet, there are a plethora of resources that can be used for music therapy, such as YouTube, Spotify, or an instrument if one has it. 

Society needs to acknowledge that music therapy is a method that has proven to be successful amongst a wide range of people with varying disorders and varying levels of depression. Well known music therapist Dr. Dany Bouchard eloquently describes how to handle anxiety during the time of COVID: “Music has a connection with memory, brings us emotions, all kinds of stuff. It is how you use it now in order to make it a music prescription” (Rowat, para. 15). Music can help with COVID-related anxiety by serving as a focusing tool that allows our mind to target what is going on now rather than worrying about an uncertain future (Rowat, para. 18). Being open to trying new modes of therapy can  be much more effective for anyone. As time goes on, some people with mental health disorders may have to increase their drug dosage due to drug tolerance that inevitably develops. At times, people who go to therapy may feel that it is not working, and can  revert to unhealthy habits and coping mechanisms. Mental health overall is something that affects people every day through their actions and their emotions. Treatment of mental health disorders is an important aspect of healthcare that needs to be improved;  it is a series of actions and behaviors one takes in order to see an actual result. Music can alter the state of someone’s mood and change someone’s behavior after prolonged daily music sessions. Additionally, the collaborative nature of music therapy allows people with mental disorders to have a massive support system on their path to recovery. Music therapy moves away from the idea persisting in mental health recovery that it is up to the person to improve themselves, and it is a solitary journey. Take 10 or maybe even 20 minutes per day to actively take part in something that involves music, whether it’s through such as playing, writing, singing, or listening.  People with mental health problems are in a daily battle  with their minds to prevent feelings of depression and anxiety from overcoming their thoughts. While psychotherapeutic drugs and therapy are helpful to an extent, music therapy can provide long term positive effects.

Works Cited

Anonymous. Personal interview. 15 April, 2020.

Castillo-Perez, Sergio, et al. “Effects of Music Therapy on Depression Compared with Psychotherapy.” The Arts in Psychotherapy, vol. 37, no. 5, Nov. 2010, pp. 387-90. ScienceDirect, doi:10.1016/j.aip.2010.07.001. Accessed 15 Apr. 2020.

Craig, Heather. “What Is Music Therapy and How Does It Work?” Positive Psychology, 18 Mar. 2020: par 1-101, positivepsychology.com/music-therapy/. Accessed 15 Apr. 2020.

Fornaro, Michele, et al. “The Emergence of Loss of Efficacy during Antidepressant Drug Treatment for Major Depressive Disorder: An Integrative Review of Evidence, Mechanisms, and Clinical Implications.” Pharmacological Research, vol. 139, Jan. 2019, pp. 494-502. ScienceDirect, doi:10.1016/j.phrs.2018.10.025. Accessed 15 Apr. 2020.

“Mental Health Treatments.” Mental Health America National, Mental Health America: par 1-10, http://www.mhanational.org/mental-health-treatments. Accessed 15 Apr. 2020.

Rowat, Robert. “We Asked a Music Therapist How to Relieve Anxiety Caused by Social Distancing.” CBC Music, 20 Mar. 2020, p. 1. CBC: par 1-23, http://www.cbc.ca/music/we-asked-a-music-therapist-how-to-relieve-anxiety-caused-by-social-distancing-1.5504973. Accessed 15 Apr. 2020.

Sankaran, Sanjana. “Music As Therapy.” Survey. 15 April. 2020.

Silverman, Michael J. “An Overview of Music Therapy as a Psychosocial Intervention for Psychiatric Consumers.” Music Therapy in Mental Health for Illness Management and Recovery, Oxford UP, 2015, pp. 60-67. doi:10.1093/acprof:oso/9780198735366.001.0001.

“The State of Mental Health in America.” Mental Health America National, Mental Health America, 2017, http://www.mhanational.org/issues/state-mental-health-america. Accessed 15 Apr. 2020.

“Suicide Data.” World Health Organization, 27 Sept. 2019, http://www.who.int/mental_health/prevention/suicide/suicideprevent/en/. Accessed 15 Apr. 2020.

Wang, Shentong, and Mark Agius. “The Use of Music Therapy in the Treatment of Mental Illness and the Enhancement of Societal Wellbeing.” Psychiatria Danubina, vol. 30, 30 Nov. 2018, pp. 595-600, http://www.psychiatria-danubina.com/UserDocsImages/pdf/dnb_vol30_noSuppl%207/dnb_vol30_noSuppl%207_595.pdf. Accessed 15 Apr. 2020.

Augusto Boal: The Madness Behind The Methods

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by Marcela Muricy, December 13, 2021

“Theatre is the most perfect artistic form of coercion.”

-Augusto Boal

Theatre is universally considered an art form, a way to embody the trials and tribulations of human emotion and virtue, and a way to speak the truths of those far too silent. Konstantin Stanislavski, for instance, was known for being a visionary of emotional discovery. He taught his actors to become the character, almost to the brink of no return (Cohen-Cruz, 2010). Bertolt Brecht then had a completely different approach: isolate the audience from emotion, and ask them to judge the conflict from the viewpoint of logic and objectiveness (Cohen-Cruz, 2010). Both became the introductory means to using theatre as a form of social change, while one man became the true pioneer: Augusto Boal. Boal — a Brazilian theatre actor, director, and playwright — created a beautiful mesh of Stanislavski and Brecht he called “Theatre for the Oppressed.” His plays were interactive and discussion-based, emotional yet objective. He is known today for opening these forms of theatre all across Europe, North and South America, and even Africa, all of which have the unique ability of creating a sense of change through critique and unity (Cohen-Cruz, 2010). For those who know him well, it is easy to admire his groundbreaking take— but for those who know Brazil, it is far easier to view him (and his methods) as revolutionary. 

Boal’s popularity unfortunately (not coincidentally) rose right alongside Brazil’s difficult transition to a dictatorship in the 1960s— so that at the height of his career in Brazil, he was assaulted and exiled for his controversial practice (1971). It’s important to acknowledge, however, that his popularity rose for a reason: his styles and methods were skillfully designed to combat the political and social turmoil within Brazil, and continue to target those issues today. 

The dictatorship, supported financially and politically by the United States, seemed ideal for many wealthy citizens who agreed with the coup. They were relieved to feel as though they could walk the streets without the fear of crime, protected by guards on every corner. For the poor or the dissidents, this was a different story entirely. People could not speak against the dictatorship, promote unity amongst the people, or offer critiques about the state of affairs. Anyone who chose to do so would be exiled, killed, or tortured for more information. (The dictatorship’s style of choice was the “macaw’s perch”, which involved tying and hanging the person upside down to wear out their limbs and rush the blood right to their head.) (Rejali, 2009). The dictatorship was not fair, not strategical, and chose personal profit over people at every given opportunity. Pablo Uchoa, whose father was a detainee, recalled these stories in a 2014 BBC article: “Many prisoners were also subjected to electrical shocks to their fingertips, genitals, and wherever else the sadistic imagination of their torturers would choose” (Uchoa, 2014). This was the setting from which Boal’s methods developed, which made them evolve from “How can we make theatre more entertaining?” to “How can we use theatre as a conduit to make a difference?” The concern of the people at the time was not entertainment— it was the pain and suffering they wished to fight against.

Boal’s theory is very involved, both mentally and physically. He wanted his audience to imagine themselves as the main character, just as many great directors do—to feel the pain, happiness, or desire that drives that person forward. Stanislavski reserved the right of “becoming the character” solely to the actors, whereas Boal wished to make everyone sense this feeling, so that the emotion became collective. His most famous method is known as “forum theatre,” during which the audience will watch the play once, consider how it could have occurred differently, watch it again, and—at their own discretion—interrupt it to suggest (or become) that change. That is, they may tell the actors how they wish for the play to be modified, or they may replace and become one of the actors themselves. The true embodiment he encouraged, it seems, is the perfect promoter of anti-military upheaval. The body’s connection to theory is what makes it powerful, as a symbol for dedicated change and action. It gives the audience a recognition of their body as power, each motion and act a new subjective lens to a complex situation. He not only wanted his people to become the characters, but to also become their own proposed solutions. In this sense, he wished for his audience to gain autonomy and independence in the context of the story and within their own lives. The Brazilian people subjected to the rule of the dictatorship—fearful of the outcome of disagreement—would have used Boal’s practice as not only a way to feel more comfortable, but also as a way to confront issues long gone unspoken. It was a way to unite the people in their mistrust, maltreatment, and dissatisfaction— all the while motivating action through reaction.

Today, Brazil’s social and political situation has not improved by much. After its shift to democracy in 1988, the nation has faced many issues with corruption, poverty, sexism, and racism. Each is as divisive and dangerous as the last, most particularly in the case of politics and corruption. In 2003, Lula da Silva ran for president, known for having had a very limited educational background and a very unfortunate life of pain and family death. This grew into a resentment of capitalism and worker treatment, and passion for politics. As a presidential candidate, he attracted people for his kindness, charisma, his humble background, and most importantly, for being someone they could trust. After years of allegations and suspicions, he was arrested for corruption in 2018 for accepting bribes worth a total of 3.7 million reais, equivalent to 1.2 million USD (Britannica, 2021). This led to riots and protests all across Brazil arguing about the validity of those allegations. They would spray paint it, scream it, put posters up, have custom door knockers, make it their wifi password, their phone case— everything: Lula Livre, they’d say. Free Lula. Or, if they disagreed, Lula Ladrão. Lula the Criminal. Jair Bolsonaro, the current president, is passionate about strong militarism and obsessed with returning to the Brazilian dictatorship (Reeves 2018). He has done countless things to incite anger from the public and believes criminals that live in favelas should “die on the street like cockroaches” (Phillips 2019). Many citizens, including Uchoa (whose father experienced it first hand) are terrified of this new reality—that Brazilians must fear the return of a dictatorship—but it is the reality of a politically, economically, and racially divided people.

“The purpose of Theatre of the Oppressed is to rehumanize humanity.”

-Augusto Boal

Methods such as Forum Theatre, then, never cease to become useful in their capability to not only change the flaws of society in the crux (government), but also the people. Boal would find random sample sizes of individuals at the park, restaurants, etc., and motivate them to theorize and discuss together, regardless of their opinions, beliefs, race, sex, sexuality, etc. They would become immersed in the theatre and feel a newfound sense of unity with one another, particularly after Boal’s “Games for Actors/Non-Actors” (Paterson 2013). During the dictatorship, the Brazilian people could discuss these issues with the cloak of just games or petty acting, coerced into developing a new sense of community identity and revolution against a dysfunctional government. These same people now, who struggle with polarization of class systems and racial exclusion, tend to remain silent and act as though they live in a racial democracy, incapable of racial tension or injustice. These same people more than ever do not understand each other’s lives and debate constantly on how to create a better future. The Augusto Boal Institute, made in his honor, continues to encourage constant reproductions or inspirations based on his work, holds panels of Boal’s relatives and colleagues, and shares important stories of his life and his time during exile. It keeps his message alive, his impact longlasting, and most importantly, it creates a space where theatre is synonymous with critique and release, with love and change, with power and unity— the very theatre Boal knew would never rest.

Works Cited

Cohen-Cruz, Jan. Engaging Performance: Theatre as Call and Response. Routledge, 2010. 

“Luiz Inácio Lula Da Silva.” Edited by The Editors of Encyclopedia Britannica, Encyclopædia Britannica, Encyclopædia Britannica, Inc., https://www.britannica.com/biography/Luiz-Inacio-Lula-da-Silva. 

“O Instituto Augusto Boal – Augusto Boal.” Instituto Augusto Boal, 2018, http://augustoboal.com.br/o-instituto-augusto-boal/. 

Paterson, Doug. “A Brief Biography of Augusto Boal.” Pedagogy and Theatre of the Oppressed, Inc., 13 Nov. 2013, https://ptoweb.org/aboutpto/a-brief-biography-of-augusto-boal/. 

Phillips, Tom. “Jair Bolsonaro Says Criminals Will ‘Die like Cockroaches’ under Proposed New Laws.” The Guardian, Guardian News and Media, 5 Aug. 2019, https://www.theguardian.com/world/2019/aug/06/jair-bolosonaro-says-criminals-will-die-like-cockroaches-under-proposed-new-laws.

Reeves, Philip. “With Memories of Dictatorship, Some Brazilians Fear a Hard-Right Turn.” NPR, 26 Oct. 2018,https://www.npr.org/2018/10/26/660984573/with-memories-of-dictatorship-some-brazilians-fear-a-hard-right-turn. 

Rejali, Darius M. Torture and Democracy. Princeton Univ. Press, 2009. 

Uchoa, Pablo. “Remembering Brazil’s Decades of Military Repression.” BBC News, BBC, 31 Mar. 2014, https://www.bbc.com/news/world-latin-america-26713772.

Physician Insecurity and Patient Expectations Drive Medical Excess

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by Ean Tam, December 8, 2021

In 2008, a seven-year-old boy complained that his stomach was in such pain that he could not sleep. The boy’s parents took him to see his pediatrician. In due time, the boy found himself in a hospital in Long Island. He was missing an entire school day, which would have otherwise been a happy occasion if it were not for the IV in his arm and the impending endoscopy—a procedure in which a small camera is inserted down his esophagus and into the stomach to check for gastrointestinal issues. The doctors could not find any explanation for the stomach pain. 

Eventually, the boy’s parents brought him to a specialist in Manhattan, who did his own tests. When all the tests seemed to be futile, the specialist asked if lactose intolerance had been considered as a possible cause. After a few days of avoiding milk, the boy’s stomach pain went away. In the end, he had no gastrointestinal issues, no infections, no serious complications; he simply could not digest dairy. Silly, right? I know. The boy was me.

Lactose intolerance is not only very common, but it also runs in my family. All my signs and symptoms indicated lactose intolerance. The evidence was there. As the saying goes, “When you hear hoof beats, think horses, not zebras.” It should not have taken three doctors and a camera down my throat to reach the proper diagnosis. So why did it?

Did my parents’ urgency for their child create a dramatic flare for the doctors? Was there a desire to take action so quickly and intensely? Maybe the doctors thought a simple answer was not satisfactory enough for my concerned parents? Maybe the multiple lab tests and procedures done on me were just the doctors’ gesture that they were trying their hardest to get an answer, no matter how convoluted and unnecessary the gesture. While this may seem ridiculous that a doctor would  offer excessive medical services just to make patients happy, it is not unheard of. In fact, it is quite common. To the detriment of the medical profession, the interpersonal dynamics of the clinic can become tangled with a physician’s fear of lawsuits.

The Power of Patient Expectations

“[W]e overprescribe antibiotics, but my own view is that I don’t really care… your goals at the end of the conversation is for both you and the mother and the baby to be satisfied.”

— Anonymous doctor 
(qtd. in Butler et al. 639)

Some doctors find symbolism in providing medical services they know are unnecessary. The doctors see their actions as doing everything they can for their patient (Rowe et al. 5). To them, the issue of overtesting and overprescribing their patients can be overlooked. Doctors have even reported that if their patient left an appointment without some kind of prescription, the doctors felt as if they had not done their job (Butler et al. 639). 

More often than not, patient expectations for their medical care are communicated to doctors implicitly rather than explicitly (Stivers 1127). Since patients are not always making their wishes clear, doctors decide to follow their gut instinct on what they believe their patients want. University of Newcastle researchers Jill Cockburn and Sabrina Pit found that if a doctor perceived their patient to be expecting medications, then the patient was ten times more likely to get a prescription (Cockburn and Pit 521). 

Now, one may say, ‘Maybe the doctor is correct. Maybe the doctor is just really perceptive, and they can tell what the patient wants without the patient saying it.’ Unfortunately, doctors are frequently wrong on this occasion. A study published in Patient Education Counseling observed that when doctors predicted a patient’s expectation for medication, the doctors were correct only 53% of the time (Jenkins et al. 276). Medications can have harmful side effects and high costs. Lab tests also bear negative consequences, especially if the tests involve radiation or high risks of false-positives. Medical services should not be given on gut instinct just to make patients happy.

However, the demand to meet patient expectations is both compelling and draining for doctors. In the short term, doctors may receive some relief in believing their patient walked away feeling fulfilled, but in the long term, the reality of not complying with standards of their medical training may kick in. In interviews with Dr. Theresa Rowe et al. of Northwestern University, doctors spoke about prescribing unnecessary antibiotics because they felt the patients desired them. One doctor remarked, “You spend 15 minutes trying to educate [patients], when they will go out disillusioned, come back the next day and see someone else, making you feel 5 minutes would be better spent just giving them a prescription and getting rid of them.” Another doctor admitted, “I do feel as though I’ve been slightly used. Sometimes slightly abused as well” (639). 

When doctors put an emphasis on patient expectations, they lose the motivation to limit medical excess, preferring to cater to customer satisfaction. Ironically, the physician makes the medical profession more mentally taxing for themselves. Now, they must walk a fine line between customer service and patient wellness. And to keep customers coming back for business, sometimes it pays to think of zebras, not horses.

Looking for Liability

“Malpractice attorneys like to say they save more lives than physicians.”

— Eric Katz, MD, MBA (329)

When we think of the healthcare we receive, we hope physicians run their medical practice faithfully, not defensively. However, an unfortunate reality is that the threat of malpractice lawsuits and mentalities such as “more is better” have made doctors weary of acting according to their medical training. Doctors would prefer to safeguard themselves with defensive medicine, ordering multiple tests or procedures that do not always make the patient feel better, but will definitely make the doctor feel better. Doctors can use tests or prescriptions as evidence that they did their job correctly and were extensive in their examination of a patient. 

At times, some of these numerous tests may alert doctors to a hidden, life-threatening illness. If we think in terms of “more is better” or “earlier is better,” then maybe the cost of defensive medicine is acceptable. However, if we prioritize the moral integrity of the medical profession, then we should not accept that some doctors direct our medical care by threat of lawsuit. Then our treatment plans are not designed exclusively for patients. Rather, doctors will begin to merge the clinic with the court, and legal opinion with patient outcome. As Johan Bester, director of bioethics at the University of Nevada Las Vegas, writes, “[Defensive medicine] represents an egregious breach of professionalism and of ethical obligations to the patient and to society” (418-419).

We should hold doctors liable for their mistakes, but we should be mindful of where the threat of liability is steering doctors’ decisions. Current trajectory suggests more defensive medicine. It would be ironic if the tool we use to hold doctors responsible for isolated incidents encourages doctors to have an irresponsible approach to treating every patient.

Conclusion

If we would like to have patient-oriented medicine, we should consider the realities in which doctors exist today. There is no magical wand to stop doctors from engaging in defensive medicine. This is more than just a patient-doctor issue. It is one that affects our economy and healthcare system: from longer wait times to more expensive medical bills. Bill Clinton said he wanted to get rid of defensive medicine in 1992. So did George Bush in 2004. And Barack Obama in 2009.

But there are realistic steps that we can take to clarify the line between patient and customer. We should be more upfront with our doctors: let them know what we expect, what our presumptions are, and what we would like done. We should not be worried about sounding stupid or wasting the doctor’s time with questions. Doctors undergo many years of medical training to give you an answer. So ask away and be frank. We cannot risk our doctors making an inaccurate assumption of our needs and then treating us accordingly. Not all of us are doctors, but all of us at some point will be patients. We do not need to be over-tested nor overprescribed. We should take up our side of the effort to prevent medical excess and preserve our doctors’ attention to us.

Works Cited

Bester, Johan C. “Defensive Practice is Indefensible: How Defensive Medicine Runs Counter to the Ethical and Professional Obligations of Clinicians.” Medicine, Health Care and Philosophy, vol. 23, no. 3, 2020, pp. 413-420.

Butler, Christopher C., et al. “Understanding the Culture of Prescribing: Qualitative Study of General Practitioners’ and Patients’ Perceptions of Antibiotics for Sore Throats.” BMJ, vol. 317, 1998, pp. 637-642.

Cockburn, Jill and Sabrina Pit. “Prescribing Behaviour in Clinical Practice: Patients’ Expectations and Doctors’ Perceptions of Patients’ Expectations—a Questionnaire Study.” BMJ, vol. 315, no. 7107, 1997, pp. 520-523.

Jenkins, Linda, et al. “Developing and Using Quantitative Instruments for Measuring Doctor–Patient Communication About Drugs.” Patient Education Counseling, vol. 50, no. 3, 2003, pp. 273-278.

Katz, Eric D. “Defensive Medicine: A Case and Review of Its Status and Possible Solutions.” Clinical Practice and Cases in Emergency Medicine, vol. 3, no. 4, 2019, pp. 329-332.

Rowe, Tiffany A., et al. “Examining Primary Care Physician Rationale for Not Following Geriatric Choosing Wisely Recommendations.” BMC Family Practice, vol. 22, no. 95, 2021, pp. 1-6.

Stivers, Tanya. “Participating in Decisions about Treatment: Overt Parent Pressure for Antibiotic Medication in Pediatric Encounters.” Social Science & Medicine, vol. 54, no. 7, 2002, pp. 1111-1130.

The Contradictory Holiday of Thanksgiving

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by Nora Rivera-Larkin, December 6, 2021

While the basis for Thanksgiving is rooted in the concept of giving back and giving thanks to the many positives in our lives as well as a way to reflect on the year, this holiday also comes with some very contradictory underlying tones. The holiday of Thanksgiving serves as a way to gloss over the struggles of many people throughout the years. The pain of the Civil War and the history of slavery, the ignored role of women in the household, and its’ use of reinforcing patriotism and distracting many from the deep sociological issues in America, are some ways that the holiday has been used to promote an exalted idea of the United States and its history. 

The first Thanksgiving, as an official national holiday, is a prime example of how the holiday has been used to smooth over the troubles of a nation. In his “Proclamation of Thanksgiving,” President Lincoln said,

“Peace has been preserved with all nations, order has been maintained, the laws have been respected and obeyed, and harmony has prevailed everywhere except in the theatre of military conflict…”

(Lincoln).

This excerpt from Lincoln’s speech shows that the establishment of the holiday was based on the concept of solidifying this idea of unity into a national holiday on the backdrop of a war that tore apart the country. Though it has a positive message and meaning, it hides the intensity of the war and the issues still rampant within the country such as institutionalized racism, the masses of freed yet unsupported slaves, and the continued resistance of the South. In a review of the holiday, history scholar Elizabeth Pleck writes, “Thanksgiving did not unify a war-torn nation, but the holiday probably did help unify the Northern side during the Civil War” (Pleck). While this new national holiday may have been an opportunity for renewed strength and power in the North, it was a conceptual holiday that paid no dues to the ongoing suffering throughout the country and did not serve as the day of remembrance and unification it was supposedly for. 

As time went on, Thanksgiving became more widely celebrated and became a day for relaxation and a positive outlook on the hard work of the past year. But it had some very sexist underlying tones: “As women in the kitchen washed the dishes, and men listened to the game, one could recognize that women (willingly) gave up their leisure, and that men and children benefitted” (Pleck). Though this situation may not be as true in current times given the many changes in the “traditional” American household, the underlying tone may still hold true. A day for celebration and relaxation is often a double-edged sword; the holiday was built on the backs of someone – whether it be a political purpose or a sexist approach – and it continues to ignore its origins and the continued work of the less fortunate. It pays no real remembrance to the work of many and has often become an egotistical holiday geared towards the more fortunate and to the men of the country. 

The final target of this holiday is children. In schools, the idea of patriotism and a sort of “happy past” is widely promoted. Oftentimes, history lessons are smoothed over to protect the image of the country and to hide its ugly truths and origins. As a land of immigrants, people saw it imperative to get children, especially immigrant children, to believe in this idea of a “golden country.” Pleck continues to analyze the teaching of this holiday in schools, writing,

The schools recognized that they had to develop an emotional bond between the immigrant and the nation, a love of country… the home was where the deepest feelings of patriotism were conveyed. Thus, the home celebration of holidays needed to be encouraged to reinforce the patriotism”

(Pleck).

Again, the holiday is twisted into a political tactic, erasing its supposed true origins and elements to form a specific idea of patriotism and unity in a child’s mind and then their home. It becomes an ignorance of struggles, of past truths, and the reinforcement of this glossy, picture-perfect holiday used to conceal its true intentions. 

It cannot be forgotten that the true pillar of the Thanksgiving holiday has been political strategy, whether to reinforce the idea of unity even in the face of war, to make an example of the power structure and imbalance between genders in the household, or to become a way to spread an idea of patriotism in the country. Thanksgiving has many ugly truths and it is important that these be taught, without the edited versions that conceal the truths of this nation. It is only when these truths are taught, when we confront our history and understand that it has been painful and unfair to so many people in this country, that we can move forward and make proper change, and hopefully celebrate a future Thanksgiving that not only gives remembrance to our most recent past year but also to the ones far before it and those who have been hurt by this holiday’s history. 

Works Cited

Lincoln, Abraham. “Proclamation of Thanksgiving.” Abraham Lincoln Online, 2018, http://www.abrahamlincolnonline.org/lincoln/speeches/thanks.htm. 

Pleck, Elizabeth. “The Making of the Domestic Occasion: The History of Thanksgiving in the United States.” Journal of Social History, vol. 32, no. 4, 1999, pp. 773–89. JSTOR, http://www.jstor.org/stable/3789891.

Today’s Crisis Standards of Care: A Death Knell for the Less-Abled

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by Vignesh Subramanian, December 3, 2021

As of November 2021, nine U.S. states – Alaska, Idaho, Montana, Washington, Colorado, Wyoming, New Mexico, Utah and Arizona – have either officially activated statewide crisis standards of care or have been on the brink of declaring their activation. The news comes as several more states, including the southern bloc of Georgia, Kentucky, Mississippi, Arkansas, and Texas, have warned that I.C.U.s are rapidly approaching capacity (Knowles). Amid waves of largely unvaccinated COVID-19 patients besieging weary hospitals, authorities have attempted to ease this burden by hastily formulating policies that will decide the relative value of human life during public health crises for decades to come. But what does all of this mean?

Crisis standards of care institute substantial changes to the delivery of healthcare services amid pervasive or catastrophic disasters, with the understanding that standard levels or quality of care can no longer be wholly provided to patient populations. In the United States, activation of these standards is formally declared by state governments and directly alters the evaluation criteria on which decisions about triage, transfers, and use of scarce resources are made. The criteria are far-reaching but vary immensely; some incorporate ‘inclusion criteria’– encouraging treatment of patients in good standing following assessments of their major organ health, life expectancy, and the order of the first-come/first-serve basis — while others also incorporate ‘exclusion criteria’– rejecting critical care for patients with low likelihood of immediate survival or poor ‘quality of life,’ or those patients for whom it is assumed that increased sustenance will not substantially provide significant benefit (Auriemma). 

Physicians’ use of this last-resort discretion can be frightening; beyond the more expected measures of postponed elective, cosmetic, and nonurgent surgeries and longer wait times in general, patients are often subject to crucial decisions made on mere whims. Physicians can send patients home to rely on inadequate in-home medical equipment, transfer them to hospice care or other centers without the appropriate specialized facilities, and even remove them from life support entirely, all over their objections. Universal ‘do-not-resuscitate’ and ‘do-not-intubate’ orders are applied as blanket protocols to all patients in cardiac or respiratory arrest if insufficient staff are available, even without consideration of patient statuses on a case-by-case basis. Ventilators are given to those who are most likely to restore their normal breathing function, nearly defeating the purpose of the devices; ambulances are not guaranteed upon emergency calls; and patients may even be denied admittance into a hospital to begin with (Chin and Harris). As the systemic capacity to treat large patient volumes shrinks, so too does sympathy for those whose lives are simply deemed worth less.

Do not resuscitate (DNR) order — A written order from a physician, issued at a patient’s request, instructing healthcare providers not to perform any form of cardiopulmonary resuscitation (CPR) – including chest compressions, cardiac drugs, or placement of a breathing tube – on the patient should respiratory or cardiac arrest occur.

(Breu and Herzig)

Do not intubate (DNI) order — A written order from a physician, issued at a patient’s request, instructing healthcare providers not to place a breathing tube to assist the patient’s breathing should respiratory or cardiac arrest occur. Unlike a DNR, a DNI still allows providers to administer chest compressions and cardiac drugs as necessary.

(Breu and Herzig)

It is therefore not surprising that crisis standards of care amount to a death knell for the less-abled. Already, reports are being made of elderly patients and those with disabilities receiving subjective evaluations of their ‘quality of life’ from their physicians in violation of civil right statutes, being denied care at hospitals without resource shortages due to mere anticipation of capacity being reached, and being pressured — especially in the cases of patients with intellectual disabilities, and in the absence of caregivers — to sign off on advance directives they do not understand. Despite their relative inability to accurately predict the long-term survival probability of patients with disabilities, or whether or not such patients will require use of greater treatment resources, many doctors and lawmakers continue to place ableist judgement above sound scientific knowledge. Of the twenty-nine U.S. states that issued crisis standards of care guidelines before or at the start of the COVID-19 pandemic, the vast majority did not include language prohibiting discrimination against elderly or disabled patients in the provision of critical care, and few used their administrative processes to close such loopholes. Some state plans actually explicitly prioritize younger patients and those without comorbidities, while others prohibit people with specific disabilities from being offered life-sustaining ventilation support or throw discretion to hospital policy (Cleveland Manchanda). Such fragmentation of standards forces the current array of disability rights groups engaged in litigation against these hospitals to base their petitions on tort law claims rather than righteous grounds of disability discrimination, leaving patients at the mercy of an indifferent medical bureaucracy.

Ableist — The quality of being prejudiced or discriminatory against individuals with disabilities.

(Neilson)

It is inexcusable that demonstrably false stereotypes about the ‘quality of life’ experienced by a patient with disabilities or old age are allowed to dictate the quality of care they receive. While the U.S. has made tangible progress towards extricating such biases from medical practice — one could certainly point to the Americans with Disabilities Act, Title VI of the 1964 Civil Rights Act, Section 504 of the Rehabilitation Act, and Section 1557 of the Affordable Care Act (DOJ, HHS) as prominent examples — those gains have evidently not been fully incorporated into the healthcare pathway. Even during a public health crisis, acute episodes of illness must not determine the relative value of a patient’s life simply because providers are under duress. Instead, moments such as these call for the best of physicians’ work ethic and equity in screening criteria and treatment allocation decisions.

Works Cited

“A Guide to Disability Rights Laws.” Civil Rights Division, U.S. Department of Justice (DOJ), Feb. 2020, https://www.ada.gov/cguide.htm#anchor64984.

Auriemma, Catherine L., et al. “Eliminating Categorical Exclusion Criteria in Crisis Standards of Care Frameworks.” American Journal of Bioethics, 18 May 2020, https://www.tandfonline.com/doi/full/10.1080/15265161.2020.1764141.

Breu, Anthony C., and Shoshana J. Herzig. “Differentiating DNI from DNR: Combating Code Status Conflation.” Journal of Hospital Medicine, Oct. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240781/.

Chin, Natalie M., and Jasmine Harris. “Examining How Crisis Standards of Care May Lead to Intersectional Medical Discrimination Against COVID-19 Patients.” Center for Public Representation, UC Davis School of Law, Feb. 2021, https://www.centerforpublicrep.org/wp-content/uploads/FINAL-Intersectional-Guide-Crisis-Care-PDF.pdf.

Cleveland Manchanda, Emily C., et al. “Crisis Standards of Care in the USA: A Systematic Review and Implications for Equity amidst COVID-19.” Journal of Racial and Ethnic Health Disparities, Aug. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425256/.

Knowles, Hannah. “Hospitals Overwhelmed by Covid Are Turning to ‘Crisis Standards of Care.’ What Does That Mean?” The Washington Post, 23 Sept. 2021, https://www.washingtonpost.com/health/2021/09/22/crisis-standards-of-care/.

Neilson, Shane. “Ableism in the Medical Profession.” Canadian Medical Association Journal, Joule Inc., 14 Apr. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7162445/.

“Section 1557 of the Patient Protection and Affordable Care Act.” Office for Civil Rights, U.S. Department of Health and Human Services (HHS), 27 Oct. 2021, https://www.hhs.gov/civil-rights/for-individuals/section-1557/index.html.