Emperor Akbar & Religion

How, if at all, was religion important in Mughal India?

     From 1206-1526, Northern India was under the control of the Delhi Sultanates.  Ruling from Delhi, the Delhi sultans began a six hundred year tradition of Muslim rule in India.  The Delhi Sultans’ long tradition of rule in India ended abruptly with the Battle of Panipat.  On 21 April, 1526, Zahir-ud-din Muhammad Babur, with his army of 12,000 warriors, defeated the much larger army of Delhi Sultan Ibrahim Lodi, and officially established Mughal reign in India.  Babur (r. 1526-1530) and his son Humayun (r. 1530-1540 & 1555-1556) continued the Delhi sultanates policies of semi-religious tolerance, but it was Ab al-Fat Jall al-Dn Muhammad Akbar (Akbar), Babur’s grandson, who crossed the religion boundary, incorporating non-Muslims into all facets of Mughal life.

      Of all the great Mughal emperors, Akbar (r. 1556-1606) is arguably the greatest of them all.  Although his successful campaigns against tribal rulers succeeded establishing his dominance over large parts of India, his true greatness resided in his ability to subdue hostilities, created by a multi-religious India.  All throughout the Mughal reign, Muslims had a large presence in India, but were nowhere near the majority religion.  Early on, Akbar was aware of the potential dangers of a Muslim ruler ruling in a Hindu dominated country.  “They were aware,” according to historian Francis Robinson, “that their rule rested on an alliance between them [Muslims] and the warrior nobles of India, most of whom were Hindus”[1].    Accordingly, he proceeded to create an empire that was based on the inclusion of all religions, while retaining Muslim control. 

      During Akbar’s reign, the Mughal Empire went through a series of dramatic changes.  In contrast to his father and grandfather’s continuation of the Delhi Sultanates policies toward non-Muslims, “…Akbar abolished the Muslim right to make slaves of prisoners captured in war, repealed a tax levied on Hindu pilgrims and later abolished the jizya[2][3].   Although Muslim leaders had traditionally relied on tax revenue from the jizya, Akbar determined the loss of revenue was worth the good will afforded him through this act. 

      Akbar’s decision to terminate the jizya, while revolutionary, was only a fragment of the changes to the government.  Upon inheriting the throne at age 13, he found himself wholly lacking in education.  While his father was a very well educated man, Akbar received little education from him, and documents from his time as emperor, led historians to believe he was illiterate.   It was Akbar’s lack of education that made his court memorable.  Akbar had a propensity for learning well beyond his formal learning, which led him to surround himself with scholars of all religions.  One of the most striking aspects of Akbar’s reign, in comparison to his predecessors, was the debates he hosted for the multi religious intellectuals at Fatehpur Sikri[4].   It was there where Akbar encouraged open discussion with the purpose of building cohesion between the different Indian religions.  Above the Mosques’ entrance is Christian scripture, demonstrating the diversity that resided within its walls.  The inscription reads, “Jesus, Son of Mary (on whom be peace) said: The World is a bridge, pass over it, but build no houses upon it.  He who hopes for a day, may hope for eternity; but the World endures but an hour.  Spend it in prayer, for the rest is unseen”[5]

       In addition to their involvements in the Mughal government, Akbar encouraged non-Muslims to be involved in Indian culture.  In the four hundred years since his death, there has been much debate over the motivations behind Akbar’s policies.   One convincing argument is that Akbar believed that in order for the empire to flourish, understanding language was vital.   Proof of this can be witnessed in the many Sanskrit writings Akbar had translated into Persian.  One such translation was the Mahabharata, which many scholars have compared to the Christian bible. Found within the covers of this significant work of literature are stories and myths fundamental to the Hindu faith.  Akbar demonstrated his religious curiosity through the translations of key texts, consequently creating a diverse Indian culture.

     In addition to literature, religiously diverse art work was appreciated during the first hundred years of Mughal rule.  Great works of art were displayed throughout the palace and government buildings, and artists, of all religions, were held in high esteem during this time period.  “ [The emperor] has painted images of Christ our Lord and our Lady in various places in the palace,’ wrote one Jesuit father, ‘and there are so many saints that…you would say it was more like the palace of a Christian king than a Moorish one.”[6].   Akbar could be found prostrating himself before religious idols, establishing a tradition of religious fusion.

     Although the Mughals implemented policies that benefited all religions, it is important to remember that India was a Muslim country, and Akbar was known to assert his religious views.  In regards to those that crossed him, “He carried a box with three compartments – one for betel; another for digestive pills; a third for poisoned pills”[7]. No one could refuse the offering from the emperor, and thus they had to suffer the consequences of their behavior.  This one example shows that, while religiously tolerant, there was little question as to who was in charge.

      India during the Mughal rule was home to many different religions, including Muslims, Hindus, Christians, Sikhs, and many smaller groups.  Even though the Mughals were not the first Islamic rulers of India, Akbar’s reign set precedence that would, if not destroy, weaken some of the traditional walls dividing the Muslims from the non-Muslims.  In addition to the taxes that were historically paid by non-Muslim inhabitants, Akbar established a tradition of a diverse government and culture.  Many theories have been promoted as to the motivations behind his policies in the time since his death, but regardless of the motivations, the first hundred years of Mughal shaped religion in India.

     

     


[1] Dalrymple, William. 2005. “‘Scholars are only now beginning to realise the extent to which the Mughal emperors adopted what most would assume to be outrightly Christian devotions’.” New Statesman 134, no. 4771-4773: 42.  (Accessed September 13, 2013) http://web.ebscohost.com.library.aurora.edu/ehost/detail?vid=7&sid=3066e09f-6f17-4e77-a885- 01f560dfc5b8%40sessionmgr104&hid=118&bdata=JkF1dGhUeXBlPWlwLHVybCx1aWQmc2l0ZT1laG9zdC1saXZl#db=f5h&AN=19179814 

[2] Jizya – a head or pole tax levied against non-Muslims.

[3] Robinson, Francis. 2007. “THE MUGHAL DYNASTIES.” History Today 57, no. 6: 22-29. (Accessed September 15, 2013).  http://web.ebscohost.com.library.aurora.edu/ehost/detail?vid=9&sid=3066e09f-6f17-4e77-a885- 01f560dfc5b8%40sessionmgr104&hid=118&bdata=JkF1dGhUeXBlPWlwLHVybCx1aWQmc2l0ZT1laG9zdC1saXZl#db=a9h&AN=25356216  

[4] Fatehpur Sikri was built by Emperor Akbar in 1569 under his close supervision.  It would serve as the capital of the Mughal Empire until 1585 when it was abandoned.

[5] William Dalyrmple, “Scholars are only now beginning to realise the extent to which the Mughal emperors adopted what most would assume to be outrightly Christian devotions’.”, 44.

[6] Ibid. 42.

[7]Wheeler, J. Talboys. “Akbar Establishes the Mughal Empire in India”, World History Center. Retrieved on 13 September, 2013. http://history-world.org/mongolakbar.htm

Freud and Psychoanalysis

Freud and Psychoanalysis

     Sigismund Schlomo Freud, better known as Sigmund Freud, was born in Austria on May 6, 1856.  One of eight children of Jacob Freud, a wool merchant, Freud’s genius and persistence took him from humble beginnings to one of the most influential men of his time.   After graduating from the University of Vienna in 1881, he began his medical career in neurology. Freud, during a long and illustrious career, demonstrated an inquisitive mind by studying a vast amount of genres, such as his analysis of Michelangelo, but he is best known for developing the Psychoanalytic Theory.    His theory, while controversial when introduced, ultimately revolutionized the treatment of neurosis.

      Psychoanalytic theory was first published in the book Studien Uber Hysterie, in 1895, written in collaboration between Freud and the prominent physician, and Freud’s close confidant, Josef Breuer.  Within the book, Freud and Breuer hypothesized that, “…hysterical symptoms originate through the energy of a mental process being withheld from conscious influence and being diverted into bodily innervation (“Conversion”)” (Freud, 2013).   The task of perfecting his methods of treatment would utterly consume his thoughts and actions throughout the rest of his life.  Although he would treat many sick patients during his career, the case of Anna O, illustrated in this book, would prove as the corner stone of his theories.

     Anna O was initially a patient of Breuer, but would become synonymous with the name Sigmund Freud.   Anna O presented Breuer and Freud with puzzling symptoms.   After taking care of her ailing father, “She developed a bad cough that proved to have no physical basis.  She developed some speech difficulties, then became mute, and then began speaking only in English, rather than her usual German” (Boeree, 2000).   After analyzing her, Freud determined that all hysteria derives from a traumatic event (i.e. Anna’s father), and ultimately has its base in sexual desires.  Although psychoanalytic theory doesn’t revolve around Anna O, three of the main aspects, repression, instincts, and transference, can be witnessed through this one crucial patient.

Repression

     One of the most important and widely accepted aspects of Freud’s psychoanalytic theory is repression.  Repression is considered to be the patients attempt to fight back their urges and wants, in order to satisfy the needs of the unconscious.  Freud, unlike many of his colleagues, believed that all repression begin early in the person’s life.  According to Freud, “repression is the corner-stone on which the whole structure of psycho-analysis rests. It is the most essential part of it” (Zepf, 2012).   Freud believed that without acknowledging the patients repressed feelings, the path to recovery would forever be blocked.

     Repression involves the distinction between the conscious and unconscious minds.  Freud believed that within every person existed conscious thought, what we see, and unconscious thought, our unseen drives.  “In many cases”, according to Freud, “they succeed in making their influence felt by circuitous paths, and indirect or substitutive gratification of repressed impulse is what constitutes neurotic symptoms” (Freud, 2013).  Past events have been repressed deep inside of the unconscious, and it is the job of the analyst to get the patient to bring the events to the conscious mind.

     In order to determine what lies inside the patient’s unconscious, dream interpretation was the viable option for discovery.   Shortly after publishing his book featuring Anna O, Studien Uber Hysterie, Freud had one of his most important dreams. The dream Freud had, referred to as the Injection of Irma dream, involved Freud and his patient Irma.  In short, the dream was about a patient getting improper medical treatment.  After analyzing the dream, Freud determined that it meant that the treatment that Anna O received from Breuer was not proper.  Thus, “…both the dream and  its interpretation form  whole, which, if properly analyzed, could offer a significant insight not only into Freud’s unconscious, but also into the structure of the unconscious in general” (Kovacevic, 2013).   The importance of the Anna O case, in regards to how Freud’s understood repression, was imperative, but the interpretation of the Irma dream is imperative to other aspects of psychoanalysis as well.

Instincts

       Along with revealing the importance of repression, the Irma dream shows how a person’s instincts interact.   Within psychoanalysis, Freud put great importance on a patient’s ego. Within each human being, there are three types of egos; the id, the ego, and the superego.  Although all parts of the ego work together, they each play a distinct role in every individual.  The different functions of the three parts of the ego are: the id is based on pleasure principles; the ego is based on reality principles; and the super ego is the patients conscious.  Freud believed that, in a healthy patient, that it was the job of the ego to balance the needs of the id, and not upset the super-ego (2011).

     Along with the id, ego, and super-ego, Freud emphasized the role of the sexual instincts.  Many experts believed, and still believe, that sexual desires and instincts begin at the first sign of puberty, but Freud would argue that they are wrong.  He believed that sexual urges start at a very young age, and have a fundamental effect on the person.  Freud believed that it was the patients, such as Anna O, libido that played a large role in their conscious and unconscious decisions.  “The infantile fixations of the libido” states Freud, “are what determine the form of neurosis which sets in later” (Freud, 2013).  Thus sexual instincts have a large effect on the person’s ego, and how the three different parts interact with each other.

     As in the revelation of repression and instincts, the Irma dream played a vital role in the discovery of the sexual instincts.   After analyzing his dream, it can be determined that, “everything blends in and becomes associated in this image, from the mouth to the female sexual organ . . . [it is] the flesh one never sees, the foundation of things…” (Kovacevic, 2013).   Interpretation of the dream, demonstrates that Freud’s sexual instincts are rising to the top of his unconscious.  These urges, apparent during the patients dream state and during analysis, determine the person’s actions during therapy, and ultimately leads some patients to develop neurosis.

Transference

     While repression and instincts play vital roles in the psychoanalytic theory, the largest, most controversial part for Freud was transference.   According to the psychoanalytic theory, “transference refers broadly to patterns of thought, feeling, motivation and behavior that emerge in the therapeutic relationship and reflect enduring aspects of the patient’s personality and interpersonal functioning “(Bradley, 1963).   Transference, according to Freud, is a fundamental part of the patients psyche, and is an obstacle the analyst has to overcome.  What made the theory so controversial was that he believed, like most other part of his theory, that all transference is sexual in nature.

     According to Freud, there are two types of transference: loving transference and hostile transference.  Loving transference, the most common form, is the form that is most likely to aid in the recovery of the patient.  While far less common, hostile transference was prevalent in the Anna O case study.   In this intriguing case, Freud believed that that Breuer failed to completely heal her because he failed to recognize her transference.   Not long after finishing up treatment, Breuer was summoned to Anna’s house.  Upon entering the room, he found her upon the bed, in excruciating pain.  In a fit of pain, she yelled “Now comes Dr. B’s child.  Recognizing a pseudocyeis (hysterical pregnancy), Breuer hastily hypnotized her to remove the symptoms and fled the house.” (Kaplan, 2004)  Freud believed that the treatment failed solely because of his failure to recognize that her unconscious was using deference in order to sabotage the healing.

      Although each individual case of transference is different, the resistance itself has two distinct problems.  The two problems are, “…more neurotic people have more thwarted libido, and therefore, a more intensive transference…and …transference becomes the strongest resistance against treatment in psychoanalysis- in spite of being originally an important bearer of healing and condition for success” (Haan, 2011).   In other words, the biggest problem with transference is transference itself. 

      In Freud’s vision for psychoanalytic theory, repression, instincts and transference play large roles, but are by no means the only aspects.  I chose to write on this topic because I feel that the understanding of the basic aspects of psychoanalysis is important for anyone interested in psychology.  For many decades Freud’s work was held in high esteem, but unfortunately, Freud’s evidence he used in creating his theory was not based on the proper evidence, so much of his work has been discredited over the last several decades.  “With the invention of tools like the PET scan that can map the neurological activity inside a living brain, scientists discounted the windy speculations of psychoanalysis and dismissed Freud himself as the first media-savvy self-help guru” (Guterl, 2012).   Although many psychologist and psychiatrist do not adhere to the psychoanalytic theory, Freud’s work was pivotal in enlightening generations of new psychologists.   Within the psychological and academic world, Freud will always be known as an innovator, and the father of psychoanalysis. 

 

 

Reference

Boeree, George C. (2000). Freud and psychoanalysis.   Shippensburg University.  Retrieved

            from http://webspace.ship.edu/cgboer/psychoanalysis.html

Bradley, Noel (1963).  Psychoanalysis and psychodynamics.  American Psychologist,

Vol18(10), Retrieved from  http://web.ebscohost.com/ehost/detail?vid=8&sid=51a4aa30-c8a7-4ea3-9e61-e6b24cb15698%40sessionmgr110&hid=127&bdata=JkF1dGhUeXBlPWlwLHVybCx1aWQmc2l0ZT1laG9zdC1saXZl#db=pdh&AN=2005-11640-013 

Freud, Sigmund (2013).   Psychoanalysis: Freudian school.   Retrieved from

http://haverford.edu/psych/ddavis/p109g/freud.psa.html  

Guterl, F (2002). What Freud got right: his theories, long discredited, are finding support from

            neurologists using modern brain imaging.  Newsweek, Vol11 (140), Retrieved from

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,uid&db=rzh&AN2003022375&site=ehost-live  

Haan, Erik de (2011). Back to basics: How the discovery of transference is relevant for coaches

and consultants today.  International Coaching Psychology Review, Vol6 (2), Retrieved from http://www.google.com/url?sa=t&rct=j&q=Back+to+basics%3aHow+the+discovery+of+transference+is+relevent+for+coaches+and+sonsultants+today&source=web&cd=1&cad=rja&ved=0CC8QFjAA&url=http%3A%2F%2Fwww.ashridge.com%2FWebsite%2FIC.nsf%2FwFARATT%2FBack%2520to%2520basics%3A%2520How%2520the%2520discovery%2520of%2520transference%2520is%2520relevant%2520for%2520coaches%2520and%2520consultants%2520today%2F%24file%2FBackToBasics.pdf&ei=LBMAUuOWJcy6yAHkkYGoCA&usg=AFQjCNEofC-soxR823eXdkjbaimvidqMUA&bvm=bv.50165853,d.aWc   

Zepf, Siegfried (2012).  Repression and substitutive formation: The relationship between

Freud’s concepts reconsidered.   Psychoanalytic Review, Vol99 (3), Retrieved from http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,uid&db=psyh&AN=2012-15014-005&site=ehost-live

Kaplan, Robert (2004). History O Anna: being Bertha Pappenheim-historiography and

            biography.   Australasian Psychiatry, Vol12 (1), Retrieved from

http://search.ebsohost.com/login.aspx?direct=true&AuthType=ip,url,uid&db=a9h&AN=12378119&site=ehost-live  

Kovacevic, Filip (2013).  A Lacanian approach to dream interpretation.  US: Educational

            Publishing Foundation, Vol23 (1), Retrieved from

http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,url,uid&db=pdh&AN=2013-09854-002&site=ehost-live

(2011). Freud’s psychological and topographical model.  Allpsych Online. 

            Retrieved from http://allpsych.com/psychology101/ego.html

Bahrain’s Struggle for Democracy

Bahrain’s Struggle for Democracy

            The Middle East country Bahrain, situated in the Persian Gulf, has a fascinating history of being sought after for its location.  Its strategic location, situated between the much larger countries of Iran, Iraq, and Saudi Arabia, has led to many countries relying on them for security.  Starting as early as the 6th Century B.C.E., Bahrain was a part of the Persian Empire, vitally important for its position on their trade routes.   Although large empires would come and go throughout the centuries, Bahrain’s location would continue to be a vital aspect of trade between the Arab countries and western countries.

In 1861 Britain signed a protectorate treaty with Bahrain, officially declaring that the small island was under the powerful British Empire’s protection.  “From 1861, when a treaty was signed with Britain, until independence in 1971, Bahrain was virtually a British protectorate.”[1]  While the country would be considered, in theory, free to govern itself, Bahrain would be ruled with the support of other nations, by the Khalifa family.  The Khalifa family, a part of the Sunni religion, ruled Bahrain with an iron fist.  The family’s violent treatment of the citizens, in combination with broken promises of reform, ultimately led to high tensions in the country.  Tensions finally culminated in mass protest demonstrations, starting on February 14, 2011.

From 1971 to the present day, the Khalifa family has caused great suffering on the Shiite Muslim citizens.  As is the cause for many other Muslim Middle Eastern countries, tensions between the Sunni Muslims and Shiite Muslims have been incredibly high since the 7th century.  Since the death of the prophet Muhammad in 632 C.E., there have been arguments about the process of choosing the prophet’s successor, and what criteria should be used in deciding on who should lead the religion.  The argument, simplified for the purpose of this paper, can be disentangled to whether or not the leader should be a direct descendant of Mohammed.  The argument made by the Sunnis is that the religious leader should be elected.  In contrast to the Sunnis, the Shiites argument is that the leader’s lineage needs to be in line with Mohammed.  The differences of opinion have been an ongoing dispute within the religion, and have led to great unrest in the region.

Bahrain, a country that has a population which is seventy percent Shiite, is ruled by a family that is Sunni.[2]  The Shiites have been persecuted for decades by the ruling Sunnis.  While in countries such as Egypt, the two groups have succeeded in creating an environment which provides relative peace for the two sects of Islam.  The discrimination has been abhorred by the majority religion in Bahrain for many years.  Until recently it had been regarded as just a fact of life.  The Shiites have had to accept employment challenges, along with violent outbreaks from the government since 1971.  In the 1990’s, during a protest in which both Sunnis and Shiites both took part for the promotion of democracy, the Bahraini Shiite Muslims were singularized by the regime as the guilty party.   It was during these protests that “… all people who were killed or injured, and all of the many thousands who were arbitrarily arrested and tortured were Shi’a.”[3]

 

            The persecution of the protestors by the government did not stop the wide spread dissension amongst the public, and in 2001 King Hamad was forced to make a promise to bring about changes.  The promise he made was “…to turn Bahrain into a kingdom and the emir into a king. In return, the dreaded state of emergency law would be ended, and a parliament with full legislative powers would be instated.”[4] Although the opposition was happy for a short time, it would not last long, and in 2002 the king reneged on his promise.   Instead of relinquishing power to parliament, he gave himself the power to veto any bills passed that he did not think fit for the country.  This meant that King Hamad and the Sunni Muslims once again were in sole possession of the power.

            The anger over King Hamad’s failed promise would fester in the public until 2011 when they would take the street in protest against the regime.  Like their counterparts in Egypt and other Arab nations during this time period,

“The current wave of protests originated from 14,000 young people on Facebook. They represent a new generation, fed up with the impasse between the al-Khalifa clan and the older Shia leadership. The chant today on the street is: “No Sunni, No Shia, just Bahraini!”[5]

 

The Bahraini youth, belonging to democratic organizations, took a page from the Egyptians, and utilized social media in order to build up support for the creation of a truly democratic country.  The use of social media, in countries where communication was strictly monitored by the government, was directly responsible for the organization of the protest groups.

 

            Despite the fact that the goal of all the protest groups was to wrestle power away from the Khalifa family, there were multiple groups of protesters.  Similar to the religion of the Middle East, the groups were broken up into several different sects.  The two largest groups were the al-Wefaq party and the al-Haq party.   Both of the parties, although differing in their methods, protested against the horrendous way in which the Khalifa Family treated the people, and fought for a more equal share in power.  In 2002, After King Hamad reneged on his promises to allow more political freedom, opposition groups began to act against the established system. “Low confidence in the sincerity of the political opening led to a range of political societies, spanning the ideological and religious spectrum, boycotting the 2002 election.”[6] Although within four years the majority of the protestors would rejoin the elections, their support for the cause continued, and the protestors would eventually rise up again.

            After the protests of the 1990’s, the next incident in Bahrain occurred on February 15, 2011.  What started out as a relatively small and peaceful protest, ended in a gruesome bloodbath.   As the protestors looked on in horror, “The tanks and armored personnel carriers of Bahrain’s military subsequently rolled into the square, and a military spokesman announced that the army had taken important areas of the Bahraini capital “under control.”[7]  With the corrupt government on their side, the king brutally took control of the situation.  A witness to this brutality stated, “…the police’s brutal response to the small and sporadic protests on February 14 made me feel compelled to get involved. On the first day, they brutally suppressed the protests. They killed a person. They shot him in the back as he was trying to run away and they killed him.”[8] The violence proved the governments, more specifically King Hamad’s, persistence to continue to fight against the relinquishing of power.

 

            The protests that occurred starting in 2011 were directly influenced by the protests that were still in progress in Egypt during this time.  “Egyptians calling for an end to President Hosni Mubarak’s 30-year rule,” according to Global Voice, “captured the world’s attention with mass protests from January 25, 2011, (#Jan25) across the country, especially in Cairo’s central Tahrir Square which citizens occupied for more than two weeks.”[9]  In order for the protestors  to have accomplished such a monumental protest, the Egyptian youth utilized social media.  While successful in overthrowing the ruler of Egypt, the protests set off a sequence of events which would ultimately result in uprising in many Arab countries.  The fear of an uprising led the nations that depended on Bahrain, such as the United States, to support King Hamad.

            As stated earlier, many nations relied heavily on the location of Bahrain for trade and security, and the United States was no exception.  “Bahrain is home of the U.S. Navy’s Fifth Fleet, which protects the vital oil supply lines that pass through the Persian Gulf and the Strait of Hormuz — an important asset for the United States in the event of a conflict with Iran. Bahrain is also a key logistical hub and command center for U.S naval operations in Iraq, Afghanistan, and the Indian Ocean.”   It was under the guise of national security that the United States was in no hurry to help remove the leader with whom they had a good relationship. 

            In fear of the protests spreading into Saudi Arabia, which lays only several miles off their eastern coast, on March 15, 2011, the Saudi authorities proceeded to send troops into Bahrain.   Although a relatively small military force, consisting of approximately one thousand troops, their presence made it clear that other Arab countries were worried.  Throughout the ordeal, with security and financial matters as a priority, the United States’ only response was to stay neutral.  Their neutrality created a storm of anger amongst the Bahraini protestors, many of whom felt the United States should have gotten  involved..  According to Ahmed Mohammed, “The US government pretended not to know that the Saudis were about to invade. After the fact, the United States feigned surprise.”[10]   He made the argument that the United States’ decision to stay neutral was directly responsible for the harsh feelings towards the country.   Mohammed‘s opinion on the U.S.’ opinion on the democratization of Bahrain, was one that was not unique.   Many believe that there is too much at stake for the U.S. and Saudi relations for them to promote change.

 

            With or without assistance from foreign aid, Bahrain is on the threshold of change.  Bahrain’s youth are fed up with being mistreated by the established government, and believe that it is time for a true democracy.  Hassiba Hadj Sahraoui,of Amnesty International said it best, “The government of Bahrain cannot carry on imprisoning people simply because it can’t take criticism.”[11]  Time will tell whether or not the protestors will succeed in their fight for freedom.

 

References

 “ A Decade of Reform”.  Bahrain American

 Councilbactoday.org/data/_uploaded/image/BahrainBroch_Full.pdf

“Bahrain and the Arab Spring”, International Socialist Review.  April 2012.  Retrieved on 24

 April, 2013. http://www.isreview.org/issues/82/feat-bahraininterview.shtml

“Bahrain: Jailed Prisoners of Conscience Speak out on day Marking Two-Year Point Since

Protests Began”, Amnesty.org.uk.  14 February, 2013.  Retrieved on 24 April, 2013. http://www.amnesty.org.uk/news_details.asp?NewsID=20635

  Jean-Francois Seznec. “Foreign Policy:Bahrain Spells Trouble for US Policy”, NPR.  18

            February, 2011.  Retrieved on 24 April, 2013.

http://www.npr.org/2011/02/18/133861647/foreign-policy-bahrain-spells-trouble-for-us-policy

“Bahrain Profile”, BBC News Middle East.  20 April, 2013.  Retrieved on 24 April, 2013.

            http://www.bbc.co.uk/news/world-middle-east-14540571

“Egypt Revolution 2011”, Global Voice.  September 2012.  Retrieved on 24 April,2013.

            http://globalvoicesonline.org/specialcoverage/2011-special-coverage/egypt-protests-2011/

John Bradley.  “The Ancient Loathing Between Sunnis and Shiites is Threatening to Tear Apart

 the Muslim World”, Mail One. 20 March, 2011.  Retrieved on 24 April, 2013. 

http://www.dailymail.co.uk/debate/article-1367435/Middle-East-unrest-Sunni-Shiite-conflict-threatens-tear-Muslim-world-apart.html

  “Naturalization as a Mean of Discriminatory Demographic Change”, Bahrain Center for Human

 Rights.  March, 2005.  Retrieved on 24 April, 2013. http://www.bahrainrights.org/node/27

 


[1]                      “Bahrain Profile”, BBC News Middle East.  20 April, 2013.  Retrieved on 24 April, 2013. http://www.bbc.co.uk/news/world-middle-east-14540571

[2]                      John Bradley.  “The Ancient Loathing Between Sunnis and Shiites is Threatening to Tear Apart the Muslim World”, Mail One. 20 March, 2011.  Retrieved on 24 April, 2013.  http://www.dailymail.co.uk/debate/article-1367435/Middle-East-unrest-Sunni-Shiite-conflict-threatens-tear-Muslim-world-apart.html

[3]                      “Naturalization as a Mean of Discriminatory Demographic Change”, Bahrain Center for Human Rights.  March, 2005.  Retrieved on 24 April, 2013. http://www.bahrainrights.org/node/27

[4]                      “Bahrain and the Arab Spring”, International Socialist Review.  April 2012.  Retrieved on 24 April, 2013. http://www.isreview.org/issues/82/feat-bahraininterview.shtml

[5]                      Jean-Francois Seznec. “Foreign Policy:Bahrain Spells Trouble for US Policy”, NPR.  18 February, 2011.  Retrieved on 24 April, 2013.  http://www.npr.org/2011/02/18/133861647/foreign-policy-bahrain-spells-trouble-for-us-policy

[6]                      “ A Decade of Reform”.  Bahrain American Councilbactoday.org/data/_uploaded/image/BahrainBroch_Full.pdf

[7]                      Jean-Francois Seznec. “Foreign Policy:Bahrain Spells Trouble for US Policy”

[8]                      “Bahrain and the Arab Spring”

[9]                      “Egypt Revolution 2011”, Global Voice.  September 2012.  Retrieved on 24 April,2013. http://globalvoicesonline.org/specialcoverage/2011-special-coverage/egypt-protests-2011/

[10]                    “Bahrain and the Arab Spring”

[11]                    “Bahrain: Jailed Prisoners of Conscience Speak out on day Marking Two-Year Point Since Protests Began”, Amnesty.org.uk.  14 February, 2013.  Retrieved on 24 April, 2013. http://www.amnesty.org.uk/news_details.asp?NewsID=20635

Kremlin and the Schoolhouse

            In 1917, the new Soviet organization, Commissariat of Enlightenment (Narkompros), implemented sweeping reforms of the existing education system.  In the book, The Kremlin and the Schoolhouse: Reforming Education in Soviet Russia, 1917-1918, author Larry E. Holmes, chronicles the progression of the school system during the first fourteen years of Soviet power.  Holmes has written several other books, including Stalin’s School: Model School No. 25, 1931-1937, and Kirov’s School No. 9: Power, Privilege, and Excellence in the Provinces 1933-1945.  Within the field of Soviet era Russian history, Holmes is considered an expert.  Holmes earned his PhD from the University of Kansas, and is currently a professor of history at the University of South Alabama.  In order to prove his argument, Holmes used his expertise in Soviet History to compile sources from, just to name a few,  books, periodicals, political documents, statistical data, and journals.

            Holmes argues that the resistance of the parents and teachers to the new educational system led to the Soviets’ educational goals for socialist reforms to be abandoned.  Holmes’ argument is clear and concise due to the book being written in chronological order. Although the book was meant to be read as a progressive account, Holmes divided up the book into four distinct sections: “The Idea and the Reality, 1917-1921,” “Change and Permanence in the 1920s, “Compromise, 1925-1928,” and “Cultural Revolution, 1928-1931”.

            The book begins with an overview of the Tsarist educational system.  By presenting a brief history, Holmes highlights how dramatically different the Soviets’ reforms were.  During the reign of the Tsar, education focused on memorization and repetition.  The main motivation behind school was for the students to learn how to be good subjects of the Tsar.  Holmes argues that the leading members of Narkompros wanted to move away from the 3R’s, (reading, writing, and arithmetic), and focus on life and the environment.   From the start, Holmes argues, the policies implemented by Narkompros led parents and teachers to become uncooperative.  Throughout its tenure, Narkompros would continue to fight a losing battle against uncooperative members of the school system.  The parents continued to insist the schools focus on reading and simple mathematics, and the teachers would continue to teach in the traditional style.

            By 1920, the seed of dissension had already been sowed, and the implementation of the NEP[1] only made the situation worse.  Holmes argues that unfulfilled promises and a lack of understanding promoted an uncooperative environment.  From the beginning, Narkompros made unrealistic promises that many educators argued could not be met.   With the focus of education on the environment, the schools were to be supplied with land and equipment.  This was to assist in providing the students with hands on experience.  When the state was unable to fulfill their promise to supply the schools with the necessary equipment, the schools were forced to make do with what they had at hand. 

            In addition to the shortage of supplies, Holmes presents evidence that the teachers lacked the understanding to implement the Narkompros education plan.   Sources are provided throughout the book that proves the teachers’ training in this new form of education was almost non-existent.  According to Ben Eklof, professor of history at the University of Indiana and expert in Soviet history, “…in the prerevolutionary period, when little more was expected than instruction in the rudiments of reading, writing, and arithmetic, a high degree of training could be a hindrance.” (53)  The distinct lack of training in progressive thought, led many of the established teachers to disobey the orders of the state, and continue teaching in the old style.

            The problems in which Narkompros faced are the primary focus of the first two sections of the book, “The Idea and the Reality, 1917-1921,” and “Change and Permanence in the 1920s.” In the final two sections, “Compromise, 1925-1928,” and “Cultural Revolution, 1928-1931,” Holmes describes the path in which the new education system took towards failure.  The complaints from the lower part of the education system began to have an effect on Narkompros’ implementation of their educational plan.  Beginning in 1921, it became clear that changes had to be made because students were failing to succeed in their studies. According to Holmes, “from 1923 – 1926 less than 40 percent of pupils enrolling in the first grade remained in school.” (94)   Clearly the changes made in the early 1920’s were inefficient, and from that point on there would be more radical changes made.  From the mid 1920’s until 1931, ideals were changed, and the 3R’s were reinstated as fundamental to the foundation of the education system. 

            Through elaborate details on both the tsarist education system, and the reforms made by the Soviets, Holmes’ argument was amply supported.  The reader gets a clear picture of the problems faced by Narkompros, caused by the resistance to change from the teachers and parents.  Upon critiquing this book, Peter Kenez, a professor of history at the University of California, believes that although the book provides ample information for his argument, “perhaps Holmes likes the archives a bit too much.”[2]  He argues that although the information in the book is pertinent to prove the argument, the reader was bombarded with too much information.

Holmes’ decision to write the book in a chronological order succeeds in explaining the downward path of the Soviet’s idealistic educational reforms.  Nicholas V. Riasanovsky, author of numerous books on Russian History, states “The four chronological parts of the volume, “The Idea and the Reality, 1917-1921,” “Change and Permanence in the 1920s,” Compromise, 1925-1928,” and “Cultural Revolution, 1928-1931,” skillfully combine a linear presentation with a remarkable number of conflicts, crises, and the resulting ups and downs in the evolution of Soviet schooling at that time.”[3]  

            After completing the reading of Holmes’ book, I would definitely recommend it to any historian or student that is interested in the Soviet Union in general or their education systems.  The argument made in this book illustrates not only the problem in education, but also problems that were faced in many aspects of early Soviet policies.  Holmes’ clear thesis and ample evidence makes the book easy to follow.  It would be hard for anyone who has any knowledge of the Soviet government not to understand the information presented by Holmes.

           


[1]                      NEP (New Economic Policy) introduced and called state capitalism by Vladimir Lenin, was created to replace war communism, and helped to stabilize the failing Soviet economy.  Although the state remained in control of the banks, foreign trade, and large industry, they allowed small business ownership and revoked grain requisition.   NEP was the Soviets economic plan until Joseph Stalin’s first five year plan. 

[2]                      Peter Kenez, “The Kremlin and the Schoolhouse: Reforming Education in Soviet Russia, 1917-1931, Larry E. Holmes”, The American Historical Review, February 1993, vol. 98. Last retrieved on 2 April, 2013 from http://web.ebscohost.com.library.aurora.edu/ehost/detail?vid=11 &sid=7d393dc1-41f8-4c21-8dc8-

[3]                      Nicholas V. Riasanovsky. “Kremlin & the Schoolhouse: Reforming Education in Soviet Russia 1917 – 1931, The Book”, Historian, Summer92, Vol. 54 , issue 4.  Retrieved on 2 April, 2013. http://web.ebscohost.com.library.aurora.edu/ehost/detail?vid=12&sid=2b28656c-67f1-4a62-a009-286e2cb7e26f%40sessionmgr111&hid=123&bdata=JkF1dGhUeXBlPWlwLHVybC x1aWQmc2l0ZT1laG9zdC1saXZl#db=ulh&AN=9601243329

In the Face of Nazi Persecution

            On January 30, 1933, Adolf Hitler and the Nazi party gained power.   Between 1933 and 1945 millions of people, including six million European Jews, would perish in direct correlation to their hateful ideology.  In the sixty-seven years since the fall of the Nazis, a myriad of research and published works have focused on the horrific details surrounding these unthinkable horrors.  Although there is no shortage of accounts of horrific tragedy, there were many instances of citizens, from all parts of German life, whose self-sacrifice saved countless lives of complete strangers.

            During the years Germany was under the Nazis’ rule, the police were used as implements of persecution towards political dissention and racial inferiority.  As Nazi anti-Semitism began to increase, the average police officers were transformed into murderers.  Whether following orders, or swept up in anti-semantic propaganda, the fact is that the majority of police officers conducted their duty proficiently.   A good example of a police officer following orders, against personal questions of morality, occurred in Poland.  In July 1942 Major Trapp of the 101st Reserve Battalion was ordered to have his men murder a large group of Jewish citizens.  Upon ordering his men, “…according to victims testimony, Major Trapp was in tears when he ordered the shooting of 1,500 women, children and elderly Jews…”[1].  In the throes of a moral dilemma, loyalty to his country won over, and at the end of the night, not one Jew was left alive.

            While instances of police murders were common during the Nazi reign, not all members of the police force were willing to compromise their ethics by following immoral orders.  In the Adriatic seaport of Fuhme (present day Croatia), the officer in charge of the police, Giovanni Palatucci, was a prime example of a self-sacrificing hero.  Palatucci was just twenty eight years old when he was made head of police in Fuhme.  With the Nazis determination to eradicate the Jews prevailing through Europe, Palatucci was order to deport all Jews to the death camps.  Instead of following his superior’s orders, “…Palatucci made sure that they were sent to the large internment camp in Campania, southern Italy”[2].  To accomplish this, he provided forged documents, successfully rescuing hundreds of Jews from certain death.  Although successful in saving many from death, he was unable to save himself, and found himself dying at the concentration camp Dachau, in 1944.

            At the same time as police officers were fighting the moral implications of mass murder, the German government, including its allies, continued to pass laws that doomed millions of innocent people to death.   Once the Nazi government had restricted all aspects of life for the Jews, they began a program of continuous deportation to concentration camps.  It was during this time that the German diplomat Raoul Wallenberg became First Secretary of the Swedish Embassy in Budapest.  Showing the character of a true hero, he sacrificed his own security by securing forged documents for Jewish refugees.  Along with the forged documents, he also established a series of housing units for thousands to wait out the war[3].  Although he was able to save around 100,000 Jews from being executed, he was unable to save himself.   When the Soviet Union reestablished control in Budapest, Wallenberg was taken prisoner, and died in 1947 while still imprisoned.

            With the air of violence always looming during the reign of the Nazis, many attempted to turn to religion for help.  Upon gaining control of the government, Hitler feared the church’s influence would undermine his power.  In a preemptive strike against the church, he capitalized on the churchs’ views that the Nazis were creating a barrier against communist power.  In 1933 Hitler signed an agreement with the Catholic Church.  This pact stated, “…that he [Hitler] would not interfere with the Catholic Church while the Church would not comment on politics”[4].   With no intentions of abiding by the pact, Hitler began to systematically remove the peoples’ reliance on religion.  Although Hitler quickly learned that the bond between the citizens of Germany and the church was too strong to eradicate, he was able to put the church into a very difficult predicament.  When forced to make a decision of whether or not to speak out against the atrocities implemented by the Nazis, the church made the decision to turn a blind eye.  As millions were being brutally murdered, the church took very little initiative to end the suffering.

            Fortunately for many, there were several courageous spiritual leaders that could not sit back and watch as innocent people were being persecuted.  Two religious men stand out for having the moral fortitude to sacrifice everything in the pursuit of justice.  The first man, Andrei Trocme, was the head of the church in the French town, Le Chembon-sur-Lignon.  As millions of people were being sent to concentration camps, between three and five thousand Jews would be saved from deportation in Vichy, France, as a result of actions taken by this heroic man.  When confronted about why he was willing to sacrifice everything, he stated that he had decided he should “obey God rather than man when there [was] a conflict between the commandments of the government and the commandments of the Bible”[5].   Unlike so many heroes of this time period, he would live to see the end of the war, and witness good triumph over evil.

            The second heroic spiritual leader that stood out in contrast to the official stance of the church was Dietrich Bonheoffer.  Born in 1906, Bonheoffer proved himself to be one of the few courageous members of the church to stand against the repressive Nazi regime.  When the Nazis and the Catholic Church made the agreement to separate, Bonheoffer stood by his principles and took the moral high ground.  In his essay, “The Church and the Jewish Question,” Bonheoffer argued that all Christians needed to stand against the totalitarian Nazi regime.  As one of the first to speak out against Nazi persecution, he proceeded to travel around and attempt to rally people against the immoral treatment of the Jews. 

            In October, 1938, after five years of putting pressure on the church, Bonheoffer made an emotional plea during a church meeting.  In this speech, he argued that, “…instead of talking of the same old questions again and again, we can finally speak of that which truly is pressing on us: what the Confessing Church has to say to the question of church and synagogue”[6].  The time had come to end the idle discussion, and begin to take decisive action against Jewish persecution.  In the face of evil, Bonheoffer proved that with the sacrifice of one’s own security, one heroic person can make an enormous difference.

            For the past sixty-seven years, historians have accused German citizens of turning a blind eye to the horrific violence conducted by members of the Nazi party.   There are innumerable accounts of citizens standing by as innocent people were being marched off to their death.  In Robert Gellately’s detailed survey on the German citizen’s response to the Holocaust, he concluded, “there was ‘substantial consent and active participation of large numbers of ordinary Germans’ in aspects of the holocaust…”[7].  As millions of Jews were being humiliated and killed by the thousands, the average German stood back and let it happen.

            Although the majority of citizens stood by as the Nazis persecuted millions, there were a few heroes that were willing to give up their personal security in order to save strangers desperately in need.  One such heroic citizen was Irena Sendler, a Polish social worker.  In the face of danger, Sendler stood by her principles, and successfully smuggled twenty-five hundred children from the Warsaw Ghettos[8].  In a letter to the Polish parliament, Sendler justifies her actions by stating, “Every child saved with my help is the Justification of my existence on this earth and not a title of glory”[9].   She gave little forethought to her own safety, and in return asked for nothing.  Sendler would become the epitome of a hero.

            During the years that the Nazis controlled Germany, fear rampaged through the world.  While many were content to go along with the atrocities, a select group of heroes sacrificed everything in order to stand up for what was right.  The actions of people like Raoul Wallenberg, Giovanni Palatucci, Irene Sendler, and Dietrich Bonheoffer, prove that humans, faced with human suffering, will stand up and fight evil.

 

 

 

Bibliography

“AJC Mourns Passing of Irena Sendler, Polish Catholic Rescuer of Jewish Children”, AJC:     Global Jewish Advocacy, http://www.ajc.org/site/apps/nlnet/content2.aspx?c=ijITI2PHKoG&b=849241&ct=5354241  

The Shalom Show on TV, http://www.shalomshow.com/holocaust_heroes.htm

“The Church in Nazi Germany”, History Learning Site, http://www.historylearningsite.co.uk/church_in_nazi_germany.htm

“Dietrich Bonhoeffer”, United States Holocaust Memorial Museum, http://www.ushmm.org/museum/exhibit/online/bonhoeffer/?content=5

Frost, Martin “The Holocaust”, Martin Frost, http://www.martinfrost.ws/htmfiles/holocaust.html

Ser, Sam, “Yad Vashem to Honor Giovanii Palatuccii, Unlikely Italian Hero”, Jeruseleum Post, 2005, http://isurvived.org/Rightheous_Folder/Palatucci_Giovanni.html

Sultan, Christopher, “Nazi Atrocities, Committed by Ordinary People”, Spiegel Online International, 2008, http://www.spiegel.de/international/germany/everyday-murder-nazi-atrocities-committed-by-ordinary-people-a-542245.html

Theriault, Anne“Andre Trocme and Le Chambon”, Catholic Peace Fellowship, http://www.catholicpeacefellowship.org/nextpage.asp?m=2554


[1]Christopher Sultan, “Nazi Atrocoties, Commited by Ordinary People”, Spiegal Online International, 2008, http://www.spiegel.de/international/germany/everyday-murder-nazi-atrocities-committed-by-ordinary-people-a-542245.html

[2] Sam Ser, “Yad Vashem to Honor Giovanii Palatuccii, Unlikely Italian Hero”, Jeruseleum Post, 2005, http://isurvived.org/Rightheous_Folder/Palatucci_Giovanni.html

[4] “The Church in Nazi Germany”, History Learning Site, http://www.historylearningsite.co.uk/church_in_nazi_germany.htm

[5] Anne Theriault, “Andre Trocme and Le Chambon”, Catholic Peace Fellowship, http://www.catholicpeacefellowship.org/nextpage.asp?m=2554

[6]“Dietrich Bonhoeffer”, United States Holocaust Memorial Museum, http://www.ushmm.org/museum/exhibit/online/bonhoeffer/?content=5

[7]Martin Frost, “The Holocaust”, Martin Frost, http://www.martinfrost.ws/htmfiles/holocaust.html

[9] “AJC Mourns Passing of Irena Sendler, Polish Catholic Rescuer of Jewish Children”, AJC: Global Jewish Advocacy, http://www.ajc.org/site/apps/nlnet/content2.aspx?c=ijITI2PHKoG&b=849241&ct=5354241

Physical and Mental Implications of Rheumatoid Arthritis

 

Physical and Mental Implications of Rheumatoid Arthritis

     Imagine that every minute, of everyday, you suffered from excruciating pain.  While it may be hard to imagine, this is in fact what life with Rheumatoid Arthritis (RA) is like.  RA is classified as an autoimmune disorder, which means that the person’s immune system does not work properly.   Symptoms for RA include: pain, inflammation and stiffness of the joints, and ultimate disability.  Although RA is three times more likely to be present in women than in men (Swann, 2011), the criteria for diagnosis is the same.  The criterion for RA includes Synovitis in at least one joint and the absence of a better diagnosis.  In addition to being an incurable disease, symptoms progressively get worse over time.  In order to fully understand RA, it is important to dissect how the disease impacts the patient physically and psychologically.

Causes

     So that one may fully understand RA, it is important to understand the causes of the disease.  Within the article, Understanding Rheumatoid Arthritis: causes and treatment, written by Julie Swann, discusses the causes of RA.  According to Swann, “RA primarily causes inflammation of the synovial membrane, which lines a joint capsule” (Swann, 2011).  Like many other articles, this particular article stresses the debilitating swelling of the joints as the primary impact of the disease.  Although swelling is the body’s defense against infection, RA patients bodies dysfunction, and cause uninfected areas to swell.

     In writing the article, Swann’s main purpose was to illustrate the many different ideas as to the cause of RA.  Although there are many varying opinions, some of the causes include: immune system dysfunction, hormones, smoking, and a virus.  Although all of the different opinions are valid, RA caused by a virus tends to be the one I agree with.  “Some patients with RA” according to Swann “have been exposed to a bacterium called Proteus mirabilis” (Swann, 2011).  Although the virus was not responsible for the patient having RA, because there is strong proof that the disease is genetic, it can be responsible for the onset of the symptoms.  

Treatment and Side Effects

     Once the doctors have diagnosed the patient with RA, the next step is to determine what treatment is best suited for the individual.  The article, Treat-to-target: A Tailored Treatment Approach to Rheumatoid Arthritis, written by Deborah Palmer and Yasser El Miedany, delves into the different treatments available for RA.  According to Palmer and Miedany, “An important goal of RA management is to maximally reduce disease activity and thereby mitigate the accumulation of irreversible joint damage” (Palmer & Miedany, 2012).   In addition to the importance of treatment, they stressed the importance of seeking medical treatment as soon as the symptoms begin.

      Similar to a multitude of chronic diseases, there are multiple treatments available for RA.  The authors describe two ways in which doctors treat RA symptoms.  The two ways are: drugs that limit joint damage and those that control pain (Palmer & Miedany, 2012).  Some of the medicines prescribed are anti-rheumatic drugs, corticosteroids, and non-steroidal anti-inflammatory drugs. 

     Even though the treatments for RA have been proven to be remarkably successful in slowing down the progression of RA, there is still no cure for the disease.  Along with positive aspects of the treatments, the drugs come with a substantial amount of side effects.  A good example of negative side effects accompanies the RA drug Abatacept.  According to Palmer and Miedany, “Recent data on several safety issues, including the risk of tuberculosis infection, suppression of response to immunization and risk of malignancy, suggest that these are relatively low in patients treated with Abatacept, in comparison to incidences reported with other biologic therapy agents…” (Palmer & Miedany, 2012).  Although the risk is low, there is still a risk, and doctors will insist on regular blood work in order to ensure the patient is staying healthy.

Psychological Well-Being

    In addition to dealing with the physical symptoms, RA patients are also prone to having psychological problems.  The article, Psychological Well-Being in Rheumatoid Arthritis: A Review of the Literature, author Lynda Getting thoroughly describes the risk of depression and anxiety associated with RA. 

     Within the article, Getting uses previous studies in order to illustrate the prevalence of depression and anxiety disorders with RA patients. According to Getting, “In a telephone interview survey carried out in Australia, significantly more adults with arthritis reported a mental health condition (14.9% versus 12.0%; p=0.004) and were at a medium or high risk for anxiety or depression (39.0% versus 31.0%; p<0.001) than those without the condition” (Getting, 2010).  The presence of daily pain and suffering in the patients’ lives, is psychologically hard to deal with, and without proper treatment, can significantly diminish their lives happiness.

     Along with the patients’ psychological health, the authors also stress the impact of RA on the families and caregivers.  Within the article, Getting states, “Many families and partners of patients with RA also carry a substantial psychological burden- this can go unrecognized, leaving them with little support in managing the impact of the disease” (Getting, 2010).   It is important the person in charge of taking care of the patient is not over looked. 

      The article gives many different ways in which depression and anxiety can be treated.  “Treatments include cognitive behavioral therapy (CBT), mediation and relaxation, biofeedback, patient education and exercise” (Getting, 2010).   For those patients suffering from depression or anxiety, it is vital to all those involved that they are educated on the disease.  For this purpose, there are many organizations that provide information on the subject.  A couple examples are the National Rheumatoid Arthritis Society and the Arthritis Research Campaign. 

Individual Case Study

     In order to reach the conclusion that there is a prevalence of depression and anxiety with those suffering from RA; psychologists have performed many different studies. One such study, performed by Kemal Nas, Psychological status is associated with health related quality of life in patients with rheumatoid arthritis, attempted to determine if RA patients are prone to depression and anxiety. 

     Using the Hospital Anxiety and Depression Scale (HADS), the researchers assessed four hundred and seventy nine patients suffering from RA.  The scale used eight domains in order to determine the percentage of patients suffering from psychological problems. “The eight domains (subscales) of the SF-36 scored on a scale of 0-100 are: physical functioning (PF), health problems resulting in limitations of physical activities; role physical (RP), physical disability resulting in limitations of usual role activities; bodily pain (BP), daily activities influenced by pain; general health (GH), self-perception of general health; virtuosity (VT), overall energy level or lack thereof; role-emotional (RE), emotional problems resulting in limitations of usual role activities; mental health (MH), psychological well-being and stress; and social function (SF)” (Nas, 2011). 

       After administering the test, it showed that, “Three hundred seventeen patients (75%) with > 7 score were grouped as having higher risk for depression and 104 patients (25%) without risk for depression” (Nas, 2011).   The results proved their hypothesis that there is indeed a correlation between those people who suffer from RA, and the increased risk for depression and anxiety.

Mental Health Testing

     With the results of mental health testing holding so much weight in the diagnosis of depression and anxiety, researchers felt it necessary determine how one test correlates with the other.  In one such study, Depression and Anxiety in Patients with Rheumatoid Arthritis: Prevalence rates based on a comparison of the Depression, Anxiety and Stress Scale (DASS) and the Hospital, Anxiety and Depression Scale (HADS), written by Tanya Covic, Steven R. Cumming, Julie F. Pallant, Nick Manolios, Paul Emery, Philip G. Conaghan, and Alan Tennant, commenced the project in order to determine the similarity between the two tests.

     In determining if a patient suffers from depression and anxiety, doctors administer one of several tests.  The two tests that this article discusses are the Depression, Anxiety and Stress Scale (DASS) and the Hospital Anxiety and Depression Scale (HADS).   The study determined that, “The HADS Depression ‘probable’ cut point and the DASS Depression ‘severe’ and ‘extremely severe’ cut point gave levels of prevalence e for depression of a similar magnitude, and are closely located on the underlying metric” (Covic, 2012).   Although the two tests vary in several ways, the researchers determined that both test a similar enough that they are both viable ways of determining depression and anxiety in patients with RA.

     While opinions may vary as to which cause and treatment is best for Rheumatoid Arthritis, it is important to remember the patient is a human being.  It is very likely that the patient will be forced to make many drastic life changes, due to the psychological and physical aspects of the disease.  Although there is not cure for the disease, there are many medications that have been created to stop the progression, and ease the patients suffering.   According to the research, the most important thing a patient can do is seek immediate help from a rheumatologist and other medical experts.

 

 

Reference

Covic, Tanya, Cumming, Steven R., et al. (2012) Depression and anxiety in patients with  

rheumatoid arthritis: Prevalence rates based on a comparison of the depression, anxiety    

and stress scale (DASS) and the hospital, anxiety and depression scale (HADS).  BMC      

Psychiatry, vol 12.  Retrieved from http://www.biomedcentral.com/1471-244x/12/6.

Getting, Lynda (2010). Psychological well-being in rheumatoid arthritis: A review of the  

literature. Wiley Interscience, vol 8.  Retrieved from http://www.interscience.wiley.com

Nas, Kemal et al (2011) Psychological status is associated with health related quality of life in            

 patients with rheumatoid arthritis.  Journal of Back and Muscularskeletal

Rehabilitation, vol 24. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21558614

Palmer, Deborah and Miedany, Yasser El. (2012) Treat-to-target: A tailored treatment approach

            to rheumatoid arthritis. British Journal of Nursing, vol 22 (6).

Swann, Julie. (2011) Understanding rheumatoid arthritis: Causes and treatment.  British

            Journal of Healthcare Assistants, vol 5(01).