Emerald green in spring and summer, a jewel-toned rainbow in autumn and snow-capped in winter, the Appalachian Mountains cast a spell on their dwellers. The 205,000-square-mile Appalachian region includes all of West Virginia and parts of 12 other states. Few have a deeper appreciation for Appalachia and its people than native daughter Paige Cordial, a psychology doctoral student at Virginia's Radford University. Cordial, who hails from Big Sewell Mountain, W.Va., chose Radford for its location — as well as its focus on rural practice, social justice and diversity, she says.
"I plan to work and live here my entire life," she says. "I can't imagine living anywhere else."
The beauty of Appalachia, however, comes with many social and economic woes. Mountaintop-removal coal mining and fracking — a technique used to release natural gas — destroys land and water and can also cause physical and mental anguish. Access to mental health care is limited, and the region is facing an epidemic of prescription drug abuse. Widespread poverty further compounds these issues. With an economy based primarily in mining and agriculture, Appalachia has been hit especially hard by the recent recession, according to the Appalachian Regional Commission. Ninety-six Appalachian counties were considered economically distressed in fiscal year 2012.
Cordial has dedicated herself to helping her fellow Appalachians face this tangle of economic, environmental and mental health challenges. She's well suited for the challenge, says her advisor, Ruth Riding-Malon, PhD. In addition to a deep empathy and understanding for her clients, Cordial goes beyond her work as a therapist to stand up for those with no voice, she says. "It's not enough for me to spend an hour a week with clients in a counseling session when I see all kinds of problems surrounding clients in their everyday lives," says Cordial. "The environment is contributing to folks' problems, and I just can't ignore that and do nothing to make positive change in the region."
Part psychologist and part activist
At Radford, Cordial has been involved in a range of volunteer activities. She helps deliver free lunches to disadvantaged families during the summer when kids are unable to get free food at school. She participates in protests, rallies and marches to end mountaintop removal and has helped to organize educational events about the issue at Radford University. And last fall, she joined protesters when a former psychiatric hospital in Radford, Va., was marketed as a haunted asylum at Halloween, perpetuating stereotypes of people with mental illnesses as scary or dangerous. The protests received local TV and newspaper coverage, which raised awareness about mental illness and stereotypes, Cordial says.
Cordial also works at a local free clinic that provides integrated health services. She and her colleagues help people cope with health challenges, including weight management, smoking and other addictions as well as mental health problems, such as depression and anxiety.
Her desire to address social issues in Appalachia is also driving her dissertation topic: the psychological effects of mountaintop-removal coal mining. Using this type of mining, workers remove upwards of 400 vertical feet of soil to get to coal cheaply and efficiently. But this efficiency comes at a high price for those who live close to the surface mines, Cordial says.
While many scientists have documented the physical health issues brought on by these mining practices, including elevated rates of cancer, increased rates of heart, kidney and lung diseases, and increased risk of birth defects, little is known about their psychological toll. To help fill that knowledge gap, Cordial is conducting focus groups in eastern Kentucky, southern West Virginia and southwestern Virginia to determine how this kind of coal mining has affected their lives.
There is a certain inevitable tension in this study because some people are completely against mountaintop-removal coal mining while others rely on it for work. That's why she is conducting two types of focus groups in each region: one for those who support this kind of mining and one for those who are against it.
Ultimately, Cordial hopes her findings can educate people on the effect mining may have on the community. She has completed four of six focus groups so far, and has found that many of the people of central Appalachia have been deeply affected emotionally and spiritually by mountaintop-removal mining. Still, she says many people feel helpless and unable to fight back, thanks to the coal industry's economic and political power. Some of them, says Cordial, don't see any alternatives for earning money in the region.
Cordial's commitment to traditional psychological treatments, volunteerism and activism runs deep, says classmate Alysia Hoover-Thompson.
"Most psychology doctoral students are doing everything they can to make their pre-doctoral internship applications look good and build their CVs through publications, research projects, good practicum placements, etc.," says Hoover-Thompson. "While Paige's is impressive, it is because she spends her time doing things that benefit the community, not because she wants to impress someone." n