Rage and its functionalities

The years that I have been in the helping profession have been many and fruitful. We have a profession that many like to claim has no definition, no clear cut professional role or boundaries, as if doctors and lawyers had those apparent clearly defined roles! There is a marked difference between our profession and at least those two: we strive for good. All professional roles had become diluted in this post modern society and lawyers , doctors and such came from roles that were non existent 2 centuries ago to highly structured and professionally organized bodies. We, I feel, are the glue that hold the lose strands of society together and without which it would unravel.
My experience has often been on the edge! I prefer the hard cases, the Hopeless, but hopeful, the damned and the fool. I have lived burn out, and as the Phoenix, came out of the proverbial ashes! I left work today, late, again, because I had been promised by some nincompoop at a Medicaid health agency  that all the case workers were in a meeting and would be available by 5PM. I took the work. I wrote the letter, got it signed and sent it off, 2 minutes to 5. I then started calling and when around 5 :45 someone answered, and informed me that all the case Workers leave at 5. I went off on a soliloquy that would have been worth taping! I continuously apologized for the nice woman who was there taking my call, and I dug into the ill conceived prejudiced, give them what they deserve approach that health insurance companies and ended by telling this woman who I think agreed with me that I was a disgrace that in our society we are starting to invest more in our pets than in our poor! I was outraged and I brought it home. If there was an infinitesimal chance of being able to solve this, I would have stayed until midnight! A woman had done the right thing and now has a night to sleep on the floor with serious health conditions. We could have repaired it. People with private insurance get to sleep in hotels! Rich people, those sleep wherever they want! They are lucky and luck is what social worker are supposed to even out. As I have said before life is a crap shoot and social workers are there to improve the odds! With empathy, with respect and with the knowledge that the Other who sits across from me is as human as I am. Not more not less. Just like me!
It appears that my discourse was heard. sometimes you just have to let them have it!

On assisted suicide and psychiatric suicidilaty

Suicidality:  The likelihood of an individual completing suicide

suicidality (countable and uncountable, plural suicidalities)

1. (uncountable) The tendency of a person to commit suicide
2. (countable) A fatality that is an instance of suicide

On assisted suicide and psychiatric suicidality:

Suicidal ideation, behavior, and risk are continuous guidelines that orient professionals in making informed decisions as to a patient's behavior and the risk to self.

Psychiatric “euthanasia" is an oxymoron. If the person, with all the risk to self or other language can by the extension of time or the intensity of the dark night of the soul provide enough evidence to a group of doctors and lawyers that s/he is unfit to continue on living and does not wish to prolong her or his possibly long but depressing life, in Belgium, it is so. In fact, Belgium has extended that right to minors, although no case has come to the courts so far.

As a Clinical Social Worker, I am thrown to the proverbial wolves with this policy. That a person at the end of life, can choose to not be further tormented with invasive treatments, I understand the meaning and the humanity behind letting a loved one go, letting them choose how to live the last few days or even months of their lives. I applaud it personally, ethically and professionally.

Psychiatry however, is another matter! An entirely different animal. A ridiculously subjective affair. Depending on the psychiatrist, depending on the therapist, depending on the quality of life, a person often, with years of suicidal tendencies, can change. After many years of different providers, medications and therapeutic styles and even schools of thought, a person can and indeed does change. If not, they are quite adept at taking matters into their hands. Efficiently, quietly and  in general effectively. The blotched attempts, the threats, the calls in the middle of the night are pleas for help, help that we might not be able to provide, but that they, of their own volition, do not wish upon themselves.

Assisted psychiatric suicide takes me to the dark sides of our professions, social workers and physicians  with the dark past of forced sterility on those we deemed inferior for reasons of race, intelligence and other subjective aspects. Social workers, psychologists, and  other professions involved in the well being of the Other, made sure that the Other did not propagate any further. We look upon this as a dark time in our history.

Assisted suicide when a cancer or other advanced illness that has no treatment anywhere, no matter the cost, no matter the expertise, will provide a short time of life in misery and is clearly a short road to the great gig in the sky, that is done with palliative care and non intrusive treatments every day in every state and most countries.

I work with suicidal patients every day, and have known some who have taken their lives in either quick and no opportunity to back track or in stronger and stronger attempts until one day. I have known of patients who hold us by the psychologically hostage by their constant threats that appear to never come to fruition. A life is a life. We are mental health professionals and the purpose of our work it to make sure that no such occasion ever comes to pass.

If indeed people with severe depression, bipolar disorder and even autism can choose when to end their lives what are mental health professionals doing? Showing them the door? What are the criteria. How many treatments is a person subjected to and what kind?

But, again, assisted psychiatric suicide is an oxymoron! Discounting the journalistic levity with which it has been managed, it is nonetheless a denial of the foundation that comprises mental health care.

TheNew Yorker in a disturbing June article explores the Belgic dilemma with critical optics. I cannot blame the journalist. The quotes are disturbing, the analogies and allegories even more so. Mixing Catholic scripture and Auschwitz references, angry bereaving children and self contained and self assured doctors, the article obviously guides one towards the natural conclusion that it is madness to help someone with bipolar illness, anorexia , even autism to commit suicide. By this logic, most of the patients I see could go to the local Euthanasia Specialist, (Euthanicist?) and get them to pull the plug, to the great nothing from whence we came. Is psychiatry ready to do away with its own specialty?    

It is a theme that I plan or reading much more into and will repost on.

 

 

 

 

life is a crap shoot and social workers exist to increase the odd that life will be beeter

On Social Work: In as much as we have structures with specific professional roles working there, such as courts, we have or must create the institutions that will have social workers as an intrinsic part of their functioning. Those left out of a society that is more and more fragmented, without family support and with a job market that has become progressively less secure, as it appears that those at the top want everyone to be a individual indentured to whatever little jobs they can get, those, I say, need social workers, because we know how to maneuver the bureaucracies that gets them housing and food and medication and mental health. Not every depressed person needs  medication but could sure use some words of kindness WITH the assistance that will make their sadness diminish, be it group therapy, better resources or how to think through a problem. Do psychiatrists know how to help someone with housing difficulties? Does a lawyer know how to deal with a woman who lives in a room with three children and cannot afford to get better housing? Does a psychologist know how to get that woman to the right places, and as a result, get the woman better housing, help her get training, and thus give her a possible future, not doomed to destitution? We are multilayered and multitaskers, we know who and how to talk to the right people, and get training in networking resources that together, constitute and substitute for what a functional well off family, an extended one, used to do and still does! Are we ignoring that we are the ones who deal with the problems of the child who is abused, the frail elderly who has no place to go, the person who wants to get out of a life where alcohol and other substances have become the only thing in their lives, robbed of home, family and dignity. Anybody who thinks that social work is a profession in extinction is either not looking around them, or living in a fantasy land where there are no poor, no homeless, no migrant refugees, no undocumented immigrants, no abused children, no beaten women who have to leave in the silence of the night lest they be killed by the beast next to them. Can I move to that idyllic place? I'll happily find a new profession because they will be Abundant, housing affordable, sick leave paid for, eduction free and should I become ill, I will not need a social worker to find me a way to get affordable medication, food delivered to my house or even a home assistant or transportation that will take me to the places I'll need to go to. Oh, and yes, I can sure use some words of kindness, therapy if you will, not the "god only gives you what you can take or cancer can be a blessing in disguise" type of worn out and offensive clichés, but researched and well thought out manners of saying words which will leave me thinking that maybe I am not such a useless piece of garbage. That's what I do every day, because the world I live in is an unfriendly one to those who have bad luck and bad timing. Shoot, who wouldn't have liked to have been born to a wealthy resourceful family? But we don't get to choose. Life is a crap shoot and social workers exist to increase the odds at a better life. There, that's my defense of social work for today!

 

From a hurt soul

Raging into the night as the poet did, air conditioners and lack of sleep, pain and relentless pressure render my spirit to a state of powerlessness and where I don’t want to be..  I am no longer a social worker but, no, I am actually a social worker because I have a profound empathy towards each and every one of the people who stand in front of me, naked and exposed. Is it a power trip? Maybe it is! I cannot, not in my heart, my soul or my conscience look upon a woman who as put together as she is at 50, had all her teeth broken as a youngster, or the resilient one who cares not for me but pretends and I sign papers because, although she does not speak it, her other teeth were also broken at a much younger age. I speak of women and men and I hear their stories and I feel for them because I once was a little girl. I once had dreams of my own. I would be an archeologist and I’d dig the earth for the past and for the stories we have all lived a billion times. Why, why must we keep on keeping on repeating the same cruelties, the same vicious deranged atrocities that awaken me in the night, startle me, me, the one who watches no news because it I have seen it all. Can it get any worse than Treblinka? They continue, I refuse. I am so angry and defeated by the men who are long dead, the teachers who have gone their way. Can I stop reliving the past in the present? Can I learn what I teach?

If I cannot, I am a hypocrite and must change course, because as I know me, I know that coherence and honesty are my only courses, as my father taught me. The price? I will pay. It does not come cheap and neither is it painless.

kittens and trauma

"their living is dependent on your caprice, rather than on the right to receive a living wage."

 That’s an exceptionally essential question for a social worker to address, but today I want to write about another topic because of its unique as well as extremely site attractive position in the web . The word is kitten. What set the whole article off was bacon, but we’re not going there. We’re going to kittens and how they attract massive amounts of traffic on the internet. The writing can be atrocious, the videos so-so, but I don’t think there has ever been a video of a kitty that failed to catch the attention of the masses, millions of them. Watching and speaking of these cute kitties has brought me to “bring it on down to me”. I am foster caring a cat; a beautiful black tortoise shell cat, sometimes known as Calico cats. I got Mia, the Kat, when she was about 2. She had been brought up with many siblings and a few racially divergent animals such as dogs as her eating habits show.  At some point, as it happens with children, somebody moved into the house, the cat owner’s grown son and he started torturing the animals, which the woman got rid of, one by one until I hope she is alone with her brother and he has no one to torture but her and she’ll come to her senses. I suggested she get rid of the son…

A good friend of mine living up in that area, where poverty, klu klux klan affiliation and retirees do not come together but live side by side, under the shadow of the Eastern Catskills, took the cat in, to keep her dog company, and ameliorate the cat’s condition  in one broad cat like stoke.

Alas for the dog and the cat, little time did they spend together as my friend, living conditions having improved for her, could not keep the cat in the new environment. In a flash of heedless sympathy, I agreed to foster care the cat, as I imagined somehow finding it a loving, compassionate, and permanent home, quickly and efficiently.

The Cat, Mia, came with the unsparing and generous luxury my friend is well known for. Mia, the Trauma Cat, journeyed the long four hours it took us to get from the forested greens of the Mountains to the urban streets of Brooklyn. Mia, The Trauma Kat was gently and carefully taken into the apartment merely to disappear for over two weeks, putting in an appearance only to eat and to use the litter box. We knew it was a traumatized cat, a young two year old cat and that we only would slowly gain its trust. This was also a cat that had been born and raised in the country and had no idea of what it could be like to live in a city. Airplanes overhead, trucks underneath, ships blowing their horn, people screaming, and in the summer the constant hummer of air conditioners. This bumpkin cat came to Brooklyn, scared, traumatized and its foster family not used to dealing with trauma in animals.

We almost refused to believe it exists. Two months later, we know better and so does Mia, the Kat. She tolerates petting and runs for the victuals. We started buying her expensive grain free, cat adequate fare, which she utterly rejected. My friend had also included in the package a large amount of canned food which by its smell and contents I was tempted to try! Mia the Kat, on the other hand would not even touch it! But unbeknownst to me an open bag of MeowMix, had been thrown in the “cat  care package”.  A few weeks later, with concerns for  an increasingly rotund cat which I suspected was pregnant, the “father” was found.  The MM* bag, hidden under a couch, with one grand hole into the plastic bag and another into the food itself was full of punctures, as the cat had found her bounty. She was feeding to her heart’s content! She would clamor and meow to be petted while she ate a few of the organic and expensive vittles, and would then sneak to the happy world of junk food.

She is still anxious, and any sound or sudden movements will drive her under any spot she can find. I will not be able to keep her forever as my lease is pretty clear on pets. She is beautiful and at night I pick her up and bring her to the bottom of my bed from whence she promptly jumps and runs to the hallway. But throughout the night I have learned better than to move my legs onto the spot she has designed for herself. A clear meow awakens me and my leg moves towards the center of the bed. 

She’s not a normal cat and she demonstrates the hyper sensitivity of a trauma victim. But gentle words, a supple bed and soothing hands as well as a quiet dark hiding spot are starting to do the magic that trauma work is supposed to do. Can I do it with people?

 

#kittens, #kittentrauma, #cutekittens, #socialwork, #socialworktrauma, #traumawork, #cutecats, #animatrauma, #traumawork, #therapyandtrauma, #thesoulofasocialworker, #socialworkny, #1199, socialworkishard, #lovingsocialwork, #MeowMix

the gentle fears that rock my soul

summer yet in the air

   confidence and immortal thoughts
    soon to be shattered to the ground
      pounced
   crushed
mortality arises

chaos and fear

incessant fear
ignorance is bliss
indeed
and the leaves fall gently to the ground
and i crumble like an old leaf
on the pavement…
                                   again

 the days blend into night

death becomes me
dastardly death
where was it all along
this thing called death
again i crumble and fail
did I say fail?
                  fall i meant

 winter rages

wintery sleepless nights
of snow and insanity
dragging my feet I arrive resigned
of the deaths that come my way
i say little and comprehend less
did i say ignorance is bliss…
no longer
illuminated on all signifiers this death word means?

 

i channel avoidance and complaisance

i won’t let it touch me
until it does and i crumble yet again

 how long this winter is

this dreadful cold frozen winter
i’m underground
there, in the place we all go to
i’m dead and deaf, mostly numb and cold

 

a slap in the face and i awake again
out of shock and into life and learning
i learn with life and i learn with death
out of a soporific stupor
winter persists

                        i’m no more and yet present

bodies and life surround my shed self

provide a warmth long absent
deep cognizance in hollowed grounds
death is no more and yet persists
with me with all

spring arrives brooding

pregnant with life and rain
could it be me crying?
of loss, of longing, fear again
no more a slave
i grew inches feet
all inside my soul

the thunder reminds me that i have a voice

the rain tells me it’s ok to cry
the losses whisper long after they’re gone
i have inside each of my cells a little
of all of who touched me
i’m whole, full of memories and gifts
and learning
                       i will do

the therapeutic alliance, part I

Social workers have passion. We struggle with hard issues, with life and death, sadness and depression, with people telling us every day that they don't want to get out of bed, not, that they cannot get out of bed, that the voices coming into their ears tell them that they are dreadful people, monstrous, that they are not worth the soil they walk on. We listen and we watch the screams of desperation of visualized trauma, rapes and abuse and beatings, imprinted on their brains and stuck as if with glue that resists any chemical or verbal attempt at coming lose.

We struggle with violence and rage and insult hurled at us from the angel faced woman whose worse curse was to be born beautiful. We sustain the invective of the exploited and abused. We take on our metaphorical laps the child within the person, and reconstruct with them another vision, another possibility. We watch in fear and wonder, as the layers peel away, and beauty and possibility reveal themselves to us.

I did not learn to be a social worker in school. But as one of my mentors said to me once, “after listening to maybe 50 people over a stretch of time, you might just start to understand what depression is”. Our patients teach us everything. We come ill prepared, with a few theories, some life experience and much trepidation. Little by little, patterns develop. As humans we are hardwired to see patterns, so we must be careful, mindful, lest we get lazy and hazy. We make foolish mistakes, embarrassing mistakes. We are called on them. By those whom we seek for advice, by supervisors, by the patients. The patients know us as well as we know them. The veneer of the profession when two people are sitting facing each other can be monumentally thin. Yet we learn that our fragilities must be borne out elsewhere. After all they seek us out. Occasionally, no word of solace or comfort is enough. Sporadically, we are left wordless by the depth of the pain or image or experience. If we are too insecure we turn the cheerfulness dial a bit. I, however, sense that it is preferable to let what was just lobbed at us sink in, in silence. We embrace, in that moment, not only their pain, but respect for their courage to expose it, we let it seep out, and slowly we de-construct to re-construct. With empathy, always with empathy. With kindness, always with kindness. Above all, with respect!

A new old death..where yet another black life should have mattered...but did not

Discombobulated, always, discombobulated at the continuous murder of black people, women, men, children. Angry that mental health or disease are ill gotten justifications for crimes committed with too much power differential. The lone white hate murderer was a lone wolf with mental issues, Sandra Bland posted a video talking about depression and PTSD, saying that hey, you know, not feeling right, it's more common than you think, and I postulate, she is scared because a new stage in her life is beginning, she is going to be back in perhaps not too friendly Texas, but wow, it's not just a job, it's a good job and one she excelled at and she gets stopped and she questions and says what I or any other female or human being could have said.
I was once stopped in New Paltz, on my last day of classes, last day of my Master's in Social Work. I was riding  the MTA home from NYC, got off the train, got in my car, and started to complete the last 15 miles that would put me in my bed. I had done a previous night shift, probably a few hours at my internship...no longer remember, but I was ecstatic and above all exhausted. On that long stretch of road that I had maneuvered a thousand times before, I heard a siren. I knew that if I drove another 500 feet I would take a left, stop at the gas station from where I could see my house.
So I did.
I turn off the car, hand over the papers and wait. and wait. and wait. Another car, police car approaches and stops. By now, I'm starting to get nervous. I am European, but of the Southern brand and look more Latina than sophisticated French intellectual!
One police man comes over and asks why I took a left on a red and I tell him that that is what we all do, not quite on red but turning on red as we do not want to take a left on oncoming traffic. It's 11 PM. Are you sober, he asks. Yes sir, I might be exhausted but I am indeed sober. I am coming home from my last class of a long two years and I am exhausted and I don't know why there are two police cars but no I was not going to stop in the darkness of the forest 500 feet behind us. From here I can see my house and I can see people. I feel safer.
Another comes over and asks what exactly are you doing at this hour?
Going home, sir, going home, and you can see I'm close to it. I'm so exhausted that I just want to put my head on my pillow and "sleep for a thousand years" as Lou Reed who have aptly put it.
I take out my NASW card and finally tell them, this was my last day of my last class and I am now an almost social worker. I work with people with disabilities at a well known institution and I am just exhausted. I have no idea why you stopped me and at this point it makes no difference. I don't even understand why a woman alone in a car, in the country with the car lights turned on would warrant 2 police cars with 4 men.
The cop, did not have much to say, not much at all. He did finalize with, pointing to my house, a nice clapboard with a great garden and front porch, go home and get some sleep. No apologies for being rude, for making me sit there for half an hour without explanation, nothing.
And thus I did and lived to tell the tale.
No such luck for Sandra Blanc. Maybe we will, probably we will not, ever know what really did transpire.
I do know, that if I were to be somewhere in the South, after being treated as she was, after three days of isolation, I would question what was coming and I would think back on what had been the end game with all the other blacks who died in jails, in isolation, with no care, no legal recourse and nobody to reach out to.
What would you do?

why this

I am a Social Worker, a sometimes writer, a frustrated one at that and I am in need of sharpening my skills and losing my fears. A blog, yet another, as I have been keeping one from time to time since 2005. They are generally uninspired, somewhat flaky experiments in ideas and projects that I have little time for. Reading and working, as well as sleep, take up much of my time and I find that after those tasks little of it is left for perambulations about what I spend 10 hours a day doing.
However, I find it important to reflect on this thing that I do, vague and yet so present, concrete and yet ethereal.
Much has been written about the role of the social worker and I believe much more will be. I find my input is or can be as valid as the next one and as such, a little discipline and some creativity will help me bring to life a nice little project where I clarify my work, I talk politics and question what must be questioned.
My role in my current job is one of clarification, empathy and co-searching for the whole within the broken.
Clichés are of little use and broken vases break my heart. Nonetheless I find solace in the Japanese art form of kintsugi, where gold is artfully used as a glue to hold the broken shards. Gold is also used to bind relationships as wedding bands all over can attest. Gold is malleable, shiny and a very useful metal. I will eventually explore the politic of dirty gold, but for now, it is of bonds we write.
So I do a little kintsugi, knowing that nobody wants to be broken, and nobody wants to be glued or stapled and much less soldered.
But people are broken and I must glue and solder and staple and do it all with words. I have no fine surgical scalp, nor do I have a metal worker's torch. Not even carpenter's glue.
Yet, I have words that bind and solder and that is my profession. I solder broken souls and spirits and hearts with words, affect and empathy.