Friday, January 6, 2017

Boundaries

2016 was a year of redefining boundaries for me.  In truth we constantly redefine boundaries.  Sometimes we do it well and sometimes we struggle, but even not doing it is doing it, so saying 2016 was the year of boundaries is saying something.  Setting boundaries in 2016 was like getting a black belt in boundaries and felt a little bit like being hit by a Mack truck.  Sometimes growth comes in slow and steady progressions and sometimes it comes in giant moments of clarity.  2016 was one of those giant moments of clarity.

Although plenty is written about boundaries and in some ways this feels like a basic concept for social work,  as I reflected on this years growth and took my lessons into my mentoring of social workers, I realized we don't talk about it nearly enough.  It might be simple but it isn't easy and as this year proved, it isn't something we just master and move on.  Setting boundaries is a skill we continue to refine as we grow as humans and as social workers.  The ability to understand, set, and negotiate boundaries is critical to social work practice.

Boundaries are a way that we do the most critical and complex thing I call social workers to do.  I talk to the social workers I mentor about how to "be with" the client.  This is the illustration I use.  "When someone is drowning I want you to be in the water with them.  I want you to be fully with them while being separate enough that you don't get pulled under with them and drown.  You cannot guide someone in the healing process while staying on the shore.  You also cannot guide someone if you allow them to wrap themselves around you and take you under water."  This illustration comes from a very real experience that happened when I was a child.  I was drowning in a river.  My mother instinctively jumped in and in her panic proceeded to try to drag me upstream.  We both were drowning.  A family friend jump in and pushed us to shore.  The friend was fully invested in our well being yet separate enough to be able to do what was needed.  Good social work means being fully present while being fully separate.  It is an art and it isn't easy.  It has everything to do with boundaries.

Boundaries tell you where you end and another begin.  They define your turf.  Emotionally, spiritually, physically..what is yours, mine and ours?  It is a way that you honor both yourself and others in your world.  They allow you and others to speak your truth and to be treated with dignity and respect.

Setting boundaries requires direct and honest communication.  It means that you are taking responsibility for your own needs.  In order to set boundaries you must feel worthy of respect and dignity and you must release shame.  You must also be able to tolerate discomfort.  When you set a boundary it is about defining what is and what is not acceptable in your world.  It dictates your behavior, not the other persons.  Setting a boundary means I will do what is right for me, whether you cooperate or not.  To set a boundary, I must let go of the outcome.  I will speak my truth, what you do with it is up to you.  The important thing is that I spoke it.

Boundaries also require flexibility.  Some violations may require instant "stop signs" to go up, while others allow for graduated responses.  The truth is many behavior patterns are ingrained and  may take practice and repetition to change.  And many boundaries require negotiation, a give and take between two people.  In order to participate in this negotiation without being lost, we must have a clear grounding in where we end and the other begins.  We must also have a clear understanding of what we find acceptable and unacceptable.

Finally, boundaries must be enforced.  If you set a boundary, keep it.  Remember good old systems theory.  All components of a system strive for equilibrium.  When equilibrium is disrupted the system attempts to correct.  When you redefine a boundary you disrupt the equilibrium of the system.  Just because you change, does not means that others in the system are ready to change.  This is a fancy way of saying, when you redefine boundaries expect that you might feel like you were hit by a Mack truck.  When you set a boundary it may be respected but it may also face resistance.  An attempt to get things back to "normal".  And if pushing on your boundary works, well people are smart creatures, we will do what works. 

All of these concepts are critical to a therapeutic relationship.  This isn't because we talk and teach about boundaries.  Yes we do that and yes that is important, but in the therapeutic alliance we have with clients we also model it.  Here is a simple example I used with the social workers I mentor.  When you are scheduled to meet with a client for 50 minutes and instead you meet with them for 80 minutes, what messages do you send them?  Do you believe that they are competent and capable of holding their feelings between sessions?  Do you have faith in them and their ability to handle life?  Many clients are currently maneuvering some sort of life disruption.  By setting structure and routine in the session, you are modeling this for their life.  When they see you set boundaries they are empowered to practice this as well.  The therapeutic environment is intended to be a safe place for them to learn to both set and respect boundaries.  Boundaries are a critical component of creating a safe environment.

So bumps, bruises, and growing pains... I am very grateful for 2016 and the growth spurt that allows me to be a better social worker, mentor, supervisor, colleague, friend, mother...

So ouch and thank you..




Saturday, November 26, 2016

Tis the Season...

By many accounts I am a super fan of Christmas.  I love everything about the season.  I celebrate all the way down to the matching pajamas, dogs included.  As we began approaching Thanksgiving, I gave the social workers I work with their annual talk.  I reminded them that the holidays are a time of struggle and grief for many and that this can include ourselves and our clients.  Below are two of my key holiday reminders.

1.  Remember self-care.  You will be extra busy.  You will also have your own grief and losses that surface.  This is a time to put self-care first.  As your clients present with increased need and your workplace becomes increasingly stressed, you need to maintain your inner serenity.  So despite the social engagements mounting and the to do list tripling, do not cut your self-care routine.  You need it now more than ever.

2.  Remember that your clients may be struggling to maintain their balance.  The added obligations that occur during the holiday season can make it hard for clients to keep their appointments. Add to that school breaks, emotional stress, and family stress, and you can anticipate that when the need is the highest they may struggle to engage you.  Give them frequent reminders, be a good role model (number 1), and remind them that in order to take care of others they must be healthy.  Most importantly remind them to give themselves grace.  The holidays can be hard.  They also won't last forever.

Returning from Thanksgiving, I began the annual routine of filling every room with a Christmas tree, hanging stockings, setting out nativities, and essentially transforming my space into a winter wonderland.  As I began this process that I  love so much I also meditated on the importance of tradition, remembrance, and expectations.  The holidays can be a painful time for those who have experienced a loss.  Some of the points below may help.

1.  Remember you don't have to be happy over the holidays.  In fact, you should feel exactly as you do.  You should also remember that you aren't alone, there are others that feel as you do.  Whatever you do, don't "should yourself".

2.  The holidays are not forever.  Whether you are having the best time of your life or feel at your lowest low, this too shall pass.

3.  Drop your expectations.  Each Christmas will be special in it's own way.  No Christmas will be exactly as you pictured it.

4.  Traditions can be helpful to processing grief and loss.  As I hang stockings, I recall memories of my grandmother who is now passed and lovingly made them each by hand.  As I hang ornaments, I share memories with my children.  Some ornaments remind me of people I miss, some of Christmas' that were painful, some make us laugh, and some make us cry.  As we decorate, we also take in our collective history.  We share it, each supporting each other.

5.  #4 above is beautiful and it works for me, BUT don't forget that traditions were made to be broken.  You may find that your previous traditions don't work for you.  The only thing guaranteed by a choice is the opportunity to make a new one.  So if something isn't working for you, change it.

6.  It is often helpful to remember people.  Perhaps you will make a dish that reminds you of someone who is no longer with you, play their favorite game, or share stories about them.  All of these are helpful and healing.  It is also important to remember that the holidays can be overwhelming.  Avoid isolating, but also build in some time to decompress.


Friday, June 26, 2015

What you Don't Say Speaks Volumes: Spirituality in Social Work





As many of you know, I am not an expert in spirituality.  Maybe it is because I am not an expert that I clearly see the need to write this, because it is not facts or answers that we need but questions and discussions.  It seems that openness and inquisitiveness may be what is called for.



I was meeting with a group of Social Workers recently and I had an interesting experience that stuck with me.  We were processing several difficult topics including, sexual trauma, abuse, and addictions.  We discussed these topics clearly, comfortably, and professionally.  Then something happened that I just couldn’t forget.  A Social Worker leaned forward in her chair, dropped her voice, apologized and asked permission to discuss spirituality as it related to how she viewed her work with clients.



This struck me, hard.  As Social Workers we have difficult conversations all the time.  We had just finished having many of them.  The truth is, having difficult conversations is part of the job description for a Social Worker.  If we won’t have the hard conversations then who will? I found it unsettling that the one topic that was too hard to discuss was spirituality. 



In my experience as a Social Worker, teacher, therapist, and clinical supervisor I have found that many Social Workers shy away from examining the role of spirituality in their own lives and practice as well as in their dialogue with their clients.  They are not provided training or guidance in how to do this and they are afraid that they will do it wrong.  They fear offending or alienating a colleague or client, so they hide behind professionalism.  They choose what is safe. 



So following a whispered conversation about spirituality in Social Work, I asked myself what my role was.  What example will I set for my students?  What does it mean to teach Social Work at a religious institution?  How will I prepare students to work with clients and will it involve spirituality?  Who will teach them to ask questions about their own spiritual journey and how it intersects with their practice?  If we are unable to embrace the conversation how will we authentically encourage our clients to share their spiritual journey with us?  Won’t they know by our silence that this part of them doesn’t belong in the conversation?  What are we losing by being quiet?



The reality is that spirituality matters to many of our clients and not being able to talk to them about something important to them limits our work with them.  Research supports this.  Ninety percent of the world recognizes some type of spiritual practice (World Christian Database, 2001).  A large database of research also supports that spirituality is important to mental health (D’Souza, 2002; Konig, 1998; Teppers, Roger, & Coleman, 2001; Russinova, Wewiorski, & Cash, 2002; Zaza, Sellick, & Hillier, 2005).  Clients use it to cope, and identify it as something that sustains them (Konig, 1998).  Religious and spiritual practices reduce isolation and loneliness and support a sense of mean and purpose (Verghese, 2008).



My own work with complex trauma, attachment, and relational disruption also supports this.  When early caregivers are attentive, nurturing and secure; children learn that people can be trusted.  On the contrary when children experience abuse, abandonment, and relational disruption they learn that people cannot be trusted and are not stable.  I have found it impossible and inauthentic to fully restore trust in a child or adult that has experienced this loss.  When you explain to a young adult who was abandoned by their parents that they can count on people; you are telling them something that is fundamentally untrue.  They know in their very core that if their mother and father can leave them that anyone can.  So, how do you encourage them to risk attachment and connection despite the very real possibility that people may disappoint them?  The only way I have seen this occur is when an individual is able to rely on something consistent and steady.  They are able to use their spirituality to identify something larger than themselves that can be a stabilizing force.  The security of this unwavering “being” allows them to take the risks necessary for relationships and connection and allows them to weather the disappointments of human relationships. 



Like I said, I am not an expert in spirituality or a religious scholar.  I don’t have answers. I have questions.  Maybe it is not answers we need but questions?  So I hope that you will examine your work closely.  That you will pay attention to not only what you are saying when working with clients, but also what you are not saying.  I hope that you will embrace a bio-psycho-social-spiritual framework.  When you are doing an assessment I hope that you will not simply check a box on your clients’ religious identification but that you will explore what a higher power means (and doesn’t mean) to them. That you will give them room to share a personal narrative of spirituality, both what it is and what it isn’t to them.  Remember the power of the unspoken dialogue and remember that you are a Social Worker.  If you don’t embrace the uncomfortable conversations, who will?







D’Souza R. Do patients expect psychiatrists to be interested in spiritual issues?  Australasian Psychiatry 2002; 10:44-47



Koenig HG.  Religious beliefs and practices of hospitalized medically ill older adults. Int’l J Geriatr Psychiatry 1998; 13:213-224.



Russinova Z, Wewiorski NJ, Cash D. Use of alternative health care practices by persons with serious mental illness: Perceived benefits. Am J Pub Health 2002; 92: 1600-1603



Tepper L. Rogers SA. Coleman EM, et al. The prevalence of religious coping among persons with persistent mental illness. Psychiatric Services 2001; 52:660-665



Verghese, A. (2008). Spirituality and mental health. Indian Journal of Psychiatry, 50(4), 233–237. doi:10.4103/0019-5545.44742



World Christian Database.  Atheists/Nonreligious by Country. World Christian Trends, Barrett and Johnson (William Carey Library 2001), updated February 2007.  See website: http://worldchristiandatabase.org/wcd/ http://worldchristiandatabase.org/wcd/



Zaza C, Sellick SM, Hillier LM. Coping with cancer: What do patients do? J Psychosoc Oncol 2005; 23:55-73

Image courtesy of StockImages at FreeDigitalPhotos.net


Sunday, April 19, 2015

Grief


As a social worker we are many things.  We are advocates, we are policymakers, therapists, community organizers and we connect people to resources. We work in many settings.  We work in hospitals, hospice, child welfare, substance abuse treatment facilities, policy institutes, homeless shelters, adoption agencies, and psychiatric hospitals.  These lists are not all inclusive. The truth is social workers work everywhere and often do everything.  One of the most important roles we have is grief counselor.  This is easy to recognize in some settings such as hospice but it is true in all the settings we work.  

A social worker walks hand in hand with a client as they walk through grief.  As a community we recognize the grief of losing someone we care about to death.   We even hear talk about a divorce being like a death.  In truth grief encompasses much more.  Grief is a response to loss and human beings experience loss throughout their life.  As human beings we grieve the loss of relationships, jobs, communities, families, parents, security, home, and so much more.   Largely, we experience grief at the intersection of our vision and our reality. 
             
Each of us has a vision of our life.  The human struggle is to integrate the reality of our life with our vision.  We ask ourselves, “What did I expect out of life?” Our answers to this question vary.  For each of us there are different pieces of our vision that are dear to us.  One of us may easily transition from one career to the next while another can’t seem to let go of “how they thought it would be”.  

The process of moving through life transitions is the process of grief.  Throughout an individual’s lifetime they have many experiences that cause a disruption in the “normal”.  This can be anything that requires a shift in the picture, anything that requires them to adapt and create a “new normal”.  To create a “new normal” we must first grieve the loss of what we thought was “supposed to be”.  We must learn to live in a world that is in some way different from what we ever imagined. 


Many of us will be successful in grieving small changes to our life vision but we must also incorporate critical incidents.  Critical incidents are those moments in life that fundamentally change our trajectory.  They alter our path permanently.  Some critical incidents may be anticipated such as a marriage, birth, graduation, or empty nest.  But many will be unexpected.  Many will be moments we never anticipated.  Contingencies we couldn’t envision much less prepare for.  This is the moment when many of us say "I will not", "I cannot".  This is the moment we often must borrow from the strength of those around us.



When these critical incidents occur our tools and coping skills are often inadequate and are overwhelmed by the abrupt and sometimes violent shift from what we “thought” our world was to what it “must become”.  It is only natural that the skills that served us so well in our “normal” would be inadequate to face this “new normal” we never imagined.   

As a social worker we will often be called upon during these times to walk with someone as they grieve, accept, and learn to find hope in new things.   During this time someone will honor you with his or her story.  They will share their vulnerability.  As you honor this trust and create a safe place for them to struggle with integrating the new, you will see the beauty of human beings.  An angle of human beings that not everyone gets to witness, The moment when someone takes what was a shattered vase and pieces it back together bit by bit until it is a beautiful mosaic.  No, it will never be the vase it was.  It will be something so much stronger and more beautiful than anyone ever imagined.  


Wednesday, October 29, 2014

The Celebration of Being Wrong

     I have a bold pronouncement for future social workers, go out into the world and be wrong!  Yes, I said be wrong.

   Here is a common internal dialogue for a social work student, a new social worker, any social worker thoughtfully facing the challenge of social work, and frankly those of us just being human:

  " Oh no, here we go. Can I do this?  Am I good enough? Do I REALLY know what I am doing?  Someone really trusts ME to do this (panic),  what if I forget a theory? a technique? What if I mess up? What if I do something wrong?"

    There are several variations of this internal dialogue but all of them involve the fear of making a mistake, being wrong, or failing.  So below is my response, to students, those I supervise, and to my own internal dialogue.

   "Yes, you can do this.  Yes, you are good enough. Yes, you REALLY do know what you are doing. Yes, you can be trusted.  Yes, you will forget a theory, you will forget a technique, you will mess up, and you will be WRONG!"

   I don't care how much you prepare or how hard you work you will make mistakes, you will stumble, you will be wrong.  As a matter of fact I am encouraging you to be wrong, to embrace it!  There are a lot of great reasons to go out and fall on your face. 

Being wrong is linked to innovation. In Being Wrong, Shulz  (2010) remarks that being wrong is linked to empathy, optimism, imagination, conviction, and courage.  It is a crucial part of learning and change. Schulz argues wrongness not rightness makes us who we are.  Here are a few points to consider:

1)  Innovation involves risk.
By definition if you are innovating you are doing something new.  This means you don't know what the outcome will be.  Innovation is important to growth and change.  If you try something new, it may work or it may fail.  You can't discover the next breakthrough if you are afraid of failure.




2)  You will ask your clients to try new things that terrify them.   
People come to see a social worker because they are faced with a challenge in life, are striving for something new, or want to reach the next step in their journey.  They have identified something they want to change.  As a social worker you work with amazing people.  Our clients are strong and resilient.  They have established coping skills and survival strategies that have sustained them through the difficult journey of life.  You will ask them to let go of some or all of these strategies.  You will ask them to risk trying thing in a new way.  You will tell them that if they want something new they will have to do something new.  You will present the idea of letting go of what they know and approaching life in a new way.  This is a grand challenge and one that you must be willing to take yourself if you are to work with people authentically.


 3)  Model being a perfectly imperfect self.
You can only give away what you have.  If you don't know how to give yourself grace and gentleness, you won't be able to teach your clients how to embrace this for themselves.  You aren't perfect and your clients aren't perfect, and here is the perfect part about that...you aren't supposed to be!



4) Get over yourself.
As a social worker you are an important part of your client's system, but make no mistake you are just a part.  You are not the all powerful Wizard of Oz.  You do not have the ability to change anything or anyone.  You simply do your part to empower, facilitate, and advocate for change.  Don't get me wrong, you are an important change agent, but it is critical that you acknowledge that you are a piece in a very large puzzle.  Your mistakes will neither break your client nor save them...you just aren't that powerful.

5)  Being wrong is a crucial part of learning and change.
You will learn by trying new things, thinking outside the box, stretching and growing.  Sometimes it will come off brilliantly and sometimes it won't.  Each of these experiences is an important piece of your growth.  Being wrong is critical to learning.  In order to learn, social workers should approach "mistakes" with curiosity.  This is why we assess practice.  We ask ourselves, "What lesson can I learn from this experience?"



Learning how to be an amazing social worker (and human being) involves the art of learning how to be wrong.  How do I balance risk with safety?  How do I respond to failure?  What do I learn from being wrong?  How do I own and model my humanness?  All of these things are skills to be learned just as you have learned and honed other practice skills.

It just may be that there really are no mistakes, only learning experiences!










Schulz, K. (2010). Being Wrong: Adventures in the Margin of Error.  Ecco / HarperCollins.

Pictures from:  Failure Stories Behind The Most Famous & Successful People Of the World, , http://www.designbolts.com/2013/05/29/failure-stories-behind-the-most-famous-successful-people-of-the-world/

Sunday, June 15, 2014

The Price of a Dream

I recently read a post (linked here) highlighting President Obama's student loan initiatives.  In the same post he says he wants more young people to become social workers (among other "helping" professions mentioned) and to be in a position to follow their dreams.  I read this post on Facebook, and as I scrolled through the comments, I noticed a common theme.  Most of the comments were negative.  They pointed to the low wages social workers earn, the poor investment of paying for a degree when your annual salary is likely to be less than the cost of your education, and how social workers are underpaid and under appreciated.  These comments struck me as somehow false, but I didn't get very far with that idea.  Yes they didn't ring true to me, but I couldn't really figure out why.  As both a social worker and a social work educator, I am aware of both the salary range for social workers and the cost of social work education.  Higher education is expensive and costs continue to rise.  Although social work jobs are in high demand, salaries are modest.  So my "feelings" and the "facts" didn't quite mesh and I tabled the discussion in my head.

Today as I was meeting with my colleagues we had a discussion that reopened the debate.  We were discussing how to approach a cost benefit analysis on an important research project.  The discussion revolved around the cost of a complex human problem.  During this discussion it occurred to me that my "feelings" and my "facts" didn't mesh because I had oversimplified my facts.

It is a common mistake, measuring costs and benefits in simple dollars and cents.  The truth is the "cost" of our choices is far more than any monetary amount will ever capture and so are the "benefits".  I once had a phone conversation with a friend while I was on my way to the office on a Saturday.  When the friend found out where I was headed they quickly offered sympathies.  In that moment I was reminded of what I have always known.  Social work is special.  I had the privilege of saying, "It's okay.  I like it".    Those who know me know I love, triple love my work.  The passion I feel for the work and the fullness it gives me are rare in a world of dollars and cents.  It's heart work.  Being a social worker isn't a "job" it is a state of being.  We get to be present with people where they are. They share with us their strength and their vulnerability.  They honor us with their story.  They invite us to travel with them on this journey of life.  You just can't quantify the benefit of that. 

I am known for challenging my students to practice radical self-care.  Maybe it is time I also challenge everyone else to radical, passionate, fulfilling work.  I wake up every day with the privilege and honor to go to "work".  That is a benefit you may never quantify but I sure hope you get to experience it.

The picture below is of OLLU Worden School of Social Service Spring Social Work Graduates.  My wish for them is all the wealth that social work has to offer.  In my experience....they will be very rich indeed.







Monday, May 12, 2014

The Power of Community

Isn't it brilliant when something catches you?  You weren't looking for it.  It just jumps out and catches you.  This blog is one of those moments.  Throughout the last few months one theme has grabbed me...community.

I have spent the last few months surrounded by beautiful, strong women.  Women who lift each other up, who comfort and nurture each other.  Isn't this life, we all need each other.  We need community.  Patch Adams described the pull for community and togetherness.

"We need each other, deeper than anyone ever dares to admit even to themselves. I think it is a genetic imperative that we huddle together and hold on to each other. There is no question in my mind that there is nothing else in life, really, than friendship.-- Patch Adams 

The last few months I have been nurtured by community.  I thought about how to share the role of community and what being a "part of" does for us.  Then I was out running.  As I hit this hill, out of breath and tired, there was a Dad at the bottom of the hill pushing a carriage with two girls in it. 
 
 
As he struggled to get the older girl to get out and walk the hill, I leaned over and whispered to her "race you to the top".  We both smiled and off we went.  We made it to the top of that hill, the 5 year, the Dad with the carriage, and me.  We all made it.  In that moment our community lifted all of us up.  It was just a moment, but it illustrates what community does for us. With the help of our community we can go a little farther, reach a little higher, and feel a little deeper.  So this blog is filled with gratitude for the community of women who continue to love me for who I am, who lift me up when I am down, who see all the best in me, and who are always there both at the bottom of the hill and at the top.  

That hill reminds me of something great in life as well as something great in social work.  Social work is about connecting people.  Strengthening the bonds that support them and building new community.  Frances Moore Lappe said it well,

"I also believe that it's almost impossible for people to change alone. We need to join with others who will push us in our thinking and challenge us to do things we didn't believe ourselves capable of. "
-- Frances Moore Lappe


So keep pushing each other, keep challenging each other, and keep loving each other.  At the top of the hill....and at the bottom.