Friday, March 27, 2020

Shame Resilience for Social Workers

These are my notes of what I wanted to present at the Alberta College of Social Workers Conference Mar 27, 2020. 


Thanks for that (the intro) or the name of the person.

Welcome everyone. I am SO happy and excited to be here. I love being in a room of social workers and crazy enough I love talking about shame resilience- I do it a lot. I am in private practice as Clinical Social Worker and shame resilience is central to my counseling philosophy and lens. Shame gets in the way for a lot of us and makes it harder for us to understand what’s really happening underneath it—our feelings; where our boundaries are and so on. We need to strip away that first layer of shame to make our way on other issues… and actually truth be told, I just think of shame as a bull shit liar—because no matter what, we are all worthy of love and belonging. And we’ll get to all that.

I’ll just tell you a little about me… well because when I’m in a workshop I like to know who’s talking. I came up through social work. At 19 years old (untrained, clearly) I drove kids and supervised parental visits on contract with Children’s Services- I don’t know why anyone let me do that. Then I worked in group care with adults with developmental delays while in university and group care with youth between degrees- in the city with McMan and the old Bosco ranch. I worked in Children’s services as a case manager and then studied the admin and evaluation side of social work at University of Manitoba looking at the integration of services for high risk kids across ministries. 

Then I spent a decade raising kids and working in reproductive health before going back to studying to bring up my credentials to become as Clinical Social Worker. I’ve been in private practice since 2012—growing my practice while under the supervision of now my friend Karen Nielsen- social worker extraordinaire. [Who would have been in the audience and gone for lunch with me after.] :-(


The origin of this talk came about 2 years ago when I was asked by Leanne Hilsen at the University of Calgary, Edmonton Division to talk at the BSW Field Supervisors’ lunch. I’ve always been a big Brene Brown fan from the first viral TED talk in 2011 and Leanne knew that from my professional social media. And then Leanne told me about this very cool social worker from Vancouver named Vikki Reynolds. And here we are two full circles around the sun later and I spent the day in a workshop with Vikki Renyolds yesterday and heard her speak this morning and I am here talking on the same topic to you great people. [which of course didn't actually happen. FC!]  
__________  

So now I want to get an idea of the social workers (both trained and untrained—some of my best friends are people who were born to be social workers and never did get the university training).

1   Who works directly with clients’ most of their time?
2   Who has been in the social work field for 1-5 years, including students; 5-10 years? More than 10 years?
3   Okay and where do we work? Large cities- Edmonton, Calgary, Red Deer/ Lethbridge?
4   Who works in town settings?
5   And primarily rural settings?
6   And where do you go to work everyday? Hospitals and Health care settings? Schools and universities? Children services? Government social services- city, other provincial programs, federal? Non-profit agencies? Community social workers? Urban Core Neighborhoods? What else do we call that—front lines, in the trenches?
What have I missed?

And then “client issues”  (and I’m using that word because we have to have a way of talking together today, but I don’t see it as us and them- because that’s a false binary set up in the professionalization of the work and it’s distancing by its nature. It’s also false to think that social workers don’t have similar experiences as “clients” or are never “clients”.)

Who works with people experiencing: 
Poverty- income instability; food insecurity; housing insecurity or homelessness?
Mental illness including severe and persistent mental illness?
Clients with a physical disability? Chronic Health Issue?
Criminal justice involvement?
Clients who struggle with one or more addiction.
Sexually exploited now or in the past?
Suffered from multiple adverse childhood events including abuse, neglect or witnessing parents with an addiction, violence between them or other issues like metal health/ criminal involvement or addictions?
Client’s who struggle with systemic discrimination and oppression related to sex, race, gender identity, sexuality, ability, income and socio-economic status.

And is it fair to say that you all know who Brene Brown is? Our famous colleague—a social worker from the University of Huston. She is a shame and vulnerability researcher. She has a viral TED-X talk from 2010 and in 2012 she presented at our ACSW conference in Edmonton. I’m a big fan. I was there at 7:30am and got my picture taken with her. She’s written 6 books- most are best sellers and she hangs out with Oprah now and has a Netflix special. And as of last week has a great podcast called Unlocking Us. 

So today I want to use some of her ideas about shame and vulnerability and how we rise up when we struggle, fall or fail—and apply them to the work we do as social workers.
 -----
As social workers we know that everyone has a story and in fact, a lot of what we do is sit with people and listen to their story…. Where they have some from, where they are now and what they might need to move forward in their own story.

And the stories we hear are most often are stories of struggle and striving. And as social workers the people we listen TO and work alongside OF, are those who are marginalized from mainstream society—who often live with systemic discrimination and oppression.

And I want to acknowledge that many social workers live in this same way—with their own experiences of systemic discrimination and oppression. There really is NO us-and-them, but in a work context we take on the role of social worker and for simplicity the person we are working with will be a “client” in the way we talk today.

So our work is messy people caring work and it’s often in a context that is filled with social injustice. We have the people we work with and the context of their lives, their lived experiences, their story and we have us—each of us as an individual—and the context of our life, our lived experience, our story.

So before I go into how hard our work can be and how natural it is that sometimes we struggle or have difficult responses to our work, let’s first just orient to our own story as it relates to social work.

Ok, so a little housekeeping…. you’ll need a pen and something to write on and you’ll also need a sharing partner for these next 3 little exercises. Please pick someone you don’t know or don’t know very well. Not your best friend you came in with and not someone you will see at work Monday morning. And can you do a quick intro with each other, please? Name, where you’re from or where you work.

I work dyadically most of the time and so I lean towards the sharing in pairs over other formats for reflection or sharing. Great! You’re all great!

Coming into your own story-- I want you to think about a couple of positive qualities that you had as a child. How adults would have described you when you were a little child—USING POSITIVE TERMS- think age 7, 8, 9, 10, 11—in there. How would the adults at home or school describe what you were like. Take a minute to jot that down. And now share that with your sharing partner.

Okay and now take a minute to think about how those childhood qualities are potentially the gifts that you bring to your work. And consider that these qualities (even if they weren’t appreciated when you were little) are the gifts you share in your best social working moments.  Consider how they connect for a minute--- And when you’re ready, share that with your sharing partner.

AND NOW: come back again. I want you to think about a recent positive interaction with a client. Is there are highlight in the last week or month of being with a client when you felt really good about it? What made it positive for you? Did you feel a sense of connection? Did you feel a sense of shared humanity or deep compassion for the client’s feelings or for their situation? Were you in awe of their ability to get through their hard times? Their resilience or tenacity to keep going? Perhaps talking with a client helped you put something in your life in perspective?

So the purpose of that is just to orient into yourself and how that’s related to your professional role. It’s meant to be grounding into what we all love most about our work and to remind us that what sets us up to fall or fail, is often NOT our direct work with clients alone. And if you haven’t heard Vikki say this already, she writes that most of use would say our interactions with clients are actually challenging, inspiring and even transforming for us.

So now I want to talk about what it feels like when we fall, we fail and we struggle. You might have an experience to draw on—when you didn’t feel like a “good social worker”- maybe in a conversation with a client or a co-worker/ supervisor or maybe just at the end of the day when you got home and had a feeling of not being able to do it.

In Brene Brown’s work, she says that the physics of vulnerability is such that if we are brave enough often enough, we will fall. Its not IF we fall it’s when.

And social workers, by our nature and our call to the profession is that we are people who strive to live with an open heart—with what Brene Brown calls ordinary courage—Ordinary courage is the ability to speak your mind with your heart—to tell your whole story with your whole heart and that includes the part of the story that has struggle in it.

Shame is about the times when we don’t feel worthy of love and belonging, and we hide a part of our story instead of stepping into the vulnerability it takes to own stories of struggle.
Shame is the feeling of being seen as failing or falling. Shame in part is a feeling like we are powerless—that is that we can’t make change happen—and as social workers (and this would be true of other helping professionals as well) we are very hard on ourselves when we fail, fall and struggle.  We don’t like a feeling that we can’t make change happen.
We know or we believe that when the people we work with struggle we will be there with compassion and empathy, but when we struggle, typically we are not as forgiving with our own selves.

And if you’ve ever heard Brene Brown say: you can only be as empathetic to others as you have compassion for yourself, as a social worker you probably thought, that’s a lie.  I’m very good at showing up for others, I’m just hard on myself. But what we know, is that if we don’t practice self-compassion, we are not able to show up emphatically. In fact, we risk thinking in us and them terms—there are people who need help and there are people who do the helping—and remember we already said that’s not only unnecessarily distancing and relationship damaging, it’s actually threatens how we hold our personal values and professional ethics.

Courage, compassion, connection help us to overcome experiences of shame. Empathy is the antidote to shame and even if as a group we are good at doing it for others we have to work on how we cultivate self-compassion. If we don’t, we will stay isolated and insulated from connection—and then shame grows.

So a couple of quick things about shame:
Shame is different from guilt. Guilt is I made a mistake and I should make amends. I step on your foot, I have some guilt- I’m sorry are you okay? Guilt is healthy and adaptive in relationships. Shame is different. Shame is the feeling that I am a mistake. There is something wrong with me. I’m not good enough.

The three things about shame: we all have it, we all hate talking about it, the less we talk about it the more it affects us.

Shame is organized differently for men and women, but it feels the same in our body. (quick side note- it’s not as gendered as this- but for the bulk of each gender there are differences that emerged from Brene Brown's original research)—most often for women shame is a web of competing conflicting expectations and a feeling of not being able to meet all the expectations. For men, Brene Brown (and others) talk about it as a box- with a limited definition of masculinity—where if you express emotion or vulnerability, you are weak. I appreciate that one may be more based in feminine ideals and masculine ideals, but I have definitely met men who struggle with competing expectations and women who were raised to see vulnerability as weakness—especially in masculine-feeling organizational settings. So let’s say its feminine/ masculine ways of organizing shame and not necessarily men and women per se.

And in the original research Brene Brown found there are 12 different categories where we can feel shame—today we are focusing on one- related to work. Some of the other 12 areas include: appearance and body image; past trauma; being labelled and stereotyped; family of origin; mothering/ fathering; physical and mental illness, including addiction. Some of these, like mothering or trauma can be minefields of shame triggers.

You’re all with me--- ok, breathe. Just talking about shame can be inherently shame triggering, but we’re going to move through it together.

That’s what shame resilience is: the capacity to recognize shame when we experience it and move through it in a constructive way that allows us to maintain our authenticity and grow from our experiences.

These are the 4 steps to shame resilience:
1.     Recognizing shame triggers
2.     Practicing critical awareness
3.     Reaching out
4.     Calling shame by its name

So first we have to recognize our shame triggers and we have to know what shame looks like or feels like for us, individually. Often our first response to shame is involuntary and it happens in a millisecond- our brain tells us to either freeze, runaway or fight and defend. In social circumstances, that means we will move away, move toward or move against. These are shame screens- it’s what we do to hide our shame and distract others from seeing it.
Moving away is withdrawing and being secret and silent about the experience. We are likely to go numb out with food, wine or beer, shopping, on-line games or social media….
Moving toward is when we are hustling to people please the people we are with—we do this so that we can still feel as though we belong to them. Hard core people pleasing isn’t something social workers would know much about (Haha).

And moving against is when we take the uncomfortable feeling of shame and discharge it outward into blame. We try to gain power over others by being aggressive or trying to control the situation (and we often reserve this one for the people we love the most).

So if we can catch ourselves in a reaction like this, those millisecond shame screens and we can stop and say—ahhh…. Here is a shame trigger. If we can get curious about what’s going on (emotionally, in our bodies and in our thoughts) it’s like collecting data about ourselves. If we can understand ourselves better, we can grow toward our wholeness. And to do this, we need to be able to hold self-compassion—otherwise we just shame spiral. Or if that’s a hard word to hold on to, simply self-acceptance. SEE my self struggling, acting out, withdrawing and on the other side, hold some self-acceptance and self-compassion—ahh, there I am being a messy imperfect human.

Shame triggers are often related to unwanted identities relative to our idealized identities. This applies to any of the shame trigger areas- my desired identities in how I want others to see me or how I want to see myself—as a mother, in my appearance, in my mental health… and we are using work here.

So lets see if we can do this as a large group—what are our idealized identities as social workers… how do we want to see ourselves?

When I think of us as a collective group, I think some our desired identities include: Being tough- we can handle it; we are resilient and can bounce back; we are also empathetic, we can help,  we can make change happen. And we are professional. We are able to talk about our clients and their experiences with a bit of emotional distance.

What are the unwanted identities?
I think they include being seen as weak, affected by our work; not able to handle it, judgmental (or non-empathetic), CAN’T make change happen, powerless, too emotional, too attached, NOT rational in the way we communicate.

Unwanted identities dictate our behavior every day. They do this because we work hard to show only the desired identities and then we don’t share what’s going on behind that.
But it’s worth it to figure out these desired and unwanted identities because the perceptions we have and how we want to avoid them are totally unrealistic and they give us little room to be messy imperfect humans.

That’s one step in shame resilience—recognizing shame triggers.

Another step is practicing critical awareness. That’s when we step back to see the context of our experiences. So Brene Brown has a few questions related to critical awareness that can be applied to any of the shame triggers areas—but I when I thought about them in how they apply to us as social workers, I was blown away.

What are the social or community expectations regarding this issue?
So thinking about the expectations that we have on ourselves or others have on is in our desired identities- tough, resilient, empathetic, but have some professional distance. Able to make change happen and get things done.
And expectations that we do more with less; do the impossible.
We aren’t asked what we need or what resources our clients’ need, but get things done.

Who sets these expectations?
They are political and complex- connected to the government and funding. The expectations are related to how society and the media understands (or doesn’t understand or doesn’t even know about) the social issue in the areas where we work… and of course, the social issues themselves are complex.

Who benefits from these experiences?
That social workers are tough and resilient… our employers. The government. The people who want us to do more with less. The people who wan to live with their privilege in action of never knowing how challenging and unfair some people’s lives are. Those who don’t want to think about complex social issues because they think someone else can do that- that person has a social worker—they are fine.

When we work with marginalized groups of people related to complex social issues, they are not really understood. People understand the context of nurses and hospitals and health care funding and will talk about that; or about teachers and schools, but when it comes to talking about complex social problems and the people affected by them, Joe Public doesn’t necessarily understand that. And so, often there aren’t a lot of people in the conversations related to the areas where we work. And they benefit by not having to personally address that there are some very big injustices in our society We aren’t just the “good Canadians” that have universal health care.

And this dynamic further contributes to the feelings of isolation—we are the advocates in our area of work and others look at us, like why is that a problem? That doesn’t affect me.
(things like systemic racism or child maltreatment or prostitution or the criminal justice system… that isn’t about them).

Are these expectations realistic? Do they conflict with each other?
No, they are not realistic and yes, they do conflict with each other.
Does it make sense that we can always be tough and resilient when we are also called to be present and empathetic with a client’s life circumstances? How do we do our work with sensitivity to the social injustice and then always stay non-emotional in our advocacy?

When we think of these critical awareness questions about the times when we struggle, we must understand the context of our work—that’s the task—broaden the lens that we are using to look back on the times when we struggle or fall…

We work in organizations without sufficient resources to address the social problem areas where we work;

There simply isn’t enough of us to go around’

We often aren’t part of decision-making that takes place 4 steps above our pay grade and it affects us and our clients.

We are often subject to organizational change and restructuring without input…because the systems we work in are political and affected by the politics of the day and funding and so on.

We work with some of the most complex social issues: homelessness, poverty, systemic racism, trauma, child maltreatment, mental illness, aging, and many more… and we work with people from vulnerable populations: Indigenous Canadians, new Canadians, people marginalized through sexuality and gender, people who live with chronic disease and disability…

So when I was working on all of this.. what came to me was this moment: So when we are tired and feel like “I’m not a good enough social worker”, why on God’s green earth (as my mother would say) do we hold that experiences as an individual pathology? What’s wrong with me? I’m not good enough. I can’t do this. I’m not normal.

So critical awareness is a practice of reality checking expectations. We need to contextualize our personal experiences and see how the larger political, economic and social forces shape those experiences and we need to normalize—other social workers feel this too. If we don’t we will further isolate ourselves or act-out.

The critical awareness piece tells us: I am, you are, we are: messy imperfect humans trying to get through some through some tough work on some tough days with competing and conflicting expectations about what we’re supposed to do and how we’re supposed to do that.

So we need to demystify the experience of shame around our role as social workers. That means we talk about it, share what we know with others and we learn more about it. If we don’t demystify the idealized identities, then we reinforce shame connected to the unrealistic expectations and continue to make exhaustion or burning out an individual pathology.

Part of demystifying idealized identities and this comes from Vikki Reynolds work is to talk about doable job descriptions and cultivating a workplace that allows for sustainability. What would it be like if there was a workplace expectation that you take an hour for lunch every day. Or there was a walking club promoted by your boss or a clinical support circle that was supported or paid for by your employer.

So leads to step 3 which is Reaching our to tell our story. (breathe) [my note to self. lol.] 
We heal shame in our connection to others. We know how to show up for our clients, but we typically aren’t great at reaching our. And if we don’t share our own stories of struggle, we wind up feeling separated from others and insulated from connection. We have to create safe spaces for those honest conversations.

When we fall, fail and struggle as social workers and that can include working against our professional ethics or our personal values either because the political structures around our work cause that OR because we make a mistake (I know, imagine social workers make mistakes….) There are some very good, but sticky conversations about how we work with clients, how people in our organizations talk about clients and whether that fits with our collective ethics (which is Vikki Reynolds work).

So what are the barriers to reaching out?
One is a sense of otherness: social workers re great at thinking our work is special. If we think our area of work is special—we think we can’t have these conversations with outside others. For example, people who work in the core neighborhoods thinking people who work outside of that don’t get it; people who work in hospitals close to critical illness, dying and death; or people who work with child trauma and abuse. We set ourselves up for insulating and think others can’t understand. It leads to working in silos.

That’s the other thing that is a barrier to reaching out—we often work in places that have a culture of scarcity. There isn’t enough of what we need… we talk about how big were the crises and how frequent and in some work places self-neglect is a badge of honor: I didn’t even have time to eat lunch. I didn’t even have time to pee.

This further reinforces the idealized identities and doesn’t provide a space for shame resilience (or for sustainability in our work).

We need to work to shit our workplace culture so that there is room for these things. We need to deconstruct work experiences of crises and talk through difficult ethical issues as they arise.

We reach out to others to help with the reality check, have honest conversations that have space for empathy through the falling and rising process. We meet to talk about our struggles—this feeling I’m not a good social worker—and also with accountability to our ethics and our collective way of understanding our work.
And so that’s the 4th step- speaking shame. It can be hard to define or describe the feeling sometimes—because shame is a unique pain—but to speak shame means that we can talk openly about our feelings and our needs.

So when we have had a hard day and we might not recognize it, but there is a little shame edge to how we are feeling, we go home and make the people closest to us guess at what we need and then we blame them if we didn’t get it right.

If you don’t ask for what you need, you will have to act out or shut down. You don’t have a choice, you aren’t getting your needs met.

And this often leads to making us feel worse and we get into that shame shit storm. So we have to be able to speak our feeling and needs related to shame, yes, but related to it all.
Really, to be able to say this is how I am feeling, and this is what I need means that we see ourselves as worthy of having those feelings understood and those needs met.
So that’s shame resilience: the capacity to recognize shame when we experience it and move through it in a constructive way that allows us to maintain our authenticity and grow from our experiences.

So to wrap-up. Shame is the study of both the power of connection and dangers of disconnection. We need to find ways to emphatically support one another when we trip on shame triggers, fall, fail and struggle-- When we re not resilient or tough or when we make mistakes or have tough ethical issues to deal with.

As Brene Brown says, it’s being able to walk into our own stories of struggle—getting curious about feelings and the associated thoughts and behaviors that help us to own our story. I’ll end with a couple of Brene Brown quotes and then we’ll open it up for the minutes we have left.

“The irony is that we attempt to disown our difficult stories to appear more whole or more acceptable, BUT our wholeness and even our wholeheartedness actually depends on the integration of ALL our experiences, including the falls.”


There is no greater threat to the critics 
and cynics and fear-mongers 
than those of us who are willing to fall
because we have learned how to rise

With skinned knees and bruised hearts;
we choose owning our stories of struggle,
over hiding, over hustling, over pretending.

When we we deny our stories, they define us. 
When we run from struggle, we are never free.
So we turn toward truth and look it in the eye.

We will not be characters in our stories.
Not villains, not victims, not even heroes.

We are the authors of our lives.
We write out own daring endings.
We craft love from heartbreak.
compassion from shame,
grace from disappointment,
courage from failure.

Showing up is our power.
Story is our way home. Truth is our song.
We are the brave and brokenhearted.
We are rising strong. 

Thank-you.
[anticipated applause].

Questions and group discussion. 

:-) Thanks for reading it. I hope I get to present it. I even had ideas to modify it for non-profit care providing agencies and public school teachers. Stupid covid and global pandemics. 


An open letter to kinship and foster parents and group care staff


Dear___[your first name here]____,

I see how hard you are working to not lose your cool. I hear that you have lost your cool. I know how hard that first week was: How much school work needs to get done? How can you get more vitamin-rich food into your picky eaters? How can you find a minute to grab a shower? How do you explain Coronavirus and Pandemic to a child who suddenly lost their family visit this week? What about all  those field trips and outings that were planned? How does video technology work and what device can be used?

How do keep the group home clean when there is a 13 yo AWOL'ing every night and returning every morning? How do you keep up with the changing demands when the routines of your group home were turned upside down literally overnight. You have staff away sick and your throat feels scratchy and the new cleaning regime is a full-time job to itself. How will you get through this?

And that's on top of you trying to make meaning out of the things you suddenly just lost because we landed in the Age of Physical Distancing and also support other important people in your life.

As many of you are aware, scared and stressed adults scare children. The sense of safety for all of us is compromised by the pandemic. You are now in the unique situation of being The Central Adult who these scared and stressed children are looking to as a way to figure out how to respond. Even though the service team of case managers, family wellness workers, youth workers and therapists are here for you, it's suddenly only over the phone or by video call. I know it's not really enough.  

The children and youth we work with are highly sensitive to stress from adults in their environment and of course, that translates to their own nervous system acting in fight/ flight or collapse. Co-regulation depends on the adult finding their calm response and setting that tone with the child.

One of the most effective things caregivers can do is take two minutes to sit, close your eyes, breathe a few deep breaths and bring the activation of your own nervous system down some. 

Consider implementing a morning routine with yoga or meditation. If you encounter resistance, set-up an option for kids to be away from the group, but close enough to observe. Young teens might buck it, but many will welcome it. These kinds of relaxing techniques provide soothing and some will benefit from it greatly and perhaps use it for the rest of their lives. 

These are unusual times indeed, but it’s hard for me not to consider that this is also our time to shine as a dominantly compassionate species. Front line caregivers are such an important and unrecognized support to these vulnerable children and youth. 

My wish for you is that you will move past the cycle of heightened response- collapse and feel your feet on the ground and be able to take a breath. 

I see how hard you are working- often understaffed and over-stressed. 

I appreciate your hard work on behalf of the kids who don’t know how to thank you.

Thank-you. Thank-you. Thank-you~ from all of the children and youth and from me.

Warmly, 

Heather 











Cancelled Conferences and Front Lines

This morning I should be standing in front of a large group of social workers at the Alberta College of Social Workers presenting: Shame Resilience for Social Workers. I was excited and scared to do this and disappointed and relieved when the conference was cancelled in the name of Physical Distancing.

I first gave the talk in April 2017 to the BSW Supervisor's during their end of year appreciation luncheon. Leanne Hilsen, from the Faculty of Social Work at U of C, Edmonton Division asked me to do it and it was an unpaid gig. She introduced me to the work of Vikki Reynold's a kick-ass social worker from Vancouver. Vikki was supposed to be the key note speaker of the conference this morning. There was a 'come full circle' feeling that didn't get to complete itself. There is a weird dissatisfaction from that open end. I hope to complete it.

When I gave the talk in 2017 I was mostly talking to people who didn't directly work with people receiving services- they were supervisors and a handful of professors and we were on Saskatchewan Drive upstairs at the Faculty Club- far away from the proverbial front lines. And social workers were feeling good- we had an NDP government and a handful of our own Registered Social Workers in power! Life was good! And when I talked about our collective professional struggles including the political, I'm not sure if they could relate.

Fast forward to September 2019 when I wrote up the proposal to re-do this talk for a larger social work audience-- the UCP were in power and delaying their budget until after the federal election in October. I started to prepare the talk as the budget of deep cuts were announced, unions and others were organizing and we were all noticing the chasm between those of us who remember the Klein years of the 1990's and those who only knew the stories. The divided world of Alberta politics versus social justice and human rights was flared.

And then COVID. Or Fucking Covid (FC) as I like to call it.

We need the shame resilience more than ever. There are so many "front lines" now. And we are paying attention to them in top priority and missing some of the many other important ones. Right now we are preparing for the physical disease- as we should be-- and health care truly is the front line. And we recognize the front line of 'essential services' as never before: grocery store staff, pharmacies, store cleaners, delivery people and the trucking industry. These are so important! These are all about the physical necessities and staying alive.

There are social and economic implications to this virus that we are only seeing the ice berg tip of right now because we are in early days. We see the 'front line' of services to the most vulnerable people- in Edmonton that's the shelter set-up at the Expo Centre for people without a place to call 'home'. And the social workers and other community workers who are risking their own health to show up for those in need.

And we have the Federal government staff who working to get Canadians financial benefits as soon as possible. They are creating and rolling out a brand new benefit on the fly within only a few weeks.

The front line I see are the kinship care providers, foster parents, child and youth care counselors and case managers who are continuing to provide services to the children who are out of parental care. These vulnerable children are sensitive to the stress of adults, acting out or inward when their environment triggers them. As FC  (remember, that's Fucking Covid) drifts further into our communities, these people continue to care for the children under circumstances much more difficult than normal.

So many homes were set-up to function well WITH community supports- school, respite weekends, rec centre passes, therapy and other professional support, FAMILY visits. These same children with their sensitive stress response systems have lost any bits of life that helped to calm and regulate them. (An entire post could be dedicated to the losses of these vulnerable children and the impact of temporarily losing family visits.)

No one has a contract with Children's Services that says they agree to quarantine with the children in their home or group care facility.

And until recently none of these agencies and homes had a "Pandemic Policy."

And now with FC, these front line caregivers are going ahead and trying to adapt to a new reality. We don't know how it is going in all the homes of all the families who are now inside with their children, but we do hold a higher standard for the foster parents and group care staff to ensure that these vulnerable children are cared for. These are unprecedented circumstances and they are working beyond the role they ever agreed to take on.

And this is where we need shame resilience more than ever. When our nervous system is activated and collapsing though the early days of trying to find our way into this new way of being, we will make mistakes. And when we do, can we be kind to ourselves and know that our best (even when we don't have a lot) is in fact enough? To keep trying is our goal NOT getting it right every time. I will say more about this when I get to writing up the workshop I am not presenting today.

I'll stop here for now. Feel free to write your thoughts from your perspective and experience about the front lines you see, are experiencing or appreciate.



Saturday, March 21, 2020

Ambiguous Loss (AL)

I don't want to write about this. Maybe I should have started with writing about "resistance". I feel a lot of resistance this weekend. And I'm cranky and sad and just slightly self-pitying. Are you with me yet?

I have SO much to be grateful for, but I will not shame myself for having feelings about losing my "normal life" (AL #1).

Until Sunday evening I was planning to have a modified-in-cleaning, but still regular-work-week.

And then they closed the schools.
Shit.

I had planned that when the schools closed I would stop seeing people in my lovely office space.  (I love sharing my office space- it's warm and cozy and I try my best to make it comfortable above all else. AL #2)

So quickly and under high stress I started to figure out video platforms for Tuesday morning while seeing the last of my in-person adults and rearrange my quickly changing calendar.

People also planning on "normal life" up and until Sunday evening cancelled their appointments. The mom coming to tell me about her family's mental health needs and begin some counseling services left a voice mail saying "I just don't have the mental space to talk about what I was coming in to talk about." (Yeah, I hear ya. Of course. No problem.)

And as my calendar started to fill up with the red bar of "cancelled" across the top of each session, I could feel my mobilized social worker heart move into decisive and concrete action: find a video platform; join groups related to telehealth counseling on social media; consider briefly ethical issues of secure platforms being down and decide some needed the counseling session more than they needed me to say, "I'm actually not allowed to use Facetime for mental health-type services." Ok, go- crisis mode. Mental health triage.

Intermittently I would struggle to keep the problem-solving part of brain going in the face of so many moving pieces and problems to solve.  I had SO many lists of what needed to be done to adjust to this new reality. I know many of you did too.

By Wednesday I had figured out what device and located where in my office would work best for talking comfortably with the 'normal' visual distance of an in-person session. (The answer is the art table with a lap top on the top of a sticker basket.)

And it was strange to hold space that way, but my social worker-therapist heart was committed. I wanted to be present for child and adult clients alike. I'm primarily child-led in my practice philosophy and it's a funny thing to keep up and nudge us along in video sessions. My young client went to her family's art area and started painting. (OK! I will paint too. Show me how you blend colors and I'll give it a try. Let's hold up our pictures.)

I felt so strangely tired after only a few video sessions in a row. I read from other therapists later, that we are straining harder to be present and attune when we are doing it across the screen. That made sense to me. My whole body was tight with focus different from in-person sessions where I am intentionally relaxing my body.

And that might be ambiguous loss #3, understanding the workings of my own internal sensations. Stephen Proges coined the term interoception to name this sense. I am highly practiced at looking inward and knowing where my conscious mind is relative to the situation and my emotional state; how my body is feeling and what I need or do not need.

BUT this week! What is that feeling?! And that one? WTF! I don't like that!

(Thank goodness for sessions-- when I focus on being present for someone else, that is still a familiar feeling even with the changed medium. Stay present and with the internal world and words of the person with you. Got it. Check!)

But the in-between times it's being overwhelmed with concern and frozen at the same time. It's feeling stuck and not even quite sure what list needs to be made. Its knowing I want to act, but feeling completely stuck in how to take the smallest step. In a phrase, it's activation and collapse.

These are not normal times. And my body responded as it was meant to-- for survival. Being overwhelmed to a certain degree will move us to be mobilized BUT only for so long in duration or intensity and then we move on to immobilization/ collapse. This is the foundation of Porges Polyvagal Theory. My experience was intense energy spent to be present in video sessions, writing emails and making phone calls and then at the end of the day, collapse.

My typical work evening routine includes sitting in my favorite chair with a tea tray and watching something neutral or funny on Netflix or other media. I often listen to music and write depending on what I am feeling or need. This week, I was completely unable to have any sensation in my ears or eyes at night. I couldn't find comfort in a show or a song because I couldn't tolerate the stimulus. So strange. (AL #4- comfort activities). Oh! That hits a nerve! How many of you have lost routine comfort activities- gym, rec centre, swimming pool, social outings, window shopping, cafe sitting? Yikes! Everyone of us is feeling that!

That's my view. What's yours? What hard-to-define and lost-without-closure-or-meaning-making loss are you feeling? You're welcome to comment from your own perspective about your own experiences if you would like. Be nice, of course. We're all in this together, friends.



Friday, March 20, 2020

Feeling Safe

Safety.


Help people feel safe and you will change the world.
-Stephen Porges. 

I have been really focused on safety and what it means to feel safe. I was talking about this in the last several months after finding polyvagal theory and its application to children living out of parental care. Many of the people I see are children involved with Children's Services. In the case of many of these children, they have been neglected to different degrees and witnessed violence and intoxication. 

Their brains have adapted for survival first. They do not have the same trajectory of brain and holistic development as a child who has been raised in a felt sense of safety. For these kids, their brains are so adapted to survival, that even when they are moved to a safe home they don't immediately feel safe. It can take months of stability and predictability and caregivers in small moments of therapeutic intervention and providing corrective experiences for the trajectory to shift a few degrees into a new direction.  

And what happens when all of their adults begin to feel unsafe? These children are like the proverbial canary in the coal mine. They will respond faster than others to the sense of tension in the air. And the air is full of tension this week- especially in larger group care facilities. It's a steep learning curve with information changing daily.

We humans in the Western world are not used to high and on-going levels of uncertainty and safety. The exceptions are plenty and these kids I described are the example. For most of us though we have multiple places where we feel relatively safe. For example, maybe work is challenging, and your supervisor is mean, but when you go home to your children or partner or you go to the gym you feel safe. You see people you know and you re-set through small or significant social interactions. We feel better about our self when we have social relationships that mirror the best aspects of our self. 

Now, we are all home. We are all feeling unsafe and tense- intermittently between feeling calm enough, distracted or simply numbed out. When our nervous systems have been activated and we can no longer sustain that level of activation we collapse. Likely many of us are hopping between activated and collapse. At least the people I've been speaking to who are juggling uncertainty on multiple fronts. 

So how do we find a way to become safe again. Is it okay to feel safe when we are (in that moment) in fact safe? How do I help my body know that it is safe? 

First, remember you deserve to care for yourself as much as anyone else deserves your care. Next find two minutes and a quiet place. 

Close your eyes and imagine a place that is calming for you. By the ocean or lake on your last vacation... or in the woods or maybe swimming lengths at the pool. Any place you have experienced as feeling calm and safe. 

Take a few deep breaths. Don't worry about counting. Just begin to slow your breath- each time going more slowly-- inhale, hold and exhale. If you feel drawn to taking long breaths and holding longer and exhaling longer, do that. If it is harder to take your breath out of your chest and into your belly, breathe as deeply as you can. No shame. No judgement. 

Feel your feet on the ground. Imagine there are roots coming from the bottoms of your feet. With every exhale you can breathe out through the bottom of the feet and release any tension…down down…. down from the bottoms of your feet and into the earth. Allow the earth to take that energy to recycle it into something else. You can let go of anything you no longer need to hold on to. 

Allow yourself to stay in this state for a few minutes. Give thanks to what or who moves you to do that and tell yourself: I'm doing the best that I can and that is enough. 

The last thing any of us need at this time is shame and judgement. Shame is frequently the emotion that fuels the anxiety/ stress/ feeling of unsafe. We are all in this together. We are all worthy of love and belonging. We all deserve support and to be seen for a human who is trying their best in these interesting times.  

Take care friends. 


Counseling in the age of physical distance


I feel like the Italians I watched on video last week-- they are in isolation talking to the "me from 10-days ago". And here we are 8 days since large events were cancelled and 5 days since the schools, libraries and rec centres closed. 

I'm not going to lose my job. In fact my job just got busier and more complex for not only the next several weeks as we are isolating, but for the next several years. It's hard for most people to see how far into the future the long-term social implications will reach. So many families rely on separation into different daytime activities; the use of recreation centres, lessons, the public library for managing the fabric of their family life. And my feminist allies know, the brunt of the mental and emotional work will fall to the women. 

And that's where telehealth on-line counseling comes in. You don't need to struggle and suffer alone. We all require someone to help us make sense of our experience and when our go-to friends are also struggling, it can be hard to feel there is space for our issues.

Consider reaching out to arrange a video counseling session. It can help you vent, have your emotional states and thoughts untangled and reflected back for you to decide their meaning and help you to re-group and start again. There are rougher seas ahead (as much as I don't want to admit that) and you don't need to sail alone.