Friday, March 21, 2008

The Big Screw Up OR The End of Denial

All happy families resemble one another. Each unhappy family is unhappy in its own way.
- Leo Tolstoy
We’ve probably all heard that the Chinese sign for crisis is the same as opportunity. I don’t know if the part about that being a Chinese sign is true, but I do believe that crisis is a chance for change. It is life telling us – Hey – this ain’t working – you can’t force it – so here’s a chance to make it right.

In my job as a social worker at a criminal justice agency, we ask complainants in domestic violence cases to come talk to us. Most of the time, they say it didn’t happen, it was her fault, they were drunk, she is crazy, he was only defending himself, she made it up to because she was jealous, etc. Once in a while, her current story may be valid. Most of the time, she’s covering up for him – out of a combination of fear, love, shame, and hope.

Some people may get caught up in trying to “catch” her in the lie. That isn’t the point. I want to reach around the story and get to the emotions. The only way to do that is put my ego aside – it isn’t about me. It is about her – and her kids. I don’t know what she is facing. It isn’t my job and it isn’t even the point to “talk her into” pursuing charges. The prosecutor will evaluate the case based on the evidence and go from there.

My part is talking with her (or him as sometimes the case may be). Yeah, it totally sucks to be in this situation. I know you’re embarrassed to be here. I know you’re not like those other women in our waiting room. But, how can your life be better? Can I help you? You and your kids deserve to be in a home where you are safe. You deserve to be respected. You did the right thing by getting help. You’re not alone. I’m worried about you. There are people who can help you if you want.

I don’t mind confronting people if it is necessary – but with compassion. Recently, a mom dropped a protective order. Based on his previous violence, there is no doubt in my mind that he will continue to hurt her and her children. I told her I was very worried about them. Right now, we have him in jail – charged with some serious crimes. We intend to keep him there. I hope we can. Mom believes he “has changed.” She doesn’t have a lot of options, so she is picking the least resistant one – false hope. I’m not pretending all her options aren’t hard or dangerous. I know that often women like her are in more danger when they leave. So, the only thing to do now is try and keep him in custody as long as possible and to keep the door open for her. This crisis is a chance for her and her children’s safety – IF we all do the right thing.

Denial is a very effective coping mechanism – for a while. I’ve certainly used it. I’m sure we all have. The thing is, eventually, we might be trying to juggle too many balls. Eventually, we get one too many and they all crash. I once had a client tell me that her husband wasn’t serious about changing. She said, “He’s just shuckin’ and jivin’.” That really summed it up. He was just talking and pretending.

With crisis, comes shame, panic, fear and relief. We often don’t even realize how stressed we’ve been until we have to stop “shuckin’ and jivin’.” Life forces us to face hard realities. So, yes, with the big screw up, comes the end of denial and the chance to really fix things.

Saturday, March 15, 2008

Boundaries

I’m always working on boundary issues. So, why am I writing a blog? I’ve got to do something with my thoughts. And - I wish we had more social workers working in criminal justice, so I hope some will read this blog and be interested. This is my technical pensieve, Harry Potter fans will get the reference – for the rest of you, a “pensieve” is a repository of memories. You can put your memories in the pensieve and that way your brain doesn’t get too overwhelmed.

Anyway – If I could think of a different word, I’d use it. “Boundaries” just sounds too psycho-babble-ish to me. Maybe, I’ll say “limits” instead. I want to talk about limits – the place where I say, “Back off, you’re getting too close, or I am.”

When I was growing up in my large, enmeshed Catholic family, I desperately sought boundaries. I surrounded myself with three cereal boxes in the mornings to give myself a 2-foot area of private space. I’d put one in front of me and the other two boxes on either side and quietly eat my cereal. That way at lease I could have a little space of my own for about 10 minutes. I also remember spending a lot of time sitting on the roof or in a small treehouse. Sometimes I’d ride my bike to the neighborhood library. In our crazy, chaotic home, there weren’t many places to have “personal space.” The idea of boundaries was foreign. If I ever complained about not having my own room, my mother reminded me that she never had her own bed.

As I got older, I had to learn about boundaries – both in personal and professional relationships. I’m getting better. I’ve had to learn how to draw limits for myself and my friends and family. I’m learning to say NO when I need to.

Boundary issues are HUGE in mental health practice. We even have fancy names for them – transference and countertransference. Transference is when our client “transfers” feelings they have for someone in their personal life to the therapist. For instance, perhaps I remind my client of her mother, so she starts treating me like that. Countertransference occurs when we (the clinician) identify the client with a relationship in our personal lives. For instance, I may start treating a client like my daughter. I may start responding to her as I would a daughter, which is never good.

Boundary issues are so important with clients, that we have strict ethical rules. We are supposed to avoid dual relationships (I can’t treat a family member or friend for instance) and unlike attorneys, we can’t have sexual relationships with our clients.

We have these rules for the protection of clients. Despite our value of “working with” our clients, the fact is that we have great power in the relationship. We must be respectful and vigilant in protecting our clients. I always remind myself that while I may have seen thousands of clients over the years, they don’t see thousands of social workers. Some may see more than others, but what I say, how I treat them, even in a short session of 30 minutes can be very important.

I once had a client return to our office after five years. She said I kept your card and I remember what you told me five years ago – I’ve thought of it often. Wow. Panic. I remember thinking that I hoped I said something good. It turns out I did (whew). I told her that I hoped he wouldn’t keep hurting her, but if he did, to come back and see me. She did – five years later. Another one of those “magical moments”, I’d say.

Keeping up good boundaries is hard work. We have to be thinking about all kinds of communication. Not only what is verbally said, but non-verbal communication, and physical communication. We usually deal with some pretty heavy and shameful stuff in our sessions. We always want to end on a positive note – remind her of her strengths and good decisions. And depending on the client at the end of a session, I might shake her hand, pat her on the back, or even give her a hug.

Many of my clients have major issues with boundaries. Early on in their lives, they were either never taught about limits (trying to use this word instead) or they were taught that their limits did not matter. We work on those issues. Often, I have clients who call me several times a day, or make unreasonable demands. These are learned behaviors – and they can be unlearned. For someone like this, I try to model boundary setting, by not responding to her excessive demands. For instance, if someone calls me 4 times in a day, I’m not calling her back until the next day (unless it really is a true emergency – you learn to tell the difference).
I have to be careful not to "do too much" for my clients. This is a mistake I made much more often earlier in my career. It isn't healthy for the client or the social worker. Kind of the old "teach a person to fish" thing. If we do too much, the client won't learn to do for themselves and they'll still be in the position of depending on someone else.

Now, in the interest of limit-setting, my kids just woke up, so I am turning off my computer and joining my family for the weekend.

Sunday, March 9, 2008

Tips for Testifying in Criminal Court

These are all the things I usually talk with people about before they testify. Maybe it will help you or your clients.

· Inside the courtroom – if you haven’t already been sworn in, you will be sworn in – you raise your right hand – listen to what they are saying – then say “I will.”

· Once you sit down, you may find that your heart starts beating quickly or you suddenly feel nervous. That is normal – even for people who testify a lot (like police officers or expert witnesses).

· Quietly take a deep breath – imagine the breath is going all the way to your stomach. Hold it and count to 3. Then slowly (and quietly) let it out. Do this 2 or 3 times.

· When you are speaking, don’t go too fast – the court reporter is taking notes of everything you say.

· The prosecutor will ask you some simple questions, like your name, what you do for a living, etc. Then they’ll get into more serious questions about the case.

· They may ask you to point out the defendant in the courtroom – this is the only time you have to look at him or her. They may ask you to describe something he or she is wearing – you might say “She has a blue shirt on.” Or “He is wearing a brown tie.”

· When you are answering questions, answer only the question the lawyer asks. Don’t try to guess at what they mean.

· Don’t try to be clever, cute, or augmentative. Be serious and sincere.

· If it feels comfortable, look at the jury when you are answering the questions – they are your audience.

· Sometimes you may get asked a question that you don’t know the answer to, or you may not understand the question. It is OK to say that you don’t understand or don’t know. You can even ask the lawyer to repeat the question.

· The defense attorney may act like she is mad at you or act like she thinks you are lying. Don't take it personally. Stay calm and only answer the questions she is asking. Don’t argue with the lawyers.

· If the defense asks you something that you think makes you look bad, if the prosecutor feels it is necessary, they will ask you a follow-up question when it is their turn.

· The most important thing: Tell the truth. Tell the truth. Tell the truth. Even if it makes you look bad or you feel that you did something bad or wrong, tell the truth. If you lie about anything, the jury might think you are lying about everything. Don’t be ashamed - Everybody has things in their life they wish they had done differently or there may be private things in your life that you don’t want other people to know.

· The lawyers can go back and forth and ask you questions –the prosecutor, then the defense attorney, then the prosecutor again.

· If one of the lawyers objects, stop talking. The judge will rule on whether you can answer the question. She will let you know if you can answer or not.

· The judge may tell you that “the rule” has been invoked. This basically means you can’t discuss the your testimony or other people’s testimony. The judge will explain more. No matter how much you want to talk about it – you cannot. You will jeopardize the case and your credibility if you do.

· Once you are finished testifying, the judge will excuse you. You may be excused to leave for good from the case, or you may be asked to remain in the courthouse. Or, the judge may let you leave the courthouse, but tell you that you will be “on call” should they need you later in the case.

· When you leave the stand, quietly walk out of the courtroom.
  • After you testify, you may feel nervous all over again. You may even feel tired. This is normal because you’ve just had to talk about something possibly personal or painful in front of a lot of strangers. Take some time after you testify to relax – take a hot bath, spend time with friends, go outside, do something relaxing.

Saturday, March 8, 2008

Suffering

Have compassion for all beings, rich and poor alike; each has their suffering. Some suffer too much, others too little.
- Buddha

What can hurt a parent worse than to watch the suffering of her or his child? As a mother, I cannot imagine a greater pain. As a social worker, I don't think I've seen greater pain. The only thing worse is feeling powerless to help your suffering child.

Being a parent is the combination of the greatest love and greatest fear. The greatest love because, well, just because it is. There is something ancient and primal about it. The love a parent has for his child is visceral – we can feel it in our guts. That leads to the fear part. We want to protect them, to make them safe, to fight for them, and clear life’s path for them.

In my work, I’ve spoken with many parents who despair at being unable to save their suffering children who are caught up in the trap of domestic violence. We’ve learned to call the victim’s mother when we are prosecuting a batterer. Most of the time, she’s worried about her daughter, even been cut-off from her and can’t figure out a way to help her get away from the violence. Occasionally, we find the mother not defending her daughter, but the batterer. That conversation is also enlightening - and disturbing. We know, too, that the parents of the abuser also suffer. Many times, the son is repeating the lessons of the father. As much as he hated his father beating his mother when he was growing up, he has internalized the behavior.

Not long ago, I met with some parents who were unable to help their daughter. Her estranged husband had killed her. The parents knew their son-in-law had been violent with their daughter. They didn’t know the extent. They did what they could. They begged her to bring her four-year-old son and come home to live with them. The daughter did try to end the relationship with her abusive husband. But, she felt she could manage the situation and didn’t want to move back home with her parents. Who could blame her? She was an adult and didn’t want to feel she was moving backwards in life. Besides, he may have gotten her at work or some other place. Moving home with her parents was no guarantee of safety.

Lost. That is the word I would use to describe her parents. They had endured many sleepless nights knowing their daughter and perhaps their grandson was being hurt. They probably felt some initial relief when their daughter ended the relationship with her husband. They probably didn’t know that a battered woman is most likely to die when she ends the relationship. Many people don’t and that is why they ask, “Why she doesn’t just leave.” They don't realize that leaving is the trigger for death.

The parents did what they could. In the end, it wasn’t enough. Nothing was. How they must have suffered. And, how they will suffer asking themselves “what if” questions. I am sure either one of them would have traded places with their daughter. Most of us parents would gladly trade our suffering for that of our children.

Our part begins with that initial meeting. We will work to bring the killer to justice. I hope the parents experience some catharsis through this process. Many do, I’ve learned. That’s what we can do for them and what we will do for them. It isn’t enough – nothing could be. But, it is something.

In suffering, there is compassion, understanding and eventually hope. The loss of a child, especially to violence, is never something to “get over” and I’ve heard many parents tell me there is no “closure.” Eventually, we hope, there is acceptance and some measure of peace.

Saturday, March 1, 2008

Don't Mistake Kindness for Weakness

We may never be strong enough to be entirely nonviolent in thought, word and deed. But we must keep nonviolence as our goal and make strong progress towards it.

- Mahatma Ghandi


In honor of National Professional Social Worker Month, please indulge me in venting on one of my pet peeves: Social Workers as Gullible Wimps

Some of my co-workers ask us if we can be available to do some “hand-holding” with a complainant. I know they respect us. I know they value our work and our opinions. And – I really try not to let this bother me, but it does. I’m trying to figure out why.

I have eight years of professional training – college, graduate school, and 2 years post graduate clinical supervision. The State of Texas says I’m qualified to diagnose and treat mental illness, even open my open practice if I want to. I don’t. I like where I am just fine, thank you. Actually, I love my job and I wouldn’t trade it for anything. My clients are awesome and I genuinely like my co-workers (like one big dysfunctional family, we are).

I guess it bugs me to have my profession reduced to “hand-holding.” And, I think it minimizes the victim’s role as someone whose “hand needs to be held.” You guys sit over there and hold hands. Of course, in reality, my co-workers and I do a lot of hand-holding and we’re glad to do it.
It is a chance to help someone when they need support. However, there is a lot more that goes on. I call it street social work. Many of our clients do not seek counseling, although I wish they would because it would help them. So, this gives us the chance to go to them, to provide some supportive and educational counseling with them.

It goes along with this idea that all you have to do to be a social worker is to “be nice.” Well, you should be kind, and compassionate, and open to all kinds of people – that is true. But, you also MUST have the ability to confront, demand, and advocate. The trick is knowing when and how to do it.

The term “social worker” is often misapplied to anyone who works for a non-profit or CPS. That’s like saying a paralegal is the same as lawyer. They both do legal work, but one has the training, degree, and license and one does not. In Texas to practice social work, a person must have a degree in social work and pass a licensing exam. There are different levels of social workers, from bachelors to masters level clinical social workers. In addition, clincial social workers are required to have two years of post graduate clinical supervision.

Social workers are the most represented discipline among mental health treatment providers. We have training and skills in crisis intervention, substance abuse, mental health diagnosis and treatment, and suicide assessment and intervention. We are trained to consider a person’s culture, gender, socio-economic class, ethnicity, and many other factors. We study social and clinical theories. We are trained to work at a political level as well. What impacts you and me, probably also impacts others and we need to demand a systemic response.

Now to the idea of social worker = gullible wimp. You’ve probably seen this in the media, when “social work” is code for someone who is gullible, not willing to be tough, or hold others accountable, things like: “We aren’t a bunch of social workers.” or “This isn’t a social work office.” Grrrrrrrr I may have compassion for someone who has done an awful thing, and even try to understand how and why he got there. That doesn't mean I don't believe he should spend a long time in prison.

Anyone can be nice. Anyone can confront. The skill is confronting someone while being kind. And being aware not only of the words being exchanged, but the emotions going on – being aware not only of the content of the conversation, but also the process, being aware of the present moment, as well as the context. It is hard work. It takes a lot of training and practice. We aren’t just having a chat. All the while, we are observing, thinking, teaching, and helping our clients to recognize their strengths and acquire skills to makes their lives better.

Yes, of course, at the heart of it are compassion, empathy and connection. It wouldn’t be anything without that. But, don’t mistake our compassion and understanding for weakness. Please.