Monday, February 25, 2013

Some Thoughts on Online Posts

Our Words Online:   Some Thoughts for People Who Work In Positions of Public Trust 

The options and capacities available in the world of online social networking and communication are increasing at a speed that leaves a lot of us with heads spinning. We share photos across the country in real time. We chat face to face with people halfway around the world. Much of what goes on in the internet world seems quickly relegated to the oblivion offered by the sheer volume of bites layering upon bites. That is, until someone either happens upon something you’ve posted, or intentionally goes looking for you, either out of curiosity, in appreciation of your work, or because they hope that they might be able to discredit or undermine you.

When this happens, just about everything you have written is right there for better or for worse. People can look at it, pour over it, distribute it, take it out of context, make attributions about you and your words, think well or poorly of you and of anyone or anything associated with you.  

In this way, a momentary annoyance, or a tongue-in-cheek comment expressed online can become a banner that grows in significance and meaning. It can become an overwhelming, even “viral”, and very permanent representation of you, of the voice of the agency, profession, or other associated group to which you belong.  This speaks to the issue that if social networking occurs “off the clock” in a person’s personal time, whose business is it if they post, for example: 

·        A complaint, frustration, or exasperation about what an un-named client has done?

·        A desire to be retired , on vacation, or doing something else?

·        Positive or neutral comments about an un-named client?

·        A re-count of an interesting or challenging “case” at work? 

These are not necessarily unauthorized disclosures of protected health information, though they easily might be. These particular types of statements are more subtly destructive of the trust the community places in us, the trust that allows people to take a risk in disclosing themselves to us, and the confidence they place in us that ultimately allows us do our work effectively. These types of statements raise questions about our fundamental values, professionalism, objectivity, respect, interest and commitment to our work and to the people we serve. They also raise questions about our basic ability to keep our mouths shut when needed.  

These posts may seem innocent to the writer or amusing to their friends, but they are, in fact, profound and far-reaching violations of the trust that our clients and our communities place in our agency and in mental health practitioners in general.


Monday, September 24, 2012

When the Unthinkable Happens: The Search for a Scapegoat

When The Unthinkable Happens

“The search for a scapegoat is the easiest of all hunting expeditions.”
Dwight D. Eisenhower

In the course of things, there are instances when communities find themselves faced with horrors of loss or cruelty that we can’t understand, even after all the investigations, criminal, civil, and treatment options have run their course.  These become the circumstances burned into our collective hearts by which we measure and judge our ultimate vulnerability as well as our resilience as individuals and as a community.  

Being faced with a situation that can’t be comprehended can send individuals as well as groups of people into a frenzied search to identify and highlight the differences between the “evil” of “the other guilty person” and the “moral high ground” of our own familiar lives and values.   

Scapegoating in various forms is a widely practiced solution that effectively restores a sense of contentment and predictability to the world when it seems overwhelmed by evil.  Unfortunately it stifles productive self reflection and does nothing to heal the grief and anguish both individuals and the community rightfully feel when innocence is horribly lost.  

Reading down through the comments that follow articles about these sorts of incidents, it is easy to interpret parts of the string as a focused attempt to find someone to blame, to gloss over and trivialize their struggles, their dreams and challenges, to dehumanize and marginalize them.  It leaves them to suffer judgments they can’t even fathom, ultimately making sure someone pays for these sins regardless of the degree to which they might be accountable.  

With fictional user names, the comment section easily becomes the modern equivalent of a masked mob, gathering in the night with torches and pitchforks, looking to dehumanize and punish anyone upon whom they can focus the sins of the day, anyone.  

To blame without fully understanding a circumstance is unsophisticated, unkind, unhelpful, and unnecessary.  Human behavior is complicated and multiply determined.  Simple pronouncements of either blame or blamelessness always do a disservice to the truth.  

We empower our courts and our governmental agencies to sort through the complexities of these situations and to do their best to come to a resolution that preserves the order and values of our culture.  They do this for us, as our representatives.    For the rest of us, let’s try sitting with not knowing, with grief and anguish for the layers of loss suffered by our neighbors. 
Try compassion and personal incomprehension.  Resist drifting into the comfort of enraged blame.  Encourage the people around you to do the same.  It doesn’t offer the same comfort as being able to “close the book” on the situation, but it will leave you a beacon of fairness, truth, and justice in a world already too full of dehumanizing hatred. 

Tuesday, January 3, 2012

A Child Goes Missing: Helping the Community's Other Children Cope

Our communities face difficult challenges every day but occasionally encounter situations that shake the very foundation of our sense of predictability and safety in the world.  These experiences can leave us needing to manage feelings of fear, anger, anxiety, and helplessness. Right now, our community is in the midst of coping with the unexplained, extended disappearance of a tiny, vulnerable child, a situation that strikes an anguished chord and generates powerful feelings for anyone who hears about it.  It is a “worst fear” scenario and one so rare that it can be difficult for parents and professionals to find a good “roadmap” for coping with it.  

Children do go missing, though and there are national organizations that provide expert resources for communities, schools, professionals, and parents who need to help children cope with the unthinkable.  

The most specific resources located in developing this resource are on the websites of these three national organizations.  If you are interested in more information, these links will provide you with a lot of useful ideas and approaches including recommendations for parents and other involved adults.   

The National Child Traumatic Stress Network:  

The resources provided by these sites offer a great deal of common agreement on what is important and what works.  Some of these ideas are bulleted here for your convenience.  They are a place to start in helping the children in your care avoid traumatic outcomes.

  • Frightened children are not safer children.    Parents who manage their own feelings, stay calm and reassuring and talk to their children in terms they can understand  have the best chance of effectively teaching their children mastery of the concepts and skills that will protect them.    
  • Children quickly pick up adult distress.  They are easily upset by the drama of media events and attention. 
  • Media events, drama, and coverage can produce increased fears and anxiety in children.
  • The more time children spend participating in or watching media coverage or adult discussion of the events, the more likely they are to have negative reactions.
  • Graphic images and stories of loss may be particularly upsetting to children.
  • Paying attention to your child’s feelings and understanding is the best way to determine what is working for them and what is not helping. 
  • Creating opportunities to talk with your child about what they are seeing and hearing and how they understand it will give you valuable insights into how they are thinking about the situation and whether they are feeling safe and protected
  • Children are often included in or otherwise exposed to well meaning community events such as prayer vigils or shrines of hope.  Older children, in particular, may want to participate, to express their prayers or good will.  Parents and schools should be vigilant, though, to make sure that the experience remains voluntary and positive for the child regardless of their age.  Children should not be forced to participate in adult venues in ways that dramatize or reinforce anguished over-identification, frighten them or make them uncomfortable. 
  • While there is no right or wrong approach to these situations, a parent or school’s sensitive monitoring of a child’s understanding and emotional state is the best way to tell whether their approach is on track or not for any particular child. 

The National Child Traumatic Stress Treatment Network offers some practical suggestions, paraphrased, and excerpted in part below, for parents if their children begin showing signs of emotional trauma. 
Helping Young Children Heal
Young children, toddlers, and preschoolers, even babies, know when bad things happen. After a traumatic event, we often see changes in their behavior. They may cry more, become clingy and not want us to leave, have temper tantrums, hit others, have problems sleeping, or become afraid of things that didn’t bother them before.  Changes like these are a sign that they need help. Here are some ways you can help them.
·         First focus on your child’s sense of safety. Your young child feels safe when you hold him or let him stay close to you.  Older children feel safe when they see their parents confident and reassuring in their ability to protect them.
·         Tell her you will take care of her when things are scary or difficult. With children who are learning to talk, use simple words, like saying ”Mommy’s here.”
·         Keep him away from frightening TV images and scary conversations.
·         Do familiar things, like singing a song you both like or telling a story.
·         Have a predictable routine, at least for bedtime: a story, a prayer, cuddle time.
·         Allow expression of feelings
·         Young children often “behave badly” when they are worried or scared. Children can “act out” as a way of asking for help. Remember, Difficult feelings = Difficult behavior.
·         Help your child name how she feels:”scared,” “happy” “angry,” “sad.”  Tell her it is OK to feel that way.
·         Talk about the things that are going well to help you and your child feel good.
·         Follow your child’s lead.  Different children need different things. Some children need to run around, some want to talk,others need to play or be held.
·         Listen to your child and watch his behavior to figure out what he needs.
·         Enable your child to tell the story of what she believes happened
·         Reconnect with supportive people, community, culture and rituals
·         Simple things like a familiar bedtime story, a song, a prayer, or family traditions remind you and your child of your way of life and offer hope.

If your child continues to be upset or distressed, you may want to consider talking with their Pediatrician or contacting a counselor or therapist.  Finding a way to help your child cope successfully with painful situations is well worth the time and attention it requires. 

Saturday, March 26, 2011

Think About Taking A Walk

Usually when mental health people recommend “walking,” they are encouraging it as a way to feel less depressed, cut down on stress, or get into better shape.  There is no doubt that walking helps accomplish all of these things. 

We speak less often though of other, deeply important benefits to going for a walk, or otherwise spending time outside, particularly in a place you love and that resonates with your heart and  soul. 

Just taking a few minutes to look up some of the different  things writers have ascribed to the outdoors and to nature, here are just a few examples of words they use:

Do you have a place that grounds you?  Is there somewhere you can go where you know you can reconnect with yourself, that brings you back to the basics of your life, what is important, and what is not?  Is there a word or words in this list that resonate with your experience of this place? 

It is common for people to think of places where they loved to spend time as children.  A lot of us go somewhere outdoors in our thinking when asked this question.  There is a path or a garden, a woods road or a lake, a spring overhung by lilacs or a field of Christmas trees.

Living more and more within the protection and order of towns, and the walls that make them up, it takes effort to find a place to wander.  At the same time the wildness we find in un-manicured, unspoiled places is an opportunity to explore what is around us, let go of day to day concerns and leave feeling renewed, refreshed, and reconnected.  We begin to sense the flow and pace of weather variation and the  harmony of the seasons.  Our sense of what we can and can’t control is altered as is our understanding of our place in the larger world. 

There are pleasures in solitary walks, and in walks with other people.  There is nothing to compare, though, with the immeasurable two-way gift of sharing the stories, history, magic, or grounding you find in a place with a beloved child.  These are gifts that carry across miles and generations and will sustain both of you throughout your lives. 

Wednesday, October 27, 2010

Behavioral Health At The Confluence

Kennebec Behavioral Health's recently sponsored conference, Behavioral Health at the Confluence: Inspired Hearts, Solid Science, and Organizational Excellence accomplished a number of functions. It was conceived as a celebration of the agency's 50th anniversary as well as a provocative challenge to the future of community mental health.

Behavioral Health in Maine and across the nation is faced with increasing demands to provide transparency, demonstrable effectiveness, and services that are predictably life enhancing. Meeting that demand will involve the evolution of a dynamic alignment between practitioners, the best, most effective clinical practices, and value based organizational and operational expertise. Each one of these three foundations is necessary, but none sufficient without the other two.

In order to be successful, these three competing rivers of thought have to be reconciled in a way that is mutually supportive rather than competing. It is a paradox, an impossible puzzle that must be transformed to an attainable possibility.

It is not easy to convey the methodology necessary to solve a paradox. The language of analogy is one tool. The ability to tolerate the internal conflict that comes from holding the value and importance of all three irreconcilable positions is another.

The way of the world is to try to force a choice between competing values with messages like:
"Relationship is enough."
"Science has the answers."
"Its about the cash."
"You have to give up your humanity to apply scientific principles."
"Your science is too expensive, you will have to make due with something cheaper."
"You need to make productivity, then we'll talk about the quality of your work."
"You can pursue one river, or maybe two, but you have to give up on the third."

A better answer is one of unyielding creative resistance to compromise on any of these three values with affirmations like:
"I will work diligently to nourish my own heart and to nourish others."
"I will work diligently to find and apply the best science possible."
"I will work diligently to support my organization and its infrastructure."
"I will not relent on remaining mindful of and promoting any one of these values."
"I will face every effort to force a choice with creative problem-solving. I will keep all three values in front of me, each equally honored."
"I will look to support my colleagues and to be supported by them. "
"I will believe the best of others and trust they will believe the best of me."
"I will strive not let them fail, and they will hold me when I falter. "
"Nothing lasts forever. This too shall pass."

The intended take-aways from the conference are:
  • A working understanding of three rivers of thought flowing inexorably toward confluence, into the future, beyond our current state of knowledge, beyond our current technologies, beyond any of us as individuals
  • Our commitment to move toward that end with clarity, focus and courage.

Thursday, March 4, 2010

Role Models - Oh Yes! Oh No!

Role models are a part of life. When we lack experience or skill or hope, and can’t see a way to get from where we are to where we’d like to be, we naturally look to other people to see if someone else has done something comparable before us. Similarly, if we see someone doing something, or being someone that we admire, we look to understand what brought them to that ability and what sustains them in it. This manner of seeking to grow is critical both to individuals and to our civilization. Without it, we would be stuck forever within the confines of our singular experience.

There can be a complication, and even a downside, though to our identification of a “Role Model.” This becomes particularly worrisome when one of our children identifies a role model, looks up to them, strives to be like them, then watches them falter. There are sports stars caught cheating or betraying a trust, beloved older cousins “getting into trouble,” a brilliant and charismatic professor seducing a student, and on and on. There is in fact, no end to the ways in which we can disappoint one another.

Interestingly enough on a different side of the same coin, if we look, there are ways in which people we might not see as extraordinary can surprise us with their talent, patience, vision, commitment, or some other aspect of their being. They might not meet our definition of a “role model” but isn’t that really what they could be in that aspect.

Navigating through life and getting the most out of “role models” without either failing to see them, crashing and burning with them, or dismissing them as completely unworthy requires us to see human behavior as complex, multiply determined and sometimes contradictory.

The reality is that no human being is purely good or bad, and the more we can process our and our children’s contradictory perceptions and begin to articulate what about a person is admirable and what is disappointing the closer we come to learning self acceptance, the appreciation of differences, and compassion for human error, both our own and others. We might even see a strategy we can use to avoid mistakes ourselves.

Monday, December 14, 2009

An Eye To The Light

An Eye To The Light

The list can grow every day. We see economic downturn, job loss, overwhelming responsibility, deployment, money worries, relationship problems and on and on. Times can be difficult for a lot of reasons. They range from global economic and environmental factors, through local challenges in our work and communities, to problems touching the groundwork of our close relationships with friends, neighbors, and family members. In the complexity and diversity of this network, it seems that when things get difficult, they rarely happen in isolation. Problems don’t come one at a time.

Difficult times can present us with terrifying images of change, loss, failure, illness, death, or betrayal – a seemingly endless flow of things that threaten to separate us from the light of the vision of what we want our lives to be. Watching the work of your heart coming apart or having to participate in its undoing can blind us to anything but the frantic need to do whatever it takes to preserve what we have. Paradoxically, that strategy, with its failure of vision can easily become one more tool in the destruction of the things we hold most dear.

So, what are our options? We rehearse through them in our minds and they run the gamut. They include images of unmitigated failure and loss, ruthless protectionism, and anything else we happen to come up with in our fear. It can become very dark. We lose touch with the fact that this is the natural flow of things.

We cannot stop the cycle of creation, maturation, and destruction, but can remind ourselves that re-creation and renewal are also implied. This flow of life is inexorable. We cannot interrupt it, but we empower ourselves when we maintain a focus on living consistent with the values that are important to us rather than violating them in a desperate effort to preserve their current form. When we look to our values as a beacon in the darkness, we find acceptance in our commitment to a purpose and are ready to move forward creatively even in those dark hours before the cycle turns upward again.