- Thank you, I'm Annemarie Gockel.
I'm an Assistant Professor at the School for Social Work.
I coordinate the First-Year Practice Course
and teach in First-Year Practice.
- And I am Mareika Muszynski
and I coteach the Racism in the United States course
to Second-Year students
and we are this year's organizers
of the Anti-Racism Panel.
We'd like to welcome the
Smith School for Social Work students,
faculty, and community members alike
to this panel presentation.
- So at Smith our commitment to becoming
an Anti-Racism Institution is central
to the mission of the school.
That is providing education for excellence
in clinical social work practice.
This mission is infused at every level of the school
including its structure and curriculum.
This syposium was orignally created
in response to student requests for an event
that could further ground and orient them
to the Anti-Racism Commitment,
and has since been institutionalized as a yearly happening.
The event is intended to provide
an opportunity for education and dialogue
in support of the Anti-Racism Commitment.
In recent years, students have in particular asked
for both tools and models to help them envision
the process of taking what they learn
about Anti-Racism work here at Smith
out into the field.
In order to meet this need for the second year in a row,
we've invited a group of clinicians,
each of whom have been Smith students
at either the Masters or the Doctoral level,
to share their efforts and experiences
in working to dismantle racism
in their day-to-day clinical practices,
in different practice settings.
As you might imagine, sharing your practice in this way
is both a profoundly generous
and a profoundly vulnerable event.
So I want to express our appreciation
for the panelists' willingness to offer us all
a jumping-off point to examine key issues
in Anti-Racism work in this way.
You have at hand brief summaries of the cases
that they will present and share with you
for the purpose of this evening's discussion
and we ask that you turn those summaries
in at the end of this evening's program.
First-year students will have an opportunity
to reflect further on the panel discussion
in their next practice and group classes
and will return their evaluations to their group teachers.
- Again this year, we have the great good fortune
of welcoming Doctor Mike Funk,
Director of the College Arts and Sciences
Academic Achievement Program at NYU,
graduate of the Doctoral Program
in Social Justice Education at
the University of Massachusetts, Amherst,
and long-time Social, SSW Faculty Member,
teaching the Racism in the United States course
and the Dismantling Institutional Racism courses.
Mike will introduce our panelists for this evening,
explain the set up for this evening's presentation,
and moderate the discussion.
Please welcome him and all our panelists.
- [Mike] All right!
(audience and panelists applaud)
Thank you Annemarie and Mareika for that warm welcome.
I don't think I could have said it better myself.
and thank you all for coming.
Some of it, I know it's your second round
of the Panel Symposium.
Some of it's your first.
So I just really appreciate having the opportunity
to moderate on this platform
that enables us to unpack clinical practice
through the shared stories of panelists.
And hopefully it also demonstrates the power of storytelling
and before we proceed though, I do want to say,
this is the first year I had a chance
to go through the convocation
and coming back as my fifth year I just feel like,
President Chris used the word "Intentional Community"
and I really feel like that this is something
that I am really feeling in the environment this year
and in the atmosphere.
I know oftentimes we like to talk about all the things
we still need to do or what's going wrong,
I think that we're doing a lot of things right
as a community,
so when I think of the Pedagogy and Diversity seminars, that
Dr. Rani Varghese who is also the Co-Bertha Reynolds Fellow,
and Josh Miller facilitate
or the Unlearning Racism Team,
or the Undoing or also the Anti-Racism Taskforce
or the Interracial Dialogues or the Council of Color or SWA.
There's many, many venues that you're all
really just taking this on and participating.
So, just actually give yourselves a round of applause
for taking it on, diving deep, and being in conversation.
(panelists and audience applaud)
I believe it's really in no small related
to the vision and commitment of actually Dean Jacobs
so why don't we give Dean Jacobs a round of applause.
(panelists and audience applaud)
And this is not an opportunity for me to ingratiate,
but actually appreciate.
I often think of our students of color
who have to go out into the fields and practice
an anti-racism project, often in agenecies
where they're the only ones and how hard that must be.
It really evokes a great deal of empathy
for kind of what it would be like for our own dean,
a woman of color in an institution
that is carrying on a legacy of anti-racism,
what that would look like.
So I just want to thank you for being who you are.
We will soon miss you but we will not forget
the legacy that you left here,
so thank you again Dean Jacobs.
(audience and panelists applaud)
So for tonight's panel, we are taking
a pluralistic approach to examining how issues
of race and racism affects your roles
as clinical practitioners with a hope of identifying ways
that you can be allies, advocates or change-agents
for the clients that you work for and with.
We have three panelists that represent
various social locations,
work in a myriad of clinical settings,
and have raised multiple theoretical backgrounds.
Of course since these frameworks are couched
within the core paradigm of clinical social work,
stressing of the Person-Environment Perspective
and stressing the Points of Therapeutic Relationship,
I take the position that difference
should not be viewed negatively or aimed to divide,
however difference serves as a catalyst for possibility,
it gives opportunities to enhance and enrich our personal
and professional endeavors.
In other words, difference is good
and difference does not necessarily
denote a lack of common ground.
With that said, just as Chimamonda Adichie
warns of the danger of a single story,
it is important to hold that these stories
that our panelists are sharing,
are not necessarily universal truths,
but they are in fact their stories
and though they are being told on a micro-level,
there's a macro-backdrop that is happening as we speak.
Just as I was saying, Miller and Garron
talk about the "adorable web of inequalities,"
there are several inequalities
that we are working to transform as we speak.
They're the cries of "Do not leave any child behind,"
but in fact what is happening,
many children are being pushed aside
and thousands are being forgot all together.
We don't have to go any further than 10 miles to Holyoke
or 15 miles further to Springfield,
where are deemed "drop-out factories"
where you have about a 50% drop out rate
for young people in public schools
and these children are overwhelmingly
black and Latino students.
And then you have programs
where you see that students do succeed
so I am thinking of Arizona and the House Bill 2281
that has banned Ethnic Studies programs
even though that we have an understanding
that these programs foster and cultivate
a pipeline to college for students
yet they're deemed to be detrimental to one's learning.
So it's clear that cultural imperialism still is prevailing,
while there are some children
that are trying to find a pipeline to college,
there's other black and Latino youth that are
really trying to avoid the schools-to-prison pipleline.
And places like New York City are setting policies,
like stop-and-frisk, that promote racial profiling
where a population of young people
that represents about 1/3 of the population
are taking about 50% of the cell blocks.
So yesterday's urban renewal
has turned into today's gentrification.
And what seems to be privileged persons' diversity,
becomes another's dead end.
Enviromental racism persists
and statistics highlighting health disparities
based on race are widening
even in cases where variables of class are controlled.
Racial inequality still exists.
So I percieve tonight as really looking at
us examining the "what"'s in hope of identifying the "why"'s
so that we can figure out how we want to approach
issues of race and racism.
Last year I introduced my panel as a group,
I called the group Dr. Funk and the Psychodynamic Three,
and they start, and this happens with groups,
we had vast success very quickly
and as a result we ended up disbanding.
(panelists and audience laugh)
Now many people probably blamed it on our egos,
but here at Smith I think it's really our ids.
(panelists and audience laugh)
So this year though, this year I think
you're gonna be really in good hands.
So before I do introduce our panelists,
I do want to say that there are some ground rules,
so again, I'm anxious and I have the easy job for tonight,
so the panelists are really pouring out
their whole hearts and their souls to share with you
to offer perspective that may aid you
as you move forward with your clinical practice.
So we do want you to practice active listening,
phenomenological listening, which would mean
you're listening to understand,
not react or respond, per se.
Each panelist will have about 15 minutes to talk
and at that time we'll open it up for question and answer.
So we do want to focus on students
because this is geared towards students
as for asking the questions.
Then we want, before you ask a question,
if you could please just say something that you heard
from one of the panelists.
You may be addressing a question to a different panelist,
but please say something that you heard
before you ask your question.
So allow me to introduce the panel.
To my left is Doctor Elizabeth Rodriguez-Keyes,
PhD, Licensed Social Worker.
She is an Assistant Professor of Social Work
at Southern Connecticut State University
who is recently tenured.
(audience applauds)
There, Doctor Rodrigues-Keyes teaches
Practice in Human Behavior in Environment courses.
She maintains a Clinical Appointment
at Yale Child Studies Center
where she conducts clinical supervision
and leads two supervision seminars.
We have Enroue Halfkenny all the way to my left.
He is a Licensed Clinical Social Worker,
a graduate of Smith College School for Social Work
in the house, an artist, a social justice activist,
and a priest within the traditional Yoruba culture
and religion.
He works part-time at a child-and-family community
mental health clinic, addressing issues
of complex trauma and problematic sexual behaviors
and has recently started a private practice,
Healing and Liberation Counseling.
(audience applauds)
Lastly, we have Arden O'Donnell,
MPH, MSW, and Licensed Social Worker,
currently working as a Palliative Care Social Worker
at Brigham and Women's Hospital in Boston.
Arden plays an active role in the supervision
and education of students and interns at BWH,
sits on the Ethics Committee
and the Social Work Advisory Board.
She has her Masters in International Public Health
and spent years in Southern Africa
running programs and providing psychosocial support
for orphans and vulnerable children.
Arden founded and still runs
a small non-profit based in Zimbabwe
that provides educational psychosocial support to oprhans.
Arden was a foster parent for three years
and adopted a sibling group while attempting
to get her blue slip.
Arden graduated from Smith in 2008.
She doesn't realize that I was adopted too,
so yay for adoption,
and let's give a round of applause for Arden.
(panelists and audience applaud)
- Okay!
I'm excited to be here at Smith.
This is a really surreal experience for me
because in 1997 I began my doctoral studies here
and I never would have imagined
that I would be up here speaking to you.
- [Annemarie] It doesn't move anywhere.
- Okay, I'll try to move forward.
This one works better.
Two of them, imagine that.
Let's move you back.
So here I am today,
sharing with you my experience of being
a clinician of color and my commitment to anti-racism work.
For me, developing an anti-racism framework
has been an ongoing process
that I have consistently explored
at various developmental stages of my life,
both personally and professionally.
I have been challenged continuously
to look deeper at both my definition
of understanding of differences
by my clients, my supervisors and my instructors.
I have examined and become more aware
of my own values, biases, and assumptions
about human behavior
and the potential impact it can have
on the treatment process of clients.
Today I will share with you how I approach
clinical work with diverse populations.
This will be illustrated by discussing the case of Carmen.
Really? Oh my God.
Can you hear me now?
(audience laughs)
This will be illustrated by discussing the case of Carmen.
(audience shouts support)
I decided to use this case
because it was a home-based intervention.
This type of service can be viewed as more intimate
or even intrusive, particularly because
the intervention is in the client's home.
But a clear benefit of the home-based service
is that is presents the opportunity
to observe interactions and the potential issues
happening on real time.
As a result, when considering in-home services
as a treatment option, there is greater need
for awareness and understanding
of one's values and biases
in order to effectively provide clinical services.
My own practice framework.
My training has been predominantly
in traditional psychodynamic theory.
My experience of being a Latina has exposed me
to certain cultural and racial beliefs.
This has required for me to be attentive to the biases
inherent in traditional use of psychodynamic theory,
as these theories can overlook the context
of cultural socialization, ethnicity,
racial identity, and ethnic identity.
Within the context of Carmen's case,
I will discuss three key elements
that I believe are important for clinicians
to consider when working with racially
and culturally diverse populations.
One is self-reflection, exploring culture,
assimilation and acculturation,
and the treatment impact on Latinos.
The Case.
I began with Carmen during my PhD coursework at Smith.
At the time I had been a clinician for seven years
and had been doing home-based work for three years.
Who am I?
Who will I become?,
were questions I was beginning to explore again.
It's like a never-ending process.
I had just begun my doctoral degree
and had many conflicting emotions about the degree.
I would be the first one in my family
to obtain a PhD.
I wondered, would the degree separate me and my family?
Would this degree change who I am?
Did I belong here?
All these questions were questions
that I was struggling with.
Ironically, "Who I am, Who will I become?"
were also major themes that emerged in Carmen's case.
Although exploring one's identity
is a common experience for adolescents,
for Carmen it was further exacerbated
by her mother's expectations around
adherence to traditional cultural values and family values.
In session, Carmen often discussed
that she did not want to be seen as a minority.
She wanted to be like everyone else.
Her solution for this was
she started hanging out with a goth group
consisting largely of white adolescents.
They were different, but to Carmen,
hanging out with this group meant
that no one could tell that she was a minority.
She was Mexican.
Carmen often wore a lot of black eye liner,
had jet black, spiky hair,
and she was pale, so she really stood out.
The individuals in her group all seemed to look alike.
At the time I began working with Carmen,
three months after her suicide attempt,
suicide was no longer a presenting problem.
Carmen denied any suicide thoughts or attempts
and had not required further psychiatric evaluation
for suicide attempts or gestures.
Upon further explanation, Carmen disclosed
that the pressures from her mother
to adhere to traditional family values
and not reject her culture had precipitated
a fight with her mother that led her to attempt suicide.
Carmen also described feeling stuck,
wanting to respect her mother
yet wanting to be like her peers.
The current presenting problem at the time appeared to be
severe conflict between mother and daughter,
centered on issues of acculturation and assimilation.
As I got to know Carmen and her mother better
it became clear that in my work with them,
identity and negotiating culture issues
needed to be addressed.
During sessions, Carmen would ask me questions
about my own family of origin
and my own personal individuation process.
These two areas became the focus of our work together.
Carmen would ask me,
"How do you manage to be both American and Latina?"
"Did you want to be one and not the other?"
These comments represented both the stress
and ambivalence she felt around her own identity.
I believe Carmen wanted to identify
with her Mexican culture and be close to her mother
but she also yearned to fit in
and be like her American friends.
Carmen had limited exposure to anyone
who intergrated both cultures successfully.
She thought that her struggles with identity
meant the rejection of her Mexican roots
in order to gain acceptance in the American world.
In sessions, Carmen also discussed
feeling disloyal to her mother, her culture,
and felt responsible for causing her mother unhappiness.
As much as Carmen was struggling with her identity,
her mother was also challenged,
not only by her daughter's changes
but also by her own.
Carmen's mother was a quiet woman
who had a difficult time understanding
how to effectively use therapy.
She had not requested therapy,
had never been in therapy,
nor was it a typical cultural practice
to talk to people outside of her family about her problems.
Initially, engaging with Carmen's mother was difficult.
I was a bilingual clinician,
that made the process of communicating possible,
however she was apprehensive about discussing
anything with me.
This may have been because Carmen's mother
was undocumented and quite possibly did not trust me.
Since the intervention was home based,
I went to their home two or three times a week.
That's a lot, sometimes to meet with Carmen,
sometimes to meet with Carmen's mother,
and other times to do family sessions.
This type of intervention facilitated
an alliance with Carmen's mother.
My work with Carmen's mother initially
focused on understanding who she was as an individual
and what it was like for her to be an immigrant woman
who was undocumented in the United States.
The connection between immigration, acculturation,
and family values were explored
in order to understand and support
the mother-daughter relationship.
During our parent and family sessions,
Carmen's mother typically cried.
She feared the changes her daughter was making
meant she would lose her daughter
and that she would become like other American kids,
forgetting culture and forgetting her.
In my work with this family,
it also became clear that Carmen and her mother
both shared the same fear,
if Carmen became too Americanized,
she would become someone else,
leaving her culture and values behind,
and more importantly for her mother,
leaving her family ties.
The focus of the work aimed to assist
Carmen not to reject any part of herself.
It was possible that Carmen could embrace
living between two languages,
two or more identities, and two cultures.
These concepts are typically associated with biculturalism.
One important aspect of my work with Carmen
was to help her negotiate her two worlds
in a way that did not leave her feeling
like she was abandoning herself,
her family, or her culture,
as she learned to fully embrace what it means
for a Latina to also be an American.
Self-reflection.
My interest in studying the experience
of immigration and assimilation
and ethnic identity began when I entered Smith.
I was interested in understanding the unique histories
of oppression, adapation,
and success of ethnic groups.
This area of study was propelled by my own
personal experience of being a second generation
Puerto Rican woman.
Living between two distinct cultures
had been an unpaved road early in my life.
My mother migrated to the United States
from Puerto Rico.
She maintained a very traditional Latino household.
I could only speak Spanish at home.
My interactions with the dominant culture
were in school and community.
The case of Carmen challenged me to reflect
on my own familiar experience of living between
two cultures.
I remember being Carmen's age and not quite knowing
my place in this world or even if I fit in.
When I went to school, there were no teachers
who were like me.
I did not have role models
that could assist me with this process.
And for the interest of time, I'll move a little faster.
(laughs)
What I'd like to say is that during my PhD training,
I was fortunate enough to find someone
who was bilingual and bicultural.
She was an amazing Latina professor
and supervisor,
and this was the first time in my experience
where I could imagine what all the possibilities
that could exist for me.
She challenged me in ways to expand my thinking.
Trying to see what we need to do.
She (inaudible) meant to challenge me in ways
to expand my thinking.
Our supervision sessions were multilingual,
consisting of English, Spanish, and Spanglish,
which was very similar to my work with Carmen.
She modeled for me how to connect with Carmen
without disclosing my own personal experiences.
On a personal level, I struggled with wanting to share
my own story with Carmen.
We were so similar.
I wanted to reassure her that I understood her struggles,
and that I also struggled with my identity
and my position in this world.
However, I recognized that Carmen must also
pave her own pathway to understand her identity.
This path would represent a very different one
from my experience,
as is often the case with self-disclosure,
I felt it was very important that I measured my words
carefully, so that I would not enter
into her experience in any ways that would not be helpful.
In conclusion (chuckles).
(audience laughs)
In conclusion,
okay, you heard that case.
Finally,
what I find really most interesting about this case
is that three years ago, Carmen emailed me.
She wanted to just let me know that she was doing well.
She wanted to thank me for helping her
during a very difficult time in her life.
She also told me that she had become a biochemical engineer.
(audience gasps)
And that she was going to be getting married
and would be hyphenating her last name.
(audience laughs)
(audience and panelists applaud)
- My name is Arden,
and I am a white-identified clinician,
and I work on a palliative care team,
and for those of you guys who don't know
what palliative care is,
it means that I work with people
that are at the end of their life.
In a hospital setting,
my team ususally gets consulted when people
are getting bad news,
that their disease has progressed,
and that there are no more therapies,
or they are in a place where they're having to make
complex medical decisions
about the kinds of interventions that they want.
This could be their code status,
or this could be, do they want to do another chemotherapy,
do they want to join a clinical trial?
My team is also consulted when there is
a lot of pain and uncontrolled symptoms, so,
I work with a lot of patients who are,
I meet a lot of people on the worst day of their life,
quite honestly,
and so, that,
and so some of my work is crisis work,
and there are some cases that I'm able to follow over time.
The other thing that's important is that
the context to where I work,
which is a tertiary facility that's in the middle of Boston,
and what I think is important for you to know about this
is that a tertiary facility is,
means that people have to have a referral to get there.
And this particular facility is the best of the best.
And I'm not,
I really appreciate the work that I do there
and the clinical practice that they allow me to do,
but,
as you walk in the doors,
it looks like a hotel.
It's like a little concierge desk,
and there's people in these cute, little blue,
these volunteers that are in these blue jackets,
and there's a big sign of the ranking of excellence,
and it's fed into by a lot of,
by it's a Harvard teaching hospital,
and so,
to tell you that people aren't engaged in anti-racism
work there,
most of them are not.
Let's just say that there's a lot of unexamined privilege
that goes on there.
It sort of, as you walk through the halls,
I feel like it seeps through them
for someone who has been a Smith graduate
and has a commitment to anti-racism work,
it sort of seeps through the walls
of the white doctors' pictures
as you run through the halls and through the administration,
and to, quite honestly straight into the patient population,
because it's fed into by
a lot of other hospitals,
and it is not,
it's not based in a neighborhood.
It's based in the Longwood Medical Area,
so there's very few patients,
and there's a lot of insurance issues,
so you need to know it's very,
there's a lot of white privilege
that runs sort of through every aspect,
including the patient population.
And, when I chose this case
a couple months ago, and I thought about it,
I really wanted to present a case
where I took a really bold stand against
what I really saw as racism
and discrimination within this facility,
and more recently, as I have
been being a professor here,
and, you know, looking again at all of my own work,
what I realized is it isn't just these bold statements
that make you do the anti-racism work,
and you'll have fun hearing about how I dealt
with this particular one,
but what I realized is it's in the every day work,
and it's in what you say and it's what you don't say,
and it's when you remain silent
and you should have spoken,
and I think that does,
it's like that in clinical practice too.
It's like it in your classes,
and it's like it in clinical practice,
and in this case, I did speak out,
but it also changed my clinical practice
to make sure that I incorporated this
into every single patient that I work with,
and I'll tell you a little bit about that.
So, if you look at the case
that I sent out,
this is a,
I'm just gonna run through, sort of my process
through this,
'cause I think it'll take you there
and you'll understand why I got to where I did.
Which was wanting to kill someone.
(audience laughs)
(clears throat)
I got this page that,
to the floor,
to meet this patient who had been disruptive
in the emergency department,
and I didn't really even believe that to begin with,
as soon as I read that she was an African-American
woman, because I have such bias against some of
the privilege at this hospital,
and I thought, "We'll see,"
and so, then I read that she had transferred
her care from a city hospital two months ago,
and I have to say that for me,
that makes a patient inherently vulnerable,
because you're not known,
you don't have an advocate,
nobody really is there
to be your sort of advocate in this hospital,
and then I read that she had also been here
for a clinical trial,
and again,
for someone who works in palliative care,
what I have a lot of fears around
some clinical trials,
and I think that one thing that has been shown
in a lot of the literature is that
no matter what your education level
and what your view is, is that
you're inherently vulnerable,
and although
it's a place that you can make a,
that a miracle can happen if you do this,
in most cases, in the patients that I see,
it increases their symptoms,
and it ensures that they spend most of the last
time in their life in a hospital,
rather than with their family,
so I'm biased to that,
but I'm also particularly
sensitive to making sure people understand
what they're getting into as a social worker,
so, and then I saw that she had,
you know, anxiety, depression, PTSD,
a history of IV drug use.
She'd endorsed that she used marijuana daily,
which you should never do in the emergency department
because there's just automatic assumptions
that are made, and so,
and then,
as I read the note what I was realized is that
she hadn't been given,
she'd been seen as the written notes suggested,
it seemed like they assumed that she was drug seeking.
And so,
I, I went immediately to the electronic record,
and this is a record that digs deeper,
and I read a clinic note which did not endorse any of this.
It said that she had been compliant,
she'd attended all of her clinics,
and that they had no concerns
about any use or drug misuse,
and so, I was starting to get really angry
about this situation, and I was thinking,
something is fishy here,
and then, I saw the CAT scan,
which pulls up on the medical record
and what it showed was that she
had disease progression
and it was breaking through her ribs,
and in case you're wondering,
that's painful, and you would get IV drugs
if you went to the hospital in this situation,
and so I went crazy.
Let's be clear.
I went nuts.
And I was 100% sure that this was racism,
and I am ramping up,
and my internal dialogue was something like,
"Are you freaking kidding me?
"I hate this hospital!
"How could I even be working here?
"Oh, sure! The best hospital?
"The best hospital in this state?
"Sure, if you're white!
"I bet if that doctor's mother walked in
"with breaking ribs, she would get IV drug,
"I mean she would get IV pain meds."
I mean, I was
very angry,
(audience laughs)
and so was my patient,
because as I'm ramping up,
she's ramping up in the room behind me,
and she's kicking out a nurse,
of the IV nurse is coming out,
and the IV nurse is walking by and like,
"She won't even let me take her blood.
"I mean, why would you even come to this hospital
"if you're not gonna let somebody,"
you know,
"take care of you?"
And I'm thinking, well, you know what they teach you
about meeting the client where they are?
We were in the same place
because she was pissed
and I was also,
so, I go to the nurse thinking I'm gonna get some
recognition here or something and I say,
"Hi, I'm the social worker.
"I'm gonna be working with Tanya,"
and she says, "She hates social workers."
And I was like, "Yes.
"She hasn't met me yet."
(audience laughs)
So, then I said,
"Well, did she talk to you about what happened
"in the emergency department?"
And the nurse looked at me like I had two heads.
She's like, "What happened in the emergency department?"
I was like, "Have you read the chart?"
And she,
and I was like, "this is discrimination.
"Don't you think this is discrimination?"
And the nurse was like, "No,
"she has a history of IV drug use.
"I mean, and she's got a mental health history,"
and I was like, I live on Mars, so,
and now I'm a Smith graduate and I care about anti-racism
work and I've been building up all of my anger
for the last year about every microaggression
I've seen,
and every single thing I couldn't call anyone on,
in this privileged place I work in,
and I'm so mad,
and
then I have to go into the room.
So I'm sure all you practice professors will have
a good time, like, deconstructing all of my
anger and what you do when you have this,
and then you have to deal with it,
so, you can have fun with that,
(audience laughs)
but, what,
and then report back to me,
so, okay,
so anyway, I go into the room.
I walk into the room,
and I said, "Hi, I'm Arden.
"I'm your social worker."
Now, it's unclear what was gonna get kick me,
get me kicked out first,
but, you know, many of my identities being white,
I'm sure was not top of the list,
and also being a social worker, she said,
"Oh no, no you are not my social worker.
"I do not need another one of you in my life.
"You can just turn around and walk right out."
And I took a deep breath and said,
"I saw what happened in the emergency department,
"and I'm pretty sure,
"if you were a white kindergarten teacher,
"that wouldn't have happened."
And she looked at me,
and sort of took a deep breath,
and a little bit glared at me, and I said,
"I want to file a complaint,
"and I need your permission,
"and I also want to make a plan
"for the next time you come in the emergency department
"to do our very best that this never happens to you again."
And,
then she said I could sit down,
so, I got it, right?
I got it.
So this is the bold statement I took,
but it isn't this bold statement.
I did take it and we did file a complaint,
and I was gonna talk a little bit about the ramifications
of that, but what I think is more,
and we can, in your question and answer if you need it,
but, the,
but what happened after that was that because
we filed this complaint,
it brought the discussion
into the room in every single clinical conversation
after that, and we were able to really talk about
what it meant to be a person of color in,
at this particular hospital,
and what it meant to really,
what it meant to her to be on a clinical trial
and how that intersected with her history
and what she viewed,
and her family's beliefs around these certain things.
It brought,
it just brought a lot into the conversation.
I was also able to advocate for her
in a very different way.
Look, I'm not even using my notes.
I think that,
the thing is,
around end-of-life issues
and around people making these kinds of decisions,
the truth of the matter is
your culture, your racial identity,
the history, your family,
all of these things are very, very important,
and in the hospital that I work in,
it's white-washed.
It's completely white-washed.
You become a 25-year old
with bladder cancer who's here.
Race is not written into
the medical records,
especially not if you're white,
or they think you're white.
It's not,
it's not talked about,
it's not brought into this situation,
and I think that what changed for me
was as we began to do the clinical work
and talked about what was important to her
and how she wanted to make decisions
and decisions she had to navigate within herself
and her family around her code status,
around where she wanted to die,
and how that,
how that played out.
The deeper the conversations that happened,
the more I realized how essential this is,
especially in the work that I do,
and so, I
tried to figure out a way that I could really
bring this in to my clinical practice
in every aspect,
and I came up with a question
that I ask all of my patients now,
and it is simply,
you know, is there anything about your racial identity,
your culture, your religion,
your spirituality that we should know
that would influence how you make decisions
in your care?
And,
that seems like a really small sentence.
It doesn't even seem like anti-racism work.
It doesn't seem like it,
but in the situation that I'm in,
and in the vulnerability with the clients
and where we all are,
it makes a huge difference,
and it opens a door,
and I was trying to think of a parallel
and I'm,
I'm a lesbian and I will say that there's a big difference
for me when someone says, "Do you have a partner?"
Versus, "Do you have a husband?"
And I feel like it's that same sentence
around opening the door for racial and cultural
differences that gives me a foothold.
It doesn't make the relationship.
I have to do work,
and I have to do my own work,
and I have to continually ask this in different ways,
but it makes me just a tiny bit safer,
and in the environment that I work in,
it is the work.
And so,
I think that that's the piece that I want to leave you with,
and we can talk about my reaction and everything like that.
I did get to work with her
because I made that plan
that set her up in the emergency department,
and they called me every time I came,
and there were plenty of situations
that she certainly needed an advocate in this,
and I appreciated working with her.
(audience and panelists applaud)
- Good evening, everyone.
- [Audience] Good evening.
- So,
my name is Enroue Halfkenny.
The multiple ways I identify,
I'm a 45-year old, heterosexual father
of two wonderful kids who
should be getting close to bedtime now.
I'm a multiracial black male.
My heritage is African,
Native American, Micmac,
Irish and Swedish.
And, what I actually would like to do first
is
send a
thanks for
my own ancestors
for doing what they did
so that I have this opportunity to be alive right now.
I also want to thank
all of your ancestors
for doing what they did
so that you can be alive and here and share this time
and this space, here together,
and also the ancestors and the spirits of this land,
so I just want to take a moment
and give thanks to all of these forces,
all of the ways that we strive to connect with
who we are,
the mystery of life and whatever that means for you,
so I just want to take a moment to do that,
and I actually also want to
just pour a small libation in honor,
and to nurture these forces as I seek
as hopefully we all seek to be nurtured by them.
So you have this
case in front of you,
so I'm not going to read through the entire case.
I'm gonna touch upon some elements of it.
So I work primarily with
young people who've exhibited some kind of
problematic sexual behavior
in addition to
lots of layers of trauma
that they've experienced and that their families
have experienced.
Can everyone hear me okay?
(audience murmurs)
Yeah? Great.
I heard a no I think, so,
so, what that means,
and what I do when I meet young people,
and the age range is anywhere from five to 22,
and this, the behaviors are
anything from
sexualized language,
when people get agitated or disregulated,
all the way up to pretty severe sexual assault,
and one thing I'm clear about
when I work with people,
and people in this field will talk about it,
it's called problem sexual behavior
because it's not a character issue.
It's not about who they are as human beings,
though, they certainly come with a lot of shame about that
that they hear from the media,
that they might hear from their families,
or from other people who they know.
So I really talk about these,
they've exhibited,
they've done something that's a problem
and it's in the realm of sex,
sexuality, sexual contact,
though the desire is rarely about that.
Suffice to say it is much more about people seeking
connection and then this is the way
it gets expressed, so,
I'm clear about that when I talk to them,
when I talk to the individuals and I talk to their families.
So really talking about these behaviors
and that the goal is that they get to have
just as the goal with a lot of treatment,
hopefully it's successful and they get to have
the kind of lives that they want,
to make the choices that they want,
and,
we deal with very real issues around risk,
so that they're safe,
and the people around them are safe.
And I say that,
I'm kind of jumping ahead,
but I say that because that was part of the foundation
of my relationship with Amir.
And it allowed for a lot of the work to happen,
so there's that kind of stance that I took
in the beginning of treatment,
but this is also after eight months of working together,
both individually,
I also did sessions with his,
family sessions with him,
his biological mother and stepfather,
also family sessions with just his mother,
and also with just his mother and stepfather.
The event that happened,
where he came into the session
and began, you know,
describing how he was lost in a predominantly black
and poor neighborhood,
and going on a rant and a tirade
about "those people."
He didn't, he actually didn't,
you know, the n-word was not bantered around,
which was good.
But, you know, there's certainly no shortage of ways
that he expressed some real hatred
towards, in this instance, black people,
and in particular black males,
but in the past, he'd also
had kind of similar reactions towards
Latinos,
people who are Chinese,
and other racial and ethnic minorities,
and so,
in the past,
I'd actually kind of taken the stance of like,
okay, I have this social justice background,
both from Smith as well as being raised by
my parents who are revolutionary organizers,
and radicals,
and so I was,
in earlier sessions, I took more of a like,
well, let's look at the language you're using
and how you're relating to people,
and how do we kind of deconstruct that,
and that really didn't go anywhere,
I mean, I think there was kind of a way
I thought I was kind of doing this good
piece of work to help have him have
a different outlook about himself,
and where he's positioned in society
and privilege, et cetera,
but it didn't really stick, clearly.
And so,
you know, I was pretty upset
as he came in and kind of was going into
this tirade, and,
the thing that,
you know as I think about it,
you know, I'm sitting there,
he's kind of going on and on,
I can see how kind of upset and anxious he is,
but it's much more of kind of a history
that he has around identifying with an aggressor,
so, really kind of turning whatever
feelings of fear, sadness he has,
and really kind of attacking people.
And so I was trying to sit there,
composed,
and truly try to listen to, clinically, what was happening.
There's an acronym I came across
which is WAIT, W-A-I-T.
And it stands for Why Am I Talking?
(audience laughs)
And,
I'm not gonna use that now,
but, in the moment--
- "I'm not gonna use that now." (laughs)
- There was a way in which,
you know, I was being triggered
and I could tell that anything that kind of came
from me, right?
Anything,
any kind of intervention that I was gonna try to do
was really coming from that place,
and, I knew,
I don't think I was thinking this much at the time,
but I'm sure there was,
knowing that that hadn't worked in the past,
so let's try something different.
But really just sitting with him there
and listening,
and having,
feeling all these things come up in me
and kind of not wanting to listen to him
and wanting to change the conversation,
but saying, well, that's not really why I'm here,
and what he's actually saying
when I really listen to him,
it's not about me,
so that kind of,
I could calm down a little bit,
and part of the reason I knew that is,
so we have this original conversation around
problem sexual behavior,
and he was someone who
partly due to his attachment history
or really,
difficult and kind of distorted attachment
that he currently has,
really looked to me for approval
on a lot of occasions.
He was very competent in
martial arts and
would actually want to try to want to show me some moves.
Not on me, but kind of in the room, like,
"Oh, I can do this and I made this guy
"almost pass out,"
and you know, kind of prove how strong
I was to him, or he'd
want to show me how many pushups he could do.
He's like, "yeah, I'm doing like, you know, 100 pushups
"a day, watch,
"I can just do these pushups during the session."
I was like, really, you don't have to do that,
and it was actually,
so this other piece I could communicate,
like, you don't have to do that.
You don't have to prove anything to me.
You don't have to prove how much of a man you are,
how strong you are.
And that was kind of connected to
his own feelings of,
well you know, I'm straight, and I know I did this
to this young boy, but I'm a man and I'm strong,
and no one's gonna push me around,
and, so I really just kind of
would make comments, just like,
"It's really okay.
"You don't have to prove yourself to me.
"You can do that, that's okay.
"No, I'm not gonna show you how many pushups I can do,"
or, these things, et cetera,
and he would kind of want me to join him in that way,
and I really tried to model that
there are other ways to be a man in the world
without doing that.
And so I had an experience of him
in kind of a trust in the process and the relationship
that really helped me to be able to sit and be quiet
and listen and actually pay attention to what was happening.
And what I began to notice and really hear
was the amount of fear that he had
and the ways that he was turning that into
kind of lashing out,
and I just slowed him down
and helped him to just pay attention
to what he was actually feeling,
which is not something that he really wanted to do,
or had a lot of practice doing,
and so, we would just practice,
in that moment, we'd just practice sitting with that,
and that led him to be able to feel
what was going on
without it being attached to what he thought
or how he thought he needed to react
towards what was triggering that.
So I wasn't going to get into
were his fears valid or not?
Right?
He felt anxious
and that anxiety triggered this whole reactivity,
and that trigger was really the part that we
paid attention to.
And,
you know, this didn't,
for myself being able to sit with it,
so as I saw that shift in him, right,
my own kind of reactivity really dissolved
and kind of went away,
and certainly I'm not,
I wasn't happy because
he still had these views of people
and still saw people of color
and people identified as gay,
or people who he saw as
less than himself, right?
I wasn't shifting that and transforming that all of a sudden
but it was like, look,
you get to feel your feelings and not have that
turn into this way of enacting whatever kinds of
violence and anger that you think
is going to lead to feeling good.
And so that, that became the work,
and, you know, there was both for me the way
of kind of looking at this in the large way,
but I think the biggest piece was
me having practice, actually,
through meditation practice and my spiritual practice,
sitting with my own feelings,
with my own thoughts and feelings,
and A, knowing that they're not necessarily
accurate or a clear thing about what reality is,
they're my thoughts and my feelings,
and I don't actually have to do anything with them,
I can have my thoughts and feelings and,
there they are, and they're gonna keep going,
right?
Just like the weather here, right?
You just wait long enough
and we'll get a nice thunderstorm rolling through.
And that really became,
that's one piece that kind of anchored this work,
as well as the kind of relationship
that we had had and the clinical work
that I was confident around at that stage.
So I'm happy to obviously answer any questions
that people have
when that time comes,
which is as soon as I stop speaking.
(audience laughs)
And so thank you all.
(audience applauds)
- [Mike] All right, thank you.
(audience applauds)
So as moderator, I will take some liberty
to ask some questions as people start
filing up for questions.
So I do also want to model
just, paraphrasing what I heard or got,
so with Elizabeth,
one of the things that I heard from you
is the importance of culturally appropriate,
not only having a supervisor relationship,
but also working with the client,
and particularly as it comes to language
or having at least an interpreter available,
and I'm wondering, like,
and this is something you can respond to or pass,
in your experience, because,
depending on what part of Latin America you're from
or Central America,
there are different push-pull factors,
how you are able to negotiate working with Carmen
in that way,
what that meant for you,
and I'm also wondering if that is enough,
so, if you're just able to speak the language,
what if I'm a black clinician
and I spoke the language, but,
I still may not be able to identify culturally,
and what that means.
Also, so, with Arden,
one of the things I heard was the importance
of validating the experiences of your client,
in particular around issues of race and racism,
and in this particular,
after you did your detective work,
it became pretty clear how egregious it was,
so it was hard to contest
that some action shouldn't be taken,
so I'm wondering if there are nuance situations
where it may not be as conspicuous,
where you have to step in, intervene,
even though there might be something that is not
quite as clear as that particular case.
And then, Enroue,
what I got was the importance of waiting and trusting
the process,
letting your client let you know what their needs are,
and for you,
what I'm wondering is particularly thinking of
clinicians of color working with white clients
that may enact racial epithets,
like, were you able to lean on a supervisor
or a colleague,
or were you able to talk with someone
your way through these issues?
- [Elizabeth] Do you want me to respond?
- [Mike] Oh, you can pass or respond.
- [Elizabeth] No, I definitely will respond.
In my work with Carmen
and with any immigrant,
but I will focus on Carmen,
what I would suggest is
listening to her story.
What is it like for her to be an adolescent,
young woman,
coming of age in an American world?
What does that mean to her?
How does she negotiate being
both a Latina
and an American?
And also,
as part of,
because she was 14,
very much the work focused on
including her mother as part of the,
as part of the relationship,
as part of the work
because she was not gonna separate any time soon.
She was going to be living with her mother.
And my work with the mother focused on
understanding what it was like for her
to be undocumented in the United States.
What is the process like for her?
How does she trust people?
How does she, to some degree,
begin to let her daughter go, to some degree,
but yet at the same time not be so fearful
that something is going to happen,
so my work with,
what I would caution people is
to not make assumptions just because
you speak Spanish,
that you have a relationship
or can develop a relationship right away.
It takes more than just knowing the language,
just like in any language,
so,
that's what I would say.
- And again, I wouldn't take it personally.
You can pass or respond.
- [Arden] I can answer that.
Well, I mean, a few things.
Number one, I think that the shocking thing
might be is that when I did file this complaint,
people didn't think it was,
I got a lot of pushback.
Nobody thought that it had anything to do with race.
And so, it,
what I built it up and sort of gave you my process,
also that I was so angry about this and everything,
but quite honestly,
I,
plenty of people saw what I saw in that chart,
and nobody else said anything,
and on one else filed a complaint,
so, I do think that's one piece of it,
and an unfortunate piece.
But the thing is that, as I started asking this question
to everyone,
especially,
I got a lot of interesting responses,
and it's changed the way I did the work,
but one I think was the most compelling to me
was when I asked
this question.
I'd gone in to see a family and
they were having to make some hard decisions
and the doctors kept going and speaking to the patient,
and we believe a lot in patient autonomy
at the hospital,
as well as you should,
and so we asked them a lot of questions,
and so we asked this question to the family,
and this family was
visually, they were white.
You would assume they were white,
and as I started to like go in there to ask this question,
I was thinking, like, I've gotta,
I'm always asking this question,
and am I gonna get anything?
I sort of was in the end of the day,
and I asked, you know,
is there anything that I need to know,
and the daughter actually pulled me out of the room
and she said, "I'm really happy you said that.
"No one has asked us here about this,
"but to tell you the truth,"
and this is the language she used.
She said, "My mother was a mail order bride
"from Eastern Europe
"and my father's taken care of her whole life,
"and after he died, she started too,
"and all these doctors are coming in and asking questions
"to her and trying to ask her to make decisions,
"and she's never made a decision in her life."
And it,
and, you know, that shifted everything,
and when you could explain that
and explained about decisions they were making,
who was making them,
and the view of this patient was significant,
and I think, to me, that was very,
that was very telling to me,
because,
I didn't expect that and no one had asked,
and so I think there are times that are surprising,
when you bring it into the room.
- So, there wasn't a whole lot of
supervision support.
Or institutional support,
other than, "yeah, hmm,
"sounds really...
"I couldn't imagine that, wow.
"That sounds really hard."
You know, that was excellent.
And, so my,
you know, so in general,
all right without getting woooo
way too far out there,
so, it's really,
for me it's really been important for me to find
my people
in broad arenas.
You know, if you look at,
I think in my bio,
you know, I've done lots of things
and in many of those things, I've been kind of the one,
I've been an outsider in that,
you know, whether,
being on the varsity basketball team at a very small,
predominantly white liberal arts college in Vermont,
having dreds,
dancing, being a radio DJ,
and doing kind of these other things,
in these different spheres,
so kind of being on the outside
and also having a class analysis
and a critique of systems at a very young age,
due to my upbringing,
knowing that, especially institutionally there's not
necessarily going to be that support.
So it was really around my community of people,
not necessarily connected to my clinical work,
or readings,
knowing that there are people in the world,
here, being one of them,
where there is that strength and there is that framework,
and that understanding,
so, and that paired with my own
spiritual work,
and the work that I've done in terms of my identity.
That became a much stronger foundation for me,
than, "Oh my god, help me figure this out,
"and what do I do with this?"
to a supervisor
and to a system that really
couldn't, didn't have the skills
to manage that and to figure that out.
- [Mike] Okay, so we have about 30 minutes
for courageous questions.
- [Annemarie] So there is a stand right there
that somebody is already going to,
and I'm going to wander over here if you want to
put your hand up.
- [Audience Member] Hi, so, the thing that I wanted
to share that I noticed,
Arden when you shared your case,
I also worked a lot in a hospital,
and I remember feeling very intimidated by the system
and by a lot of the power differentials,
like with doctors and medical staff,
and I just really admire that you took that risk
to be bold and to confront what is a very intimidating
system, in my experience,
so I thought that was really amazing.
So I'm kind of curious.
I know we talk a lot about in our practice classes
and other classes about,
you know, like encountering racism in clients
and there's this tension between, you know,
wanting to provide an effective intervention
but also sometimes feeling a need to confront those views
and you spoke a lot to that,
and I'm just wondering if you can talk a little bit more
about,
'cause it sounds like in that just,
in that instance, that it was really helpful,
you know, to kind of sit and to wait,
to sit with the feelings, but,
was there a lot of tension there for you?
Can you elaborate a little more on that,
or, like, would it have been,
do you feel like if it,
if the therapy had continued,
would you have addressed that maybe later on,
those views?
Like, I'm just kind of curious to know a little bit more
about that.
- [Enroue] It was pretty challenging.
Based on,
I mean based on who I am,
that, at that particular instance,
it was, you know, I guess more directed towards me
and how I identify,
was certainly more triggering,
but it didn't kind of all of a sudden make it important.
It was mainly, how do I manage this,
my own disregulation,
and maintaining what my professional role is,
and being a human being,
so, we actually,
treatment continued and his,
you know, kind of in one way,
kind of his level of risk went down and his insight went up
and ability to manage his feelings,
that all improved,
like all those good things happened,
and some of that happened, in,
there's a couple sessions where we actually went for
a walk, and in that,
certain things happened and he had that same response,
so this incident kind of became a cornerstone
that we could keep referring to,
and that I could keep saying,
"So here's another situation where
"this happened, you got scared,
"or worried about something or felt some kind of danger,
"and then you immediately turned it around
"and started attacking,"
and so that became the work.
Now, the challenge is that I would have loved
to have had him, you know,
to have this whole revelatory, you know,
transcendent,
oh, he's like working for liberation,
for all people now, and like, you know,
maybe so, I don't know,
doubtful.
And part of it was based on what his,
you know, the setting that he's in,
so he returns to this is how the world is,
because the people around him didn't have that awareness
and actually, I didn't realize how much they didn't
until I got feedback from someone who had
done some of the initial intake stuff and said,
"Oh yeah, they have,
"you know, the family kind of feels this way,"
but that had never come out in my work with him.
The other piece is that
it became less important to then say,
oh I have to address these specific things,
about how you're targeting these people or not,
it's really like how you're in the world,
and if I could help him to not have that reactivity,
then those things wouldn't really happen,
to an extent that it was dangerous.
And that was part of,
that was part of the goal, right?
All the stuff up here around,
oh that'd be great and he's in the world
and confronting and challenging, shhh, great!
Not really where he was at.
Really would have required, you know,
really extensive, kind of different piece of work,
and some of the challenges actually had to do with,
so he was on probation
and once probation ends,
there's less, you know, pull,
and influence that they have for him to stay in treatment,
even though his,
his mom and stepfather kept him treatment,
after that, because they felt that he had a good
relationship and was making some significant progress,
so, you know,
this is how we meet people where they're at.
I would have loved to seen this,
and like, woo, this is where it is,
and like, he wants to go be,
you know, a sniper for the military,
and, okay, you know,
and you want to have these relationships,
so let's help you have these relationships
and be in the world in a good way, and,
that's the work I can do,
like, that's my piece.
To get from here to here.
- [Audience Member Two] First I would like to thank you all
for coming and being so willing to
share your personal clinical stories with us.
My reflection is particularly for Arden, I suppose.
I really appreciated that you were
telling us how making that complaint
really brought talking about race into the room
with her, but I guess,
what I'd like to ask is,
what do you do in situations,
it sounds like you work a lot in a very white-washed
environment, you said,
so I'm wondering what you do in intraracial situations
where it's you as the white clinician
and a white client, and,
do you address race directly?
It does sound like, in what you just responded
to Doctor Funk, it does sound like you said
you still continue to ask the same questions
of everyone,
but I am also wondering how do you work with your own
racial identify in an intraracial relationship.
- [Arden] That's a good question.
Wow.
I do try to bring it up.
Obviously after that one situation I told you guys about,
I do try to bring it up.
I will say that when I,
I tend to try to dig down in just a little bit deeper,
because when people are making decisions around,
around things like code status,
where they want to be,
how they want to deal with their family,
there are a lot of different levels,
and I really feel like, that,
culture and your cultural history
and what it is plays into that in a lot of ways,
and so I sort of have to,
I think tease is out in a different way.
Sometimes it's around,
sort of,
I mean sometimes it's around class,
sometimes it's around spirituality or religion
or trauma history.
I've had a lot of situations like that,
but I think that when I'm working with
another white-identified client,
I think that there are times that I do actually reflect
about the privilege of the institution even within that,
because, it opens up a conversation for them
about how they're different,
and how they, how they view things differently,
and I think that for me,
I wish I,
I'll think more and see if I can think of another example,
but I just feel like that,
if you bring it up no matter what it is,
if they have anything that's different,
then they're able to open it up in a different way.
I'm not sure if that's answering it really.
- [Elizabeth] I think you give them permission to talk
about it when you bring it up.
- [Audience Member Three] Hi, thank you for the cases.
They were wonderful.
I have a question for Enroue,
regarding the case of Amir,
and you write in the case that he was aware of your
African heritage,
prior to making these comments about
black people,
and I'm wondering if there was anything,
if he felt at the point in which he brought up
those comments in his work with you,
he felt safe enough to
try and test your limits and test your relationship
and if it was part of something
that was being enacted,
if you wanted to comment on that.
- [Enroue] I would say yes.
(audience laughs)
You know, that's the,
you kind of talk about these things over here
and create this safe space, and that's good,
and here's, oh yes, I'm here,
you're good.
You don't have to prove yourself.
Brings up these other little things.
Oh, yes, that's okay,
and then, oh!
Now, I don't think he was like,
"Oh, here's this plan I'm gonna do,
"and when he's all calm and happy,
"then I'll spring this," but,
that was certainly kind of how it worked out.
One thing I wanted to add is that,
so I do bring up kind of issues of
liberation with clients
and work with them around things,
so, it's not only like,
oh, well, they're not gonna reach this place,
we kind of don't do it and we kind of work on
how they can be good people in the world,
but it's,
it's different than having a conversation with somebody
around how privilege and oppression
is enacted upon us,
and how we enact those things,
so it's things that get brought up,
whether it's, you know,
what is the impact of poverty on someone's depression,
or the impact of sexism when you're looking at domestic
violence,
so those things get kind of stated and named,
so that, yes, these are all these forces,
some of them, you know, you get to kind of manage
and some of them are like, whoa, this is a big thing
to really work on,
but in terms of, you know,
we look at, like, treatment plan
and interventions and knowing the reality of how long
someone's gonna be there,
you know, you can have these grand ideas about
what success is or what it looks like
and it's where people are at and what they're,
what they want, you know.
We don't get to decide all those things.
We can think about it, but...
There's a question up here also.
- [Audience Member Four] Yes, thank you.
This is specifically to Doctor Rodriguez-Keyes.
You made a mention about
when you were in your graduate program
about feeling
just as if you belonged there
and you started to question yourself
and basically your,
if you're good enough to be in that program.
How did you reconcile with that,
and how did you continue to reconcile with that?
- [Elizabeth] It's a really great question.
I think, for me, it's been a question
that I've asked myself,
I think through,
I would say, a lot of,
what's the word I'm looking for?
Through various stages in my life
where I start to,
when I meet a goal
or have a new accomplishment,
the way I reconcile with being as (inaudible)
It took me awhile to feel like
I belong here,
like, oh my god,
I'm as good as every other student
who was in my class.
I had support around that
so I wasn't alone.
I had a good cohort
so we really bonded well together,
and that really helped me to feel like,
oh my god, I can bring something to this group
and I have some unique abilities,
and it's been a process for me,
and I think everything I do,
when I was hired as a professor,
I was like, "Awesome!
"That's great!
"Oh my god."
You know?
So it is and I think for me,
it takes me awhile to really fall into that
position, into that place.
I don't move fast.
I stay with the anxiety.
I don't run from it.
I explore it.
I grow from it and it grounds me,
so, that's how I've been able to get through it.
Every process for me has been
not easy.
It's been difficult.
I've never had models that I could say,
oh, when I grow up, I want to be just like her,
so, it's been a process for me
to look to other people to say,
wow, they have some really good qualities.
I can get there,
but I do get there,
and I'm okay.
So, I say,
if you feel that way, just really sit with the anxiety.
It's good.
Because it makes you strong.
- [Audience Member Five] So,
this is for anybody on the panel.
A lot of you talked about reactivity,
countertransference or feeling isolated
where you worked or without supervision.
I was wondering how do you deal with
that gut reaction you get sometimes
when someone says something,
and it's either old or new or something totally different.
How do you handle that moment
while still remaining empathically open
to your clients?
- [Arden] Well I should have learned about that "wait"
that he talked about, a long time ago.
- [Enroue] I'll write it down for you.
- [Arden] He's gonna write it down for me.
(audience laughs)
As I was thinking about the difference in the way
that we dealt with that case,
obviously you can see,
maybe switch,
maybe you should speak to that.
(laughs)
- So notice that.
Right?
Silence is okay.
You know the things hit us.
We're human beings.
I had a supervisor who
talked about,
she'd been in the field for 20 years,
actually I think more than 20 years,
and was a Smith alum,
and she spoke about having this elephant skin,
this like (exhales),
and there are other people who I've encountered
who talked about having, you know, thick armor.
Okay, gotta go to work.
Wa-cha!
Get ready to withstand, to tolerate,
and I decided that I did not want to live my life that way.
That was not the kind of professional I wanted to be,
not the kind of human being I want to be,
so many of
the things I try to get is how can I develop skills
to,
to have an open heart
and to be connected in that way,
and use the skills I have,
but have that as a fundamental piece,
and I acually,
one thing that really helped me when I was,
I was an intern is,
during my first year's placement,
around Christmas, my grandmother died,
and I went to
be with her.
I was able to be with her the days before
and to be with her and my family
in her room,
and a lot of that was really just being with her,
and there was nothing to do other than that,
or I should say,
there was everything to do with that,
and it wasn't a matter of making any of her pain
or discomfort, or ways that she was not present at all
in the room shift,
or go away,
and she died
and I had the opportunity,
which was initially pretty terrifying,
but to then,
I said, well I have this opportunity
to then be with her body after she had died
and to really give thanks
for her,
for the body that was her,
knowing that it wasn't the totality
but of giving thanks for that,
and when I returned,
and started seeing clients
in my internship, in my placement,
this shift happened where I didn't,
it wasn't about me taking things on.
It wasn't my burden.
Their pain was not my burden,
and I could be present and be connected with them
and be this witness to that,
and so,
the continued cultivation of that quality
and that skill base,
along with, you know,
the skill base that we have as clinical social workers,
has been,
that's really been the vital piece.
- [Elizabeth] I'd also like to respond to that.
I will say, if you don't have supervision,
seek private supervision.
It is important in the beginning,
especially as you're getting into the field
to understand the feelings that are being evoked in you.
It's important to process them
so that as you sit with different clients,
what's being evoked in you doesn't come out,
so I think it's really important.
If your agency does not offer that,
pay for it.
It's worth it, especially in the beginning
of your training.
- [Arden] And I obviously use a lot of humor
in the way I deal with things,
but I will say this.
I think that having some sort of meditation practice
or ability to ground yourself,
and know what you have to do,
because that,
I presented a case where I obviously went
sort of crazy in the situation,
but I spent a lot of time
being with people as they're dying,
and, that takes,
you have to hold a lot of space for that,
and you have to be able to hold your energy,
and you have to not be able to,
you have to be able to have a boundary
to allow them to be there,
because I think it's when you're able to be fully present
and I do have a meditation practice,
although you wouldn't be able to tell,
by the way I'm acting up here,
and it,
so I can like steal some of your stuff,
but,
I do do that,
and I will say that when I walk into a room,
and I think there's sometimes things that you can do,
little things that you can do.
Before I walk into every single room,
I stop and I take a breath,
and I just say a quick, like, little,
I'm not sure prayer is the right word,
but just, sort of, just,
let me be grounded here,
let me have this be about them,
and not be about me,
and I think that it is in that
that you're able to really hold tight.
I couldn't in the case I presented to you,
but in most cases, I think that
having that practice and being able to go back
and ground yourself in it,
gives you at least enough space
that you can really do some good work.
- [Mareika] Yes?
- [Audience Member Six] Hi, I want to start by thanking
Doctor Rodriguez-Keyes,
and Enroue for speaking to a couple of my anxieties.
One being that I feel too familiar with someone
who looked and seemed a lot like me
and how I would handle that,
and for Enroue,
that someone would be so different from me
that I would wonder how I would handle that,
so thank you for sharing your narratives in that way.
But my response and question is for Arden,
so, I didn't know you were in this,
and so I'm very,
I feel very fortunate to have you as my policy teacher.
(panelists laugh)
(audience laughs)
- [Arden] If you can imagine what that,
if you can imagine what that class is like.
(audience and panelists laugh)
- [Audience Member Six] But my gut,
and I think emotional response to your narrative,
your case study was that,
you were the only one, and that must have been really tough.
It seemed like you were sort of the anti-racism
or you are the anti-racism,
racism of your place,
and I'm wondering,
I'm thinking about what Enroue mentioned about,
sort of finding his people,
getting his team,
and if you felt able to do that,
or if someone was in your position and felt like
maybe they're the only one
and not many people could identify,
do you feel that you could find your team
and get more people sort of committed to
the, your efforts so that you're not the only one
and so isolated?
- I do, and I really have done my best to try to
facilitate a lot of conversations at the hospital.
I do sit on the Ethics Committee
and try to really bring this up as a conversation.
It's difficult.
I think that with you, the situation is that you do have
to find the community around you.
I think the more you talk about it and the more
you point it out and you find a few groups of people
who are able to talk about it and bring it,
that it's able to grow,
and I actually do see it growing in my hospital.
I cannot say that it's just because of me but
I certainly think that bringing it into the conversation
helps, even in little pieces.
You just have to be patient,
and while you're being patient,
you have to find other people outside of it.
- [Audience Member Seven] Elizabeth,
Arden, and Enroue, thank you so much.
I'd like to make a horizontal kind of observation.
I appreciated the
(clears throat),
well what I noticed was
how you maintained sense of humanity,
both in yourselves and the people that you worked with,
and I really appreciated that,
and so my question is,
for, well, okay, so,
you,
similarly it's a horizontal, open question for anyone
who can respond,
feels like responding,
so, you were once students
and now you're in this role of being a supervisor.
What,
what kind of recommendations would you give
for students,
particularly students of color,
when engaging their supervisor
around these issues.
What can we,
how can we approach,
how can students approach this?
What would be,
what would be a good way?
(audience and panelists laugh)
- [Enroue] Does someone want to jump in on that one?
- [Elizabeth] You know, I think it's a dialogue that needs
to be had with your supervisor,
but it needs to be, like,
with a client, a delicate dialogue.
You can't just say, okay, I'm Puerto Rican,
how do you work with Puerto Rican people?
Eh...
It just needs to be something delicate.
You need to feel like your supervisor,
you need to build your relationship,
and let your supervisor get to know you.
I'm not saying self-disclose about who you are,
but get to know your ideas of
where you're coming from and how the work
impacts you as a person of color.
I think building the relationship with your supervisor
and approaching it that way can help,
and as you see clients, you can talk about
the similarities and the differences that you have with
your client and the struggles that you may have.
I think the conversation,
I would say start the conversation slowly
and continue.
Don't get discouraged if your supervisor doesn't respond,
don't get defensive if your supervisor
doesn't respond.
Sometimes your supervisor may not even know how to
have the conversation.
- I'm not officially a supervisor, so...
- I think your supervisor should be able
to have those conversations.
- [Enroue] (laughs)
- [Elizabeth] She should, but it's not...
- I mean, I'm not saying that they always do,
but I do think that your supervisor should,
hopefully, be able to do that,
and if they don't,
complain,
(chuckles), no.
(Audience laughs)
File a complaint!
No, I mean, if you're paying them,
stop paying them, right?
I mean, but as a student, you have to do it a little
differently.
Or get a new one, but, no.
I'm kidding.
I think that that's a very difficult conversation.
I think bringing up, asking someone else to look at
their own stuff is very difficult,
but I do think that bringing it up regularly,
hopefully with change something.
- [Elizabeth] But be patient.
It's not an easy conversation to have.
I just say you need to be patient.
Some people are really comfortable with having
the conversation,
and in my work, I've seen some people that just really
struggle with it,
and, I agree with you.
They should be in a different place, but,
they're not,
and that needs to be respected too.
- [Enroue] And something I would add,
so you know, you're speaking,
you know,
you're speaking to power, right?
So, there are a lot of strategies to do that.
One is really being,
so do as much work in general,
on your container, right?
So that the things that come up,
so your relationship with your supervisor
is a formal relationship,
and so it's also really important to be clear about
what the limits and the boundaries of that are.
And you then get to determine
the type of conversation about that you want to have,
and that's gonna ease the way,
so that you're not,
"Uhhhhh, my god, here's my most vulnerable thing,
"putting this out here and" (groans),
right?
And anything that comes on, you're gonna be
reactive and defensive,
even if they're supportive,
'cause that's your expectation
and that's where your hurt is.
So the more you can
work on that piece,
the easier that is.
Now, it also means that in the moment,
you can think clearly about what you want
and what your needs are and what the issue is
about what you need the supervision to address.
When we're reactive,
do we think clearly?
No.
Right?
We don't perceive things clearly, so,
the more we can kind of sort some of that out
to decide the conversation we're having,
the easier that's gonna be.
Speaking to power is difficult.
They often don't want to hear it.
That's the nature of it.
So also understand that, kind of going in,
and maybe there are ways that it can be a
joint effort, right?
Not, what are you doing or not doing,
but, how can we or how can I better understand this?
So how can this,
you know, so shifting even the perspective,
and not immediately putting that person as the other,
can be helpful.
- [Mike] If I could just add to that really quickly.
And someone who's not a supervisor,
I think part of it is also,
find foster supervisors as well,
so it may not be the person that you directly work with,
but someone you can align with within
an organization or agency,
and I think what happens oftentimes,
at least my experiencing students at Smith,
is everything is contained and we have all these
opportunities for conversations and dialogue,
and then you go into your field placement,
in the middle of god knows where,
and then all of a sudden you don't have any resources,
but you have to be really savvy
in looking for communities of people
who are talking about these issues,
and being savvy about getting support
because it may be an impasse,
or you may run into the wall with your direct supervisor,
but of course, you have to be
really creative in finding various avenues of support.
- [Audience Member Eight] First I wanted to thank all of you
for everything that you've shared,
and especially Doctor Rodriguez-Keyes.
Before I started at Smith,
I worked with adolescents at New Mexico,
and I dealt a lot with Latinas and Latinos,
just sort of coming into their identity and that struggle,
so I really appreciated hearing, sort of,
how you handled it and your experience.
My quesetion is for Arden.
You alluded to sharing with us
the ramifications of filing a complaint,
and so I'm wondering, just as far as like how that worked
in a professional aspect,
but you also said that,
it was able,
you were able to sort of
bring race and cultural factors into clinical conversations,
and I'm wondering sort of what that looked like,
just outside of you,
and like the question that you're bringing in
as far as if you saw it with nurses
and other staff at the hospital?
- [Arden] So when I filed that complaint
with Patient and Family Relations,
I really had to fight to get it,
and there was a lot of disregard to what I said,
and there was a denial,
and I really,
I really insisted that they speak to that particular doctor
that they find him.
I really wanted him, sort of,
sorry, or her,
(audience laughs)
found and said something to,
and I made sure that that happened,
but it caused a little bit of a stink,
and it certainly put me on the map as someone who,
you have to be a little bit careful around,
like I'm sort of the one that's watching,
so that's not like pervasive,
but I do think that I'm somebody who people know
will always do that,
and there's some ramifications to that, right?
And I was willing to take them, but,
they certainly were ramifications,
so I think that that piece is,
and I also will do things like,
the other day I,
I mean there's a lot of hierarchy in the hospitals.
If someone asks a question,
and I cling with my fingernails to the lowest clinical rung
of that ladder,
(audience laughs)
as a social worker, and,
barely swinging on it,
but you do have power in this,
you have power in where you are,
and I think as long as you know that,
and the truth is that people do sort of know
that they shouldn't be doing this,
or if you bring it up,
people do respond in a way many times,
and so, the other day,
there was a patient who I really felt like was being
treated differently, because of their
race as well as the fact that they needed
an interpreter and the hospital wasn't getting it,
and they weren't regularly getting it
and you see this,
and I actually listened to a whole set of rounds
and then the attending was there,
and I pulled the attending aside,
away from everyone else, and I said,
"I really would like to believe that this patient
"would be treated this exact same way if they were white
"and they spoke English,"
and the doctor sort of stopped and looked at me.
And she said, "Well, so do I,"
and I said, "Okay, then I just want you to make sure
"that's the case."
So,
if you do that every once in awhile,
(audience and panelists laugh),
people start looking at you
(Enroue claps)
in a little bit of a different way.
I mean, I said it very quietly,
I did it sort of subtly,
but she really, you know,
I didn't say it in front of people,
but, she won't do it again, right?
Hopefully.
- [Elizabeth] (laughs)
- If I have anything to do with it.
- [Annemarie] So regrettably we're gonna have to
begin coming to a close.
I'm just gonna make a few announcements.
There are a few student-led groups that are
having discussions directly after the panel,
the Unlearning Racism group will be in Seelye 206
and is offering a place to process feelings and ideas
that have come up during the panel.
Also, the Council for Students of Color
will be meeting in Mowangie inside the Davis
Student Center at 9:15
for self-identified students of color.
There may be other groups that didn't
specifically ask us to make an announcement.
If there are,
please, student reps, be outside in the foyer
so that people can meet up with you.
And I really want to just take an opportunity
to extend our great appreciation
and thanks for the sharing of each of our
panel members tonight.
(audience and panelists applaud)
Mike, did you want to say a final word?
- [Mike] Now that I'm on the spot.
(laughs)
No, just want to say that I heard you ask
a lot of good, thoughtful, reflective questions,
so thank you for,
I mean, we're getting a round of applause,
but please give yourself a round of applause as well.
Stay in the conversation,
keep doing the work,
as Arden said, "Break the silence."
- [Arden] (laughs)
- [Mike] Make sure that you keep breaking the silence.
One love.
- [Mareika] Please leave your cases.