this social worker is thinking

reflecting helps me, I hope it is interesting to you

Every good piece of writing needs a good story and what better than a stolen one…

This story belongs to a woman. Her name is Kate. It is also story of three other characters, trauma, toxic stress and recovery.
Woman tripping over a rugKate lives in a village. She is used to village life and to village people. One day she travelled to London to give a talk on Neuroscience at a renowned University. On her way there, she tripped on a hard paving stone, on a busy London street. As the ground came up to meet her and covered her in mud and grit and wet, she looked around for a helping hand. Being a village person, who was used to village communities, she was not expecting the hard city response she got, from hardened busy commuters.

No one stopped to help. No one stopped to see if she was okay. No one stopped to offer that human contact which provides reassurance in moments of crisis.

The fall, followed by the absence of assistance, not only left her sore and wet and cold, it also left her feeling vulnerable and alone.

 

This was trauma.

 

So, feeling vulnerable and alone, and looking much worse, she stumbled along the street and through the doors of the University. A brief wave of hope washed over her as she approached the attentive security guard at the front desk to request first aid. The security guard, however, did not see a University Lecturer, or a Neuroscientist. He saw a wet, dirty, bleeding mess of a woman and quickly told her that if she turned back around, went out through the doors and along the street, she would find the A&E department.

 

This was toxic stress.

 

This was the moment when the well-practiced British stiff upper lip was quickly replaced by a lower wobbling one. When any sense of adult composure or decorum was suddenly unattainable and instead Kate crumbled. Not only did she crumble, but she blurted; that form of talking when you want to say a thousand things all at once, but in reality you are too emotional to say any of them coherently.

What the security guard heard, amidst the tears and the weakening of the knees, went something like,

“… lecture…. neuroscience…fell over… late… wet… cold… a mess…please help”.

At which point, the security guard, half as broad as he was tall, came out from behind his security desk and, towering over Kate, put his hand up and said,

“Stop! What you  need right now is a hug.”

With which, he put his broad arms around her and provided the kind of bear hug you would expect from a man of his stature; the kind that squeezes you to the point of almost unbearable, but equally to the point of utter refuge.

 

This was recovery.

Kate did not really need first aid. She was actually fairly capable of cleaning herself up and attending to her own minor bruising and grazes. What she needed was a validation of her felt experience. For someone, in her moment of trauma, to connect with her; to hold her in their mind and consider how she might be feeling; and to provide the kind of stability which proves that the world is not falling apart around you.

 

I was told this story by Kate. She told it to illustrate the need for children, from a young age, to have safe adults around them, who connect with them in moments of trauma and show them that the world is not falling apart. Babies are born with two states: the world is fine and the world is falling apart. It is through relationship, with safe consistent adults, that they learn the intricacy of emotions between these two states. They learn that the world can be a safe place and that they have safe dependable adults who meet their needs. They learn that trauma can happen and so can recovery. They can fall over and scrape their knee and someone will be there to help them up and give them a hug. This relationship has become commonly referred to as the attachment relationship. (Thank you, Mr Bowlby.)

Kate went on to explain that children who do not have this attunement with a trusted adult, cannot resolve the toxic stress they experience. Kate explained that toxic stress affects the functioning of certain parts of the brain. These include the logical, rational conscious thinking parts of our brain. Toxic stress can make us act more impulsively, intuitively and emotionally. Children who have unresolved toxic stress, therefore, can struggle to use their logical rational, conscious, thinking brains. They can display a variety of internalising or externalising behaviours which seek to control the world around them and make it safe. They do this because they struggle to regulate their emotions. They are stuck between “the world is fine” and “the world is falling apart”.

At this point in the story I am going to switch tack and talk about my job. There are lots of social workers in my line of work. In fact there seem to be fewer and fewer social workers at the moment, because lots of them are leaving or are having time off sick with stress (nationally rather than specifically to my place of work). Research suggests that the average life expectancy of a frontline child protection social worker is 2 years. After this, most tend to leave or to burn out. I heard of a local authority who had 12 social work vacancies in a team of 15. What happens when social workers leave, is that the social workers left get more work to do and the work we do can be emotionally intense.

Child protection social work is no doubt a tough job and having just completed my newly qualified year I have seen a number of colleagues decide to move on to new ventures because work-related pressures just got too much. I have been saddened to see fantastic people, who have made a real difference in the lives of children, become overwhelmed with toxic stress. I know that I too am vulnerable to this predicament. I am also stubborn, some people think frustratingly so, and I am determined not to be beaten by toxic stress.

So I have been thinking….

1 thinking_capI have been thinking about Kate and I have been thinking about toxic stress. I have been thinking about the work I do and the emotional rollercoaster it puts me through. There are many days where the ground comes up to meet me, as I fall flat on my face. There are many days where I feel so alone in the responsibilities I take on, with the children I work with.

I have also been thinking about my social work friends who have so courageously endured periods of unresolvable toxic stress. When I have talked to them I have realised that they have been emotionally traumatised by the work they have been doing. The pressure of keeping children safe in a society where there is such public condemnation if we do not succeed and often in a work culture where you’re just expected to get it all done.

 

I have realised that as a social worker I need a security guard who is half as broad as he is tall who can say “Stop. What you need right now is a hug.”

"I’ll just pretend to hug you until you get here."I need my emotional experiences to be validated. I need someone to empathise with how I am feeling. I don’t need practical first aid. I am almost sometimes pretty competent at my job. But I need people who act as an emotional mirror, who reflect back to me that the world is not falling apart around me. I am fortunate that I find myself in a place where I have this. I have survived my first year of social work practice and I plan on continuing to do so.

To end my story… I had a student social worker shadowing me this week and she asked me what one thing I would advise her; what would she need to learn to be a great social worker. Although there is no one thing which makes a great social worker, I know that I need to recognise how I am feeling and why I am feeling it; I need to be kind to myself and recognise that, as a human being, I have emotional needs; and that a metaphorical, bear-hugging, security guard is the thing which will enable me to continue being any kind of social worker at all.

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Life is not Disney.

Image

Cinderella’s Law. No, not the latest animated picture, but a campaign to change the law. Making parents criminally responsible for emotional abuse. This has cretaed a lot of chatter in the social work world and from my reading two themes emerge:

  1. Emotional abuse is just as harmful to children as physical and sexual abuse. There is an increase in awareness and reporting of emotional abuse (according to NSPCC stats). It should be handled with the same criminal rigour that is afforded to other forms of abuse. The law is outdated because it does not recognise this equality of severity and needs to be changed.
  2. Criminalising emotional abuse will not increase its detection and will not reduce suffering of children. Emotional abuse needs to be addressed, but making a new law is not the right way to go about this.

There are several decent articles and blogs out there, commentating on these themes and more. If you’re interested I would suggest Community Care as a good starting point for these debates.

Another line of thinking has struck me, however. I grew up on Classic Disney. I’m sure I’m not alone in that, or in my idealised imaginings of Prince Charming sweeping in on his White Steed and saving the day, in whatever form he may come.

Growing up there are some things I have learned.

Life is not Disney.

I am not Cinderella.

Nor am I Prince Charming.

Cinderella has been chosen to represent children suffering emotional abuse, but scratch beneath the surface and I would say she is a poor reflection. When I look a little closer, Cinderella would not be found on my caseload as a child protection social worker.

Mr Disney is painting an imaginary world which denies us several realities.

Mr Disney does not allow Cinderella to love her Wicked Step Mother. To need her Wicked Step Mother.  Whether practically or emotionally. To have an attachment relationship with her Wicked Step Mother, however insecure, through which she understands her world.  This is the complexity for children suffering emotional abuse. Such complexity can be hard for me to understand, so I can only begin to imagine how confusing it must be for the children living in the midst of it. That their source of derogation, of rejection and of fear is also the place they look for affirmation, love and protection. This is not to say that I should ignore suffering of the former because of children’s need for the latter, but if I do not recognise how intertwined and enmeshed these two are, then in taking away the abuse I am also tearing away what is known and what is secure.

Check out this video, but be warned it is hard-hitting.

https://www.facebook.com/photo.php?v=644670088960805

Minute seven, says this so much better than I can…  “wanting the most important things back again. Like wishing you could see your Mum’s smile again. And hear her sing that one favourite song, that always calms you down.”

In all of my interventions, and my playing Prince Charming, do I really think I can find a solution that replaces the effect of that song? I need to value the role such “songs” play for children, as well as the chaos which surrounds them.

Mr Disney does not allow us to believe that the Wicked Step Mother was once a Cinderella. The NSPCC states that 1 in 4 young adults report experiencing significant maltreatment in childhood. For parents I am working with, I would say that this statistic is closer to 4 in 4. This does not make behaviours they show toward their children, or in their adult relationships, acceptable or even excusable. Significant harm is still significant harm. Social work, however, is not about looking at a problem and finding a solution. It is not about seeing a Cinderella and finding a Prince Charming. There are many steps between the A and the B. One of the important steps is the “why”.  All behaviour is meaningful. So the behaviour is not the problem. The problem is the reason for the behaviour, but it is here that we can also find the solution.

Mr Disney creates magic and wonder, where frogs can turn into princes and pumpkins into beautiful carriages. For Mr Disney, however, the Wicked Step Mother is always a Wicked Step Mother. He not only refuses to allow us to see where the Wicked Step Mother has come from, he refuses to allow us to consider what she could transform into. If I do social work according to Mr Disney, I am falling short. If I see parents as fixed and unchangeable, I am not considering their capacity to change. To understand what is harmful to their children and to learn new ways of parenting.

And they all lived happily ever after…

Mr Disney does not consider the emotional and behavioural impact of the harm Cinderella has suffered. Children are resilient and they are survivors. When life is scary and harmful and unpredictable, children learn ways of dealing with this. They adapt strategies to keep themselves safe, not only physically but also emotionally. These are not always healthy strategies, but they achieve their purpose. Survival.

Children take these strategies with them through life. Even when we might think they are now safe. They can still feel in survival mode.

Check out the prologue of this book: http://books.google.co.uk/books?id=mjx0EcXmuYYC&printsec=frontcover&dq=attachment+disorder+colby&hl=en&sa=X&ei=mo2LU_zuK8eVPemngdAJ&ved=0CDMQ6AEwAA#v=onepage&q&f=false

It is not as simple as sweeping in on our white steed and taking the princess to her new castle to live happily ever after.  What children need is more complex and involved than this “concise” blog allows. What I will say however, is that I need to be realistic about the impact of children entering into foster care and if it is “necessary”, then to consider the support and understanding they will need in making this transition.

This blog has focussed on Mr Disney stories where Cinderella leaves behind her cellar to live in a beautiful palace and where the “Wicked Step Mother” has no role to play in “rescuing” her. This is what we are talking about if we are convicting parents under “Cinderella’s Law”. By casting these archetypal roles we are massively over-simplifying lives which are more complex and changeable than we ever truly comprehend. More importantly we can be denying ourselves, and the children we work with, solutions which enable them to grow up with their family.

In short, families are not made of victims and heroes and villains.

Life is not Disney.

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The wisdom to know the difference…

So sometimes the most frustrating conversations  I have with my manager are the most thought-provoking.  This week the conversation went something like this (with slight improvisation for dramatic effect!! ) …

Manager: so how was your visit?

Me: well Mum denied drinking

Manager: there’s nothing we can do about that

Me: nothing we can do? Her doctor says she will die if she keeps drinking

Manager: yes she will probably die, there’s still nothing we can do

Me: but her children will suffer a significant grief if that happens (increasingly exasperated tone)

Manager: yes that is true, it doesn’t mean there is anything we can do

Me: Ok (not really okay but unsure what else to say at this point)

Manager: (as I walk off, frustrated) there are things that we can do something about though…

 

Sometimes I want to play the superhero. I think I should be waving some magic social work wand to make “everything right” in a family. I get so involved in the harm children might be at risk of experiencing, that I take on full responsibility for stopping this from happening. This isn’t realistic but it’s really hard for me to stop. Or to acknowledge that some of the children I work with will be harmed, despite me working with them.  I’m not saying that I should accept this fact and do nothing. I would never allow myself to say this. On reflection… I don’t think my manager was saying this either.

 

There’s a poem written by some religiousy guy called Reinhold that talks about:

The serenity to accept the things I cannot change

The courage to change the things I can

And the wisdom to know the difference

 

It’s this final one that escapes me time and again. For people that know me they will recognise that I am not reluctant to speak my mind or step up to a challenge. I’m quite prepared to take a stab at making change where I can. Accepting what I cannot change is less easy, for a stubborn perfectionist such as myself. The first step in that battle, however, is recognising that what I am trying to change is not within my control. It’s having the wisdom to know the difference. Well in this respect, I’m not very wise!! I am not a believer in lost causes, particularly when that cause is safeguarding children. This a contentious issue and one that people understandably get really emotional about. Even as I am writing this I am battling again with how best to articulate my thinking. There is no scenario where I should consider protecting a child from harm to be unachievable. It is my job to strive to ensure that it is. There is something, however, in recognising what about a family I am able to change and where my efforts should be focussed.  By seeking to change this Mum’s drinking patterns, when she won’t admit to me that she is drinking at all, creates a situation where I am pushing her into a position of defending her “innocence” and me into a position of trying to catch her out. This is difficult to evidence and stops us from working together. And if we’re not working together then how can change be committed to, achieved and sustained?

So what is within my realms of influence to change? What will this parent engage with me about? What can I evidence? For these children I can evidence developmental delays and emotional distress, but this reflection is not so much about this family, it is about me dealing with uncertainty. If I am honest one of the reasons for my impassioned response to this piece of work, was that I could not be certain about the drinking. I have a parent denying drinking and professionals reporting smelling alcohol on her.  This leaves me in a place where I cannot be certain of the reality of the situation. My lack of certainty means it is beyond the realms of my control and therefore I am not in a legitimate position to facilitate change. I need to accept that I cannot change it, but I will be honest, that leaves me far from serene!! Serenity is not my forte!! A shift in focus, however, on to the things I can work with a family to change: to increase their resilience and lessen the harm to the wellbeing of the children. This shift, reduces my anxiety, about that which I cannot change, and engages families in achievable change. My reflections always seem so idealistic and the realities of practice much messier, but at least it’s somewhere to start…

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Relationship based practice… how could it be anything else?!

I returned to University this week for the first time since graduating. I was asked to talk to some students about my experiences as a newly qualified social worker. This opportunity, to share my thoughts, gave me the chance to “reflect”… a word used so habitually in my student days, which now, can seem like a luxury, amidst social work days full of deadlines, performance indicators and twenty things that all needed completing yesterday. Having this opportunity made me prioritise reflective time and, as I so often find with this reflecting malarkey, once I pop I just can’t stop!! Such “popping” has led me to this blog which will in turn lead to… well, as they say, watch this space!!

My university visit also led me to an old lecturer (no reflection on her age) who is writing a book on relationship based practice in children and family social work. My comment to her went something like “relationships are so central to my practice, it’s just that procedures and structures and performance indicators (yes those again!!) always seem to get in the way”. This very gracious lecturer gently suggested that “there was always space if I made room for it”.

Where my newfound reflecting has taken me, however, is to consider that we were both wrong. The reality is that I can’t get away from relationships in social work. In fact, my comment served to highlight how I can use external factors as an excuse for my lack of consideration to the impact of relationships on the work I undertake with families. It’s not about making space or things getting in the way, it’s about acknowledging the intrinsic unavoidable nature of relationships within social work practice. Then again, maybe I don’t want to look this deeply because rather than families it might require me to change!!

Families are not asked to input data into a computer to produce a ready-made social work assessment and plan. They are asked to engage in a relational process where I meet with them, we talk and share information and thoughts. I try to understand them and hope that they can understand me and somehow through this I form views and make judgements which are communicated in my assessment and result in my plan of action for a family. If this is an effective process, it is one where assessments depict a variety of perspectives including the views of the child, the parents and professionals supporting them. The plans that come from this process are created with families and are therefore committed to by them.

This might seem a little idealistic and I know that social work practice is so much more complex than this, but whatever the complexity or perceived level of “success” in these processes I cannot escape the fact that the relationships formed within them, remain foundational to the outcomes seen. If I am not aware of the nature of the relationship I am forming with members of a family, then I will be unaware of how this is impacting on the change that we are working toward. I could, in some ways, be fuelling the reason for my involvement in the first place, or preventing change from occurring. I am also unable to learn from ways of working which promote resilience and positive change within families, because I am not reflecting back on the times when advice has been taken on board, plans engaged with and change committed to and how my relational approach might have facilitated this. The reality is, however, that whether or not I do any of this, the relationships will still be there.

So what?! Where has this “revelation” brought me to?! Well, it has inspired me to “think more”, which has to be a good thing!! I cannot say that it has changed my practice yet, but as I have said once already in less than 1,000 words… watch this space!!

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this social worker is thinking

reflecting helps me, I hope it is interesting to you

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