Preparation

We stood speechless as we scrolled through the images that she had sent without captions. Utter misery inflicted on desperate people at our Southern border. How in God’s name are we allowing this?

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This afternoon I sat in a coffee shop preparing for work later this week with a group of medical fellows. We will be talking about the Latinx immigrant population in our community using an intervention called, “Yo Veo,” meaning “I See.” We will use a series of photographs by the photographer, Janet Jarman http://janetjarman.com to begin our conversation. The images from her story, Marisol and the American Dream, form a jumping off point to consider the ways in which migration experiences shape an individual’s experience with various systems, such as health care or education. As we go through Marisol’s story, we will also spend time with data collected from young people and their parents here in North Carolina. Some of that data comes from studies I’ve done with colleagues through the years and some comes from the good work of others.

Using visual images and the performing arts to promote nuanced and reflective conversation about race, ethnicity, culture, migration, difference, and professional practice is an approach I and others I work with have been refining since 2010. Although we use a particular method to structure these experiences, the conversations are open-ended and unpredictable. Sometimes the mood is tense. Other times the room floods with empathy. Usually, at least at first, there is a mixture of wariness and confusion as participants search for a “right” answer to the questions posed. Gradually, the group grows more comfortable with not knowing, a posture which overtime gives way to understanding, reconsideration, and respect. Although the structure is the same, no two Yo Veo conversations are alike. As a facilitator, comfort with ambiguity, trust in the process, and a willingness to let the images work is key. This flexibility and responsiveness is what gives the approach its power and differentiates it from more traditional “trainings” focused on diversity or difference. Our research indicates that what we do does influence professionals’ attitudes and motivation to engage with clients, students, or patients whose backgrounds leave them open to disparate health and educational outcomes. For those interested, links to some of our published research articles are at the end of this post.
Immigration questions appear to be evergreen in our society, a consistently hot topic. As such, whenever I prepare for a Yo Veo conversation, I end up tweaking the slide deck. Sometimes, I am tailoring for a particular type of audience or a particular timeframe. But usually, I am incorporating images and information that speak to the current moment. A month or so ago, Janet sent me images from her recent time in Tijuana covering “the caravan.” My son was in the kitchen when I opened the file. We stood speechless as we scrolled through the images that she had sent without captions. Utter misery inflicted on desperate people at our Southern border. How in God’s name are we allowing this?

Today was no different. I looked at more images taken by other photographers that document the separation, loss, atrocity, occasional resilience, and faith that characterize the current, shameful chapter in our national immigration story. As I look, I know our Yo Veo conversation this week will be meaningful. But it is hard to focus on the work through my tears…

 

https://www.researchgate.net/publication/256198342_How_images_work_An_analysis_of_a_visual_intervention_used_to_facilitate_a_difficult_conversation_and_promote_understanding

https://www.researchgate.net/publication/316751923_Making_a_difference_in_medical_trainees’_attitudes_toward_Latino_patients_A_pilot_study_of_an_intervention_to_modify_implicit_and_explicit_attitudes?_sg=S7zdUrG8227FpulXPLcUwk2i40_pBF7TXCnkRG1BQX3yJfFDdkACTP_U4HOG6_K3pFui-4hDRWzYKnLpB_Wrg666VffmqQS-1qxgGs4a.NU_7u7ToJ1VTc0TIDKXbtmKhf54TXaOZyl-7LxuODnrtyrHC_UGQCuLV-wYSyg9pND38LuYGQ-lj16rSoxHTpA

 

Photograph Credit: https://static01.nyt.com/images/2018/12/26/podcasts/27daily/26daily-superJumbo.jpg?quality=90&auto=webp

“Always listen to the Art.”

What we practice becomes part of who we are.

The whole culture tells you to hurry while the art tells you to take your time. Always listen to the art.        -Junot Diaz

Several weeks ago I was at UNC’s Ackland Art museum guest lecturing for a class. The photograph that accompanies this post is by Layla Essaydi and was the starting point for our conversation. It was shown to me by a museum educator colleague a number of years ago. I’ve back to it again and again. http://www.unc.edu/ackland/collection/?action=details&object_link_id=2006.14

When you see it in the museum, it is about 5 feet tall and draws your attention immediately no matter what else is in on display. My first reaction upon first viewing was a kind of alarm and discomfort. Without encouragement to keep looking, I might have frowned and looked away, eager to move on to something I could easily understand or find less threatening. Instead, I’ve been learning to wait. When students come with me to the museum, my goal is for them to begin learn to do the same.

As you can see in the photograph, veiling or covering is central. Each figure in the image is veiled to varying degrees. For many of us in the U.S., the age progression the photograph implies makes us uncomfortable. A child is carefree and uncovered. Covering engulfs the adult. We assume these women – somehow everyone assumes each figure here is female –are oppressed. Alternatively, maybe they represent a “veiled terrorist threat” that we do not understand and against which we are powerless to defend. We are nervous, we are frightened, we are angry. We are ready to either reject or rescue the picture’s inhabitants.

My museum colleagues are expert at slow looking, a practice that often translates to sitting with discomfort and noticing details. As I and my students practice staying engaged, our initial associations give way to curiosity. What is on all of their skin, their coverings, and the walls behind them? It looks like Arabic script. The Koran? Something else? Are they all women? Where are they? Who is taking their picture? Why did they agree to pose for it? Why are they looking directly at us with stares that give away so little?

When the curiosity begins, so does the learning. We learn that the artist created the photograph soon after 9-11 in response to the growing prejudice toward Muslims in the aftermath of that terrible day. We learn that she is Moroccan by birth and American too; that she splits her time between the U.S. and her homeland. We learn that those depicted in the image are her friends gathered for a party in a place where women, in days past, were sent when they “misbehaved.” The writing is Arabic script inscribed in henna, a celebratory material. It is used in this work to symbolize women claiming the skill of writing that was denied them in times past.

These bits and pieces generate more questions. What about that gaze? Why so direct? Why no smile? Why does the border look like part of a dark room photographer’s contact sheet? Why, when I ask what magazine this photograph might be in, does everyone say, almost without a breath, “National Geographic?” We are back to new layers of association to sort through. As we progress through them, we gradually learn what this photograph and its inhabitants, with their challenging gazes, are asking of us, even as we are asking questions of them.

They ask us to acknowledge our fears, confront our assumptions, move beyond them to learn more, and to revisit the image instead of walking past it. What we practice becomes part of who we are. Immediate outrage, speaking based on what we think we know versus what we’ve verified, considering the “other’s” point of view. Ideas that seem so basic, so urgent, and in such short supply.

No Bad Days

This morning, I started writing sitting on a seawall where my young son was fishing. Computer out, glasses on, skin tan, and my hair a little blonder because of sand and sea, I was reveling in my son’s fun, the beautiful water, enjoying a peaceful moment. A man came by and asked the following question: “What do you call a smart, beautiful, blonde?” Although I didn’t ask, he gave me an answer. “A golden retriever!” When I looked perplexed, he asked if I didn’t like jokes. I smiled and went back to my writing. He then asked if I wanted to hear something “a little bit dirty.” I declined and bid him adieu. Sexism at its finest. Yet, it always takes me off guard and I can never respond in the moment with the quick comeback that will put the offender in his place. The incident was all the more jarring sitting in such an idyllic spot.

Of course, not nearly as jarring than the day’s news. When we’re on vacation, my husband deletes Twitter from his phone and strongly requests that I not bring work along. I like to post pictures to Facebook mainly so our extended families can follow along on our adventures, a habit that keeps me connected to the strife that never seems to stop including this morning’s reports from Baton Rouge. Self-doubt floods in as I post pictures of stunning scenery and family fun while colleagues and friends are trying to help others understand why #all lives matter is an easy out from acknowledging systemic racism and its ever-spinning sequelae. I find myself asking is it okay to disengage for a while? Is it even possible?

“Self-care” is a term that was unknown to me when I was in my masters program; now, my students talk about it all the time. There is more recognition that social work and other helping professions takes a toll on our well-being and our effectiveness, a concern shared by colleagues in medicine, occupational therapy, and nursing among other disciplines. But the term, “self-care” doesn’t sit well with me. It conjures a box to be checked, an appointment on the calendar, something that happens a few weeks a year or for an hour a day, too discrete, too time-limited. Maybe this term is more about a longing for a way of being, a way to stay moored when the waves, whether small swells that throw us off-balance like the one I experienced this morning, or overwhelming seismic sea waves, that occur because of deep ruptures– think Baton-Rouge, Dallas, Baltimore, Stanford, Orlando, Nice — threaten to capsize our sense of purpose and meaning.

Two days ago I saw a window decal that said, “no bad days.” There is something about that simple statement that has been working on me and is teaching me something about weathering and, better yet, thriving in the ever-pounding surf. Perhaps it is a kind of mantra that might encourage me to stay engaged with the suffering of the world, denounce its savage idiocy when I must, and still celebrate its beauty and joy. Individuals who have confronted life-threatening illness often seem to understand that there are truly “no bad days.” They seem to know that as long as we live and breathe and have the great good fortune to work to make the “earth as it is in heaven,” then there are really no bad days. There are moments we may regret, lives lost that we mourn, changes to make, causes to champion, and always work to do. There will also be moments to cherish, wonder to find, and love to give. No bad days? No bad days.

Hopeful Musings

Recently, my older son wrote a story that he has entered in a contest. He is a good writer and the story has a strong voice. Like most of what he reads, it is a dystopian, sci-fi tale with a teenage protagonist. When he gave it to me to read, he warned me that it was dreadfully sad. It has a grim ending and I found myself suggesting ways in which he could change it to make it happier. And, of course I probed to learn if the ending was a reflection of his personal state of mind. (No – thankfully!) He said the ending was an experiment with writing a counter-narrative to typical endings in which the hero or heroine somehow figures out how to save themselves and humanity from almost certain destruction. As a writing experiment, I understoond his choice. But our conversation triggered several memories and got me thinking about why we look for hope in stories, how hope and happy endings are different, and what the ingredients of hope might be.

In a conversation with my own mother when I was very young after seeing the 1971 movie version of “Fiddler on the Roof,” I questioned her as to how there could be a story without a happy ending. As a seven year old, I was confused when the villagers began to leave their town and the fiddler followed behind leaving the audience somber and melancholy. Her simple reply: “Not every story has a happy ending.” A mysterious answer for my childish mind but I remembered it.

The second memory was from college in a women’s fiction class my senior year. We’d read the Pulitzer winning play, “ ‘Night, Mother” and had been asked to reflect on the protagonist’s choice of suicide. I railed against it, not believing that her life was so hopeless to merit such a choice. During class discussion, others defended the play’s ending and I was left feeling a bit unsophisticated for not agreeing. Of course as Frank Rich lays out in this review, http://www.nytimes.com/1983/04/01/theater/theater-suicide-talk-in-night-mother.html , the point of the play is more about the desperation all around us that our culture fosters than the central character’s choice. Yet our class discussion has stayed with me all these years as I’ve moved from being student to teacher and into roles in which perhaps my most important function is to provide hope.

Of the many rewarding parts of my job, one of my favorites is supervising students in a community clinic that is run by UNC’s Department of Clinical Psychology. Two of our second year MSW students are placed there and do therapy with a wide range of clients from the campus and surrounding community. Supervising these students means co-facilitating a seminar with colleagues in psychology, meeting with the two students weekly to discuss their client interactions, watching tapes of their therapy sessions, and reading notes. It’s work that keeps me close to practice and gives me a rare window into the everyday stories of people in my community. It is joyful work because every year I get to witness such growth, in the students I supervise and also in their clients. Through their stories, choices, and changes I re-learn the meaning of hope and get to think far and wide about the particulars of how it is kindled.

We all find ourselves with friends and loved ones in difficult situations and states of mind. Some have little hope that their circumstances, relationships, health, or well-being will improve. They wish for the past and fear the future. Others appear intent on destroying themselves to avoid pain they believe they cannot survive. If you’re like me, our first response is to try to fix it, which often means we flee into platitudes: “Just do something to distract yourself.” “Stop worrying. It’s going to get better.” “You’d feel better if you a. go to the gym every day b. get a manicure c. go back to work d. quit working so much e. volunteer, and on and on. But to the person who is supremely discouraged, who has lost heart, these platitudes sound like an unknown dialect. Suggestions and solutions do not constitute a language that can be understood by the discouraged.

What is the right language to speak to those who are suffering often in circumstances that have no easy, quick, or certain solution? In recent years, I’ve become interested in an approach called “Acceptance and Commitment Therapy.”[Look here if you want more information. https://contextualscience.org/act ] Here’s the premise. We will not free ourselves from suffering as long as we are a part of the human condition. We may suffer more or less at particular times but suffering is ubiquitous. The only question we can answer is what is it we value and then commit to live in accordance with those values. Concepts like independence, safety, serving others, having strong relationships, working for justice, revenge, achievement, learning, living our faith, all of these constitute values – some positive and some negative. When pressed, most of us will choose a positive value or two which can become a North Star to someone unmoored, adrift, and in pain. The therapist’s role is to help uncover those values and help figure out ways that individuals can live in accordance with them despite suffering and circumstance.

What does this look like? Suppose I live with chronic pain but value social connection and giving back to my community. Instead of not getting up and participating in a volunteer opportunity because I am afraid of the pain, I would get up, do what is possible to deal with the pain, and get to my volunteer post. Not because doing so will alleviate my suffering but because I will be living in accordance with what I value regardless of suffering. It isn’t about feeling better. It’s about living my values regardless of how I feel. The model’s power comes as we shift from trying to feel better to trying to be better. Regardless of my circumstances, I am better when I live in accordance with my values. When suffering becomes too great sometimes we lose sight of what our values really are. But when we can be led back to them and reclaim them, the choice of what to do becomes clearer.

Stories give us role models for this process. The teen protagonist that survives the fatal virus attack, the alien invasion, or the zombie show down, gives an example of how someone stays true to something important even in grim circumstances. In the best stories, the hero’s triumph is not because of smarts, ingenuity, or good luck although they use those things to good effect. They triumph because they continue to care about something bigger than themselves and live in ways consistent with the values they espouse. That doesn’t always create a happy ending but perhaps it gives us a model of hopefulness, a belief that that seeing another day is worth it if it gives us a chance to live out values we hold dear.

Photocredit: Skylar Searing

Thanksgiving

Thanksgiving
Last spring I stopped writing. There was both too much and too little to say in a season so rich with disappointment. Grant application after grant application was deemed “close, but no cigar.” Article after article – rejected or sent back ‘revise and resubmit,’ yet again. Relationships with colleagues I cherished were strained, distant, and uncomfortable. Only the fierce love of my husband, children, and close friends felt sustaining. And there was nothing worth saying or writing, just choices to make about how to move forward. Today, as I look out the window at a beautiful tree in the last days of its autumn glory, of course I feel differently…filled with Thanksgiving. Because, guess what, fortunes reverse. Grants have come through, articles are being accepted, and damaged relationships are healing. But it is not only because things are going well that I am thankful. It is because of what I learned and/or was powerfully reminded of during that disappointing spring. But first, here’s what I didn’t learn.
I didn’t learn that work is unimportant and the only important things are my family and friends. I didn’t learn that I should stop and smell the roses and not work so hard because it’s all for naught. I didn’t learn that I should be more strategic in my work choices so that I can make sure to advance when I want to. All of those are, in my view, hackneyed responses to professional disappointment. I think I didn’t want to write because I didn’t want to write a cliché. Sometimes you just have to wait for something better to say.
Many years ago when I decided to become a social worker, my minister at the time wrote me a letter which I have always kept and can still recite almost by heart. In it, he wrote about the difficulty of any helping profession: the low pay, the close up experience of other peoples’ pain, and the long hours. He wrote that it helped to have a touchstone, a way of remembering why one made such “a seemingly foolish choice.” He then inserted a quote from Fredrick Buechner that has resurfaced on Facebook and elsewhere in the last few years. It was fresh then and goes like this:
Vocation: It comes from the Latin vocare, to call, and means the work a man is called to by God.
There are all different kinds of voices calling you to all different kinds of work, and the problem is to find out which is the voice of God rather than of Society, say, or the Superego, or Self-Interest.
By and large a good rule for finding out is this. The kind of work God usually calls you to is the kind of work (a) that you need most to do and (b) that the world most needs to have done. If you really get a kick out of your work, you’ve presumably met requirement (a), but if your work is writing TV deodorant commercials, the chances are you’ve missed requirement (b). On the other hand, if your work is being a doctor in a leper colony, you have probably met requirement (b), but if most of the time you’re bored and depressed by it, the chances are you have not only bypassed (a), but probably aren’t helping your patients much either. Neither the hair shirt nor the soft berth will do. The place God calls you to is the place where your deep gladness and the world’s deep hunger meet.”

Source: Wishful Thinking: A Theological ABC by Frederick Buechner
And, in the end, this is what I learned. My work is mine because I was given it to do. I was called to it. I can’t escape it nor would I want to regardless of whether it takes six months to be successfully funded and published or six years, whether it is regularly affirmed by those around me or whether it’s not. I also learned that none of it means anything without people who love me fiercely, unconditionally, and demonstrate that clearly when the chips are down. I could not be more thankful to have people like that in my life. That kind of love is the best of all medicines. So now I will write again about all the work that is coming to fruition and about the great people I get to work with and learn from. And to those of you on similar journeys facing professional disappointments, remember that work you are called to is yours no matter how it is seen at a particular time. It will have its moment.

China Return

On this trip to Shanghai, my husband was the main event.  He was teaching at the law school and it was great fun to have a China adventure together.  And while he was teaching I was returning to “ T” village, the village where my Chinese colleague works and where we have been doing a Photovoice exploration with mothers who are members of the  “floating population,” migrants who come from the Chinese country-side to work in the cities.  The village, made up of 4000 people, is small corner of a big world and the mothers group is a small subsection of that.  But forgotten parts of the world have stories too.

 On this trip, we had a three hour meeting to “member check” – research-speak for going back to those who gave you their “data” to begin with to talk with them about what you heard and, in this case, saw in their photographs. The goal is to see if the researcher’s interpretation makes sense from the research subjects’ points of view. 

As before there was a lot to talk about and one conversation led quickly to many.  There were new babies to meet, specific problems to bring up with the agency social workers, as well as the task at hand. This group laughs a lot but tears come quickly too. Not ten minutes into the meeting, we were deep into talking about family elders – the other family members that are “left behind” in a quickly changing China.  Most of the literature at the moment focuses on “left behind” children, children whose parents move to the cities in search of work.  Children are left with grandparents or other relatives while their parents move to secure a better life.  Scholars speculate about and some have documented the ways in which this situation taxes a child’s well-being.  But elders are left behind too – a situation that does not fit with traditional intergenerational relationships in a country where filial duty is deeply engrained.

The first time we talked with these mothers about their photographs, we did not ask about elders.  But the answer to the question was in their photographs nonetheless.  You see there were no elders in their pictures and this absence, combined with silence, suggested an important theme we might have missed had we not taken an unusual approach to code our photographs for ideas and symbols that were not discussed in the photovoice transcripts.

 Elsewhere in Shanghai one sees elders everywhere, in the botanical gardens doing Tai Chi or dancing, or taking a grandchild for a stroll on city streets. On the weekends, three generations are often out together shopping or enjoying a fine spring day.   But in the mothers’ pictures there were none.  When we asked about the absence the tears began to flow.  “In China,” I was told, “ we have a saying ‘elders are a treasure for the family.’ Being away from them is terrible but we have no choice.  We call them every day.”   Immigrant parents from Latin America sing the same song with different harmony.  They lament the relationships their children will not have with their grandparents and remember how important those relationships were in their own growing up.  They worry that they are not present to care for their aging parents and that getting to them is so difficult when illness and infirmity demand.  It was a moving conversation and I felt grateful to be trusted, through my Chinese colleagues, with such information.

You may wonder as you read this, “so what?”  What could one possibly do about migrant separation from elders in China?  I, too, have my doubts.  But then again…this conversation is about an ancient, engrained cultural value.  Most Chinese people, no matter their station or status, espouse filial duty meaning that there’s reason to hope – if these stories are heard by those who can make change.  A graduation speaker at UNC several years ago said that all work worth doing is done in faith.   Migrating to a new home is also done in faith – faith that there is something worth working for, people waiting that will help you through hard times, and that your labor in some unknown corner of the world will mean something.  So perhaps we are on very different but parallel journeys these moms and I.  And my and my Chinese colleagues’ job is to make sure, to the extent we can, that their faith is sustained.

December Thoughts

It is gray and wintery outside, “December” is playing on my Ipod, and I’m finishing up odds and ends before heading home to celebrate the season’s joys with my family.   And maybe because the day is gray and the music wonderfully melancholy, I find myself finally breathing after a semester of much too much work and anxiety, reflecting on the strange juxtaposition that is Christmas when you are no longer a child.  The season’s joys…are so…complicated, mixed with sorrows  to which I am a bystander, yet affect me and others deeply -illnesses that have hit too early, deaths after suffering and deaths with no time to say goodbye,  some expected and some unspeakable, all in the context of carols, lights, and children who still believe in magic.  Bah humbug.

The first holiday season I spent working in the ER was like this and, in fact, I found a button with a Boyton cat on it saying, “Bah Humbug” that I wore every day. Fires, rats, maltreatment, dire injuries –  bah humbug about summed it up.   At the same time, it was the most junior social worker’s job to coordinate all of the holiday giving around the hospital and I was the most junior, both in age (24) and length of employment (five months).  I was supposed to create a screening mechanism for people who asked for help with toys, gifts, food, etc.  But I had no stomach for determining who was “deserving” or “truly needy.”  So whoever asked was assigned to a team in the hospital that wanted to sponsor a family. And guess what?   We didn’t run out of people who wanted to give.   Every family got far more than they asked for and teams were contacting me up until the day before the delivery date saying they wanted to participate and adopt a child or a family.  The cafeteria called me and said they had 30 hams they didn’t know what to do with.  Everyone was so pleased; it was a record year of giving for the hospital – did wonders for community relations.

On Christmas Eve, I went with the hospital security guards to deliver the loot.    And, although it was fun to play Santa, it took me into many of our patients’ homes and, of course taught me so much about their challenges with their health, their parenting, and all the rest.  There wasn’t one place that we went that day where the need was not acute, no family that was undeserving, cheating the system, or whatever might have been prevented by a screening procedure.  Maybe it was just good luck.

That afternoon, I must have flown home to be with my family – I don’t remember for sure.  But I do remember that the experience helped me begin to make sense of the duality of the holidays and perhaps to know their sacredness in a new way.  Each of the season’s stories are not “feel good” stories.  They are stories of uncertainty. How will we preserve our traditions in the face of these oppressors?  How can this child be safely born when the only place to stay is a stable? How will we cleanse the temple without oil?  What does that star mean and where will it lead us?  Iin the end, we come back to the beginning.  Perhaps it should not surprise us that uncertainty and sadness seem so vivid against the backdrop of holiday cheer.  That’s what the season is about to begin with – putting one foot in front of the other, even when we don’t know exactly where we’re going or whether we have the supplies we need, giving to one another with the assumption that others deserve our kindness without having to earn it, and, that even in seeming scarcity, there really is enough.