10 things a year as a therapist taught me about life, work & growth

As of 6pm on Friday, I am no longer a therapist.

It’s a strange, bittersweet feeling. For over a year, being a therapist was more than just a job–it was part of my identity. Work didn’t get to stay at work; it was part of my life in a deeply profound way. My co-workers became my supporters in ways that were unlike anything I’d experienced at any other job; the concept of a “mental health day” took on an entirely new meaning, being present in my work became more important than ever.

Looking back on the past year, it’s hard to pick out the things that I learned from being a therapist as opposed to things I learned simply by getting another year older (and maybe a few months wiser). But that, I suppose, is why self-reflection has become such an important part of my growth process. I’ve written before about journaling and how daily reflective practice has changed the way I spend my time, but it really has made a huge difference–not just in my ability to look back at moments of gratitude, but to watch myself experience learning and growth. It’s also allowed me to read old entries and see the places where I learned hard lessons and received some painful reminders of my own limitations–limitations that, thanks in part to that active self-reflection, I was sometimes able to turn into strengths.

But not without challenges, and not without luck, and not without help.

For better or worse, I’m a lists person, and I do my best memory collection through organization. So, here we are:

10 Things a Year as a Therapist Taught Me about Life, Work & Growth

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embracing vulnerability (happiness project, part 5)

Fairly early on in my graduate social work program, our program director sat down with my cohort and talked to us, pretty frankly, about the burnout problem. Some fairly ridiculous percentage (like, 21-67% across multiple studies) of mental health workers report high rates of emotional exhaustion and cynicism with the profession, leading to increases in anxiety, depression, and stress-related health issues. She told us, gently but frankly, that in her experience, a significant number of MSW grads end up leaving the social work field, or at least direct service work, within five years.

I remember, distinctly, looking around that room of bright-eyed, bushy-tailed MSW students, and thinking to myself, “Okay, some of us are gonna burn out, but I’m not going to be one of them.”

What’s that saying about famous last words?

When I chose social work as a field, I knew I was getting into a profession with long hours, low pay, and high rates of compassion fatigue. I’ve written before about the struggle I’ve had balancing my own need for self-care with the desire to spend all of my emotional energy on my clients, and in all honesty, it’s something I’ve struggled with throughout my career–and probably always will, regardless of whether I’m in direct service work or not. It’s just another part of who I am, much to my husband’s chagrin.

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But as convinced as I was at the beginning of my graduate program that I was not going to be one of the social workers who burned out in their first five years, I’m beginning to admit that maybe I am. It’s impossible for me to ignore that in the year that I’ve been in clinical work, my health issues–both physical and mental–have gotten worse, my stress levels have skyrocketed (despite pretty significant work over the last six months on self-care routines), and overall, may happiness has just decreased. I love my clients, and in many ways I feel deeply fulfilled by the work that I do. But I also feel tired, frustrated, angry, sad, fiercely furious with the social systems I’m forced to work within, and overall, exhausted.

So, as I recently announced to my work colleagues–and therefore now all of you readers–it’s time for a change.

Besides being one of my absolute least favorite things on the planet just on principle, being on the job hunt means exposing myself to one of my biggest anxiety triggers: putting my own future in someone else’s hands.

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I spend a lot of time hanging out with my therapist and talking about why this is such a big deal for me, and in all honesty, we’ve been digging around in it for awhile. We’ve spent a while going back and forth talking about how much I love to plan and control things (case in point), and how job searching is basically impossible to plan or control, because all you’re doing is sending cover letter after cover letter out into the void, hoping like hell someone will send you an email.

(Also, can I just say that whoever started the “due to the amount of responses, we will only contact you if you are invited to interview” thing is an absolutely terrible person? Because seriously. Send a batch “rejection” form email if you have to, but leaving everyone else in limbo is awful, and I hate that it’s become the norm.

Anyway. I digress.)

Wrapping my mind around just why it is that this job search thing makes me so uncomfortable–beyond just the aforementioned frustrating limbo–has been an ongoing challenge over the past month or two that I’ve been engaged in this process. I’ve probably spent two or three days’ (or at least nights’) worth of time trying to connect to the feelings of fear and anxiety that come up every time I think about writing another cover letter or sending another email, and each time, I find myself back at the beginning of my thoughts, deciding that this must just be some kind of personal failure.

But help comes through in weird places.

In my post about New Years’ Resolutions, I talked about wanting to make an effort to watch one TED Talk each month. I spent most of January vaguely scrolling through the TED site from time to time and occasionally bookmarking things to maybe watch later, and ended up scraping in right under the wire last night, thanks to a list of 5 Must-See TED Talks for Social Workers that a friend of mine shared on Facebook. The one I picked was “The Power of Vulnerability” by Brené Brown, and you guys, I don’t say this much, but it was actually life-changing.

 

In her talk, Brown talks about the biggest barrier to human connection is shame–something that each and every one of us feels at one time or another. Shame is that deep, emotionally exhausting feeling of not [blank] enough–not good enough, not smart enough, not worthy enough. And that to overcome this shame, what we need to do is allow ourselves to be vulnerable; “to allow ourselves to be seen, really seen,” in order to embrace connection. And that, of course, is absolutely fucking terrifying.

So Brown set out to do some research, to deconstruct shame and kick vulnerability’s ass, and to figure out just what it is that separated the people who were able to overcome shame and believe themselves worthy of love and happiness from those who couldn’t. What she found, at the heart of the matter, was this:

“There was only one variable that separated the people who have a strong sense of love and belonging and the people who really struggle for it. And that was, the people who have a strong sense of love and belonging believe they’re worthy of love and belonging. That’s it. They believe they’re worthy.”

Brown wanted to dig deeper, so she sat down with her interviews and did a more in-depth analysis to see what those people with a belief in their worthiness had in common. And she found four factors. The first three, I thought, seemed to make pretty perfect sense. They had a sense of courage, or as Brown phrased it, “the courage to be imperfect.” They were compassionate to themselves. They had connection.

But the last factor, to both Brown’s and my chagrin, was this: they embraced, wholeheartedly, vulnerability. They knew that in life, vulnerability was a necessary, if uncomfortable, emotion–necessary for connection, necessary for learning, necessary for growth.

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Brown’s reaction, and mine, was essentially this:

What the hell, research?!

(It was at about this point in the video that I realized that Brown and I would probably get along really well.)

I’m not going to recap the entire video, because you should really watch it–please, please watch it–but I will tell you what I really took away from it. Vulnerability, as awkward and stomach-churning and anxiety-producing as it is, is something that we must connect with if we are to connect with all of the emotions that come with growth and progress. When we close ourselves off from vulnerability in order to avoid the painful feelings that sometimes come with it–fear, anxiety, disappointment–we also lose out on happiness, on personal growth, on excitement.

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When I meet with my clients and they bring an uncomfortable feeling into the room–depression, grief, worry, pain–I ask them to spend a moment sitting with that feeling. I ask them where they feel it in their bodies, where they carry it–in their shoulders, in their chest, in their belly? I ask them to connect with the feeling and allow themselves to feel it, rather than instinctively away, because listening to those feelings is part of the process of understanding them. But doing this for myself has always been something I’ve recoiled against, preferring instead to press past vulnerability and project an air of surety or calm.

It may seem strange to bring vulnerability into my happiness project, but the more I think about it, the more I begin to understand that embracing vulnerability is a critical part of practicing happiness. Where my clients need to connect to the feelings they bring into my office, as I prepare to leave that office I need to connect to the vulnerability of allowing others to control where I go next. I need to lean into my discomfort, not push it away, and only through that discomfort and vulnerability will I be able to reach out to opportunities.

As uncomfortable as it is, I don’t know where the next step in my career will be. But I know that vulnerability is part of the journey.

And, strangely, I’m excited to start.

#readingwednesday: is it me or my meds?

“On Prozac, Sisyphus might well push the boulder back up the mountain with more enthusiasm and creativity. I do not want to deny the benefits of psychoactive medication. I just want to point out that Sisyphus is not a patient with a mental health problem. To see him as a patient with a mental health problem is to ignore certain larger aspects of his predicament connected to boulders, mountains, and eternity”

– Carl Elliott

 

I’ve had a complicated relationship with psychotropic medication.

 

When I was in college, I spent a lot of time being not-so-gently nudged into therapy by multiple people (my family, my friends, my then-boyfriend who is now my husband). While it might sound odd coming from a now-therapist, I really wasn’t into it. It seemed very weird to be talking to a stranger about my problems (cue ironic trombone noise), and I didn’t like the idea of doing it–it set off major alarm bells with what I now know is my anxiety. But hey, hindsight is 20/20, right?

 

While I wasn’t in therapy in college, my sophomore year was when I started seeking medication to specifically deal with my fibromyalgia and migraines, and suddenly found myself on a series of antidepressants. I didn’t realize it then, but SSRIs and SNRIs are often used to treat physical  conditions as well as psychiatric ones, and that meant dealing with all of the many side effects, some of which exacerbated the very conditions they were supposed to be treating.

 

Now, working as a mental health therapist for a child and adolescent agency, I often find myself referring clients for medication evaluations with our psychiatrists and psychiatric nurses–sometimes at their request, sometimes at the request of their parent or guardian. In our practice, clients receiving medication are, with some rare exceptions, also required to be in counseling with a therapist. I would estimate that probably about 60% of the clients in our practice take psychotropic medications, which leads to a lot of questions about the nature of how we refer kids for meds, how we decide when they need meds, and what it means to use psychotropic medications on young, still-developing personalities and minds.

 

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I first read David Karp’s Is It Me or My Meds? for a sociology course in college, but found myself drifting back to it a few weeks ago after having a conversation with a teenage client about her difficulty in deciding whether or not she wanted to give meds a try to manage her depressive cycles. Part interview report, part research project, Karp’s text explores the relationship between “pills and personhood”, looking at the ways in which people of different ages, backgrounds, and mental illnesses relate to their diagnoses and prescriptions.

 

When I read this book back in college, my knee-jerk reaction was almost to recoil. It freaked me out to learn about the ways that psychotropic medications changed the way people think and feel. I didn’t like how easily it seemed that psych meds were prescribed and the high rates of people–especially kids and teens–on multiple meds at once. (In all honesty, this is something that still worries me–the CDC reports that one in thirteen American kids between the ages of six and seventeen takes at least one psychotropic medication, and rates of psych medication prescription soars when kids are involved in the special education, foster, and juvenile justice systems.) That said, even in my first read-through back in college, I could see that Karp is careful to take a nuanced approach to understanding psychotropic medications, and for good reason–Karp discloses in his preface that he himself has taken antidepressants for years, and had spent a significant amount of time struggling with the changes he noticed in himself when he began taking medication.

 

Reading the book again as an adult and a therapist, I have a different experience. I’m more appreciative of the way that Karp works to understand the entire system of each person he interviews–looking at the whole person, the context of their experiences. In the work I do now, I’d estimate that eighty-five to ninety percent of my clients come to me with a trauma history–some kind of experience of pain or fear that had a significant impact on the way they currently function. I’ve learned the way that trauma can disguise itself as ADHD and Oppositional Defiant Disorder and depression and anxiety, and while I deeply appreciate the ways in which psychotropic medications allow my clients to function while we work through the underlying issues that contribute to their symptoms, I also understand that without the therapeutic component of their treatment, medication alone would not be sufficient to keep most of them functioning.

 

There’s a reason why the recommended treatment for most mental health disorders is to utilize a combination of medication and psychotherapy. Two of the many medications I take currently to manage my physical chronic health conditions are psychotropic, and even though those meds aren’t prescribed for to treat my anxiety and depression, I’ve found that I do considerably better managing those symptoms when in therapy than I do while taking those same medications without therapy. Is It Me or My Meds? isn’t the most academic or always-engaging of texts, but it is a great read for anyone who is trying to explore the decision to start medication, and I would absolutely recommend it for clinicians who want to improve their insight into what their clients might go through when they make the decision to start–or to stop–psychiatric medication.

 

Karp’s book asks its main question right in the title, and in all honesty, it doesn’t find a real answer. As clinicians, we tell our clients that medication can help them be the best, safest version of themselves; as patients, we do our best to hope that medication isn’t changing who we are. There is no single experience with psychotropic medication, but each person who takes them makes that decision carefully, and often uncertainly. If nothing else, what I take away from this book–and back to my clients and myself–is that medication is a step on a journey to living as one’s best self.

 

It’s not the destination.

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For more great images about conquering the mountain of mental illness, check out The Doodle Chronicles on Tumblr.

world mental health day 2015

Days that draw attention to mental health and mental illness are bittersweet for me.

Working in the mental health field means that I am, on a daily basis, on the front lines of helping others on the road to recovery, whether that means teaching and practicing coping skills for depression and anxiety, processing and overcoming trauma, finding alternatives to self-harm or restrictive eating or substance use, or any other number of therapeutic activities. My clients range from five to twenty, and each of them has their own story, their own journey, and they’re all at different points on that journey. I feel so blessed, every day, to be there to watch them grow and change as they learn more about themselves and take steps—slow steps, baby steps, whatever is the right pace for them—to get to a place where they are safe, and comfortable, and ultimately, hopefully, happy. As stressful and infuriating as my job can be, I deeply love the work that I do.

For me, the part of World Mental Health Day that is the most difficult is the part that is personal.

To be a therapist with mental illness is to feel like a walking contradiction on good days and a hypocrite on bad ones. It’s constantly wondering whether or not it’s safe to self-disclose, not to clients, but to co-workers and supervisors, wondering if they’ll treat you differently if they know that you might be closer to clients at the beginning of their therapeutic journey than to those at the end. It’s teaching coping skills and feeling hope for your clients and frustration with yourself, the constant questioning of why these skills don’t work for you, or at the very least, why you can’t just teach them to yourself.

A note: You can’t practice CBT on your own brain. It doesn’t work.

I don’t know exactly what DSM codes my own therapist has on her paperwork for me, and I don’t spend my own time with that brick of a book diagnosing myself. I know enough about my own mind to acknowledge that I have struggled with depression and anxiety for years, likely for longer than I’ve understood the concepts. It’s only been in the last few years that I’ve realized that the way my mind works isn’t typical. It’s not typical to have to spend five minutes taking deep breaths to work up the courage to make a phone call, to lie awake at night terrified that a conversation in fourth grade might come back to haunt you, to be suddenly struck, in the middle of a perfectly lovely day, by a wave of thoughts that everything you’ve done amounts to nothing, and that you’ll never be the person you thought you could be when you were little. It’s not typical to have to force yourself through things like taking a shower or getting dressed because the very idea of movement seems overwhelming and exhausting, to burst into tears at the smallest provocation, to sit in a bathtub and wonder what would happen if you just put your head under water and let it stay there. It’s not typical to wonder what the world would be like without you in it, to glance at telephone poles and road dividers and wonder what would happen if your car slid on wet pavement or ice. To not want to kill yourself per se, but to think, sometimes, that it would be okay to fall asleep, and stay that way.

Combining all of this with a chronic physical illness compounded things over the past few years. Study after study has found correlations between chronic pain and depressive disorders, and they’re so wrapped up together that it’s impossible to distinguish cause and effect. The addition of pain to existing depressive and anxious symptoms can take an okay day to one where leaving a bed is impossible. Guilt runs rampant; you tell yourself, you should be able to do this, you’re weak, you’re letting everyone down. This is why no one wants to spend time with you.

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(The rational therapist’s mind knows that these are intrusive thoughts, but an anxious mind is louder, a depressive mind more poetic, and the rational mind has a soft voice and is easily overpowered.)

This year, I took the radical step of putting myself into therapy, and that step in and of itself was terrifying. I was scared that a therapist would tell me that I wasn’t fit to work with clients, that until I got my own shit under control that there was no way I could practice as a clinician. After the brief, horrific therapy attempt I made in college, trying again, in a clinical community as small as the one in Berkshire County, made my skin crawl. I’ve been hugely lucky to find a therapist who is kind and comforting and candid, who allows me to take of my therapist hat while using my own background and knowledge to help me understand the way my own mind works—or rather, doesn’t. These last few months in therapy have been terrifying in their vulnerability, but I feel so, so glad that I’ve taken that step.

But even therapists aren’t immune from stigma, from repeating the same harmful statements that keep people who could benefit from treatment from seeking it. I recently had a conversation with a professional who’s been in the field longer than I’ve been alive, and her offhand comment of “Well, there are some people who can solve their own problems, and others who need someone to help them do it, but it really shouldn’t be for everyone” made me feel nauseous and judged. I still feel my heart jump into my throat when I mention my therapist to a co-worker, and I watch their micro-expressions for the tiniest hint of judgment or disappointment. I put on a façade of functionality, because even I have convinced myself that there is a time and place to acknowledge my own mental health needs, and those times are limited, those places few.

I hesitated before writing or posting this tonight, and part of that hesitation came from the internalized stigma I’m still trying to overcome. But World Mental Health Day is important. It’s so important that we tell these stories, that we take these thoughts and feelings out of the darkness and bring them forward so that people know that they are not alone. Depression and anxiety are still daily struggles for me, and will almost certainly remain so for a long time, but even compared to a few short months ago, I feel safer, more prepared to manage those feelings simply by acknowledging that they are there.

For any of my friends who are struggling with mental illness, I urge you to take a step—however small—to move to a safer place. Confide in someone. Start a journal. Reflect on the positive moments in your day, whether it was a hot cup of coffee or snuggles from a pet. Visit a therapist, if that’s something you can do. Ask for help, if you’re feeling unsafe. But know that you are not alone. That however loud anxiety brain shouts, whatever poetic words of despair depression feeds you, that you are loved, and cared for, and the world wants you to stay.

Walking On The Earth

past the cover: how having an invisible illness made me a more empathic social worker

The first time I heard a fellow social worker say, out loud, “If you come in with a coach bag and manicured nails and tell me you’re on welfare, you’re damn right I’m going to judge you,” I almost cried.

We’re an appearance-based culture. This isn’t news to anyone, or it shouldn’t be–we live in a world where what you look like is everything. People are judged on the street, sometimes violently, sometimes fatally, by their skin color, their body shape, the way they are dressed. The way we are perceived determines how we are able to move through the world. It’s the difference between being treated with deference or with violence, with respect and safety or with disdain and assault. And this treatment has consequences: micro-aggressions build up in our systems over time to eventually contribute to experiences traumatic enough to merit a PTSD diagnosis. And statements like the one my co-worker made? Are absolutely micro-aggressions.

This made me want to tear my hair out for a number of reasons. First and foremost: social workers, we should know better. Unlike other professions, our education is firmly based on meeting the client where they are, understanding client strengths, and our code of ethics relies not only on us not putting our own prejudices aside when working with clients, but also critically examining those prejudices and figuring out if they are compatible with our line of work. This means that sometimes you need to take yourself outside of the bubble of anti-poor bullshit that growing up in a capitalist society has forced down your throat for your entire life. Fun!

Second of all: as someone with an invisible and chronic illness that qualifies as a disability, I am continuously baffled by the things people say when they think everyone in the room (or even everyone in hearing distance) thinks and feels the same way they do. I’m talking about people who say things like, “Why do people want trigger warnings on syllabi? It’s not like real life comes with trigger warnings, you need to just get over your issues.” (I’d like to introduce you to allergy warnings and MPAA ratings, bro.) Or, “She definitely wasn’t disabled, I saw her get out of the wheelchair to reach something on a high shelf.” (Pro tip: standing isn’t the same as walking! Reaching isn’t the same thing as being mobile over long distances or periods of time!) Of, “Why are you so picky about where we eat? You need to try new things!” (Hey, only certain foods won’t render me a dying mess for the next five days, but I’m trying to spare you the inner workings of my GI track. I can change that, if you’d like. How do you feel about gory details? Oh wait, you said there’s no trigger warnings in real life, so I’ll just give you ALL the gory details. Yay for you!)

The face of disability is changing, and we–social work professionals especially, but I would argue that this should apply on a cultural level–need to change our perspectives accordingly. Ask your client if she can climb the stairs to reach your office. Double check with your friend before you make restaurant reservations at that hip new place. Consider implementing a scent-free policy at your workplace. If you’re planning to walk somewhere rather than drive, even if it’s “just a few blocks”, check with everyone that it’s okay–don’t just voluntell them. Don’t make snide comments about people’s weight. Don’t call people “lame.” Google “how to not be ableist.” Learn some things.

Just like the face of disability is changing, so is the face of poverty. Over the course of the last decade, the cost of “stuff” (televisions, phones, computers) have plummeted, while the cost of living essentials (college tuition, health care, child care/nursery school, vehicle maintenance, etc) have risen exponentially. This means that people with iPhones and nice cars might be the same people who struggle to feed their kids healthy meals, maintain their homes, and pay for childcare while working at their jobs.

“But Shelly,” I hear you saying, “Why don’t they just sell their nice things to pay for those essentials? Surely if they weren’t paying for a smartphone or a flatscreen TV, they could afford food and nursery school!”

No.

Thing number one: you have no damn idea where people got their “nice things”, and therefore have no idea a) if they are in a place to get rid of them and b) if getting rid of them would make any difference to their situation at all. Take the infamous iPhone, for example. “If you can afford an iPhone, you definitely shouldn’t be on welfare,” boasts the fiscal conservative on Facebook. What an original perspective! Except that it doesn’t consider the following:

– The person could have received the phone as a gift, be on a family plan, purchased the phone and plan prior to needing public assistance, etc.
– The person could be applying to jobs in sectors that require constant access to email, news, or other media (more on this later).
– Terminating an existing plan and phone in order to trade in for a cheaper one can cost more money than the person would saved, while simultaneously removing a major resource from a person’s life (access to information, support systems, etc).

Not enough of an example? Consider cars. One of the most common “get out of debt” tricks people seem to recommend is that if you have a car worth more than $4,000, you should sell it and get something cheaper. Now, as someone who has bought multiple $2,500-$3,000 cars from Craigslist, I can tell you the following: You might get a cheap car up front, but you will pay for that car in repairs and maintenance EASILY five or six times what you put in initially. Why? Because if someone is selling a car for $2,500, there’s a reason, and it’s probably not just out of the goodness of their hearts. My first car was $2,300 off Craigslist, and every single oil change also came with a new problem (confirmed by more than one mechanic) with at least a $50 price tag. So on top of gas, oil, and registration fees, I was paying at $50-200 in repairs every three months. It adds up very quickly, and in the long run, you’ll pay more for a cheap car than you ever would for a car that is, at first glance, more expensive. Terry Pratchett put it best:

“The reason that the rich were so rich, Vimes reasoned, was because they managed to spend less money.

Take boots, for example. He earned thirty-eight dollars a month plus allowances. A really good pair of leather boots cost fifty dollars. But an affordable pair of boots, which were sort of OK for a season or two and then leaked like hell when the cardboard gave out, cost about ten dollars. Those were the kind of boots Vimes always bought, and wore until the soles were so thin that he could tell where he was in Ankh-Morpork on a foggy night by the feel of the cobbles.

But the thing was that good boots lasted for years and years. A man who could afford fifty dollars had a pair of boots that’d still be keeping his feet dry in ten years’ time, while the poor man who could only afford cheap boots would have spent a hundred dollars on boots in the same time and would still have wet feet.

This was the Captain Samuel Vimes ‘Boots’ theory of socioeconomic unfairness.”

(Terry Pratchett, “Men at Arms”)

Bottom line: if you have a well-made car that’s worth a lot of money and is completely paid off, it seems like horrendously bad financial advice to advice someone to sell it and get something they’ll sink a ton of cash into, especially when the cost of an unexpected repair could be the difference between having enough money for groceries or medication and going without.

“So don’t have a car!” Fiscal Conservative on Facebook inevitably says next. “Take the bus!”

And we’re back to assumptions. Not everyone has access to public transportation–maybe they live somewhere without a reliable system, or physically can’t access it due to a disability (look at that intersectionality right there). Maybe the schedule isn’t compatible with their work or childcare schedule. Bottom line: you do not know their circumstancesDo not assume you do.

But even putting aside the financial aspects of this whole “if you have nice things, you’re not really poor!” narrative, imagine how incredibly invalidating of a person’s experience of poverty it must be to hear those words. Or don’t bother imagining: just read some of these first-hand accounts. Highlights include:

“When I was a child on welfare, eating rotten lunch meat, walking in shoes with cardboard in the bottoms to cover the holes, I had an extensive collection of My Little Ponies.  Not “one or two horses”; over three hundred, all told, and almost all the major playsets.  Maybe, oh, 10% of the total came from my mother, over the course of the eight years I spent collecting and living with her.  The rest were gifts from family members who didn’t know about our situation, but knew from Gramma’s chatty “everything is fine” letters that I loved My Little Pony.  They were from the charity groups that let you sign up and specify what your children wanted for Christmas.  They were from me saving every penny I found on the street.  They were from favorite teachers who knew how poor we were, who wanted me to have birthday happiness.  We’re talking thousands of dollars of plastic horses, almost none of which took a dime from Mom’s budget.  And the ones that did?  She was a mother trying not to break her daughter’s heart.

Every time someone yelled at us because poor people shouldn’t have nice things, we all died a little inside, and I clutched my horses even harder.  I needed something bright and beautiful in the world, to make up for the roaches in the walls and the mold growing on the butter.

Unless you’re someone’s accountant, you don’t know where they’re putting their money, and it’s not your place to judge.”

“We were eating only donated Panera bread, rice, and turnips. My father was sneaking to the various blood banks in town to sell his plasma at twice the rate they allow. My mother was dying due to not having her medicine, which cost well over $1,200 a month after insurance.
My autistic baby brother wanted to do something nice for me.
He worked for months making custom art pieces to sell. He worked up courage despite crippling social anxiety and speech problems to ask the neighbors if he could do chores for them to earn more money – raking the yard, helping clean their house, walking their dogs.
For nine months he carefully hoarded his money in a jar in his bedroom. He counted it every single night and compared it to the cost of what he wanted to get for me for Christmas.
Finally he had enough. He bought me a DS Lite and a pokemon game.
He was so happy.”

When we perpetuate a narrative that people must live with nothing in order to be deserving of aid, we invalidate the experiences of people who do their best to cling to joy in horrendous circumstances. We make children feel like they’re wrong for keeping a toy. We make parents feel sick for buying Christmas or Chanukah presents, while simultaneously building up the narrative that to be poor is to have nothing, and to have anything is to not be poor enough to deserve help.

All of this goes back to the narrative that appearances are everything. If you look online, you can find dozens of charities that work to give low-income job applicants haircuts, business wear, etc in order to succeed on a job interview. So much emphasis is placed on not looking poor in order to access essentials such as employment or healthcare, and yet we criticize those who don’t look poor enough to need public help: if you can afford a manicure, you shouldn’t need TANF, but good luck getting acing a job interview with dirt under your fingernails.

“I do not know how much my mother spent on her camel colored cape or knee-high boots but I know that whatever she paid it returned in hard-to-measure dividends. How do you put a price on the double-take of a clerk at the welfare office who decides you might not be like those other trifling women in the waiting room and provides an extra bit of information about completing a form that you would not have known to ask about? What is the retail value of a school principal who defers a bit more to your child because your mother’s presentation of self signals that she might unleash the bureaucratic savvy of middle class parents to advocate for her child? I don’t know the price of these critical engagements with organizations and gatekeepers relative to our poverty when I was growing up. But, I am living proof of its investment yield.”

(The Logic of Stupid Poor People)

The point of all of this is that we have created a narrative that simultaneously disdains anything that implies poverty while rejecting those who do not fit into the framework of what poverty “should” look like. I know a PhD who works as a barista and is swimming in loan debt while projecting an air of suave yuppiness, but she struggles every time friends ask her to go out to dinner because she knows she can’t afford it but doesn’t want them to know. I have friends who give each other manicures and find designer-label bags and clothes at thift stores to avoid being seen as poor (and therefore lazy, unmotivated, and a handful of other racially and economically coded adjectives) when they apply for jobs, but are still called welfare queens when they go from a job interview to a social service office.

(A sidebar, here: Lest anyone interpret this as a nice way of saying “not everyone is poor because they made shitty decisions, so you should be nice to all poor people!”, let me be very clear: I am saying this because it does not matter why someone is living in poverty. Maybe they did make shitty decisions. Maybe they did spend their money on an iPhone instead of saving it for an emergency fund. It doesn’t matter. Bad decisions do not invalidate people as human beings and should not give someone else the authority to deny people access to basic essentials like food, shelter, and health care. This is the 21st century. Move past your concept of the deserving and undeserving poor.)

As I talked about in my last post, keeping up appearances while struggling with social expectations when you don’t fit the mold of what someone thinks you “should” look or act like is a balancing act. Having an invisible disability has turned every day into an uncomfortable conversation. How much do you tell people about the realities of what you’re feeling? How often can you call someone on inappropriate comments or ableist language without becoming “that” friend or coworker? Will I stop being invited out? Will my friends still want to hang out if they’re worried about “accommodating” me? On the other hand, can I afford the recovery time if I push myself too hard, ignore my limits, do something unhealthy or unsafe for my body’s abilities? It’s enough to make you feel like you’re drowning.

 

The one up side to my illness is this: it has made me more understanding, more empathic, and more attuned to the realities of just how exhausting it is to keep up appearances. For me to become the sort of social worker who invalidates a client’s physical or mental abilities, financial state, or level of honesty based on their appearance, their performance of ability, or their possessions would be deeply hypocritical, and in some ways, I’m grateful to my disability for deepening my ability to look past a person’s presentation and to try and understand what their needs are while treating them like a real person.

Because in social work, it is so easy to become judgmental. We hear tiny things every day that add up to a professional mindset that is so inherently in contrast to what our code of ethics asks of us: to respect the dignity and worth of each person, to practice cultural competence, to allow for self-determination. And when we do that, we’re not just betraying our profession, we’re betraying our clients.

As difficult as it is–and I know it’s hard, I know, because I’ve been doing this professionally for less than a year and I’ve already seen and heard things that make me want to crawl under my bed and never come out ever again–we need to remember that we are in this profession to be advocates. Nine times out of ten, our clients are the people who have never had someone support them, who have been invalidated and disempowered and disenfranchised over and over again. Our clients are the people who have had disadvantage written on their bodies throughout their lives in the form of race, and size, and ability, and health. And as frustrating as it can be to watch the cycle of abuse continue, to see decisions made that might not be the most objectively advisable decisions, to see the gentle (or not-so-gentle) suggestions you make be ignored time and time again, it is still our job to support our clients to the extent of our abilities and to remember that they are people who are deserving of dignity and respect.

For younger/newer professionals (what up, cohort!) one of the hardest parts of this is challenging those who are older and more experienced (and therefore, more jaded, burnt out, set in their ways, etc) on their perceptions of their clients or client base. The first time I gently suggested to a family member that hey, maybe capitalism isn’t a great system, I was treated to a lovely rant about economics (how nice), personal responsibility (oh, glee) and those good ol’ bootstraps (how exactly are you supposed to pull yourself up by your bootstraps when you don’t have boots?). It was a very uncomfortable car ride. And as good as I felt about systematically breaking down every single one of this person’s arguments as mega super classist (because I am a boss), it was awkward, uncomfortable, and did not leave me feeling like a happy camper.

And the crappy part is, I’m going to have to do it over. And over. And over again.

But the crappiness of advocating for those living in poverty is nothing compared to the crappiness of actually living in poverty, just like advocating for those with disabilities is nothing compared to actually having a disability. And as exhausting and secondary trauma-inducing as it is, I am proud to be a member of a profession that was built around building people up instead of knocking them down, and I will continue to do so as long as I can. And when the burnout does start happening–which I know it will, probably sooner rather than later just given the population that I work with–I will remember the people who looked past my appearance of functioning and understood my limits, who understood that my presentation and my ability are not always synonymous, and I will try, for at least one more day at a time, to do the same for my clients.