Did you ever see the movie, Jerry McGuire? Jerry wrote a manifesto based on the ills he experienced in his sports management company in an attempt to effect positive cultural change. Do you remember how that turned out? In case you missed it, Jerry was fired.
Another similar real life story was told to me by one of my social work professors who is no longer with us in this world. He blew the whistle on the corruption in the insurance industry in a Canadian Province which literally led to him being driven out of the province and landing in Ontario.
What Jerry and my professor shared in common was that they were driven to try and make their worlds better places. In the end, they ended up where they were meant to be and were healthier individuals as a result of it. They rid themselves of the cognitive dissonance and incongruence of working in a system that made them mentally unhealthy and morally/ethically bankrupt.
I’ve attempted to write versions of the following article many times in my life, but fear always prevented me from sharing my perspective and from ultimately blowing the whistle on a system that is making me – and I suspect many others – ill. I hope to generate honest discussion and thought about the current state of society and the people charged with treating society’s ills.
I am a Social Worker in my 18th year of front line practice. As I write, I am not well. Although in the current positive climate of mental health and wellness strategies in our society, I should not feel shame or guilt to admit this, yet I do. In fact, it makes my skin crawl to utter the words that I am mentally ill.
Although my legitimacy as a professional helper comes from social work education and practice, there are many other people in our field who have other education backgrounds and are equally skilled in there capacity to help, so I will herein use the term “professional helper” to refer to the field generally.
My illness is of the brain and emotional regulation kind. Diagnosed as panic disorder it is much more complicated than that for me. While I know that I am human, I have relied on my brain and more fully my “self” to be the treatment for my clients over the years and I feel like I am somehow broken in that I am currently unable to employ my “self” to help others. Although professional helpers rely on knowledge of human behaviour and systems, the multitude of theories and interventions designed to help people in crisis during periods of suffering, those interventions flow from the professional helper.
In addition to the tangible and measurable symptoms I am currently experiencing, I believe my illness is due to much more than my personal mental health functioning. I have felt like I have been dancing with and around a slow wave of melancholy and dysphoria trying to taint me with its toxicity for several years.
I am under no dissolution that my situation is unique, worse than, or perhaps different than that of others who treat people for a living, but in this day of digital information I find it’s further isolating that other people in similar situations aren’t out there sharing their experiences. I suspect that the lack of information about and for professional helpers isn’t there because like me, others have and continue to suffer in silence.
I finally took a medical leave – but of course like any good helper I argued with my doctor against it – after a chain of events left me in a poor state of functioning. At the final moment before I called the time of death, my memory was defunct and my focus was non-existent. I could no longer exude hope for those in my charge who needed hope more than anything. The hopeless helper is not okay because we adhere to professional ethics and values which above all else necessitate that we are hopeful and active in bringing change to our clients’ lives and society as a whole.
So, in addition to my own intrapsychic mental health, what is the toxicity that I speak of? I think there have been several factors which have combined to help me along the path to compassion fatigue or burnout or perhaps more aptly, general malaise of the existential variety. For the purpose of brevity and significance, I will talk about three of these factors and try and explain how these have combined to break one’s spirit.
Cubicle divided offices.
Most professional helpers do not work in offices. The cubicle or in some cases wall-less office is not an office. In my opinion it is in fact a legitimate workplace hazard that can make people sick. How you ask is this possible? Allow me to explain. It is well known that stress and traumatic stress is a measurable and real phenomena. When one of your colleagues is particularly stressed or experiencing trauma or secondary trauma, the stress from that person or the situation that they are dealing with impacts on everyone around them.
If you have ever worked in child protection you will understand immediately what I am referring to. Once an apprehension has been started the details of the matter and the preparations are inherently traumatizing and everyone in close proximity is impacted by that stress. Have you ever heard a colleague learn about a devastating event on the phone? Of course. What is not so tangible and measurable about the modern day cubicle divided office, is who and how much a person will be affected. Moreover, if you are an introvert, the mere effort it takes to function in a cubicle divided office is life altering.
One size fits all therapy.
Brief solution focused Cognitive Behaviour Therapy (CBT) and mindfulness based approaches are the most used modalities for therapeutic practice. Many new professional helpers may be hard pressed to be able to identify many more therapeutic modalities than those listed above and for good reason. However, these evidence based treatments which have been the focus of the profession for more than a decade have now created client outliers whose suffering continues and who feel personally responsible for their problems and suffering.
What I mean here is that some people require more time to change and heal while some people may need more evidence based tested therapeutic long term interventions. The longer term the intervention it increase opportunity to develop a stronger therapeutic relationship consisting of accurate empathy, warmth, and positive regard. Unfortunately, the good old social work texts such as Turner and Tuner social work treatment have no place in the political and economic climate of today.
So, we have people who are once again abused by the helping system in that the conclusion left upon service users who don’t benefit from CBT may be a feeling of failure. It may seem as if they aren’t trying hard enough to change their thoughts, perhaps worse they are resistant to therapy and want to remain in suffering. Ultimately, they are discarded from therapy and left to pick up the pieces alone.
I think would be remise of me not to note that even more appalling than an adult being left after therapy feeling that it is somehow their fault that they aren’t better is the current situation for at risk children who are treated in schools. Same situation applies. Although the literature and research surrounding the therapeutic and developmental necessity of at risk children having a caring adult is profound, our helping systems do not support a professional helper being that person. Do we ignore the systematic oppression and poverty while using therapy to help clients cope with society and social justice issues, and how could this be successful?
So, we have children referred for counselling for a variety of reasons (depression, anxiety, domestic family violence, substance abuse, to name just a few), they aren’t cured after six sessions but they have formed a therapeutically important and significant relationship with the helper. What do we do to these children?
We terminate therapy, and I would suggest do them harm by adding a loss and bereavement to their list of risk factors. I personally cannot ethically do this to children and I believe many of us in the field have found ways to undermine the system so that we can remain involved with these children beyond six sessions and even for as long as it takes. But, this comes at a cost to us because there is a great deal of stress associated with breaking the rules even when it is best for children.
The shrunken size of the world.
It is a small world after all. We now live in a world where global trauma, anxiety, and the perpetuation of fear are common place. It is hard not to see that our communities and more globally, the world as a whole has both benefitted from the age of technology as well as created a Pandora’s Box. Readers familiar with the great writing of George Orwell, Adolf Huxley, and more recently, Neil Postman, will understand the dire warnings they tried to convey to humanity as a whole. While the benefits of technology are widely known and praised, the hazards and negative outcomes for people and communities are less discussed.
For people already suffering with anxiety, for example, symptoms are increased on a daily basis by being consumers of information. It is next to impossible not to see the world as a scary and unsafe place. The internet tells us every day about human atrocities and the positive psychological movement which has many potential benefits cannot counter the global anxiety index.
I believe that the global anxiety index is a measurable phenomenon which raises anxiety symptoms in individuals and human systems. One need not look very far to see the impact of the heightened and highly sustained impact of global anxiety. We read daily about the increase in sleep disorders, anxiety in all of its forms and symptomology, depression, and all other mental health disorders are at levels not previously seen in humanity.
I believe that this new baseline of high anxiety is not sustainable and is the root cause of many of modern day illness and dysfunction. Ironically, this is not something imposed on us by some external entity rather than the result of technology in which we have created and embraced. Postman wrote tirelessly about the negative impact of technology on human literacy and intellect.
In my experience, the cures for global anxiety – namely meditation in its many brands – work for some people but herein lies the problem. I strongly suspect that those of us who have resisted the destruction of our thought processes are more immune to the helpful benefits of meditation and CBT strategies. Why?
In effect, modern day therapeutic strategies are based on one’s capacity to trick one’s mind into thinking positively. Some of us just aren’t susceptible to trickery. We have tried and tried again to adopt mindfulness and thought distortion changes in our lives but in the end, we conclude that it is not our thoughts that are distorted. In fact, nothing is distorted and we live daily with the impact of global trauma and anxiety.
I believe further that the only potentially possible way to get through this life as a professional helper and more generally as a mentally well citizen is to revisit and readapt existentialism. Yalom and others have embraced existentialism and used it to treat people with many mental health ailments.
But, existentialism needs a revamp in the technological age because what many people struggle with is not just the notion that we are ultimately alone, but we must now examine the unretractable information technology systems we are reliant which also may serve to perpetuate our symptomology. I will be brutally honest, I’m not sure how else we will get through this.
For sure, existentialism is a depressing ideology, but the help in it lies in the paradoxically and poorly understood and discussed end result. If we can find a way to embrace existential tenets, eventually the suffering goes away. But, this is a lengthy treatment and one that requires periodic revisiting. Therefore, it cannot be supported by our current mental health systems. If you can’t trick yourself into getting better, you will be discarded to the land of “it’s your fault”.
I am not sure where we proceed from here but I am finally ready and able to be the face of change if that is what is needed.