Systems Perspective and the Myth of the Self-Made Man

As a social worker, we spend a good deal of time looking at systems, and systems work means we can’t only focus on what’s “wrong” with the individual in our office. Our focus can’t simply be what can this person do to move toward more emotional happiness? We need to always be considering how living in the world and engaging in relationships with other systems and other people play a large role in what this client does, how they think, and how they feel.

My job isn’t to just locate the unhelpful belief my client has about their self-esteem or retrain how they respond to a negative thought. When doing systemic work—even with just one person—I need to look at how race, ethnicity, age, sexuality, and gender play a role in my client’s life. I need to look at how that client’s family system, school system, government system, community systems, and more played a role in shaping my client.

As basic as this is, it’s important to note that It’s a fairly un-American way of going about things.

The Big Lie of Individualism

We’re taught that we should hold up the self-made man. We celebrate that guy to no end in movies, plays, songs, and stories. It’s our enduring myth.

We, social workers, see the monstrosity in that idea—pleasant and attractive though it is. We know that human beings can only grow and thrive within relationships, not apart from them. We know that nothing is self-made. We know that we are working from day one of life to attach to others.

We need to push back on the “self-made man” myth because it’s racist. It’s sexist. It’s heteronormative.

And it’s killing us.

And since I work mostly with men I want to be very direct because it’s literally killing us as the suicide rate for men is incredibly high: five times greater than for women. And we apply words like “strong” and “hard” when we’re describing masculinity? Something is missing. The weaker sex, the special snowflakes, are the ones who are supposed to need help. Not us.

Social workers disagree about many things and we have lots of ways we think are the best way to help any given client, but one thing we can all agree on when it comes to healing is that the relationship does a great deal of the work. It can begin to heal trauma, mental illness, and the “worried well.” It’s the way in, it’s the way through, and it’s the way out of suffering. It’s not the only thing, but it’s part of everything. Death is in the separateness, the lack of relationship.

And name your –ism because that’s about separateness too. We can’t fully heal a white person without moving through white supremacy together and we can’t help men without addressing the patriarchy. We may not call it out or by these names, but to connect with someone in their suffering is to refuse white supremacy and masculinity.

We need to keep doing what we’re doing, but we need to go further. We’re healing the people without healing the system and we can only thrive so much within a sick system.

Moving Ourselves Toward an Ego Dystonic State With the World

In a mental health session, our work is often to connect our client with other people. Often this happens through the therapeutic relationship with us first, but ultimately, it’s done so they can connect with the other people in their life. Doing this on an individual level is important, and as difficult as it is (and it is difficult), it’s really the bare bones of our work. Because what we’re doing, if we stop there, is helping people build up coping strategies to survive in a broken system.

So we have to stop and ask ourselves if in our work we are challenging the system that our clients live in and, not for nothing, that we’re living in too. Now, this can be a controversial stance for some people. It sounds “agenda-driven” and done unskillfully it is just that. But for those who feel they are thriving in this patriarchal, white supremacist world, do we have any choice, ethically, but to aid them in shifting their lens?

For too many of us, we have come to see this world as ego syntonic and we need to push toward discomfort in ourselves to see the world as it is. And that will move us toward change.

A Child Welfare Example

Let me take my work in child welfare as an example. Most of the parents I’ve worked with over the years are well-meaning and loving people. Many of them are involved in child welfare because they had hit their children in order to discipline them. Many of them feel this is ok. Many of the child welfare workers think it’s ok to physically discipline a child. We even have different words so we separate “abuse” from “physical discipline” and we jump through hoops to try to define “excessive corporal punishment” as separate from “physical discipline”. Many parents have no hesitation telling me that when their child gets out of line they need a slap, a spanking, a something that lets them understand limits, but that this is discipline and not abuse.

And in the course of this conversation, I usually hear the inevitable, “It happened to me and I turned out ok.”

And right there is the thing that I’m talking about with these systems. You “turned out” in such a way that you think it’s ok to hit a child, your child. And this is the proof that you didn’t turn out as “ok” as you think. You grew up with something violent being normalized.

But that’s our society. That’s the society that collectively calls sexual assault “locker room talk” and elects a president. That’s the society where powerful, talented men are allowed to produce and direct movies for years without consequence for their sexually abusive behavior.

Systems work is helping people see that things they take for granted could be wrong. Knowing

  • That there are not simply two genders.
  • That race is not encoded in our DNA.
  • That women are not genetically more nurturing.
  • That there are no such things as boy and girl toys.

Knowing all that means we have to fundamentally shift our way of thinking, our way of feeling, our way of living—day to day—in this world. And we may need to fundamentally, though not radically, change the way we approach therapy.

Merging the Therapist and the Advocate

Great things can come from our work with individuals, couples, and families. We can support people in relieving a lot of pain and finding healthier ways to interact. We move people through trauma, out of depression and anxiety, and to better navigate relationships. We help people live within our broken world—which is no small feat. Part of our happiness can only come by becoming more open to uncertainty which is all we really can be certain about.

But can we do more or does our job end there?

I believe we can. Not by “pushing an agenda” or preaching, but by becoming grounded in a strong analysis of the patriarchy, in racism, and in anti-oppressive work. With this analysis, we understand ourselves differently and we understand others in a new way. We see more easily how reactive our clients can be while not realizing they’re being reactive. We are so skilled at reaching for feelings or for picking out the latent content. We see through all of the mental healthy stuff, and we bring it into our work. But, we can see through the racism, the gender norms, the patriarchy, the homophobia and bring that into the work as well? The stronger we are in our own analysis the more able we are to help clients see when they’re reacting to a system instead of their own desires or someone else’s needs.

Most of us just aren’t so good at doing it yet. So many of us separate this work: “I’m a therapist in the office, and I’m an activist when I’m outside.”

That’s great. It is. But we need to find a way to merge the two. To make them inseparable.

Can we repair an airplane while we’re flying it? Can we change our systems while living in them?

Well, first off, we have no choice. We can’t step outside of it because it’s the air we breathe.

With everyone we meet, whether client, friend, lover, or family we need to be grounded in our awareness. We need to support the people we care about, our clients or otherwise, and do all the great engagement and interventions we learned in social work school and beyond—but we have to have an eye on the system. The system they’re in. The one we’re in. The whole shebang.

We need to not preach. We need not be so agenda driven that we miss the humanity of the client or clients sitting in our offices and their suffering. Our need to end the patriarchy cannot be at an individual client’s expense, of course!

But in session and out, we need to be on the lookout for moments to open our own and others’ eyes to the sickness that we are living in. The sickness that lies and says this is the only way to be.

The Roots of Self-Hatred and Fostering Self-Compassion in the Therapeutic Relationship

Depressed, ugly, unlovable, coward, idiot, defective—the list is endless. When people have a long history of punishing and berating themselves, they can become fused with the concepts these thoughts construct and take on the belief that their true self is faulty. Clients (and if we are honest, most of us) therefore walk around with notions of who or what they really are, and more often than not hate or shame themselves for it.

self-hatred-2 (2)But, whatever particular set of epithets our personal history has led us to fuse with, one thing most of us share is that we intensely dislike and often criticize ourselves for whatever self-concept we hold.

Most of these labels arose from painful moments in our history. The pain, and often shame, that these events elicited became attached to the memories of the events and the labels our behavior, experiences, or entire self received on those occasions. In turn, our very notion of self becomes aversive—something to move away from.

This can lead to self-hatred and self-shame and take many forms, including suicidal ideation, self-harming behavior, self-chastising or self-aggrandizing talk, putting on a mask and pretending, ruminating, self-shaming, and dissociating.

Fusion of our sense of self with content or labels of experience is often prompted and reinforced by caregivers or peers, through statements like “Little Joe is such a shy boy,” “You asked for it!” “You’re such an idiot for not seeing this,” “You’ll never amount to anything,” and so on. Soon enough, that other-initiated talk can turn inward and become self-sustained disparaging self-talk.

Is it any wonder that deep-set self-hatred is so prevalent? Because of this dynamic, it is clinically crucial to promote a more flexible sense of self that can help clients disentangle themselves from rigid self-concepts and the limitations they impose on behavior.

As mentioned, our self-concepts are largely the products of our learning histories, especially in relation to our caregivers and attachment figures.

Early on, children have no more language for their inner experience than they do for the experience of their senses. And whereas learning to orient to sensory experience is necessary for physical survival, the world of inner experience only acquires significance because it is important to other humans in our lives. It is through social interaction that we learn modes of interacting with our inner experience. This is why it is so common for people to recognize their caregivers’ voices in their self-talk.

When caregivers are stressed, absent, overworked, avoidant or overcome by emotion, chances are they will not respond in ways most conducive to children learning how to recognize and name their inner experience and accept it as normal. Under these conditions, children might be told that they are angry when they are in fact hungry, that they are hungry as the clock strikes noon, that they are not (or should not) be sad when they are feeling sad, that they want ice cream when in fact their caregiver wants ice cream, and so on.

Repeated such experiences during early development may lead to children having difficulties in learning to name what they feel or want with any precision. Their inner experience might have received so little attention that they have no words to describe it. In many cases, they will have learned to fear, deny, or judge their inner experience rather than notice and accept it as one may notice and accept the changing weather. The world of inner experience can thus become an unfamiliar, unstable, treacherous territory, full of darkness, threats, and defects. And that, in turn, will further feed self-hatred, shame, fear, and a sense of unrelenting inner conflict.

In clinical settings, clients who are unable to understand, tolerate, or effectively communicate their inner experience may say that they do not know how they feel or think. They might be unable to describe inner sensations or name their emotions, perhaps only locating feelings in their heads; or they may react aversively to any attempts at helping them contact inner experience, such as through eyes-closed mindfulness exercises.

Because we learn our relationship with our inner experience and concepts of self largely from our attachment figures, the way caregivers respond to our bids for connection as children can have a profound impact on our later behavior in relationships with both our selves and others.  A history of consistent reinforcement for connection bids could result in a secure attachment style, whereas a history in which such bids were consistently ignored may lead to an avoidant attachment style. A history in which those bids were consistently punished could produce an attachment style that’s fearful.

These styles could in turn be reflected in individual styles of relating to inner experience: secure and accepting, avoidant and dismissive, fearful and critical, or disorganized and unaware. Of these, only the first style would naturally incline the individual toward self-compassion. The others would naturally fuel different forms of self-hatred, self-shame, and inner conflict.

It takes a specific learning history and a deliberate context and community to build an accepting and kind relationship to one’s own experience—a relationship that consistently reinforces compassion for one’s own aversive experiences and those of other people. When that history is missing, a healing relationship, such as the therapeutic relationship, might provide a privileged context for building a new learning history that fosters self-compassion skills.

In this way, the therapeutic relationship offers a setting in which a different approach to the self and one’s own experience becomes possible. This can range from helping clients learn to receive their negative self-concepts with strength, wisdom, and kindness to helping them transform a sense of self that is unstable or disorganized. Within this context, clients can also adopt a more flexible sense of self.

Standardized Testing – Words a Therapist Shouldn’t Hear

Mental health professionals learn to expect and recognize additions to the common words and phrases we hear. ‘Facebook Feud’ and ‘emotional affair’ have been added to the lexicon of couples and family therapy. When working with teens ‘cyber bullying’ and ‘sexting’ are sad additions to the counseling vocabulary. In substance abuse treatment we strive to keep up with the latest slang for the various drugs and their methods of use, from ‘huffing’ to ‘spice’ and ‘Special K’. Listening for repeated words and phrases tells us much about local and societal trends and where we need to focus our clinical attention.

standardized testingI am stunned and saddened, therefore, by how often my colleagues and I are hearing ‘Standardized Testing’ coming from the mouths of anxious children. Whether the anxiety initiates within the student or is picked up vicariously from school personnel doesn’t matter – the distress makes a comfortable home within the brains and bellies of children and stays there.

Students tell me stories of how standardized testing is discussed on the first day of school, and that ‘intervention’ periods are hijacked for endless practice tests. Children hear their favorite teachers talking in the hallway – or even at the front of the class – about how their jobs are on the line and it is understood – covertly or overtly – that the kids must save the adults.

Rumors get started, and are not corrected, that 50% of a child’s grade is based on testing results and that ever-dreaded summer school could be in the child’s future if they don’t score well. Kids hear the urgent message on the home answering machine telling parents to insure their child gets plenty of sleep and a well-balanced breakfast before testing days – as if sleep and good nutrition are not important on learning days – and as if we aren’t fully aware that these messages paradoxically result in difficulty eating and sleeping. Children know that the stakes are high, and they feel the burden of the American educational system on their shoulders.

Whether standardized testing improves education, or whether it is an adequate assessment of teacher effectiveness or what a child actually knows, are arguments I will leave to others. My concern is that I should not be hearing about the ‘OAAs’ within the walls of my Ohio counseling office. I and countless colleagues beseech educational policy-makers to find other ways to accomplish whatever it is that the high number of standardized tests are meant to accomplish. Children already have enough reasons for stress, anxiety and depression.

Using Games in Therapy

Games are an engaging way to build the therapeutic relationship while assessing a child’s strengths and areas where there is room for growth.  Playing games as they were intended to be played can teach you a lot about a child’s functioning in multiple areas, and adding a therapeutic twist can make games highly adaptable to many clinical issues (ex. feelings, CBT, social skills, etc.).  Below are some suggestions for how you can use games in your own practice.

Purpose of Playing Games in Therapy:

  • Rapport Building: Games are a fun way to begin building rapport with clients.  How the child plays can tell you a lot about their functioning and engaging in an activity can take some of the perceived pressure off and help increase comfort and disclosure.  You can also see how they are at multi-tasking/holding a conversation while playing.
  • Frustration Tolerance: How often does the client become frustrated and how do they react and regulate their emotions when they do?  How do they respond to falling behind or losing?  Do they give up or push through?  Are they able to verbalize their emotions?  Do they become aggressive?
  • Decision-Making: Are they able to quickly make decisions and adapt their strategy as needed? Did they demonstrate impulsivity? Are they confident in their choices or appear insecure?  How much reassurance from you do they seek?  Are they able to look at the whole picture or do they think of moves one at a time?
  • Problem-Solving: Can they identify what their options are?  Are they quick to ask for help or able to use their problem-solving skills without much direction?  Do they show flexibility when things don’t go their way and easily move onto other strategies?  How effective was their problem-solving?
  • Response to Rules: At the start of therapy, I usually let the client dictate the rules and do not interfere if they change them.  Do they follow the set game rules or make up their own?  How often do they change them?  Do they ever permit you to win?  Later on in therapy I may state that we will play by the game’s rules, which I enforce, to see how they react or teach appropriate social skills/sportsmanship.
  • Provides Opportunities For Positive Reinforcement, Redirection and Limit-Setting:  How do they respond?  Does behavior improve?  How much redirection do they need?
  • Social Skills: Games are perfect for teaching social skills, conflict resolution, and good sports-personship.  They are highly effective when played in group therapy and give the therapist tons of opportunities to model, reinforce good behavior, facilitate positive interactions, etc.

Creating a Therapeutic Twist:

  • Create a Color Code: This is a simple way to modify games to fit specific therapeutic issues.  Many games already have colorful pieces, and if they don’t you can easily add multi colored stickers.  Then write out a code in list form (ex. every time you land on red describe a time you were angry).
  • Write up Cards: You could also use a color code with multi-colored stacks of cards.  Having more questions allows you to address more specific issues.  You could forget the color code and just play the game normally and have a client answer a question before each turn.
  • Alter the Board/Pieces:  You could also write questions or tasks directly onto the game board or pieces.

Create Your Own Games:

  • Bare Books has inexpensive blank game boards, books, puzzles, etc. that you can use to create your own therapeutic games.  A professional looking blank board game is just $3.95.  They have flat rate shipping so I suggest getting together with a couple people to place your orders.

Buying Therapeutic Games:

  • Games made specifically for therapy can be great, though are often expensive.

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How to Find a Therapist in Your Area

Shop Around-Find the Right Therapist for You
Shop Around-Find the Right Therapist for You

Finding a therapist that is right for you can be a very daunting process. If you are like me, then you get easily overwhelmed with the number of mental health professionals that are out there. Therapy is an important part of the recovery process so finding a professional in which you can trust can make all the difference. Here are some ways you can begin your search for a therapist.

1. Make a list of the types of therapy you want to try. If you have no idea which type of therapy you want to test, that’s fine. It will allow you to have a broader search when you begin looking. For those of you who already know your interests such as Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Dialectic behavior therapy and more, add this to you search list.

2. Call your insurance company. This is an important step because it will allow you to really get a great list of professionals that can help you. Your insurance company can provide you with therapists in your area that accepts your insurance plan.

3. Ask around in school. If you are in high school or college, your guidance counselor or counseling center is a great place to start. You can ask of if they know any professionals in the area or even organizations that offer therapy. They might even help you out by putting together a working list of therapists.

3. Utilize your Personal Networks: Word of mouth may be more useful than you think. Asking family members, friends, and coworkers about the therapists they’ve had or heard of can really give you an inside scoop.

4. Google Search: Upon having several therapists on your lists, goggling them can really help to narrow the list even further. Look up their websites, LinkedIn and really think about the pros and cons of each person on your list.

5. Skype and Phone: For those of you who are unable to go out for therapy, it may help to narrow your search for therapists who do Skype and phone consultations. This is a great option because it takes into account those who might have a hard time leaving their homes due to their mental illness.

Regardless of how you get there, remember that finding the right therapists means finding the right one for YOU. Don’t hesitate to test the waters of therapy. If someone isn’t working for you, do not feel obligated to stick with him or her. This is your journey to recovery and it’s okay to put yourself first.

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