by Dr. Danna Bodenheimer, LCSW, author of Real World Clinical Social Work: Find Your Voice and Find Your Way
Although not everyone agrees on how the results of the election feel, the fact is that the majority of my clients have been seriously suffering. In fact, in more than a decade of practicing, I have never seen anything quite like what I am seeing right now. Session after session, my clients are coming in with feelings of complete despair and hopelessness. I work with a very marginalized population, most of whom are afraid for the future of their civil rights, their health insurance, and their overall safety in the world. And the fact is that I am running out of things to say. This is partly because I feel similar to how they do. It is also because I feel as if we are in some uncharted territory, societally, where the rules of how we typically think things function don’t seem to apply. We are in a new era with a murky future. Our ability to make sense of things feels different. And, the ways to navigate through it are certainly not obvious.
I have been repeatedly asking myself, what is it that I am doing, anyway? I don’t know any more than my clients know about how things are going to turn out. All I have is my training, my colleagues, and my ability to reflect. All of these have been falling short for me in some ways, but in the past few days, I have started to re-calibrate a bit, to find an increased clarity about my purpose.
This clarity came to me when imagining going home for Thanksgiving. I am not sure who Thanksgiving feels simple to, but I am not one of those people. Neither are most of my clients. I generally find that the return home can unleash a tremendous amount of fear and regression. After all, we walk around with a snapshot of what is available to us during these family traditions, and it leaves us with information that we negotiate throughout the year. We feel crowded out at the table or that there is a seat for us; we feel that there are enough resources or that there is a scarcity; we feel that someone remembered that we are a vegetarian and made us a special meal or we feel invisible when there is nothing to eat. Thanksgiving themes end up being life themes, and during the actual holiday, these themes are experienced as intense realities.
Struggling with my own feelings about returning home, I remembered a bit about why we do this work. I went into my own mind and soothed myself with some important pieces of information:
- I knew I would probably overeat, because I can become socially anxious and use food to comfort this.
- I knew that there would be a lot of small talk that would be difficult for me to negotiate, because I am fairly introverted and prefer deep conversations.
- I knew that no matter how I felt during the meal, that the feelings would pass and I would be cozy at home soon enough.
- I knew that even though my family really loves me, that they still say incredibly hurtful things and that this has more to do with them than it does with me.
- I knew that the opportunity to be together is still an opportunity, even if it brings complicated feelings with it.
These thoughts, musings, and feelings are pieces of my internal world. And because of my relationship with myself, my loved ones, my therapist, my supervisor, my colleagues, and my clients, I can enter this internal world and find comfort and wisdom. And so I recalled, that amidst the election fear and turmoil, and amidst the holiday parades, that our work as clinical social workers remains steady; to assist in the solid development of soothing internal worlds.
There have been times of strife before this election - much worse strife in fact. And there will be times of strife in the future. Our work, always, is to help clients have in them inner mechanisms that prepare them for this strife. There are several elements that help clients to develop inner worlds that sooth anxiety, depression, and fear. First, it is essential to remind ourselves and our clients that we are not working to eliminate painful affect states. Instead, we are working to find the tools to survive the inevitability of these states, with the assurance that there are feelings of relief that almost always come with time and connection.
It is also essential to remember that by sitting quietly with clients and offering them our complete focus and curiosity, we are aiding them in the process of taking in that quiet and curiosity and starting the construction of that very real estate within their own minds. The simple act of setting aside a sacred frame for our work translates into the possibility of having this infrastructure within us. Further, by bearing witness to our clients’ affect states that feel intolerable and not becoming swept up in their storms, we remind them that their internal experiences can be survived with both feet on the ground.
In addition to bearing witness, we also help our clients in the process of growing insight about what is going on with them. By paying close attention to their patterns of behavior, of thought, of self-sabotage, of dreams, and of realities, we see and learn things that are blind spots for our clients. By gently sharing these observations, we invite clients into the study of their own minds. As students of their own psyches, they begin to gain a certain mastery over their own behaviors, even as they remain somewhat enslaved by them. Take for example, my very unoriginal overeating at Thanksgiving. I haven’t mastered it, but I do understand it, and that understanding helps ease my own fears about losing control.
While I am certainly not comparing the Holocaust to the current election, I have been doing a lot of thinking about Anne Frank recently. I specifically reflected on her use of her diary. Her diary was a place for her to export her internal world and to then have her internal world reflected back to her. She was able to make use of this tool, the tool of her own mind, to survive and comfort herself through horrifying conditions and daily fear and terror. I think this was largely made possible by the security of her family connections - connections that were good and loving. She was able to sustain the sentiment that, “Despite everything, I believe that people are really good at heart.”
It is useful to remember that there are many different parts we can play in the Anne Frank story. We can be the secure attachment that made her good faith possible; we can be the actual diary that reflects the realities of one’s inner world; we can be the reader of the diary sharing what we see as the story unfolds; or we can sit, side by side, as the storms pass through - mutually unsure of the outcome - but mutually assured of the importance of being together; being together so that being alone won’t hurt as much when that time comes.
Dr. Danna R. Bodenheimer, LCSW, is in private practice at Walnut Psychotherapy Center in Philadelphia, PA, and teaches at Bryn Mawr College Graduate School of Social Work and Social Research. Read more of her clinical perspective and tips on the most burning questions of developing clinicians in her book, Real World Clinical Social Work: Find Your Voice and Find Your Way.