— Hudson Tyler is a current student in the Master of Social Work program at Portland State University.
As the next generation of social workers, we are graduating into a world of impossible problems. Extreme inequality in the distribution of wealth, systemic racism, gender and sexual discrimination, ableism and the erasure of those living with disabilities, increases in domestic abuse, gun violence, suicide, and the rising rates of mental health issues across all conditions are only some of the troubling realities before us. Billy Joel could reignite his music career with a sequel to We Didn’t Start the Fire by simply listing a day’s worth of New York Times Headlines: climate change, public shootings, anti-transgender bills, war in Ukraine, abortion bans, pandemic death tolls, and the literal Doomsday Clock ticking closer to total annihilation.
Perhaps most despairing, we’re the generation of social workers that saw an entire workforce collapse. In Oregon, COVID-19 increased demand for behavioral health services that were already scarce. For many of us, our practicum experiences have highlighted this trend by exposing us to staffing shortages, overworked teams, high caseloads, lack of resources, patient/consumer dissatisfaction, concerns about safety, questionable boundaries, and uncertainty that our impact can make a difference.
If these realities distress you, they should. And I ask that you read on, because this is a message of hope.
We can face reality as it is because we see in ourselves, in others, and in the world, a passion for picking up and healing broken pieces. We are critical optimists. We’ve been so close to death and suffering that we know how to live, love, and follow our hearts with an authenticity that will preserve us.
We learned how to become effective because the world demands that we be both efficient and thoughtful. We lead with empathy, we tolerate distress, and we know our boundaries and limits.
The School of Social Work asks us time and again to answer how and why we chose to become social workers. They need to start asking us what makes us so effective. How do we remain so patient, mindful, critical, justice-oriented, hopeful, compassionate, mission-driven, entrepreneurial, loving, spiritual, honest, friendly, non-judgmental, curious, and brave? How do we hold the tension between an open heart and the devastating impact, weight, and depth of problems we can do little to control?
We know that present-day social workers are diplomats that skillfully synthesize and navigate the intersection between psychology, advocacy, community, healthcare, research, policy, and welfare. We are tasked with solving the unsolvable and we have an increasingly larger place at decision-making tables. We know how systems work. We know how to work systems.
I encourage you to reflect on the systems you’ve been working, because chances are you’ve made a larger impact than you realize…
This year, I’ve been navigating Veterans Affairs as a learner. I do my best to be mindful, to be patient, and to be a critical thinker.
I currently work as a trainee psychotherapist, spending most of my time encouraging Veterans to explore the normal cognitive and emotional processes that result from severe trauma. Part of this work includes my involvement with the suicide prevention team, where I follow-up on calls to the 988 Veterans Crisis Line to offer support and resources to those who suffer. I also co-facilitate two therapy groups: a DBT group and a process group for Veterans with suicide safety plans.
Veterans tend to have incredibly complex biopsychosocial experiences. As we sit together, our therapeutic space validates the anger and betrayal they have experienced; many recognizing that military service was exploitative of their desire to escape from a family of origin, or financial limitations. The “poverty draft” continues to utilize the promise of socialized care to enlist young people, many marginalized, from desperate situations. Many Veterans have combat trauma. Too many Veterans have military sexual trauma. Veterans see the tragedies of the human experience without much of the psychological and emotional training and support that we social workers receive. Many have forgotten how to feel. Unfeeling is the last defense available to a human system that has reached a point of critical meltdown. I do my best as a practitioner to hold space as a supportive, safe, and honest mirror that invites feelings to emerge.
I’ve learned quite a lot about Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Acceptance and Commitment Therapy (ACT), behavioral activation, Motivational Interviewing, polyvagal theory, and the philosophical approaches of Dr. Carl Rogers and Dr. Irvin Yalom. The latter, it turns out, shares my love of Nietzsche.
I’ve learned a lot about the power of relationship and the importance of genuine connection in the healing process.
By all measures, I am an effective social worker. My patients attend their sessions and report benefiting from our work together. I communicate well with my supervisor, the teams I am a part of, and our coordinated care providers. I stay curious and spend most of my time reading and learning new things. And I integrate the feedback I receive and apply my new skills in service of others. Most importantly, I choose to continue feeling. I embrace and invite the discomfort that comes with this job.
When we stop feeling, we can’t be curious. Curiosity is what sustains our ability to be present and effective. When we stop feeling, we find unsustainable ways to cope. At worst, we project our own wounds onto those we intend to heal. Effective social workers can reconcile the proximity of our own turmoil and the suffering of others within the context of social and environmental systems in order to transform them.
Some of my latest curiosities include:
- Questioning the supremacy of our diagnostic system (in fact, many DSM contributing psychologists are quoted expressing dissent against the scientific validity of pathologizing human emotion);
- Learning how social work prioritizes strong therapeutic relationship built on trust, honesty, love, and open communication - evidence-based practices can support this but are not enough in of themselves;
- Wondering to what extent evidence-based practices may well be a policy excuse to enforce time-limited therapy and preserve a supply of clinician-consumers paying to practice;
- Recognizing that time is precious and graduate school is insulatory to the realities of the urgency in many professional settings;
- Noticing that the more Western European someone’s family of origin is, the more likely they are to hold a position of power in a workplace and the less likely they are to understand the nuances of cultural humility;
- Seeing that social workers are not often treated very well, including by other social workers;
- And observing the ways that pathologizing natural responses, such as anger, is a major hurdle for clinicians who should know how to sit with and navigate strong emotions more skillfully.
I have found that I really enjoy the work I'm doing with a Veteran who recently made it through chemotherapy. He's 66 but could be 86 by how much of himself he sacrificed to survive his cancer. We chat about his family, childhood, daughters, spirituality, and what he does to make the most of his life with chronic pain. Our work together is deeply relational and centered on where he’s at. While I cannot take away his pain, I can be with him as he embraces the experience and makes meaning out of the circumstances that shape his life.
I'm optimistic about the future of my social work career. I know that many doors are open ahead of me, and to all of us who have chosen to be effective. I encourage you to sit with discomfort and invite it inside your heart, as you would a dear friend. Notice your fear, anxiety, worry, sadness, anger, frustration, pain, and let it stir in you, without judgment, because those feelings are showing you the path forward.
With loving kindness,
Hudson