In Search of the Golden Thread

Retirement a Psychological Journey

Photo by Wendy Wei

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

Originally written November 2023

“The initial touch of the golden thread is always attended by a certain kind of feeling. Experience will bring trust in that touch and the feeling that accompanies it, familiar recognition at its emergence.”

—Stephen Buhner

In less than a month I will be leaving an organization where I’ve spent the last 30 years of my professional life. The moment that I imagined over the years is now weeks away. I experience it as a traveler who has lived in one city and grown accustomed to its people and, its culture. As an inhabitant of this city to leave it is to become once more a foreigner, an emigrant.

For most, this is a significant life event and ranks alongside life events like graduation, marriage, and becoming a parent. My story is not unique. It has caused me to revisit who I am, and what I do outside the context of the workplace. While the type of work I perform can be done outside of the workplace, my attachment to it is felt more poignantly as I discard material work policies, print files, and publications that have outlived their usefulness. The events of the past week reverberate in my mind. My last joint-home visit with a colleague, being informed of my successor, and a small retirement luncheon at the behest of several coworkers.

* * * *

What I hope to convey in this piece are the psychological and emotional effects associated with detachment, and identity when explored through the lens of retirement from the workplace and a long professional career. I will examine this experiential process over the next several months defined by 3 Phases:

1. Respite- A short period of rest and relief from something difficult

2. Reformation- The act or process of changing and improving something

3. Reconciliation- A process of making two different ideas and facts exist or be true at the same time

R E S P I T E

Letting go for me is hard because I’ve been with the same organization for such a long time. New social work employees entering the Social Work profession today have more career opportunities than I did when I graduated in the late 1980s.

Factors that determine longevity in agency-based practice for younger social workers who entered the profession within the last 10 years may correlate with their age and social demographics making it easier for them to transition between jobs than it was when I entered the profession in the early 1990s. (Salsberg, 2020)

That being said, the effect of my age (over 60) combined with 3 decades in the same agency has created a sense of shortsightedness that I must now learn to navigate.

In addition to working full-time, I have maintained a solo practice, concurrently for the past 12 years. My solo practice has been dwarfed by work within the agency. This is a “first”. And, as with all firsts, one becomes aware of how certain environmental factors impact the psyche.

As I prepare to enter the Respite phase, I am entering a period where I will slow down and relax certain boundaries and expectations designed to meet the needs of the workplace and focus instead on activities that I have devoted little attention to or neglected completely. This should be a period marked by the rediscovery of familiar interests and activities I enjoy. I plan to read more, write more, and spend more time cycling. For retirees entering this phase several questions may be helpful with the transition:

• How will my use of time affect my relationship with others (spouse, adult children, other family, friends, and acquaintances?

• What activities and hobbies will require a sustained financial investment (travel, vacationing, purchases)?

• How will I manage disenchantment and disillusionment when my “to-do list” gets shorter and I run out of things to occupy my time?

For retirees who are in relatively good health, and who have prepared for retirement, managing disenchantment and disillusionment should be short-lived.

I am less concerned with running out of things to do than I am with the impact my retirement will have on my relationships with others. And, less income, which will force me to sacrifice some conveniences that I’ve grown accustomed to —like online book purchases and journal subscriptions, maintaining my bikes, and dining out.

Because I’ve spent time thinking about post-retirement activities and how I envision my time will be used, disenchantment and disillusionment should be kept at a minimum. I also have a realistic sense of my skills. And, how my age, interests, and the context in which they occur, influence the type of people, activities, and environments that I seek out.

I will miss working with some of my soon-to-be former clients with whom I have had a long professional relationship. The absence of those relationships at times does create an emotional void in the same way it does with some colleagues.

Because the majority of my clients are significantly older, and some are in poor health, I wonder what will become of them. And, how their story will end. Will they be able to procure the resources that they need from someone else? How will my clients experience my retirement?

I manage these thoughts by communicating to some clients (where I think the therapeutic relationship is significant) what they should expect when our work together has ended and reassuring them and their families that others like myself will pick up where I leave off. I provide them with the name and contact information of my replacement and remind them that they can consult with other staff in the program.

I attempt in this process to acknowledge my own emotions through self-reflection. I remind myself that our work together is temporary and that the client’s work will continue in alternative ways. I reflect on the client’s accomplishments and challenges yet to be attained. I allow myself space to reflect on what went well during my work with clients, and when there was failure. Finally, I remind myself and the client that problem resolution is ongoing and as some problems are resolved others will take their place.

Naturally, there have been many changes within my workplace over the years. Some changes have been quick and easy to learn while others have been more difficult and slower. I now know what adaptations I can make concerning how I work. Retirement is a conscious adaptation I am making to continue my work within a new context that is more physically and emotionally accommodating.

One thing that I’ve become more aware of is how a busy work life can mask emotions that lurk beneath the surface. Always present, but less noticeable because of distractions that result from an engaging work-life. This will prove challenging as I seek to re-examine old themes of success, failure, and opportunities for growth.

In the next essay, I will examine Phase 2- Reformation.

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References:

Salsberg, Edward, et al. “The Social Work Profession: Findings From Three Years of Surveys of New Social Workers.” The Council on Social Work Education and The National Association of Social Workers, https://www.socialworkers.org/LinkClick.aspx?fileticket=1_j2EXVNspY%3D&portalid=0, August 2020

Market Economics: Teachable

Photo by Brett Jordan

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

“You can be shaped, or you can be broken. There is not much in between. Try to learn from everybody, especially those who fail.”

—David Foster Wallace

In my previous three essays, I used concepts found in economic theory to illustrate how human relationships mirror financial markets. I will continue that theme here as I examine the fourth and final characteristic of a healthy marriage or long-term partnership— being Teachable.

At its core being teachable is simply admitting that you have more to learn. I can never remember a time when I felt that I had learned all I needed to know about things germane to living a meaningful life. There is always some unknown fact or tidbit of knowledge related to someone or some thing that I find helpful after learning about it. Things which in the beginning appeared finite and limited in scope, but upon deeper inquiry and observation were found to be rich with meaning. Like when a few interesting trees become a forest to be discovered. Being teachable has more to do with your approach to learning rather than the accumulation of knowledge through formal education. I have chosen a simple definition for being Teachable— The ability and willingness to learn by instruction.

In a market economy, there are many things we need to learn if we are to become financially wise. How you learn things is primarily up to you. When I was young my father used to say that experience is the best teacher. And, he was correct. But, experience without being teachable is not enough. All knowledge comes at a price. And, we each must calculate what we are willing to pay. We all learn things late in life. And, most come to value foresight over hindsight.

For me being teachable has shortened the negative impact of failure. It has caused me to accept that I will often miss things at first glance, or minimize the importance of what I learn until I have suffered the consequences of being unable to apply it much later when it becomes essential for me to know.

In marriage and long-term partnerships being teachable is a virtue. The concept of learning about oneself and from one’s partner is often taken for granted. What I have learned from couples in therapy and from my own experience is that we leave too much up to chance. Left to itself in the beginning a relationship for a time may yield excellent returns on a couple’s investment in each other with little effort. This is often referred to as the “honeymoon” phase. In economics, the honeymoon phase is sometimes used to describe a time in which a special low-interest rate is offered for a short initial period before reverting to a standard rate for the remainder of the loan. The honeymoon period typically ranges from several months to a couple of years depending on the type of loan and the lender.

I believe this concept describes how most romantic commitments are often initiated. Couples are often attracted to each other because interest rates are affordable and the returns are generous. However, over time the standard rates return and they are paying more interest and wonder what they missed in the beginning and what they can do to avoid a possible recession. Being teachable says we will never know everything about our partner, but we must be willing to learn and accept that certain parts of us interfere with how we relate to our partners and the need to change and commit to working on those areas of our relationship that lead us toward conflict.

In the previous essay titled— Intuition, I presented a fictional couple, Len and Liz to illustrate how communication between partners is often influenced by thoughts and emotions that are linked to past histories. We learned that both Len and Liz had developed responses toward perceived indifference or actions that caused each to draw inaccurate conclusions about the other.

When we examine the couple’s communication we see that their conflict occurs primarily when they feel threatened, or insecure and they engage in what is commonly referred to as “protesting” behaviors, when one partner is pursuing the other in a negative way. Protesting is a natural response when one feels unsafe and vulnerable. These behaviors are typically characterized as Blaming, Demanding, Clinging, Nagging, or Controlling. Couples engage in these types of behaviors when they are desperate to get their partner’s response.

The corresponding and opposite behavior we observe in communication between couples is when one partner withdraws. Similar to protesting, withdrawing is a natural response and occurs when experience has taught you to be guarded with your feelings to avoid difficult interactions that you believe will make things worse. Some examples of Withdrawing behaviors are Appeasing, Placating, Minimizing, Avoiding, or Not Responding.

In relationships, both partners approach one another in one of these two ways. While there may be some variation, each is likely to have a preferred style of managing conflict that will be more prominent. You can also see this play out when both partners engage in similar behaviors. Some couples exhibit only protesting, while others only withdrawal behaviors. These behaviors are ways in which the couple has learned to manage vulnerable feelings that are evoked by a real or imagined threat.

Let’s pick up where we left off, and learn more about Len and Liz and their negative cycle of communication and what interventions may help them to improve.

Both Len and Liz are byproducts of their families of origin. Len was forced to take on parental responsibilities as a child and resented that both of his parents were unavailable for him growing up. He learned to cope by being guarded with feelings that could subject him to criticism or scrutiny from confrontations with his mother. He learned from his father’s absence and alcoholism that others couldn’t be trusted to fulfill their responsibilities. These learned coping strategies were carried into adulthood and now are playing out in his marriage with Liz. He views Liz as blaming and controlling, and similar to when he was a child, he withdraws to avoid conflict with her in the same way he withdrew from his mother. Len however is unconscious of these behaviors that over the years have become autonomic and a hard-wired means of survival.

Liz learned at a young age that in order to gain her parents’ affection she must achieve superiority in areas valued by them. Social class and distinction were well-defined. She was graded on her achievements as compared with those of her peers and expected to measure up. She struggled to be herself and make decisions without the scrutiny of her parents who often disapproved of her ideas and desires. Liz also learned that a life built on living in the shadow of her parents who were both accomplished professionals, her father, a concert musician, and her mother a playwright for a large theater company would leave her shallow and unfulfilled. It was a form of rebellion that led her to travel overseas and work with a humanitarian organization for a couple of years before returning to the States and continuing her work with refugees against her parent’s wishes. Liz in ways similar to Len was attempting to redefine what she wanted for herself and in marriage. Many of the lessons growing up for this couple failed to prepare them for the type of knowledge they would need to navigate the complex emotions evoked in a marriage relationship.

This couple engages in negative thinking about each other which provides them with a means of escaping more vulnerable feelings such as shame, disappointment, discouragement, and loneliness. These are their primary or responsive emotions that lead to expressive or reactive behaviors designed to protect or self-soothe. The very thing Liz does to cope with her insecurities (making decisions without consulting Len and minimizing their financial priorities) triggers anger, defensiveness, and withdrawal in Len. The couple’s reactive behaviors aimed against the other perpetuate the cycle of distress.

What may prove helpful in the beginning is for the therapist working with Len and Liz to identify ways in which anger and resentment that are expressed in different ways by each partner often hide more vulnerable emotions like shame, disappointment, and loneliness. Clinical Psychologist and author Dr. Sue Johnson in her book— Hold Me Tight writes that couples in marriage and long-term partnerships seek three basic things:

Accessibility— staying open to your partner even when you have doubts and feel insecure. It means taking a step back and attempting to identify their primary emotions and attachment needs.

Responsiveness—responding to your partner’s primary emotions— (fear, surprise, anger, sadness, shame, joy)

Engagement—remaining engaged and signaling to your partner’s need to be valued and trusted. (Johnson 2008))

Good therapeutic approaches in the end should allow Len and Liz to begin to see and feel things that they were blind and numb to prior to beginning therapy. When the deeper experience of the couple’s criticism is identified, core sadness and loneliness in the relationship are revealed. (“You don’t value my contribution to the marriage, You never consult with me for purchases over our budget.”), often pushes the distant partner even further away. Similarly, partners who withdraw typically reveal fear of disappointing or failing, which is also very painful, and underlies their problem-solving, placating, and eventual withdrawal. Unfortunately, this approach will typically reinforce alienation and evoke more criticism. And so the cycle will feed on itself until the partners begin to share their core sadness and fears, opening up the possibility of new experiences and responses. (Kallos-Lilly, Fitzgerald 2015)

Therapy alone however cannot help Len or Liz unless they are both teachable. What teachability will look like depends on a number of variables and approaches that I am unable to unpack here. But one thing should be evident regardless— Being teachable means that I am able to admit failure and let go of my need to always be right. Genuine humility is a relational skill that never grows old and communicates that I don’t have to win the argument or have the last word. It is a skill because it rarely happens. on its own. It requires repeated effort or practice and is not often reciprocated. Historian, Drew Gilpin Faust, I believe captures best what it means to become teachable. She writes— “You must open yourself up to the notion that you have a lot to learn, that what you do not know is close to infinite. A sense of ignorance fuels the desire to overcome it. Humility is a prerequisite for becoming educated.”

Becoming educated for most of us means that in doing so we will make mistakes and fail in our efforts. In a committed relationship, there will be times when we think we know everything we need to know about our partner or our circumstances. At other times we will feel hampered by disbelief, injury, and insult. But we must always seek to learn more about the options that exist to help us with challenges in communication and in sharing our lives with those we love.

There are a number of resources on the market that can help you learn more about yourself and your partner. If you’ve ever met with a financial planner to discuss investment options, it’s likely that at some point during the discussion, the planner indicated that in order to get to know your risk tolerance they would like to administer a test involving a series of questions to better learn your perspectives on money, and factors that influence your spending and saving habits. The planner will then use these results to create an investment plan tailored to your personal traits for financial decision-making.

In the field of mental health, social workers, psychologists, and counselors also use tests to better understand their clients. And to help clients better understand themselves and those they are in a relationship with.

Some of the most popular personality tests used by mental health providers are: Big Five Inventory (BFI), Myers-Briggs Type Indicator (MBTI), and the Eysenck Personality Questionnaire (EPQ) to name a few. Each of these tests are designed to measure different aspects of personality.

These tests are simply guide posts or snapshots that may help explain how we think and what influences our thoughts and behaviors. They may provide additional therapeutic insight for things not previously considered. They should never be reviewed in the absence of other data.

Over the years, I have spent a lot of time thinking about relationships in general, what truly matters, and how to develop and sustain the type of commitments that most of us want. Patience, gratitude, and intuition all are essential. Being teachable however, is what allows couples to experience the relational growth that results in permanent and positive change.

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References:

Sue Johnson, Hold Me Tight. (New York, NY: Little Brown, 2008), 49-50

Veronica Kallos-Lilly and Jennifer Fitzgerald, An Emotionally Focused Workbook for Couples. (New York, NY: Routledge, 2015), 39

Market Economics: Intuition

Photo by Content Pixie

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

“Intuition will tell the thinking mind where to look next”.

—Jonas Salk

Have you ever known something without knowing how? Maybe you have experienced a type of knowledge that defies explanation. Sometimes in hindsight, there were hints or subtle clues that when examined more closely appeared connected and formed the basis of your knowledge, when you knew that something you did was right or wrong, good or bad, wise or foolish. Or, perhaps still, you remain clueless as to how or why you knew something. You just felt it.  In my first two essays, I examined two characteristics— Patience and Gratitude, that should be present in all healthy marriages and long-term partnerships. Like the first two essays,  I will continue here to use concepts found in economic theory to illustrate how human relationships mirror financial markets.  I believe the term— intuition has broad application and should be seen as a utility in helping to resolve differences far beyond economics. I will now turn to the third characteristic, “Intuition”.

There are many variables that influence our decisions in the realm of personal finance. Reason and emotion are two such variables that take turns convincing us of one thing or another. They are not enemies as some would have us believe, but collaborators. Each is dependent on the other. They are not mutually exclusive. If they were we would all be automatons or emotional illiterates. Reason and Emotion in healthy persons seek a balanced approach to knowing. They serve as tools that help us improve our effectiveness in resolving complex problems when few rules or objective guidelines exist. 

When learning macroeconomics, I was taught what happened to interest rates when certain things shocked an economy. But, when I had to draw graphs and solve equations to work out the answer, intuition became a bit of a misnomer. Problems that do not benefit from intuition are ones that have clear objective criteria, rules, and lots of data with which to perform an analysis. Classic economic models rely on an objective framework to compare and contrast human behavior under conditions both favorable and unfavorable that predict how people will respond to what they observe. Most models generally don’t offer a process or method to solve real-life problems. Therefore, my goal here is simply to illustrate how intuition plays a significant role in the emotional health of marriages and long-term partnerships.  I have defined intuition for this essay as— The ability to understand something instinctively without the need for conscious reasoning  (Sutton 2020).

What I have learned from working with couples is that it takes a very long time to develop accurate intuitive judgments. According to the research 10 years of repetition and feedback. This may explain why if a marriage or partnership can reach the 10-year mark, the likelihood of a lifetime investment is greatly increased. For intuition to fully develop requires that couples repeatedly engage in making decisions about what is effective or ineffective related to their investments in each other’s lives and receive accurate feedback on whether those investment decisions made for oneself, or their partner are profitable. Over time partners learn to recognize the most important signals both verbal and non-verbal that each sends to the other, ignoring irrelevant information. When these observations are identified and openly discussed, couples can begin resolving problems that interfere with their communication accurately and in intuitive ways.

Psychological theory tells us that feelings are important and essential. And that couples sometimes make decisions that are implicit or not directly expressed to their partner. Adam Smith in 1759 introduced the phrase “ The Invisible Hand” as a metaphor for unseen forces that move the free market economy. The concept says that free markets will determine an equilibrium in the supply and demand for goods, simply by following their self-interest. That is consumers and firms can create an efficient allocation of resources for the whole society. 

I believe this term is of limited value when applied to marriage and long-term partnerships, but I wish to stretch the definition in a way that may help to make my point. In marriage and long-term partnerships, couples make decisions about what on the surface would be the most desirable outcomes for their relationship. These decisions as previously stated are often a combination of repetitive practices in addition to how certain decisions made them feel, along with their associated outcomes. In healthy relationships, this says that any harmful or vindictive decision taken against my partner is a violation of their investment in me as their trusted partner. The logic goes something like this— what benefits me should benefit my partner and what benefits my partner should benefit me. This line of reasoning forms the basis of our intuitive process and implies that within a relationship self-interest should translate to good decisions that maximize the quality of the relationship for both partners. Assuming that spouses and partners have defined what they expect from and want from the other and have negotiated what each is willing to invest to meet those expectations, the relationship thrives. While there may be disagreements and issues that threaten the equilibrium of the exchange of goods and services, the relationship is usually able to withstand most threats, that if left unchecked would otherwise lead to a crash.

Intuition is comprised of three variables: Time, Pressure, and learned Heuristics (rules of thumb). First, Time is often required for learning. ( i.e., What happens when I do A-B-C… Z ?). Second, Pressure requires that some decision be made in a short period of time that lacks reliable real-time data for which to make one. And Third, Heuristics (general knowledge) requires that I use mental shortcuts to make general assumptions about decisions that would be too complex for lengthy analysis.  (Locke 2020)

 Each of these conditions inherently poses some risks when used exclusively for making decisions that have long-term consequences and could lead to errors for couples that use them to solve problems of a gravitas nature.  But what happens when we ignore certain feelings, that interfere with communication, or fail to communicate those feelings to our partners, and spouses?

Last year I came across an article that describes what I believe is the root cause of failed markets, or for our purposes failure in marriages and long-term partnerships. The article says that failure in committed relationships occurs when our partners block us when we try to articulate how we feel, fail to listen or acknowledge how certain things impacting the relationship matter to us. 

“The real reason for break up lies in one or both spouse’s sense that they have not been heard that something important to them has been disregarded, that their point of view has not, at a fundamental level, been acknowledged or honoured. It doesn’t matter what the subject of this non-hearing happens to be: it could be that they haven’t been heard about their views on money, or on the way the children are being brought up, or on how their weekends should be managed, or on how intimacy occurs or doesn’t occur. It’s feeling unheard for our differences that is unbearable; it’s never the presence of differences per se. . . There’s a big difference between a partner not doing what we want and a partner not hearing what we want. It’s entirely possible that one would remain with someone who doesn’t share most of our interests— so long as they happen to accept and signal an understanding of how much these interests matter to us. . . We just need to make sure that we are people who listen; who when the partner has something very important they need to get across to us, can bear to take things on board, can bear to acknowledge an opposite position, can bear to say: ‘I can see this matters a lot to you… and I will try my hardest to think about it and see what I can do about it. From here, it really doesn’t matter if things radically change or not; the vital work will have been done— and the relationship will have been assured.”  (School of Life 2022).

This ability to take on differences not shared by our partner requires patience, gratitude, and intuition. It requires that we explore the reasons those differences exist in the first place, and whether those expressed differences will place a burden on the relationship that is untenable.

Intuition is a form of information processing distinct from analytical reasoning. The latter is slow and methodical, while the former is automatic and quick. While intuitive processes are often developed without conscious awareness, I do believe they can be enhanced. Counseling Psychologist Claire Vowell, Ph.D. notes— “Non-verbal decoding or the reading of body language plays a vital role in intuitive processing. Not only do we read other people’s non-verbal cues to make judgments, but we are also constantly communicating our own internal state, usually without conscious attention.” 

In a known economy, some investors become complacent. They rely only on their observed verbal and visual cues of the market. However, what these investors overlook are the emotions that are not seen or heard explicitly. It’s these implicit emotions that drive investor behavior. 

In marriage and long-term partnerships, verbal and non-verbal cues form the basis of what we may know about our partner. Oftentimes these are good indicators and predictors of what will happen next. Particularly when the same cues reoccur over time in similar contexts. However, the danger comes when we observe such behaviors without examining their origin or the thoughts underlying the behavior. It’s possible to assume the reason why certain behaviors reoccur without ever getting to the beliefs that precipitate what we observe.

As I sometimes explain to my therapy clients, the conflict is more than what you see and hear, it’s more about what each partner feels and whether they can acknowledge or articulate those feelings within themself to their partner during times of disagreement, and whether those feelings are understood and acknowledged by their partner. This phenomenon within couples’ work is seen in the following fictional example.

Len and Liz have been married for 4 years but are now contemplating separating. They met while performing volunteer work overseas. They dated for about a year prior to marriage. Both report experiencing dissatisfaction within their relationship that began shortly after they married and involved frequent verbal conflict, resentment related to financial priorities, and a physical lack of intimacy. Len reported believing that Liz did not value his role in the relationship, which caused him to become discouraged due to his belief that he was undervalued and dismissed. Len complained that Liz did not consult with him when she made major purchases or when making plans with friends and family. Liz described Len as unforgiving and easily angered. She expressed that Len held deep resentment toward her stemming from his own family-of-origin experiences and was discouraged because she couldn’t be herself in the relationship because she desired to avoid conflict with Len. Liz reported her parents as perfectionists, and that they imposed high expectations on her regarding her appearance, academics, and some social situations. Liz said that she often felt as if she had no voice, indicating that her parents would dismiss her opinions and emotions, especially when these feelings and opinions were at odds with theirs. She accused her father of preferring her older brother to her and that she could never live up to her parents’ high standards. Liz, as a young adult during college and after graduating, sought out friends who were successful and whom she believed would elevate her own sense of identity. She later came to the realization that these friendships were not emotionally nourishing and sought friendships with persons that were more emotionally available. Her beliefs of inferiority led to increased anxiety and dissatisfaction with her weight and general appearance. She became preoccupied with compulsive cleaning and excessive worry about her appearance. When she felt unable to maintain these self-imposed standards or when Len failed to acknowledge them, she would become depressed and verbally withdrawn.

Len reported that his parents divorced when he was about 9 years old and that he remembers that his father was rarely at home. And when he was at home, he was intoxicated and asleep. Len’s mother worked in a food processing plant with rotating shifts. She was gone a lot and Len and his younger sister were often left to fend for themselves. Len remembers that while his mother worked hard, she was cold and bitter, often criticizing him for not being more responsible with completing household chores and looking after his sister. Len said that his mother’s lack of availability and his father’s absence contributed to his reluctance to seek the support of others during times of hardship. Len said that he felt unable to openly state his needs or express opinions within his family system. Len, as a young adult after college, became a business consultant for a small non-profit organization. He liked his job and was well-liked by his colleagues, but attempted to avoid getting close to them on a professional level because he feared becoming vulnerable. And, that others in the organization with more seniority would take advantage of him or attempt to downplay his achievements. As a result, he would often withdraw and become depressed, preferring to work independently and from a distance. The periods of withdrawal contributed to Len’s own use of alcohol at times to cope with work-related stress and to self-medicate depressive symptoms that further strained his relationship with Liz.

What we see in this fictional vignette is that both partners believe they are the recipient of unfair treatment by the other. Liz believes that her partner Len is unforgiving and easily angered. She claims that Len fails to acknowledge her efforts in the marriage and therefore blames him for failing to meet her needs to be affirmed and accepted for who she is. Len too believes his wife Liz does her own thing and fails to consult with him on matters he believes he should have input, and therefore feels devalued. Both express anxiety on certain occasions and become mildly depressed when communication breaks down. 

Two things are required of both partners at this point if they are to address the underlying drivers of their reactive behaviors. Therapy with this couple is best done by helping Len and Liz become self-aware of their underlying emotions and better equipped to learn how to be responsive and not reactive to what they are feeling through exercises that focus on self-management. Intuition requires that there be a shared knowledge of oneself and one’s partner. And, most importantly how to articulate this shared knowledge in ways that heal and strengthen their connection with each other. This process of restoration yields gross revenues for vested partners. The process itself begins with identifying types of emotions that trigger a thought or an emotional response. Len and Liz must learn to identify certain types of emotions (responsive vs. reactive emotions) that occur when disagreements begin to show themselves. Once they are able to differentiate types of emotions that trigger specific thoughts or behaviors, they must trace the origin of these emotions and expressions to the purpose these emotions and expressions served when they first appeared.

All couples in long-term commitments regardless of whether they are experiencing conflicts in their communication or not must learn what in the present, they are unaware of. This lack of awareness is often difficult to accept. As humans, we pride ourselves on being knowledgeable and keeping score. Particularly if we’ve experienced adverse consequences for failing to do otherwise. The process of becoming more intuitive requires couples to unlearn some of what they think they know. And, to discover why their thoughts generate powerful emotions that are expressed in ways that either help the relationship grow stronger and more resistant to destructive forces or serve to weaken it and the emotional and physical bonds that enable stability.

The process of becoming more intuitive involves some risks because it requires a willingness for partners to be fully known, and bear the discomfort and vulnerability associated with exploring how to reinvest in their relationship in ways that promote satisfaction and sustainable growth.

7 Key Points to Remember:

• Economic Intuition is a way of thinking and should be seen as a utility in helping us to resolve differences far beyond economics.

• Problems that do not benefit from intuition are ones that have clear objective criteria, rules, and lots of data.

• Intuition plays a significant role in the emotional health of marriages and long-term partnerships.

• Failure in committed relationships occurs when we fail to listen or acknowledge how certain things impacting the relationship matter to us.

• Non-verbal decoding or the reading of body language plays a vital role in intuitive processing.

• All couples in long-term commitments must learn what in the present they are unaware of.

• The process of becoming more intuitive involves some risks because it requires a willingness for partners to be fully known.

In the fourth and final essay, I will explore what it means to be teachable. And how without being teachable your best efforts to preserve your marriage or long-term partnership will likely fail.

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References:

Jeremy  Sutton, “What Is Intuition and Why Is It Important? 5 Examples.”  Positive Psychology, https://positivepsychology.com/intuition/#:~:text=Intuition%20is%20that%20feeling%20in,or%20fear%2C%20in%20another's%20face,  August 27, 2020.

 Connson Chou Locke,  “When It’s Safe to Rely on Intuition: and When It’s Not.” Harvard Business Review, https://hbr.org/2015/04/when-its-safe-to-rely-on-intuition-and-when-its-not, 

April 30, 2015.

“Why Some Couples Last and Some Don’t.” The School of Life,  https://www.theschooloflife.com/article/why-some-couples-last-and-some-dont/, February 23, 2022.

Market Economics: Gratitude

Photo by Gabrielle Henderson

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

“The deepest craving of human nature is the need to be appreciated.”

— William James

Most consider financial wellness to be the ability to manage your money effectively. While it’s impossible to eliminate every risk to our financial portfolios, one thing remains always within our control— the ability to give thanks. I learned this lesson years ago when returning to my native District of Columbia after having lived in Florida for a number of years. Not long after returning, I met my future wife. I had saved while living in Florida and while I had some student loan debt, it was manageable. So, I lived at my mother’s house until I regained my bearings while searching for employment, and my own place. However, I decided to take the first couple of months after returning and do nothing except enjoy the outdoors, fish, cycle, and read for hours. Besides, it was the beginning of summer. And I wasn’t about to allow the summer to pass without soaking up as much of it as I could. I would soon be mourning the loss of it and the return of winter. After having spent five years in the Sunshine State I needed to prepare myself mentally for things to come.

I met Merlene a few months after returning to DC. My meager savings by the end of the summer was dwindling when we met. I had just started a new job and was attempting to build back the money I had depleted on bare essentials— food, gas, and car insurance. So, our dating life was not extravagant—free concerts, budget theatrical performances by local artists, museums, and restaurants. On a few occasions, Merlene gave me money for gas and offered to pay for dinner when we went out. I remembered her acts of kindness toward me. I was just beginning to regain my independence and felt toward her an immense sense of gratitude for her kindness and acceptance of my lowly estate.

In my introduction to the topic of Market Economics, I said that currency comes in many forms. One form of currency is gratitude. Gratitude is an emotional currency that often holds more nominal value for those who possess it than for those who don’t. Gratitude is defined in this context as the quality of being thankful and ready to show appreciation for and to return kindness.

According to a research study published in June 2014 in Psychological Science, people make better financial decisions when they feel grateful. Being in a state of gratitude made participants more likely to have the patience to save for a higher return on their money.  David De Steno of Northeastern University’s department of Psychology led the interdisciplinary research project, entitled Gratitude: A Tool for Reducing Economic Impatience. The study’s aim was to weigh how various emotions affected people’s ability to make better financial decisions by choosing to receive a greater amount of money in 30 days versus a lesser amount immediately.

In the study, participants were given a classic test of their ability to delay gratification, not unlike the famous Stanford “Marshmallow Experiment.” The Stanford experiment tested to see if children could wait 15 minutes to receive a second marshmallow (or another goodie) along with the first. In the gratitude study, adult participants were given a choice between receiving $54 now or $80 in 30 days. While the dollar figure was modest, the rate of return was impressive – a monthly return of 48% or an annualized return of 57%. To test the influence of specific emotions on their financial decision-making, participants were directed to spend 5 minutes journaling about something that would lead them to feel either grateful, happy, or neutral before making their decision. Those who were either happy or neutral were very likely to take the $54 offered instead of waiting for the $80, with no significant difference between those in a happy or neutral state of mind. Researchers discovered that those who put themselves in a grateful state of mind significantly increased patience and self-control. Not only were the participants in the state of gratitude more likely to wait 30 days to receive the $80, but the results also showed that the more gratitude the participants reported feeling, the more willing they were to wait for the larger return.

I believe this study suggests that gratitude is an important element in experiencing contentment and inner wealth. I say “inner” wealth because similar to patience, gratitude is a state of being where the value is defined by how one thinks about oneself relative to others, or in the case of a marriage or long-term partnership, one’s partner. https://thoughtprint.consulting/blog  June 24, 2023. Examining the benefits of delayed gratification can often decide whether a long-term relationship will survive the ups and downs of a volatile market economy. An example of this can be seen in how most long-term relationships are formed and sustained over the years. Couples like companies, when forming a partnership, learn about each other’s assets, their histories, their affiliations, their deficits, and how each handles circumstances beyond their control. They discover about each other the influences required for rational decision-making and how to spend, save, and invest their capital with the purpose of obtaining a return. Couples must also navigate crises and learn how to suffer loss without becoming insolvent.

I would be remiss at this point if  I neglect  The Law of Diminishing Returns when discussing gratitude. The Law of Diminishing Returns in economics says there is a point where continued effort fails to produce the desired result. That is to say, if my investment in a particular area increases the rate of profit from that investment, it will only do so up to a certain point. And after that point has been reached, each additional input of measured effort results in a smaller increase in output or returns. The Law of Diminishing Returns, while used primarily to describe production and workflow in business cycles, has broad application for other areas including work, friendships, and romantic relationships.

For example, if you are investing heavily in a relationship and it appears to be getting worse instead of better (e.g., more arguments or conflicts) then this could mean that too much time is being spent in one area of your relationship. Licensed Professional Counselor Marlayne Whitlock says, “Couples often ‘memorize the dance steps’ to their relationship. They expect their memorized behavior will always work. ‘This is the way we’ve always done it in the past, so doing more of it will surely make things better.’ . . . It may mean that a simple change is needed, or goals might need to be redefined.” During times of uncertainty, misunderstanding, or tangible loss, perceived indifference to such failure or the inability to quickly resolve it creates a myriad of emotions that will suffocate any hint of gratitude. For this reason, cultivating a gracious mindset becomes essential in promoting healing to repair the damage done by its opposite ingratitude.

In marriage and long-term partnerships, focusing on what you or your partner do not possess is easy. This could become a dominant theme in your thinking. I am not suggesting that qualifying negative criteria used to determine whether you should invest in a long-term partnership be eliminated. Only that determining your own liabilities and those of your partner requires a macro-approach and should be balanced with a thorough estimation of the total portfolio including individual and jointly held qualities and traits.  Therefore, the aim of gratitude is to help us to be thankful for what we have, or our partner has rather than what we don’t have. For many of us, gratitude may require a change in the steps of the dance, or in market economics a change in investment strategy.  In practical terms how might this look? 

In a market economy, outcomes are affected by labor. If labor fails to match demand, consumers of those services and goods become dissatisfied with output. The same is true in marriage and long-term partnerships. And, even when labor matches demand, we grow accustomed to goods and services being produced at a rate that satisfies the demand. Particularly when labor is sustained for long periods. However, an equitable division of labor may not be enough to ensure that partners are satisfied with their relationship. 

Researchers, Angela Trethewey at California State University and Jes Alberts at Arizona State University write  “When you perform work around the house from cooking to laundry to checking your kid’s homework, it often feels like a burden to yourself and a gift to your partner.  So, if you don’t feel that your partner is grateful for your efforts, especially if you perform the lion’s share of domestic labor, that’s likely to exacerbate feelings of inequity and dissatisfaction making a difficult situation even worse”. In their research, Trethewey and Alberts found evidence through focus groups, interviews, and surveys with people in heterosexual and same-sex relationships that gratitude isn’t just a way to mitigate the negative effects of an unequal division of labor. Rather, a lack of gratitude may be connected to why that division of labor is so unequal, to begin with.

Their research suggests partners’ response threshold for particular tasks are decided by the degree of dissatisfaction that exists before one partner is sufficiently bothered to perform a task not being done or performed unsatisfactorily. They give the following example:

 “If Joan’s partner Ted is disturbed when the trash in the wastebasket approaches the rim, whereas it doesn’t bother her until the trash spills onto the floor, Ted will take out the trash before Joan is moved to do so. If the difference in their disturbance levels is great enough, Joan never will empty the trash, because Ted will always take care of it before it bothers her, possibly before she ever even notices the garbage.

What’s more, if one partner does something well, that increases the chance he’ll perform that task again, just as failing at the task (or a lack of opportunity to complete it) decrease the chance he’ll get another turn. Then consider that, before long, the partner who performs a task more frequently will likely be seen as a specialist at it. Taken together, these facts explain how one partner can get stuck with a household chore.”

Sociologist and writer Arlie Hochschild coined the concept of emotional labor in her book titled— The Managed Heart- 1983. Hochschild believes that in relationships, individuals offer each other “gifts,” which are something extra, beyond what is expected. For Hochschild, the expression and management of emotion are social processes. Therefore, what people feel and express depends on societal norms, one’s social category, and cultural factors.

You may recall when discussing the topic of patience, I said that careful identification of how each partner interprets what they see, hear, and feel becomes the key determinant in whether or not the relationship will survive. It should be underscored here that perspectives held by each partner be jointly analyzed based on the sociocultural factors that influence their individual behavior. That is to say, do these perspectives hinder or help gratitude to flourish? And, if not why?

Gratitude reflects what we believe we deserve for ourselves and our partners. It reflects what we have been taught. It shows love and respect. It is a language that is acquired. It is a language that is learned.

The Roman philosopher Seneca  (4BC – 65 AD) wrote the following on gratitude and what it really means to be generous – “Benefits, as well as injuries, depend on the spirit… Our feeling about every obligation depends in each case upon the spirit in which the benefit is conferred; we weigh not the bulk of the gift, but the quality of the good-will which prompted it.”

For these reasons and more, expressing gratitude to your partner reminds them that the division of labor is not fair and that their contributions are a gift.

American author Annie Dillard in her effort to encourage generosity for aspiring writers, I believe offers sound advice for married couples and long-term partnerships in a market economy.  She writes-- The impulse to save something good  [gratitude] for a better place later is the signal to spend it now. Something more will arise for later, something better… The impulse to keep to yourself what you have learned [or earned] is not only shameful, it is destructive. Anything you do not give freely and abundantly becomes lost to you. You open your safe and find ashes.”

It is unlikely that gratitude will eliminate all conflict surrounding couples’ division of labor, but it can help partners reduce the frequency of their conflicts and most importantly avoid the trap of taking each other for granted.

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References:

DeSteno, D., Li, Y., Lerner, J. S. (2014).  Gratitude: A Tool for Reducing Economic Impatience. Psychological Science (25), 1262-1267 https://davedesteno.com/publications/gratitude-a-tool-for-reducing-economic-impatience-pdf  

Dillard, A. (1989, January 1.) The Writing Life. Good Reads. https://www.goodreads.com/quotes/151317-one-of-the-things-i-know-about-writing-is-this

The Law of Diminishing Returns. Grow Counseling.com https://growcounseling.com/relationships-diminishing-returns/

Trethewey, A., Alberts,(2007, June) J.  Love, Honor, and Thank. Greater Good Magazine, June 2007. https://greatergood.berkeley.edu/article/item/love_honor_thank  Whitlock, M. (n.d.). Relationships:

Market Economics: Patience

Photo by John McArthur

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

   “Patience is not the ability to wait, but the ability to keep a good attitude while waiting.” 

-Unknown 

Before pursuing a career in social work, I took a keen interest in economics. As an undergraduate, I stacked econ courses because the introductory courses were much easier than chemistry and physics. I’ve always struggled with the pure sciences because I’m a slow learner and resources that lent themself to application were not always accessible. However, I soon realized that while physics and chemistry require high critical thinking skills and logic, the deeper you go into economics the laws of economics don’t always apply. This is because economics is influenced by the irrational nature of humans. With chemistry and physics, you can be certain that if you try to measure a specific property among a spread of possible positions, if you repeat the measurement many times you can trace out the distribution of possible results. With the social sciences what is certain is relative uncertainty. Human behavior, while often predictable, fails to conform neatly to theorems applicable to precise outcomes. Social Scientists must incorporate laws involving both the physical world and society. And the complex relationships that exist between the two. Economics in many ways helped me to explain a broad range of positions with an even wider range of outcomes. I am beginning to return to economics in helping me to navigate the world of interpersonal relationships-mainly couples. It’s messy work, but I enjoy learning from my observations and applied research in its most basic forms.

Over the next several months I will be examining four characteristics found in healthy interpersonal relationships. I will use concepts found in economic theory to illustrate how human relationships mirror financial markets. The following characteristics and their definitions are:

• Patience- The capacity to accept, tolerate, and delay problems without becoming annoyed or anxious.

• Gratitude- The quality of being thankful; readiness to show appreciation for and to return kindness.

• Intuition- The ability to understand something instinctively without the need for conscious reasoning.

• Teachable- The ability and willingness to learn by instruction.

“The qualities most useful to ourselves are, first of all, superior reasons and understanding, by which we are capable of discerning the remote consequences of all our actions; and, secondly, self-command, by which we are enabled to abstain from present pleasure or to endure present pain in order to obtain a greater pleasure in some future time”. Theory of Moral Sentiments (1759), Adam Smith

Patience encompasses tolerance, which is the ability to hold fast to guiding principles that have a historical pedigree in times of instability.  Relationships like financial transactions are based on conditions that strengthen or weaken patience. Identifying what allows you to feel safe in a relationship is the key to remaining patient. In couples therapy, I try to identify types of “currency” that govern the collaboration between partners.   Currency comes in many forms: intellectual, physical, sexual, psychological-emotional, and material- property. Each partner in the relationship must determine the type and value of the currency they hold to be exchanged. Couples moving toward long-term commitments naturally attempt to differentiate the types of currency that exist between them and their value. Rarely do both partners hold currency having an identical value between them.  The collective values shared by each partner are what promote patience. Patience is a slow organic process. It cannot be forced.

Financial investors are warned. to take a long-term view rather than trying to second guess the market and selling off stocks and transferring funds according to the ebbs and flows of the market. The standard advice is that you shouldn’t be investing unless you’re prepared to hold on to your portfolio for at least five years or more. And, that ten years, twenty years, or more is even better.  This is because of the principle of Compound Interest. 

An example of this would be your investment of “time” into your partner’s life over the course of one year, by sharing in household chores, shopping, child care, and transportation.  While these investments of time may hold no monetary value, they add quality to your partner’s life over time.  After the first year theoretically, your original investment should have added value to your partner’s life.  This added value should consequently increase your net worth in the relationship, by allowing your partner the freedom to work and pursue other commitments.  The original principal has over the year yielded some returns and interest or value to the relationship.  And your partner’s ability to increase their own value independently due to your investment.

As humans, we crave stability. Long-term commitments and partnerships hold the greatest opportunity for gains as well as the greatest risks for loss. Patience is cultivated over time. It is often decreased by market conditions represented by challenges that disrupt the equilibrium or comfort zone between the known and the unknown. Conditions that promote patience and those that undermine it are linked to quality and quantity. When my supply is plentiful and exceptional my patience is high, and my confidence is strong. However, when supply is scarce or inferior my patience is low, and my confidence may weaken or become absent altogether.

Assuming we are mentally and emotionally healthy, to begin with, most couples seek balance and attempt to minimize stressors associated with conflict. One of the problems with maintaining patience in long-term relationships is that we have few incentives to do so. The emphasis within the last fifty years or so has been toward self-centeredness as opposed to self-denial. At the risk of overgeneralizing this trend, it is safe to say that most couples fail to appreciate the intrinsic qualities or values that each partner brings to the relationship. Appreciating or possessing acceptance of personality traits in our partners having lesser values can and does help with stabilizing the equilibrium that allows for gratitude, another essential quality that I will explore in greater depth in my next essay. An example of this can be easily found among most families. It’s a given that we often will tolerate more from a blood relative than we would a stranger. We do this because our connection by birth or blood is something we do not choose. Some may argue that within certain cultures even marriage is not a choice. And their assertion would be correct. But, for those connections that are familial, there’s often a sense of duty or commitment. 

That is to say, we tolerate undesirable qualities because they represent only a part of the collective value of the person with whom we are in a relationship. Individuals usually possess positive qualities or values that exceed those traits that we find undesirable and offensive. As a result, by their very nature, long-term relationships should over time produce the type of patience that endures. For those of us in long-term partnerships we understand this. Time, however, is a non-sequitur.  Time alone may fail to fix relational conflicts or heal all wounds.  In some instances, time fails to guarantee that patients will survive in turbulent market conditions. So, when do such conditions destroy patience?

To translate this into economics, we must remember the values or currencies we bring into the relationship are rarely fixed. This means that we must learn the principle of diversification— a strategy that involves investing in a variety of commodities to reduce the risk that will cause the relationship to suffer. English philosopher and poet Eric Carpenter (1844 -1929) describes this process. “For any big [successful] relationship plenty of time has to be allowed. Whichever side of the nature - mental, emotional, physical, and so forth— may have happened to take the lead, it must not and cannot monopolize the affair. It must drag other sides in and give their place. And this means time, and temporary bewilderment and confusion.”

To apply this in economic terms we must see interpersonal relationships in the way we see banks and capital markets. Both are simply a means of matching savings to investments. Couples that realize the benefits of patience are more efficient with their currency. They save and spend wisely which promotes long-term growth.

British Economist, Andrew Haldane,  describes the challenges in achieving this delicate balance: “The implication of such behaviors [impatience] are far-reaching. “The patient planner becomes a spontaneous doer when outcomes are within reach, The cautious saver becomes a reckless spender when nest eggs are close to hatching. The long-term investor becomes a short-term speculator if assets can be cashed. As temptation beckons, the devil on one shoulder whispers more seductively than the angel on the other. Preferences switch as the distance becomes instant.”  (“Andrew Haldane: Patience and Finance - Bank for International Settlements”)

In these scenarios one thing is clear. Couples are more likely to experience impatience when expectations appear imminent and certain. Humans are not hard-wired for patience. We need incentives in small quantities. If I believe that my investment in my partner will yield a future value greater than the present, I will tolerate their shortcomings and inconsistencies that otherwise would tempt me to divest and curtail future dividends. And, when patience is rewarded by incremental increases in valued currency, I am encouraged to continue what I am doing even when stock values fluctuate. Patience is impacted by multiple variables— type and value of the currency (those positive values that are desirable and appreciated by my partner), and rates of exchange, how much certain tangible goods are valued by my partner at a given time. Gains and losses are inextricably connected. This is what makes the cultivation of patience so demanding in relationships. The expectations that partners place on each other are subject to change based on what is seen, heard, and felt during the relationship. Careful identification of how each partner interprets what they see, hear, and feel becomes the key determinant in whether or not the relationship will survive.

So, what we can learn from the parallels that can be found between couples and their interaction with each other based on market economies?

• In a market economy, most economic decision-making is done through voluntary transactions according to the laws of supply and demand. Remember that each of us holds types of currency. The value of which fluctuates based on supply and demand. Couples must practice patience when evaluating their currency and be willing to endure temporary deficits until supplies reach satisfactory levels. What this means for the couple in the midst of a recession is that they must rigorously evaluate their currency and ask themselves and their partner— what values and/or commodities my partner brings into the relationship that makes me a better person? And, do I possess more or less value if those commodities were absent, and my partner was not present in my life?

• A market economy gives entrepreneurs the freedom to pursue profit by creating more valuable outputs than the inputs they use up, and free to fail and go out of business if they do not. In short, as the saying goes no person is an island. Each of us possesses qualities that are the result of other people’s investments in us. It would be wrong for us to say that we possess all of what we need independent of others to reach our full potential. Therefore, we must be careful not to squander the goods we have received from others. This means that I must acknowledge the good I receive from my partner and be willing to risk losing it, knowing that if I fail through a lack of patience to find ways to reciprocate the investment that my partner has made into my life and into our relationship, the business of what keeps us connected will not succeed.

• Economists universally agree that market-oriented economies produce better economic outcomes but differ on the precise balance between markets and central planning that is best for a nation’s long-term well-being. Most couples forget that competition is good. Competition says that I am willing to fight for what I want in my relationship at the exclusion of all things harmful to the one I love. Patience, therefore, allows me to compete for what is best, desirable, and most profitable for the long-term growth of the relationship.

Hannah Arendt (1906 - 1975), historian and political philosopher, writing on love and the fundamental fear of loss concludes by giving us what in the end we gain from being patient. She writes, “ A love that seeks anything safe and disposable on earth is constantly frustrated because everything is doomed to die. In this frustration, love turns about, and its object becomes a negation so that nothing is to be desired except freedom from fear. Such fearlessness exists only in the complete calm that can no longer be shaken by events expected by the future.” (“Hannah Arendt on Love and How to Live with the Fundamental … - Pocket”)  Patience, therefore, is the recognition that loss is inescapable and that what we truly desire in a market economy is freedom from fear.

Conversations, Critiques, And Reflections

Photo by Maria Oswalt

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

At the end of last year, I found myself contemplating as I often do about what matters most. And how this manifests in my personal life. Like others in the behavioral health community, I look for similarities that define what is considered normal or uniquely characterize developmental stages in the human life cycle. The late psychologist Erik Erikson, a name familiar to most, identified eight stages of psychosocial development along with their relative age range: Trust (0-1), Independence (1-3), Initiative (3-5), Accomplishment (5-12), Identity (12-18), Relationships (18-40), Contribution (40-65), and Reflection (65- +). The theory maintains that personality develops in a predetermined order through each of these stages from infancy to adulthood. Through each stage, a person is said to experience a developmental “crisis” that could have a positive or negative outcome on personality development. According to Erikson, the successful completion of each stage throughout the life-cycle results in a healthy personality and the acquisition of basic virtues. A crisis results when the psychological needs of the individual are in conflict with the needs of society.

While I like Erikson’s theory of psychosocial development I find the developmental progression to be too rigid because the theory implies a failure to develop at any given stage is a lost opportunity for growth that is no longer accessible. According to Erikson, I am at the tail end of the seventh stage labeled “Contribution”. The opposite of Contribution is withdrawal or stagnation. The key features of this developmental phase are giving back to society, raising children, being productive at work, getting involved in community activities and organizations, and seeing myself as part of the “larger story.” If I fail to contribute to the larger story or if my voice is silenced, I will become disconnected and uninvolved with society as a whole and remain undeveloped.

This brings me to another question that prompted this contemplative exercise. If what matters most in life can be defined according to Erikson’s model, what happens when my personal needs conflict with those in society? Can they coexist as equals or is there a constant state of disequilibrium? I believe when using terms like “crisis” and “failure” to describe psychosocial development, one must use caution. Erikson’s theory while helpful can also be harmful if the definitions used to define the needs of society (inclusive) are counterintuitive to my individual needs (exclusive).

Let me explain my dilemma by outlining the stories of others and what I have learned from them. Ivan Illich (1926-2002) was an Austrian priest, theologian, philosopher, and social critic. He was best known for his institutional critiques and revolutionary perspectives. He authored or co-authored over eighty books, along with numerous articles. One book, in particular, catches my attention. “Tools of Conviviality” (Harper & Row, 1973) is a book that provides us with a broad examination of the institutions that dominate modern life and the need for fundamental technology reform. Illich defines “conviviality” as the opposite of industrial, autonomous productivity. Rather, it is the creative dialogue among persons and between individuals and their environment. Illich argues for the multidimensional balance of human life which should serve as a framework for evaluating a person’s relation to their tools because modern technologies often serve politically interrelated individuals rather than the common citizen,

In the mid-1990s the tech revolution was just beginning to take off, and I had already begun to feel the pain of the feeding frenzy looming on the horizon. A frenzy of never-ending voices, words, pictures, and sounds. Unaware of the insatiable appetite that would ensue or where technology would lead, I decided to limit my exposure to television and radio media for reasons related to mass marketing and the pressure to buy into what was dubbed the Internet, then known as the World Wide Web. In the beginning, the Internet served neither my needs nor my interests. Now I can barely imagine life without it. This was for me a crisis. One that replaced the search for material in the stacks of public libraries, and databanks, pieced together from collected notes and conversations from multiple print media. I believed then as I do now that our inability to control our appetite and dependence on technology would result in mental obesity. As computers and automated technologies became more accessible to the average citizen, I made this decision because my attention to detail and ability to focus was becoming fragmented. In short, I began losing the ability to question opposing views and manage the push from those who promoted what they wanted me to believe- that more is better and that if I’m not looking at or listening in, I’m missing out. Therefore, according to Erikson, my individual needs were at odds with those of society, or at minimum the needs of the social media giants.

I think Illich knew where unregulated technology would lead us. With all the modern and time-saving conveniences we enjoy, we have become slaves to the machine. It’s not that technology is bad, but our inability to control it is. Illich talks about the desire for speed, which is essentially at the root of most technologies. By contrast, the absence of technology made us more socially interdependent and required that we exert ourselves physically, which had a more humbling effect. When work is not abusive or used as a means of punishment it is a reward in itself. The quality of human capital has depreciated in the age of automation. Formal education, the college degree has replaced or revised the role of apprenticeship and participatory education in what is often referred to as blue-collar trades. Even in higher education, before the 19th century, those professions where mastery of science or the arts was largely determined by book learning, the human element of mentorship was key to one’s success. This can be observed in ancient Greek literature where various schools of thought grew up around noted teachers and scholars. Plato, Aristotle, Sophocles, and the like all had a following, much like the students of the 1960s whose liberal icons formed the backdrop for political thought. Even the university is not sacrosanct. Illich in the book describes the effects of technology in the classroom. “A certain type of reading skill is disappearing- in effect physical intercourse between reader, printed text, and the world beyond.” He compares book-based learning to electronic media. “When the sensual, textual, actual book-as-body goes, so goes a form of human interaction.” I believe Illich is correct and think that this trend affects social relationships. He goes on to say “The embrace, the kiss, the face-to-face conversation are celebrations of sense in a senseless world of artificial intelligence and electronic communities.” What I conclude from Illich’s thesis is that technology cannot replicate the characteristics that define those aspects of personality responsible for our humanness. The very essence that makes each person unique in form and character. That our interpretation and interaction with each other and the world around us make us human. The social narrative for development is that what is good for society is good for the individual, but if this is true why should I feel stagnate and undeveloped for eschewing technological advances that produce more alienation than cohesion and exclusion among communities? Particularly communities of color.

Let me explain. While technology is not directly to blame, individuals and companies that create algorithms that allow their social media content to incite individuals toward acts that promote injustice and inequality appeal to the lowest common denominator- hate, discrimination, exclusion, greed, intolerance, extremism, and misinformation. Companies that fail to exercise good business ethics have unfairly tried to silence those critics who have spoken out against them. Appealing to the lowest common denominator affects every member of society. However, the African American community and other marginalized groups like women, and the LGBTQ community have suffered the most. This I believe is primarily the result of greed and the exploitation of “gig” workers who are employed on demand by large tech companies Most of these companies are more beholden to their shareholders than their consumer base. Therefore, social media monopolies (you know who they are) want to generate money. Tech investor and activist Ellen Pao in her book “Reset: My Fight for Inclusion and Lasting Change” (Random House 2017) highlights her own experience as a corporate executive who experienced and fought against exclusion by predominately white men. Pao explains how corporate culture often creates bad actors and bullies that ignore many of the policies that govern their businesses and use their platforms to discriminate against women and minorities.

Make no mistake. The failure of big tech corporations to protect the civil rights of their employees or those who use their platforms is not about free speech or the suppression of First Amendment Rights. It’s about the creation of poorly defined standards or their (corporations’) failure to enforce them. We see this where certain politicians will get a pass for posting misinformation or extremist views on their platforms. This is a soft endorsement by social media executives who choose to look the other way and fail to restrict or ban the type of content or practices that create addiction, misogyny, and racial and ethnic bias that results in polarization among social classes. The reality is that the business model used by most corporations is quite lucrative and designed to keep us as consumers staring at our screens and becoming more outraged or entertained rather than informing us. In short, exploitation.

Returning for a minute to Erikson’s model, I’m reminded of the delicate balance between growth and stagnation which is where I am at in my developmental journey. The reality is that some things are neither good nor bad. A thing can create growth or stagnation. It just depends on how it is used, who uses it, and the intended or unintended outcomes. William Treseder, a corporate entrepreneur and author captures my sentiment in his book “Reset: Building Purpose In the Age of Digital Distraction” (Lioncrest 2018). Treseder writes that humans do not respond well to an infinite supply of anything. Choosing quality over quantity is hard for us. He compares information to food and says that we aren’t all sufficiently wired to know when to stop. He writes- “We’re curious creatures and at some basic level we want to see it all. We enjoy the mental stimulation and the illusion that we’re learning something new. And, at times being focused and purposeful is one of the hardest things for us to do. In short, we choke. “We consume without exercising judgment or connecting to a larger purpose.” It is this illusion of learning created by the myriad of voices and their stories that I wish to avoid.

In addition to the social impact of technology, certain technologies restrict accessibility for specific segments of the population. Have you ever attempted to call a company business and needed to navigate the telephone prompts and filters in order to speak to a live person? When the selections provided by the virtual assistant don’t fit the category that you are calling about? This has become a part of the digital landscape and an unavoidable way of conducting business. I understand the rationale for using this type of technology and am not suggesting that virtual assistants be abolished. However, I do believe that an element of personality or humanness is lost when we are constrained by certain types of technology that limit the range of human interaction and/or expression.

Much of my work involves communicating with seniors. I do this using multiple modes: meetings, telephone, voicemail, email, text, and video conferencing. What happens when someone I am working with is unable to access or use the technology that can assist them with meeting a personal need? Many of my clients are in their 70s and 80s and were locked down like everyone else during the pandemic. Some are tech-savvy and managed emails and text messages on their phones and tablets with minimal difficulty. Others engulfed by users of technology remain isolated by limitations, whether by designs outside of their control, their own choice, or a combination of the two, and were literally cut-off from all but the most basic form of long-distance communication- the telephone. Some of my clients housed in assisted living facilities were not even in possession of their own mobile devices due to their health conditions. Those who were capable of using a phone but dependent on the availability of a single landline or the willingness of staff to assist them with making or receiving calls from loved ones suffered emotionally. The families of some clients were responsive during this period by purchasing a tablet or basic smart device for their homebound loved ones which increased their autonomy and ability to connect with those outside of their facilities. Other residents whose families lived out-of-state, who were without family, or whose families were economically incapable of making such accommodations were further isolated. Some of the smaller privately owned facilities with fewer than 10 residents were better able to pivot using their homes in ways that would allow for limited contact and connectedness when Covid-infection rates soared. Using a combination of quarantined indoor spaces with outdoor visitation when weather permitted, allowed a semblance of normalcy.

This, like most topics I wrestle with, is a complex one. There are other perspectives of this narrative that should be considered. This however is the lens I find most helpful in reflecting on challenges associated with living life in a technological age. Erikson, I believe if he were alive today would say that his model is helpful only when constructs used to define stages of development are well defined. We need to answer the question, what should each of these stages look and feel like? Their appearance has become blurred by generational influences that were not a part of today’s lived experience. For example, my present developmental stage “Contribution” differs as a baby boomer (1946-1964) from that of other generations- millennials (Gen Y. 1981-1996) or zoomers (Gen Z. 1997-2012). Because of this experiential gap, technology and my relationship with it will be different from those of past and future generations. What I believe doesn’t change over time is our fundamental need to be seen as singular, unique beings, capable of contributing something from oneself as “gifts” to the world. I’ve concluded that AI rather than enhancing individuality and creativity is often used to strip away those aspects of our personality that allow us to develop and reach maturity. Illich if he were alive would say that technology is being used to move us toward reductionism instead of a holistic approach. Illich would agree, that our failure to regulate technology has resulted in technology running amok. And, that the politicization of greed has changed the social fabric of the community to one that measures development and growth only in terms of profit and pleasure. These virtues- profit, and pleasure are toxic, addictive, and left unchecked soon become inseparable from life itself. These examples highlight both the benefits and limitations of technology when circumstances present barriers and users misappropriate their technology or weaponize it to do harm to those who look and think differently from them. And to others who lack the knowledge to implement such technology, lack accessibility, or the inability to separate fact from fallacy.

GOT REST?

Photo by Alan Retratos

By Sterling Hawkins, MSW, LCSW-C, LICSW

It's the holiday season, and whether or not you celebrate traditional holidays, there's one thing in common with all holidays. It is a period when no work is done. Work in the way we understand it- A regular activity that one engages in to earn a livelihood. Holidays and how they are celebrated depend on who you are, and what you believe. On a personal level, holidays often allow me to reflect on my relationships with others and places where I enjoy spending time. I've always equated holidays with rest. As a college student, I remember looking forward to winter break, when exams and papers were all done, and I could visit with friends back home, and enjoy seasonal food and drink. But what I remember most were the hours of unstructured time. This meant for at least a week or two, when I was not visiting or socializing with friends, I could sleep whenever I wanted. Strangely, however, once my sleep deficit resolved, I never felt completely rested. It wasn't until years later that I realized that my definition of sleep was too limited. Leave it to me in my ignorance and efforts to oversimplify what for others seemed obvious. I failed then to appreciate the importance of expanding my definition of rest.

 Dr. Saundra Dalton-Smith, a physician and researcher, in her 2021 Ted-Talk explains that my mistake is common. We try and fix an ongoing lack of energy by getting more sleep; only to do so and still feel exhausted. Dalton-Smith identifies sleep as physical rest. And only one of the seven types of rest we all need to remain healthy. The six other types of rest she identifies are mental, sensory, creative, emotional, social, and spiritual. In this article, I only will focus on three of the seven types we typically don't consider when thinking about rest. You may read the entire transcript or view the TED Talk by clicking on the link below.

Sensory Rest

In today's climate of digital connections, those of us who enjoy its modern infrastructure have unlimited access to individuals and information wherever and whenever we choose. Dalton writes "bright lights, computer screens, background noise, and multiple conversations... can cause our senses to feel overwhelmed."   

If you are like me, there are times when you find yourself unable to resist checking email, voice mail, and responding to texts. Sadly, at times, our devices exert more control over us than we should allow. Dalton says we can start to counteract the negative tendencies simply by closing our eyes in the middle of the day for several minutes or intentionally unplugging at the end of every day. These and other mindfulness techniques create moments of sensory deprivation that can begin to undo the damage inflicted by our over-stimulating world. 

Creative Rest 

Have you ever wondered why individuals take sabbaticals? A sabbatical is a break or change from a normal routine away from work. Traditionally, sabbaticals were offered to individuals in academic settings to give professors a year's leave of absence from teaching to pursue research, publish, or time away to engage in professional interests outside of the classroom. The sabbatical by design allowed persons to remain employed and still be compensated during this time.

While Dalton does not use the term sabbatical to describe creative rest, it is implied by her definition. One purpose she says for creative rest is to engage in problem-solving or as a catalyst for brainstorming innovative ideas. In short, inspiration. Dalton comments "Creative rest re-awakens the awe and wonder inside each of us."   While it may be impossible to pursue a year-long sabbatical, it is possible to incorporate aspects that lead to discovery, self-awareness, and exploration in our daily routine.

To dig a little deeper into the origins of creative rest we need to examine the root or context of sabbatical. The word sabbatical can be traced to the Greek word sabbaton which is derived from the shabbath, meaning rest. The Old Testament refers to the sabbath as God’s Day of rest- Genesis 2:2-3. And following Genesis the Sabbath was to be applied to his followers wherein his people were required to rest after six days of work- Leviticus 23:3. Taking a sabbatical has always involved rest for deep reflection, rediscovery, and reimagining. Dalton writes that one way we can practice creative rest is by displaying images of places we love and art that speaks to us in our workspace. It is hard to feel inspired or rested where creativity is lacking.

If you're wondering if taking a vacation will allow you to meet your creative rest requirements, think again. Vacations are primarily for recreation and are typically short breaks that disrupt our regular routines and provide us with distractions and fun stuff to do or see. Oftentimes, vacations by their nature create more stress, because you're painfully aware of their limited duration, and seek to cram multiple activities into a narrow timeframe. In contrast, a sabbatical is usually for one year and geared toward education, learning how to improve one's self, and developing or producing something of worth. Sabbaticals are designed to overcome certain challenges, be they mental, physical, or spiritual that only time and intentionality will resolve.

Spiritual Rest

Spiritual rest according to Dalton is "the ability to connect beyond the physical and mental and feel a deep sense of belonging, love, acceptance, and purpose."   Spirituality encompasses activities that take us outside of ourselves, away from material or physical things, allowing us to embrace the soul or spirit profoundly. No one spiritual practice can claim exclusivity. Prayer, meditation, silence, and the sounds and songs of nature whether produced through voice or musical instruments can create a sensory experience or belief that there exists something greater than us. Spirituality in this context is different from religion which is defined as a set of beliefs or practices shared by a community or group. In contrast, the type of spirituality being implied involves an individual practice used to cultivate and develop a sense of peace and purpose.

In his poem titled “Time Off Work,” the author Carl D’Souza asks a question:

In an ideal joy and happiness society, would every working person get time off work to rest,

to rejuvenate,

to play,

to self-entertain,

to self-educate,

to care for and improve one’s mental health,

to travel and explore,

to do family joy,

to do friendship-joy

to do romance-joy,

to do joy and happiness activities?

In response to D’ Souza’s rhetorical question, we must each acknowledge that our world is not ideal and that there is much sorrow and unhappiness. And forces conspire that compel us to believe that sensory, creative, and spiritual rest are impossible to fully achieve. However, it is rest that brings us closer to the ideal and rest that allows us to practice in the words of Behida Dolic, “Little gestures of the soul” that don’t take an immense amount of energy. Finally, as you pause from work to celebrate, reflect and reconnect, remember to incorporate rituals involving these types of rest into your holiday.

_____________________________________________

References:

Dalton-Smith, S. (2021, January). The 7-types of Rest that Every Person Needs [Video]. TED Conferences. https://ideas.ted.com/the-7-types-of-rest-that-every-person-needs/

D’Souza, Carl. “Time Off work”, Hello Poetry.com, https://hellopoetry.com/carl-dsouza/poems/?tab Oct 2021

Life's Final Chapters

Photo by SHVETS Productions

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

I’ve been thinking about what matters most at the end of life, and why it matters.  It’s not always what you think.  Most of the things we hold onto both emotionally and physically change throughout our life cycle.  What is well known in the field of aging is that people at the end of life want to feel that their life was complete.  How they go about that is expressed in different ways depending on the individual.  Along the journey toward end-of-life care, we usually accumulate “stuff” that somehow in the beginning seems important, but over time and at the end often changes value.  I believe what becomes important for most, in the end, involves effective communication, care coordination, and physical, emotional, and spiritual support.  So how do we get there?

American physicist, Alan Lightman in his collection of writings titled  “The Accidental Universe: The World You Thought You Knew, writes “ I don’t know why we long so for permanence, why the fleeting nature of things so disturbs. With futility, we cling to the old wallet long after it has fallen apart. We visit and re-visit the old neighborhood where we grew up searching for the remembered grove of trees and the little fence. We clutch our old photographs. In our churches and synagogues and mosques, we pray to the everlasting and eternal.  Yet in every nook and cranny, nature screams at the top of her lungs that nothing lasts, that it is all passing away.” This sentiment echoed by Lightman is acutely evident in death. Death involves a change from a life we know and can observe to what is certain but hidden and unknown. Death involves change.

As Americans, we have a strange relationship with death. We acknowledge it and sometimes even prepare for it. We write and even sing about it. However, few of us welcome it when it comes, if given the chance to do so. Perhaps it comes when life is good, and the summer years of life remain rich and vibrant. Or, before spring has yet to bloom. Or, when autumn leaves fall, or winter’s snow has killed off the maiden grass and the thistle. It always comes.

I had the opportunity years ago to participate in a couple of training programs offered by a hospice organization. What I learned back then helped prepare me for my work today, with those who are in their final years of life. Back then I never gave as much thought to the resistance to death when a diagnosis presented insurmountable challenges for the patients with whom I worked. But now after years of working with the chronically and terminally ill, I see how the subject of death for some patients and their families is terrifying. Particularly for those who were born and raised in the United States. Unlike non-western countries, many Americans have an aversion to death. I believe there are three reasons why this occurs:

[1] We remove death from our lives by avoiding thoughts or conversations about death

[2] We use technological advances to delay death. And,

[3] We separate the dying from society in medical facilities.

As a child, I remember going to funerals when somebody would die that was known to me or one of my parents. On rare occasions, I might get to see the person before they died. If they were sick and, in the hospital, dying at home or in a nursing home, my mother sometimes carried me with her to see them. But in most cases, I just learned about their death from my mother or someone else in the family. In the 1950s and 1960s, health education was severely restricted to those who were not employed in health care. Many physicians and specialists within the medical establishment held a very paternalistic approach to informing their patients and relatives about the nature of their illnesses.  In such instances, I recall the expressions of disbelief and phrases the family repeated as heard from the deceased person’s physicians— “Heart just gave out…, died of pneumonia…, cancer took her…, didn’t take care of himself…” Curious kid as I was, I remember thinking to myself, “what exactly does that mean?” It was only later that I realized the stigma associated with dying without the knowledge or power to change the narrative about what we should know, when possible, prior to death’s occurrence. Being African American and uneducated in most cases during the fifties and sixties meant limited access and disclosure about medical practices from those providing the treatment.   In the 1960s  segregated hospitals were common and legal throughout the United States.  Even in so-called mixed-race hospitals, Black patients were often housed on separate floors.  The notorious Tuskegee syphilis study a government-led experiment on Black males ran from 1932-1972  and killed over 100 men.  People of color were often discriminated against and were restricted from receiving care.  As a result, African Americans are often suspicious when their doctors begin withdrawing medical treatment or fail to disclose the implications of their illness.   Some physicians fail to engage in end-of-life care planning, the discussion that examines a patient’s disease process, and treatment approaches they can choose from, including hospice.  Too often these discussions simply don’t happen and because of the lack of trust, African American patients and their families don’t ask specific questions to become better informed and educated about what choices are available.  The conclusion is that doctors need to clarify what is happening medically for those at end-of-life in terms that can be understood while providing education on what treatment options are available. Such attitudes of racism and discrimination still exist today.  However, with the digital revolution of the 1990s came the opportunity for the public to access health information that was long restricted and available only to Whites.

Working in both hospital and home care settings as a social worker have taught me priceless lessons about accepting my own mortality and the importance of making adaptations to our life instead of alterations that are in the end untenable and do little to improve one’s “quality of life”. 

As I write this, I’m aware that some may argue that quality of life is a relative term. One might say that an alteration for one person may be an adaptation for another. Let me explain.

The modern usage of hospice as a place for and philosophy of end-of-life care began with the work of a British physician named Dame Cicely Saunders. Dr. Saunders began work with terminally ill patients in the London area in 1948. The term “hospice” is defined as a program that gives special care to people who are near the end of life and have stopped treatment to cure or control their disease. Hospice offers physical, emotional, social, and spiritual support for patients and their families.  The main goal of hospice care is to control pain and other symptoms of illness so patients can be as comfortable and alert as possible. It is usually given at home, but may also be given in a hospice center, hospital, or nursing home.

One of the key components of hospice philosophy is the discussion of the goals of care. The topic of goals of care deserves its own article.  But for simplicity, I will cite a few components when discussing goals of care that can be expanded. Tailoring services to match the needs of the last phase of life requires defining that phase in the most relevant ways. Because the phenomenon of a long healthy life followed by chronic and debilitating illness in the last phase is new in human history. We are just beginning to understand the dynamics.

In a White Paper published in 2003 by the Rand Corporation, the following components were said to be integral to adapting health care to those with serious and chronic illnesses in old age:

·        The timing of death remains unpredictable until late in the course of serious chronic illness. Therefore, special arrangements for care near the end of life must be triggered by the severity of symptoms, rather than waiting for a reliable prediction that death is near.

 ·         The major causes of death are all progressive, degenerative illnesses that leave people in fragile health for a long period of time before death. Programs and policies to improve care for chronic conditions need to accommodate the fact that death is the eventual outcome.

 ·         Designing reliable care systems might best build upon the time course and nature of the service needs of a small number of populations, differentiated by the trajectory of disability and symptoms over time, rather than conventional differentiation by care setting (e.g., hospital or home) or diagnosis.

It’s unlikely that such systemic changes will improve health outcomes, so long as the topic of death remains something to be avoided.  However, each one of us can do our part to preserve those aspects of life that death cannot take away. I’d like to suggest five ways we can do this: [1] We can begin by being present with those facing death, wherever they are emotionally and psychologically. What this means is that [2] We must not marginalize their feelings. Equally important is [3] Not ignoring them (the dying).  At times, I still find this personally challenging.  In health care, it is difficult not to develop some emotional attachments with those who receive our services. To avoid these emotions, we sometimes avoid interacting directly with our clients.  Being a part of a healthcare team that offers bereavement care for its providers is helpful if your practice is dedicated to those who have fragile health conditions or are terminal. If you are a behavioral health provider, you should [4] Seek to become knowledgeable about disease processes and their treatments. Ask questions. Read the literature. Stay informed and share information honestly with those who inquire of you. The last thing we can all do to ease anxiety, denial, and depression for those facing death is to [5] Listen more and talk less. I believe this to be essential and one of the easiest ways to connect and engage with those facing death.

Cambridge University philosopher Stephen Cave in his book titled “Immortality: The Quest to Live Forever and How it Drives Civilization” gives a fitting conclusion to the narrative of death, one he calls the “Mortality Paradox”.  He writes, “We are therefore blessed with powerful minds yet at the same time cursed, not only to die but to know that we must…. This is the central theme of philosophy, poetry, and myth; it is what defines us as mortal. Since we attained self-awareness as Michel de Montaigne wrote, ‘death has us by the scruff of the neck at every moment.’ No matter what we do, no matter how hard we strive, we know that the Reaper will one day take us. Life is a constant war we are doomed to lose.”

In our journey toward the end, as healthcare providers,  let’s remember to assist those who are already there watching and waiting for the final chapter to end their life’s story.

___________________________________________________

References:

Hospice of Holland Inc. (2019) A Brief History of Hospice. Retrieved on 17 September 2022. Available at https://understandhospice.org/brief-history-hospice/

Lynn, Joanne & Adamson, David M. (2003) Living Well at the End of Life: Adapting Health Care to Serious Chronic Illness in Old Age. Retrieved on 17 September 2022. Available at https://www.rand.org/content/dam/rand/pubs/white_papers/2005/WP137.pdf

Michas, Frederic (2022, March 3) Number of U.S. hospice providers from 2009-2019. Retrieved on 18 September 2022. Available at https://www.statista.com/statistics/339895/number-of-hospice-providers-in-the-us/

Caring For Yourself When Caring for Others

Photo By Rod Long

By Sterling M. Hawkins, MSW, LCSW-C, LICSW

When you’re young, you don’t know what your needs are.  You receive the good and the bad of whatever people, parents, siblings, spouses, and friends give to you.   As we grow and mature, so does our understanding of what our needs truly are.  And, at times how dependent we are for having those needs met.  Through experience and by discipline most work to avoid being at the mercy of others who perhaps express similar needs.  They are familiar but strangers all the same and represent an anomaly in ways we don’t want to be treated.  When a parent or guardian cares for you based on how they were cared for at a similar age, in some instances the care may have been perceived as good.  In other instances, deplorable, unsafe, or physically and emotionally harmful.  Subtle at first and over time some needs become more pronounced in older adulthood.  Who will care for me when I am no longer able to care for myself?  And, what will be required of me when others call upon me for help?  We will ask ourselves one or both questions at some point and discover what it means to be a giver or recipient of care.

Caregiving is defined as providing care for the physical and emotional needs of a family member or a friend in their own home.  Caregiving may involve assisting with meals, personal care, transportation, helping with medical procedures, and therapy.  As this definition implies, these activities are usually performed by a family member.   However, in addition to family caregivers, there are also volunteer caregivers, who are usually unpaid and provide companionship, supervision, and assistance with routine and non-medical tasks to individuals in service to their community.  And, finally, there are professional caregivers.  These are individuals who are hired to provide care that may be medical or non-medical in assisting others to live as independently as possible.  Professional caregivers can be hired privately but are usually employed by assisted living or skilled nursing facilities.  One in five Americans (21%) identify themself as a family caregiver.  23% of Americans say caregiving has made their own health worse. And finally, Family caregiving spans all generations, including Boomers, Gen-X, Gen-Z, Millennials, and Silent.

Caregiving is essential to our emotional and physical wellbeing, and while we often consider only services provided by individual caregivers, other entities such as state and local governments, private and philanthropic organizations usually support the family caregiver, enabling them to perform tasks for those who depend on them for certain activities to be met. 

We each come to caregiving with different expectations and responsibilities.  For some, it is a job or duty.  Others choose to serve in this role.   While each caregiving experience is uniquely personal it is a journey that most will travel during our lifetime.

There are many facets of caregiving.  And the literature is replete with information to help guide caregivers as they define their roles and responsibilities, and the intersection of the individual, family, and community systems.  Numerous studies have been conducted on the social and emotional burden placed on caregivers, but few offer strategies on how practically to cope by meeting the spiritual needs of family caregivers.

In the book, titled “Caring for the Spirit of the Family Caregiver- Forty Days of Reflections to Strengthen and Encourage” by Dr. Rev. Beryl Dennis, (Covenant Books Inc., 2020), she examines the role of self-care through a first-person lens, as she gives readers a glimpse of her own story as a caregiver for her parents and how her own faith and practices allowed her to find patience and encouragement associated with that role. 

Dr. Dennis offers the reader a Judeo-Christian approach to caregiving.  However, I believe the problems, principles, and practices are also applicable to non-faith traditions.  I recently reviewed this book and believe it is a good resource for those who identify themselves as a family caregiver.

The material presented is based on her research investigating biblical models of care that help sustain family caregivers spiritually and emotionally.  She speaks to a large audience: Identified family caregivers, those who are associated directly with a family caregiver (other family members, neighbors, friends), and finally community groups who engage with the family member receiving care in collaboration with the caregiver.

The findings from her research revealed that what matters most when addressing the needs of family caregivers is those effective interventions begin with an assessment of a caregiver’s risks, needs, strengths, and preferences.  As a qualitative study, Dr. Dennis completed her research by conducting interviews to answer the question-- “What do family caregivers need to give them spiritual and emotional sustenance?”  

To create a tool useful for caregivers, resources are presented in a 40 Day Devotional guide.  Dennis emphasizes that the roles and responsibilities associated with caregiving often create a “wilderness” effect for the caregiver.  The forty days is more symbolic than literal and represents a “journey we grow closer to God in strength, courage, and faith.”

Each devotion is organized into five categories: Scripture Text, Biblical Models, Theological Reflections, Family Caregiver Insights, and Prayers.  Scripture Texts first identify a caregiving need or problem.  Second, Biblical Models are identified to highlight relatable characters in Scripture.  Third, are the implications that follow from the place and/or circumstances where these characters find themselves.  These serve as Theological Reflections.  Fourth, Family Caregiver Insights examine the practical insights for learning. And lastly, Prayer becomes a personal petition, a psalm, or a lament to God.

The devotionals are divided into topical sections that address common problems associated with caregiving, people written about in Scripture to learn from, and promises God gives to those who believe in divine help.  Principles consistent with humanitarian values and practices address needs that are important for engaging in any difficult and sustainable work.  Having been a caregiver myself at various times throughout my life, I can attest to the value of addressing my own spiritual needs in the process.

I like that the book can be used as both a daily devotional and as a reference for aspects of the caregiving experience.  The prayers are short and simple expressions to God that are written in common everyday language.  What I enjoy most about this book is the way Dennis blends her own experiences with those experiences of the persons she interviewed. The caregiver's insights are personal yet concise. Insights center on the adult child as a caregiver for an aged parent. As this is most common.  The result is a seamless guide that enables caregivers to become stronger and spiritually grounded in their identified role.

In summary, caregiving requires an investment of the self.  This investment is multifaceted and the spiritual component of who we are as caregivers is often ignored.  At times the concern for making a safe and comfortable living environment for the person receiving care creates stress, anxiety, isolation anger, resentment, helplessness, and grief in our own life.  These stressors are sometimes invisible, and at their core are inseparable from our spiritual needs.  Addressing the spiritual needs of the caregiver is foundational to the health (physical, psychological, and social) of the caregiver.  In my own education with family caregivers, I explain that the attention they give themselves can have a positive impact on the person receiving care and the quality of life they experience.

Andrea Wilburn in her recent article titled “Caring for Aging Loved Ones,” best describes this experience. “We are all going through life events for the first time, figuring things out.  Learning how to love in an intelligent connected manner… we need to look out for each other and encourage each other.  These are conversations that we should be having in an openly social affirmative manner.”

My challenge to caregivers is that you need to explore those resources that will best equip you to care for that someone who is depending on you and to identify and develop those spiritual practices that will renew your spirit.

_____________________________

References

AARP and National Alliance for Caregiving. Caregiving in the United States 2020. Washington, DC: AARP. May 2020. https://doi.org/10.26419/ppi.00103.001

 Wilburn, A. [2022] Caring for Aging Loved Ones. The Good Men Project, Retrieved on 12 July 2022.  Available at https://goodmenproject.com/featured-content/caring-for-aging-loved-ones-kpkn/

A Crisis In Coping

Photo by Cottonbro

By Sterling Hawkins, MSW, LCSW-C, LICSW

I attended a conference on suicide last month.  Death by suicide is trending up again following the Pandemic, which started me thinking about those individuals that are considered high-risk and also those without known risk factors. No matter how we define ourselves, our human condition unites us in the ways we experience our internal landscape or the factors that place people at risk for a crisis. The simplest definition of a crisis is— a time of great disagreement, confusion, or suffering.  I believe that it is safe to say that everyone living has experienced or will experience a period of crisis.  While each of us may exhibit a vast array of emotions leading up to a crisis, how we survive in the aftermath has a lot to do with preparation given that crises are a fact of life.

Our capacity for anticipating and interpreting what is happening is key.  Biochemical changes in the brain react to external stimuli and cause us to behave in similar ways at various times.  Adverse historical experiences may also influence what happens leading up to a crisis.  There are other factors as well, least of which involve the misinterpretation of what we witness occurring in our own life or the lives of others we know personally, and how these feelings intersect, change, or remain the same over time.  When we know the science about the mind and body, and how they are designed to function in what can loosely be defined as normal situations, we can then learn to regulate these factors using behavioral and Psychopharmacol interventions.

We live our lives on a continuum.  Drive the body or mind too aggressively in a particular direction and you will experience a crisis.  So, I began by asking the question— What are the drivers that enable us to survive crises for those who may not be suicidal, but are simply stressed, angry, or hopeless?

In not wanting to oversimplify a very complex subject, I will restrict my comments to what I have learned from my own personal experience and in working closely with others.  There are three fundamental and overlapping principles that I have found helpful when it comes to crisis management.  I’ll briefly share each of these. 

Having realistic expectations about yourself and others

Even in the absence of illness and disability, we are challenged.  We each have expectations for ourselves and others.  At times it’s easy to follow the momentum of what worked well for us in the past.  Success and accomplishments eventually do wane.  Having realistic expectations essentially means not being afraid to ask yourself questions and being willing to re-evaluate your worldview, values, and personal beliefs.

 Choosing a proper point of reference

Being able to live with a positive outlook means accepting your strengths and your weaknesses while making improvements wherever possible but recognizing that not everything circumstantially may change.  The concept of having a transcendent versus imminent point of reference becomes critical.  It is known that anything belonging to our material world can be damaged, destroyed, or taken from us.  So, when loss, sickness, or death occurs we have nothing left apart from the memory of what was. A belief in God or something outside of the “self” that transcends our material world is a rational way that gives our life meaning and purpose and balances individual potential with our human tendencies toward failure, and those influences in our life over which we have no control. 

 Being patient and allowing certain others to help you.

Our individual blueprints are under constant revision.  Too many suggestions from too many sources create enormous mental and physical pressure that will paralyze your personal growth and development in the areas you need it the most. So, when seeking help, carefully reach out to those who know you best and care about you. Reach out to those persons who are willing to be truthful and make sacrifices without bargaining or secondary gains.  Certain outcomes following a crisis may teach you things that will enrich your life.  In the moment, all may seem hopeless.  However, our reference point is often the equivalent of viewing a single frame from a full-length film.

 “THIS EXPERIENCE TAUGHT ME THAT AT TIMES THERE ARE NO VISIBLE INDICATORS.”

In the late 1980s, I received a letter from the mother of a friend and former college classmate named Sandy.   For several years after graduation Sandy and I kept in touch by writing letters and using 60-minute cassette tapes to document the stories occurring in each of our lives for the other to listen to.  These tapes we would send each other every two or three months cataloged the highs and lows in our lives and our shared faith.  I had not heard from Sandy for almost 6 months after writing to him the previous summer when the letter from his mother arrived.  I was a stranger to her.  We had never met.   She began by congratulating me on my new job which she apparently learned about from the letter that I had sent to Sandy the previous year.  She then told me that Sandy had committed suicide and that he had been sick on and off and that he suffered in the end. 

After working through the grief, I couldn’t seem to shake how if I had known Sandy was ill, I could have supported him emotionally, and perhaps he would not have ended his life.  I struggled to identify missed cues and questions I failed to ask.  This experience taught me that at times there are no visible indicators.  Particularly when geography is a barrier.  Was it just complacency, assuming everything was fine, or a comfortably loose connection? 

Back then there was no social media, no Facebook, Instagram, or Snapchat.  So often, the lives of friends and families remained shrouded in mystery until we could see them in person.

Had I known Sandy was ill I would have traveled up north from Florida where I was living at the time to see him.  I would have done whatever I could to let him know I was there for him and try to keep him from sinking emotionally past the point of rescue.  I would have tried to help him not to escape the sorrow but tried to support him while embracing it. His mother’s letter was brief because to her I was a stranger known only through the letter I had written.  She had no obligation to express more details.  The weight of her son’s death I am certain was made even heavier as she penned her reply to me.

Expressing compassion toward those who suffer in the midst of their darkest night is something we must always be willing to do.  To ask challenging questions without judgment or denial we must accept the fact that we too are just as vulnerable in certain ways at certain times.  And, that those in crisis require of us the capacity to love.

There’s more of course to crisis management and intervention than just these three approaches.  This is simply a primer for anyone considering what insulating strategies aid in preparing for and coping well in the aftermath of an emotional crisis.

In the words of Jordan Peterson— “There are so many ways that things can fall apart or fail to work altogether, and it is always wounded people who are holding it together.”