“She let out a burp and got rid of it!” – learning from a social worker’s stories about bodies in mental health professional conversations
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Lily, a social worker, tells a story from her experience about a difficult conversation with a client that caused distress. She struggled to find support within her organization and line management. This led her to start practicing yoga to better connect with her body and cope with stressful conversations. Her story highlights the lack of support for social workers to process traumatic stories and the need to incorporate the body's experiences into professional conversations within the mental health field.
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“She let out a burp and got rid of it!” – learning from a social worker’s stories about bodies in mental health professional conversations
- 1. J O M E N S I N G A “SHE LET OUT A BURP AND GOT RID OF IT!” – LEARNING FROM A SOCIAL WORKER’S STORIES ABOUT BODIES IN MENTAL HEALTH PROFESSIONAL CONVERSATIONS
- 2. LILY’S STORY OF WHY SHE STARTED YOGA… (WORKS IN A LARGE INCOME SUPPORT AGENCY, 2010) Interview context – story felt like vomit Student debrief – sat away and let out a burp to get rid of it Organizational response – no one available, hurt back In-line management – didn’t want to hear story and be traumatized Off-site supervision – used a body technique to deal with the story Own response – Started yoga to befriend body
- 3. WHILE THE BODY IS INARTICULATE, IT IS NOT MUTE… (FRANK, 1995, P.27) Presented Lily’s story first to give preference to the body’s voice and stories about bodies before other dominant discourses begin to drown them out Will now explore: Background/literature Lily’s place in the larger study Exploring stories as living artifacts Learning from Lily’s narrative(http://yogamodern.com)
- 4. BACKGROUND LITERATURE REVIEW & UNDERPINNINGS Bookriot.com
- 5. LOCATING THE BODY IN THE PROFESSIONAL CONVERSATION: ‘…bodies can be seen as the foundation as well as the product of both discourses and institutions. Discourses, in other words, are embodied, and social institutions cannot be understood apart from the real, lived experiences and actions of bodies.’ (Williams & Bendelow, 1998, p.66)
- 6. LOCATING THE BODY IN THE SOCIAL WORK CONVERSATION: • Post-enlightenment and Western Christian beginnings Cartesian dualism & Suspicion of body (Saleebey 1992; Peile, 1998; Tangenberg & Kemp, 2002; Cameron & McDermott, 2007; Bell, 2012) • Focus on ‘doing’ rather than ‘being’ a social worker (Saleebey, 1992) hegemony of science and evidence based practice consumer = object
- 7. LOCATING THE BODY IN THE MENTAL HEALTH CONVERSATION: Social workers advocate for a more holistic approach but compete with the bio- chemical-medical discourse objectifies the consumer Marginalization of the body’s voice in the social work conversation failure to explore the corporeal capacity of both the consumer and the social worker (Cameron & McDermott, 2007)
- 8. MY PROPOSAL … MAKE SPACE FOR THE BODY’S VOICE IN THE SOCIAL WORK/MENTAL HEALTH CONVERSATION Need to: • In a previous paper, argued that we need to understand practitioner’s somatic map to distinguish between habit and what is to be experienced in the room (Mensinga, 2011) • Listen to existing stories what strategies and power structures support or discourage exploring the body in the professional conversation (Frank, 2010; Plummer, 1995)
- 9. PART OF A LARGER RESEARCH PROJECT UNDERTAKEN IN 2 0 1 0-11 http://www.surfinaustralia.com.au LILY
- 10. PART OF MY PHD STUDY - LILY • 1of 9 human service workers (6 = social workers) • Part of a focus group of 5 women that was interviewed on 3 occasions (from regional center in North Queensland, Australia) • 1 of 6 women (from North Queensland X 3, Central Queensland X 1, New South Wales X 1 and in the United States X 1) who were interviewed individually either once (X 3) or 3 times (Lily & 2 others)
- 11. PART OF MY PHD STUDY – LILY’S NARRATIVE • Collected from first interview at her home • Chose her narrative as it was: • told as a whole (requiring minimal ‘tidying up’ to enhance its readability), • epitomizes many of the issues raised by the other participants • highlights the pressures that exist in the sites in which many professional conversations arise.
- 12. EXPLORING STORIES AS LIVING ARTEFACTS: ARTHUR FRANK & BODY NARRATIVES http://www.westsidebooks.com
- 13. FRANK’S DIALOGICAL NARRATIVE ANALYSIS APPROACH (2012) My interest in Lily’s narrative is to explore how the body stories within Lily’s narrative serve her and others to attend to their own, their colleagues’ and consumers’ well- being Frank says that stories can: • Deal with and/or cause trouble for people • Display and test people’s character • Make a particular perspective or orientation plausible • Teach people about what is valuable and good as well as what should be ignored and held in contempt
- 14. FRANK SUGGESTS THE RESEARCHER IDENTIFY (2012,PP. 45-49) : What narrative resources are available and if they can be used to tell new stories Who the stories can be told to and why they can or can’t Who would be accepted / prevented from being a member of a group if they understood the story How the story encourages people to be who they are and/or who they could become How the storyteller maintains their social/ personal/ professional position by telling the story and in the way that they do
- 15. EXPLORING AND LEARNING FROM LILY’S NARRATIVE PLOT, CHA RA CTERS, POLI TI CS OF LI STENI NG TO BODI ES
- 16. Story told in the form of a ‘quest’ (Booker, 2004) to rid bodies of the horrible story to: 1. Relieve the consumer of his anguish 2. Ensure the wellbeing of the student 3. Regain Lily’s own equanimity in the work place NOT UNCOMMON IN SOCIAL WORK STORIES … except includes new material: • the impact of a burp • the use of a body technique (EMDR) THE BODY’S CONTRIBUTION TO THE PLOT coloring.4you.com
- 17. THE INCLUSION OF ‘BODIES’ AS CHARACTERS Characters: • Social worker – qualified, agency mandate • Consumer – able to tell story for 1st time • Student – observes S.W. , training • Line manager/supervisor – ill-equipped to deal with trauma • Off-site professional supervisor – skills to work with vicarious trauma • Consumer’s body – ill relieved • Lily’s body – injured, listens to another body friend • Student’s body – burped protected
- 18. (http://yogamodern.com) LILY FEELS AT LIBERTY TO INCLUDE THE BODY – WHY? Leder (1990) makes the point that in general to participate in a complex world the body tends to remain invisible until something goes wrong. Lily takes note of body when she hurts her back, but is likely she was already aware of the link between body and mind - e.g., consumer tells story for 1st time, heard student mention effect of burp; link made to her sore back; participation in EMDR Body assumes a subjective status rather than inanimate object that can be ‘done to’ • Narrative technique? • No! • The the turning point in Lily’s narrative is not so much a re-storying of what occurred, but an actual intervention used by the body to communicate with another.
- 19. THE POLITICS OF LISTENING TO THE BODY Just as bodies are inscribed with greater and lesser degrees of perceived power on the basis of race and ethnicity, age, gender, and (dis)ability, so the value of knowledge from the body reflects the social power associated with the individual: more powerful individuals define what knowledge is accepted and embodied by social institutions. (Tangenberg & kemp, 2002, p.15) Lily works in income support agency, body is viewed more subjectively Line manager not required to attend to worker’s off-site physical ailments even if related to work Accepted that off-site supervisor provides support (AASW) and can use variety of techniques
- 20. HOW DOES LILY’S STORY SERVE US? Frank (2012,pp. 45-49) : • Narrative resources? – new stories of the body helping to overcome the horrible story – burp; EMDR; yoga; breathing • Who can the stories be told to and why? – income support vs. mental health social worker; student vs. worker support; line manager vs. professional supervisor • Who is accepted/prevented being a group member by understanding the story? – income support agency vs. mental health agency • How does the story encourage people to be who they are? – watch where you sit; burp if you have to; take up yoga to become more body aware • How does the story teller maintain their social standing/positioning telling the story in the way they did? – the quest story resonates it is a common story in social work
- 21. pinterest
Editor's Notes
- I started yoga after I hurt my back! I hurt my back after an interview I had with a mentally unwell person who was very traumatized. He wanted to tell his story to explain why he was so ill. He said it was the first time he had told it. The story itself was horrendous, horrible, horrific and graphic and when he told it he got quite agitated and actually blurted it out - like vomit! I was sitting close to him, so it came out all over me. That’s how it felt. I felt like it had really permeated my whole self. When he left he was fine. He left feeling much better (laughter), but he had left devastation in his path. I actually had a student with me at the time so after he left I debriefed with her. She said that she didn’t take the ‘impact’ of what he said as much as I had as she was sort of sitting away. Interestingly one of the things she said was that as she left the interview room she actually let out a burp and ‘got rid of it’. Unfortunately, my own supervisor was on leave and we were very short staffed so I didn’t have anyone to talk it over with. That all happened on the Friday and then on the Saturday I wrecked my back. I was on my back and in bed for two weeks after that. I could not move and at the time that story kept milling around in my head and I really wanted to get rid of it. Since then I have read stuff about hurting your back and how it can signify that the load is too heavy. I really think my sore back was related to that day, it just seemed too much of a coincidence not to be related. When my boss came back from holidays, I rang her. She came to see me at home, but when I told her that I really needed to talk about the incident and get rid of it she was not sure how to deal with my request and said “Don’t tell me about it, I don’t want to know. If it traumatized you it is going to traumatize me!” Luckily I have an off-site professional supervisor who also came to see me. She said “I will try a little thing that I do” which she did and it helped. It scrambled my mind. She asked me to think of the incident while I followed her pen with my eyes as she drew figure eights in the air - and it worked! It’s amazing, it instantly worked! After that I decided that I really had to look at self-care, and ways to de-stress from work because work was very, very stressful. I have been doing yoga every Friday for about three or four months now and I can actually feel a very big difference in myself. I am certainly less stressed at work. I don’t feel overwhelmed whereas I did feel overwhelmed before. I don’t think the work has got any less, I think it is being able to de-stress that has helped. I find at work I am now conscious of breathing, posture and a whole lot of just little things that I try to do during the day. In fact if I take a tea break or something, it is more to take a breathing break. So from that point of view I have found that it has been hugely helpful.
- Professional discourse: A verifiable and tested knowledge base that will take priority over other knowledge sources (Chenoweth & McAuliffe, 2012) Member’s bodies are ‘docile’ and/or will ‘disappear’ through a learned process of self-discipline (Foucault, 1997; Rose, 1990)
- Need to: Understand practitioner’s somatic map to distinguish between habitual responses & what is experienced in the liminal space between the worker and others while they navigate community, agency and consumers’ physical spaces (Mensinga, 2011) Listen to existing stories told by social workers about and by their bodies in the sector to better understand what strategies and power structures may support or discourage the telling of these stories in the professional conversation (Frank, 2010; Plummer, 1995)
- Could look at content ONLY, but am interested in more than this…. How do stories serve the teller? Frank Suggests the following questions to help explore and better understand the stories told
- While highlighting this aspect of Lily’s narrative may appear to lend support to the Cartesian argument that the body and mind are separate, the way in which Lily integrates the body’s voice demonstrates a developing awareness of the intricate link between the two and how they can be included in the professional conversation. Lily describes how when her back is injured (her body’s voice) she becomes aware of the burden that listening to this particular story brings with it and that it will continue to mill around in her head until she can ‘get rid of it’. Interestingly, neither of her supervisors chooses to listen to the story. Her line manager refuses because she recognizes the impact it has had on the bodies of others who know the story; while her off-site supervisor chooses to use a technique that involves using her own body and movement to communicate with Lily’s body directly rather than by way of words. This intervention not only surprises Lily it also seems to encourage her to take up yoga as an embodied practice so she can continue the conversation she has begun with her body and at the same time, seek mental stress relief through her yoga practice.
- . Leder (1990) makes the point that in order to participate in a complex world the body tends to remain invisible until something goes wrong. Although the workplace is already overwhelming, it is not until Lily hurts her back that she stops and reflects on the incident she believed caused it that she considers the impact the work is having on her body. Although we don’t know what the content of the story was, the consumer intimates that it was because of it that he was mentally ill; and we are told that when the story was vomited out of his body, he was able to feel much better. In Lily’s narrative then, both the consumer’s story and body assume a subjective status rather than inanimate objects that can be ‘done to’. In fact, as has been alluded to in the previous section, in all her interactions, Lily attributes specific characteristics to the various bodies with which she comes into contact, enabling them to participate in the ‘quest’ as living entities. While on the face of it, the technique Lily adopts to tell the story is similar to the externalising techniques adopted in Narrative Therapy (White & Epston, 1990), the turning point in Lily’s narrative is not so much a re-storying of what occurred, but an actual intervention used by the body to communicate with another.
- it is evident that she actually uses her narrative to highlight and teach her listener about whom, where and in what circumstances it is appropriate to include the body’s voice to achieve preferred outcomes.