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Pain and empathy

This past week in the New York Times Magazine I came across this article, The Hazzards of Growing Up Painlessly, about a teenager who has a genetic condition that makes her unable to feel pain. Coincidentally on the same day I read this blog post by a Korean Adoptee, Joy Lieberthal. Joy writes, “It is so bittersweet to realize that without the pain, there can be little in the way of true joy and I struggle to make sense of the idea that oftentimes in adoption, this paradox exists time and time again.”

I’ve been thinking about this concept a lot in the past few years. I’ve talked about it in terms of something I’ve noticed frequently with adoptive parents who tend to over-compensate for the pain and trauma their child has experienced by attempting to eliminate pain in their children’s lives. One of the things I found most interesting about the story of people who do not feel pain is that some question whether or not these folks that can’t feel pain can also feel empathy or emotional pain.

The idea that empathy is driven from being able to relate to someone else’s pain based on one’s own knowledge of pain is fascinating. Roland Staud, the doctor who treated the teenager profiled in the NYT article, wondered if the connection between feeling physical pain and emotional pain would affect the teen. Author Justin Heckert writes, “[w]e sometimes experience emotional pain physically — Staud used the tried-and-true example of heartbreak, how the end of a romance can cause a physical pain — and he wondered if the relationship between the body and emotions also goes the other way; if a person lacks the ability to feel physical pain, is her emotional development somehow stunted?”

As it turns out, Ashlyn Blocker, the teenager at the center of this article, does cry and does react to others’ pain, even if she can’t describe hurt or pain. Is it true that to experience joy once must feel pain? Is it imperative to have a physical understanding how pain and suffering feels in order to be able to develop empathy? This study on folks with Congenital Insensitivity to Pain (CIP) and empathy found that those with CIP relied on their (what I imagine must have been learned) empathetic skills to imagine others’ pain.

In the past I have used the analogy that when we experience “growing pains” both physically and emotionally that it is a time of development and growth; like Joy, I have always subscribed to the idea that to know happiness and to be empathetic, one must have known pain personally. I have told adoptive parents who describe the ways they try to take the pain involved in adoption away that they can only provide a “soft landing” for their child because you can’t take away or prevent pain, and that it’s a normal part of growing as a human being – and further that those who don’t experience “growing pains” don’t “grow.” But this article gave me pause; clearly there are those growing and developing without first-hand experiencing the “pain” associated with growth; however I am still left curious about how pain is defined; and if the brain still reacts to painful stimuli even if it doesn’t tell your nerves to react.

How much is empathy a learned concept that can be taught or modeled by parents and how much is it a factor of our own experiences? And in what ways does this impact social work?  How schools of social work teach empathy for students who haven’t experienced much personal experience with pain or suffering?  On the other hand, how do we help students that have experienced trauma, pain or suffering to be reflective of how their own experiences impact the way their empathy is triggered and/or applied?

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Treating difference

– otherwise known as the post in which I ruminate on the “other” and whether inclusion or exclusion is the answer.**

We (those of us who fit in to a dominant group) like to tell people who don’t (the other) how they should live. And then we often expect gratitude from them for our generosity in thinking about their “best interests.”

One of the books I’m currently reading is “Developmental Disabilities and Child Welfare.” by Ronald Hughes and Judith Rycus. This book, published in 1998, is a good primer for anyone looking to become more informed about how child welfare professionals need to understand and respond to children in the child welfare system with disabilities. While reading this book earlier today, I was struck by the author’s discussion about the importance of the inclusion of children with disabilities into mainstream settings (here I believe they mostly are referring to educational settings, but could definitely be expanded to all settings in which typically developing children interact).

The authors stress that segregation is a disservice to both individuals with disabilities as well as to society in large, because for the individual it 1) denies the person the opportunity to be part of the same world as anyone else, 2) it sends a message that they inherently can’t participate in the same activities as the rest of society, and 3) singles them out for special treatment rather than treating them as their typically-abled peers.

The disadvantage to society at large is that segregation perpetuates the stereotypes and myths about persons with disabilities, and that society will not recognize the many contributions that are made to society by persons with disabilities . The authors write, “An extension of this myth is that people with disabilities prefer life and activities with ‘their own kind.’ It is true that years of segregation can contribute to feelings of anxiety and fear when a person with a disability is confronted with an integrated environment…This myth is often a rationalization to cover and reinforce our own discomfort in the presence of persons with disabilities” (p.23).Continue Reading →

Webinar presentation

On December 9, 2010 I will be presenting:

Passages: A Lifetime Perspective on the Developmental Tasks of Adopted Persons (#2006)
Presenter: Jae Ran Kim
Date: Thursday, December 9, 2010
Time: 1:00 PM to 2:30 PM (CST)

Jae Ran Kim, distinguished adoption presenter, reseacher and AHA Advisory Group member, discusses the model created by psychologists David Brodzinsky, Marshall Schecter and Robin Marantz Henig to illustrate how the developmental tasks of adoptees differ from those of non-adoptees, and how these unique differences manifest throughout the adoptee’s lifespan. Kim also discusses ambiguous loss, a construct originally hypothesized by Pauline Boss, author of Ambiguous Loss: Learning to Live with Unsesolved Grief, and how it impacts the lives of people within the adoptee community.

For more information on how you can register for this webinar, click here.

Part 2 – Discriminating against parents of color in the child welfare system

This post was published on Harlow’s Monkey blog in April 2008.

ShatteredbondsIn trying to figure out how to begin this post on communities of color and child protection issues, I found it difficult to know where to begin and where to end. Trying to finger the exact places and times that the child welfare system discriminates
against communities of color is like trying to pick out which piece of hay in the haystack is to blame. The issues are so intertwined that it is impossible to sort through.

The discrimination occurs on micro, mezzo and macro levels; everything from the federal legislations that either purposely targeted communities of color or structurally supported hidden bias against these populations to the individual
social worker whose inexperience or bias resulted in discriminatory treatment. Most of the time, it’s a combination of many levels of discriminatory interventions by the child welfare system and society at large.

To begin, I feel it is important to clarify some definitions and themes that you will often see in discussions and research about communities of color and child welfare:

  • When we talk about research we need to keep in mind that correlation does not equal causation. One thing often miss-communicated in articles about child welfare is when a correlation becomes misrepresented as causation. For example, there is a correlation between being poor or in poverty and having
    child protection interventions. This does not mean that being poor or in poverty causes child protection interventions; it means that of those people involved in child protection there is a stronger likelihood of being poor or in poverty.
  • Over-representation refers to a group’s percentage or number is larger than other groups. An example of over representation would be the number of African American men in prison in the U.S. in 2003. Of the 1,316,415 men in prison that year, 586,300 were African American versus 454,300 white males. African American men are overrepresented.
  • Disproportionate refers to a higher percentage in a given circumstance than in the overall population. An example of disproportionate would be that African American children were 21.4% of the children in foster care for the state of Minnesota in 2003– despite the fact that African American children made up only 5% of the overall population.

There are two important books that are must-reads for anyone interested in examining the historical and current practices of child welfare discrimination towards the African American population. These are Dorothy Robert’s Shattered Bonds: The Color of Child Welfare and Children of the Storm: Black Children and American Child Welfare by Andrew Billingsly and Jeanne M. Giovannoni. I believe every single social worker who works in the child welfare system should be required to read these books.

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A brief history of child removal/child protection (part 1)

This post was first written in February, 2007 on my Harlow’s Monkey blog.

Seesaw_1 One of the first things that a social worker who focuses on child welfare issues soon realizes is that the practice of child welfare is fraught with several inherent value and ethical conflicts.

At the core of this conflict is the question of whose rights take precedence: the parent or the child.

Over the past 200 years, our society has struggled with this conflict. Thus, at some points in history we will find that the rights of the child are considered more important; at other times we see laws and policies that support the rights of the parents.

We tend to think that child abuse happens squarely within the context of a nuclear family and often, we blame those who are responsible for the day to day care of said child or children. But I agree with Pecora, Whittaker, et. al (2000) who also place the responsibility for care of children in the hands of society at large – on the community, social and institutional levels. With that perspective, we might claim that any society or community that does not provide safe housing, adequate nutrition and education or violence-free environments as committing child maltreatment.

Shireman (2003) points out that on an institutional level, for example, our society is guilty of maltreatment when “schools, legal authorities, or institutions designed to care for children and families fail to provide adequately for all children.” To me, this includes the structural discrimination that negatively targets certain populations. I’ll delve into this further in my next post, but think of things such as equal education, housing, medical care, finance, employment, etc. that have/continue to purposely discriminated against some populations. If we are structurally contributing to suppressing the opportunities for targeted populations, and those children suffer as a result, then we are guilty for the maltreatment of those children.

This is not to say that individual parents should not be held responsible for the care and treatment of their children; but I believe that our institutions and policies also need to be responsible.


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Rage against the machine*

* with apologies to the band (I was college undergrad when the band was popular)

I thought I’d cross-post some of the blog posts I wrote on my other blog about child welfare. My other blog is focused heavily on adoption, so I wrote several posts to help articulate some of the broader contexts that influence and impact what happens specifically regarding the adoption process in the United States. This post from March 2007 in particular reflects my experience working for a large public county child protection/child welfare program.

Titanic_2

It’s a precarious position for anyone who tries to be an agent of change within any institution. It can be difficult to balance the needs between individual people and systems that were created to help and instead have become so bureaucratic that it is a wonder anyone is helped at all.

When I was in graduate school for social work, we were often told that social reform and social justice were as important to the profession as the ability to empathize and help. Truthfully, however, the field of social work is quite polarized.

I would say the majority of the people in the field (and most of them are women) came into the program because they wanted to "help people"  (I could go into a whole separate post about how women are valued in our society and why that created an over-representation of women in the "helping professions" because that deserves an investigation as well. But I’ll leave that for another day).

Many of my colleagues spoke passionately about how their personal spiritual beliefs "called them" to the field.Well, I have no argument with that because in a way I also feel "called" to my work, though not by a sense of spiritual duty. My "calling" if you can call it that, was based on many goals;  first, I did not want to participate in a profession that was based on the production, marketing or selling of consumable goods. Secondly, I wanted to try to be an agent of change within the field and represent as a voice not included in the existing framework (as both a person of color and as an adoptee). Third, I strongly felt I could contribute to critiquing and challenging the current paradigms of practice and research.

I think "helping people" is a nice goal too. And I believe that it is very important. But in my view, having only a tight focus on "helping people" is limiting. We can "empower" people to change their lives on a singlular basis and I believe that is all well and good. But without looking at the rest of what is happening in the forest, we might be encouraging people to try and work within an overall system that is set up to fail them and send ’em right back to your doorstep.

We give a lot of lip service to the abstractions of  "social reform," "social justice," and "empowerment." But it would be more accurate to say that a great deal of social work involves social control more than our obligation to empower the people we serve. And, in fact, I have difficulty with the concept of "empowerment" because as one of my insightful fellow grad students once stated,"empowerment is a gift we bestow on our [clients]." We’re speaking about privilege here, because as social workers we have the power and control (backed up by our government and agencies) to make people do certain things in order to receive services. Right, we don’t just believe in the welfare state – people need to prove or earn their way to services.

What we are really about is telling people how to fix their lives the way we think it should be fixed, as arbiters of whatever framework of morality we believe.

The result is a push-pull between "worker" and "client" (on a tangent, let me just say that I really despise the way social work has chosen to appropriate business/market economy language – as if the people who use services are free to choose among a buffet of options).

The push-pull in adoption services is balancing the needs of prospective adoptive parents and the children who become adopted. I’m not selling goods, but I’m definitely selling ideologies. In order to make prospective families and children in foster care appealing to each other’s social workers, we use marketing strategies. Wednesday’s Child or Thursday’s Child as many "markets" call them are features of foster care children in newspapers. Just like the puppies and kitties they feature for adoption on other days. We use brochures and flyers and videos of the kids to show prospective adoptive parents. And prospective adoptive parents are asked to make brochures and flyers about themselves so the children’s social workers can determine if they look like "a good match." Many adoption agencies have web sites where prospective parents can look at featured children and read a little blurb about the child. If that doesn’t seem eerily like shopping on the internet, then you are not being honest with yourself.

It’s one part marketing and one part matching services like an on-line dating service would provide. Which begs the question: who is the real "customer" in this transaction? The prospective parent, or the child?

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Quoted in Brain, Child Magazine article

CoverSU10 Many thanks to Dawn Friedman for this very nuanced article, “The Myth of the Forever Family” in Brain, Child magazine about adoption myths and specifically, the best article I’ve read so far on the really, really difficult and complex inner-workings on a family who is considering or has considered dissolving an adoption.

Dawn interviewed me and a few of my thoughts were included in the final article.

You can also participate in the discussion that will accompany it at the Brain, Child blog.