My Ethical Stance

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My Ethical Stance

This is not the first time that I declare my ethical position, but still believe that I need to review it after 10 years of clinical practice. To review my ethical stance, I need to go back to my core belief and motivation to do this social justice work—my abusive childhood. To date, I can still remember when adults in the street saw the scars and bruises on my and my siblings’ bodies; the first question they asked was “Who hit you so severely? Then, once our answer was our mother, they asked the second question “Is she your biological mother?” When the answer was yes, their answer was “You must be very bad children because no biological mother would beat up their children like this.” Those strangers’ confirmation just granted my mother’s abusive right to basically mentally and emotionally ruin three of her children’s self-esteem and self-worth because their conclusion re-confirmed my mother’s mental abuse that we were the devils. I call it secondary abuse because its impact was way worse than my mother’s physical abuse. Yes, social justice is my ethical stance that motivates me to do the work. My position is to advocate and protect the vulnerable including children, youth, adults, seniors and the disable.

What do I value in this justice work? I believe that I need to be honest to myself and my work at all times. In clinical practice, I need to be honestly reflective what I am doing with my clients and answer difficult questions to myself after a challenging session. When I am in the session, I need to be present and genuinely alive. Being present is taken from Dan Siegel’s idea of COAL–being curious about the experience, open to the present experience, accepting what is happening and loving myself and the experience. This state of mind can truly bring me to be present and alive, meaning genuinely love what is happening with my experience with a client.

Another value I hold is to be transparent to my work with clients, supervisors and colleagues. Being transparent means that when I am contemplating an idea in the session, I will let my clients know or even I really can’t recall some information, I am going to be honest. I believe that being real and realistic is a division of being honest. Thus, if there is a challenge in accomplishing my job, I need to assess my limits in advance in order to not disappoint others. When I am calling a professional for a family, not only did I get the consent first, but I also let the family know the result of my conversation with the professional as soon as I can. I need to update my work, so let my clients know the progress that I promise them. Another transparency is like what Vikki Reynolds said, she “leans in” to other professionals to let them know she understands that all the professionals are there for the clients and we all have the same goal to help the clients. By leaning in to other professionals can help the family get what they need in a better manner because I am there only for the sake of my clients.

According to Dan Siegel’s brain integration, the visible, natural outcome of brain integration is kindness and compassion. Kindness is involved “honoring and supporting the vulnerability of others and the self” and compassion is “to take actions to reduce the suffering of others”. After decades of working with families and children, I realized that my core belief is based upon being kind and compassionate. Interestingly, recently I just re-read one of my favorite books “Life Will Never End”, a great Chinese book that I read 20 years ago. It is full of stories about reincarnation telling us that we are not living this one life and we will come back to resolve problems that we did not find a solution for. It says the only thing to resolve conflicts, hatred and wars among people is to be kind and compassionate. I am amazed about the same theory between the east and the west, but also strongly believe that kindness and compassion is the foundation of my ethical practice.

 

References:

Family Worker Training + Development Programme Inc. (July 9, 2016). Reflections by Vikki Reynolds. Retrieved from: https://www.youtube.com/watch?v=w1iu4KdgTM4

Reynolds, V. (2016). Workshop notes: An ethical stance for therapy. June 25, 2016. Vancouver, British Columbia: Canada.

Siegel, D. (2012). Pocket guide to interpersonal neurobiology: An integrative handbook of the mind. New York, W.W. Norton & Company, Inc.

What Does It Mean To Be Alive?

Psychology

Taipei City Mayor, Wen-je Ko, was invited by TED Talk to share his view on life and death as he was a distinguished doctor in the field of Extra-corporeal Membrane Oxygenation (ECMO), an extra-corporeal technique of providing cardiac and respiratory functions to support people whose heart and lungs are unable to provide enough oxygen to sustain life. His expertise internationally acclaimed his use of machines to keep patients alive as long as to 16 days without a heart. His most successful case was a man with minimal lung capacity living through ECMO for 117 days! He claimed that he probably is the physician who has seen most cadavers during his leading role in the ECMO field in Taiwan. In his video, he shared his experiences in saving lives and witnessing numerous deaths. His answer to the question of death is the question “What does it mean to be alive?” If we live on machines, does it mean we are still alive? With our regular breathing and heart beating, does it mean we are living?

This really makes me rethink about my life and my role as a family therapist. What do I do to make my life influential? I remember the first time I thought about this was in my high school. Clearly, I knew that I was going to do something for the benefits of others because I believed that it was the only way to make life meaningful. I also knew that I was going to honour each individual’s differences despite their social status, which was a strong indicator of who we were in my culture. However, I went through various stages of challenges. In the first stage, I struggled with these concepts as I laid my judgments on people who I believed were just wasting their lives for nothing, like using drugs. My honouring was not unconditional. In the second stage, I learned to leave them alone as a way to respect their decisions, but I could not do anything for them or with them. Lastly, I understood that they might not make the best decisions, but I could offer my compassion and empathy to be there for them although I disagreed with their choice. I realized that life is way more complicated than I had thought as a high school student.

Recently, I studied Dan Siegel’s interpersonal neurobiology and learned that his belief of the signs of a well-integrated brain is demonstrated through kindness and compassion. The definition of kindness is “doing something to benefit others without reward” and compassion is “taking action to reduce suffering of others”. Finally, I realized this is the stage of my life where I want to treat people with kindness and compassion regardless what, how, where, or who they are. After all, I know that I will be at peace.

References:

Ko, Wen-je. (February 13, 2016). The wisdom of life and death. Taipei, Taiwan. TEDx Taipei 2013. Retrieved from: https://www.youtube.com/watch?v=N0zhdMwD2Z8

Siegel, D. (2012). Pocket guide to interpersonal neurobiology: An integrative handbook of the mind. New York, W.W. Norton & Company, Inc.

Siegel, D. (2015). Workshop notes: Mindfulness, mindsight and the brain: What is mind and the mental health? October 20-21, 2015. New Westminster, British Columbia: Canada.

 

Yoga Is Powerful

Neurodevelopment

IMG_0294Although I have been practicing yoga for over four years, I still gain as many benefits from it as I did the first time. From the first session, I repeatedly had the same image in my mind for a month. It was a crying infant opening her arms and asking her mother to hold her; it was the time for a baby to get connected and protected by the primary caregiver. It was the vulnerable time the toddler shows her desperation to be held and soothed.

 

As an adult, independent woman, I could not believe what I saw. I could not believe the power of yoga that could awaken the most unconscious information of my childhood and reveal my implicit memory in such a vivid manner; it was powerful and amazing. Since then, yoga has been my favourite exercise. Actually, for me it is not an exercise, but an inspirational tool to connect my body, inner self and emotions. It nurtures the integrative processes of my brain. If I have a question and do not know the answer, after going to a yoga class without thinking about it, usually the answer emerges- either during the class or at the end of it. I don’t even have to search and the key point of the answer materializes effortlessly.

 

According to the Neurosequential Model of Therapeutics approach, the development of the brain is from the bottom up and organizes into four hierarchical areas: the brain stem, diencephalon, limbic and neocortex. The brain stem modulates sensory integration; the diencephalon organizes self-regulation; the limbic system governs relational functions, and the neocortex oversees cognitive functions. Yoga practice helps practitioners monitor and focus on breathing (function of brain stem), organize self-regulation through regular breathing (function of diencephalon), and makes relational connections between practitioners’ emotional self and the mirror (function of limbic). I propose that the process of yoga practice establishes connections between our brain stem, diencephalon, and limbic system – three of the four functional domains in the brain. That is a significant practice and that is why it is so powerful and effective for brain integration! Integration is the ultimate function of the brain to leading a harmonious life and maintaining a sense of equilibrium. Yoga basically helps stimulate the growth of the integrative fibers in three areas that are responsible for the integration of the brain.

 

The benefits I am exploring only relate to healthy neurodevelopment, not even the muscular level, like improving physical fitness and increasing the metabolism by stretching and sweating. With so many benefits, why don’t you consider trying yoga?

 

References:

Siegel, D. (2012). Pocket guide to interpersonal neurobiology: An integrative handbook of the mind. New York, W.W. Norton & Company, Inc.

The ChildTrauma Academy. (February 2, 2016). Introduction to Neurosequential Model of Therapeutics. Retrieved from: http://cctasp.northwestern.edu/wp-content/uploads/Introduction-to-the-Neurosequential-Model-of-Therapeutics.pdf

 

 

 

 

The Myth of Being Human

Psychology

Recently, I saw a documentary program about a Chicago police detective and commander, Jon Burge, who oversaw the torture of more than 200 criminal suspects, most of whom were African-Americans, for almost 20 years! After his conviction, the state government realized that he had put at least 12 people on death row for crimes they had not committed. His tactics included burning with radiators and cigarettes, as well as electrocution. Amazingly, during that long period of time staffs at City Hall were apparently aware of his conduct, but nobody was willing to report him.

This story reminded me of the experiments that a psychologist at Yale University, Stanley Milgram, conducted in 1963: “Obedience to authority.” His experiment set up a situation where an authority figure instructed subjects to perform acts conflicting with their personal conscience. The result revealed that 65% of them were prepared to obey even if causing apparent harm and distress to another person hidden from their view. (In fact nobody was physically harmed, although some of the subjects became very distressed).What an amazing result!

In 1974, Milgram summed up his experiment, by noting: “… how much pain an ordinary citizen would inflict on another person simply because he was ordered to by an experimental scientist.” Apparently, the result tells us that such behaviour is highly likely despite our personal moral imperatives against hurting others. This really intrigues me to think about human beings and human behaviour. Shall we trust ourselves and others when we can escape being caught? I recall that many years ago a friend of mine said he did not even trust himself, let alone trust others. At that time, I was so naïve to disbelieve what he had said. Now, I think I understand what he really meant. I think we really need to focus on our integrity, be very aware of what we are doing at all times and truly be honest to ourselves. This can be very challenging, but it is achievable.

 

 

References:

Gane-McCalla, C. (January 25, 2016). The Top 5 Most Corrupt US Police Officers of All-Time. Newsone. Retrieved from: http://newsone.com/1551885/top-5-corrupt-police-officers/

Wikipedia, (January 25, 2016). Milgram Experiment. Retrieved from: https://en.wikipedia.org/wiki/Milgram_experiment

McLeod, S. (January 25, 2016) The Milgram Experiment. Retrieved from:

http://www.simplypsychology.org/milgram.html

Realm of Reality

Addiction

I was working downtown eastside directly with women who struggle with substance misuse, mental health, homelessness, and physical and emotional pain for over 12 years. In the beginning, it was hard for me to believe that I was working there only a year after migrating from Taiwan, a country which treats drug issues as criminal offense. In my country, we used to treat substance users like criminals, only really troubled people would associate with them , let alone working with them regularly. Thus, I asked myself many times, why I enjoyed my work there.

 

After getting to know them, I realized that they are really not much different from me. Usually, they have had a harsh life that is so unbearable for anybody and no wonder they use substances to help them cope and reduce emotional pain. I remember there was a girl who was only a year older than my son. While I was conducting an intake with her, I asked how she had ended up in downtown eastside. She was so youthful, pretty, and fresh! She was beautiful! She told me that she grew up there and that was the only place she knew! I felt so sad and hopeless. She was only a year older than my son and I could not believe that she already had a child; she was a baby for me! I kept asking myself what more I could do for her, but really I had no answers.

 

Understandably, I don’t really share very much about my work in downtown eastside with my friends, either in Taiwan or here in Canada. I don’t want to hear their judgments about my clients. I know most people can’t understand them, but they criticize them and expect them to do more as a person. There will never be a satisfactory answer to this question and I prefer actually doing and being there for them, rather than stigmatizing them.

 

Sometimes though, I like to share the reality of those individuals’ lives with other people, like my son. He told me a story about an experience he had in high school. One day, when he was in a social class, the class was discussing drug issues and people in downtown eastside. He told me the whole class was putting down those people, and he was the only who told them the other side of the story. He was proud of himself that he knew he was not better than them; he was simply lucky!

 

Remembering the last few times driving on E. Hastings between Abbott Street and Dunlevy Avenue, I told myself that I would definitely miss this area when not working there. The people in downtown eastside teach me about life, between reality and illusion, beauty and ugliness, luck and misfortune, wealth and poverty, wellness and sickness, functioning and chaos, and normality and craziness. To be true, we all have these elements in ourselves to a greater or lesser degree. The issue is how we manage to find a balance between these polarities. I am grateful that I did not suffer the kind of conditions that tormented some of these people. I did not have an uncle or caregiver who repeatedly raped me for years in my childhood and I had a nurturing relationship that buffered me to be strong and resilient.

 

I miss my work and relationships with those individuals who I encountered in the last 12 years; they will be in my prayers.

 

 

Further Reading:

Mate, G. (2008). In the realm of hungry ghosts: close encounters with addiction. Toronto, Canada, Vintage Canada.

Left, Right or Both?

Neurodevelopment

–An integrative approach
When my 22-year-old son called me and repeatedly asked me why he had to pay so much tax and complained that it did not make sense to him, I knew there was no point in telling him “Buddy, everybody pays tax!” This kind of logical, sequential reasoning did not mean anything to him because after working four days in a row on overnight shifts, he was emotionally drained and physically too tired to think or listen. In short, he was throwing a tantrum at me. However, using my training in neuroscience, I stopped telling him the facts and instead provided a comforting and nurturing approach by listening and showing my understanding of his frustration. Within minutes, he did not challenge me with the same questions any more. Then, I told him to have a good sleep and we could discuss more on the following day. He agreed.

The key point here is that not only do we have a solid relationship to trust each other, but it was the moment I recognized that his brain had been hijacked by his physical fatigue and overwhelming emotions, so he was only operating on his right brain. Before going further, we need to appreciate the different functions of our brain. The right hemisphere is an experiential, non-verbal, and emotional brain, dealing with things such as facial expressions, eye contact, tone of voice, posture and body gestures. The left one is a logical, linguistic, and literal brain, which deals with facts and leaner thoughts. In other words, the right brain focuses on the context and the left is about the text.

Thus, at that point I did not try to rationalize with my son or make him understand the fact that, “Everybody pays the tax!” When our children are tired, hungry, hurt, or scared, they may behave in a totally unreasonable way. It is not the time to help them understand the world or teach them a good lesson. Rather, it is time to connect with their right brain and once the emotional connection is achieved, we can start to direct them with their left brain to complete the task.

When my son threw his temper tantrum, he was overtaken by his right brain and could not access his left one. If I kept telling him the facts or reasoning with him, I was forcing him to use his left one, which contested his brain function. As a result, he would not have felt understood, which would have kept him staying in the right brain–overwhelmed by a flood of feelings and overpowered by escalating frustration and anger until he broke down. By listening to him and showing my empathy I was, in fact, able to help him feel connected and understood, which tamed his emotional circuitry in the right hemisphere in a timely manner. This is the beauty of a healthy relationship that allows the involved parties to work on things with care and understanding, so everybody can keep progressing. Of course, after our phone conversation my son never asked me again the amount of tax he just paid because he knew it right from the get go!

Further Reading:

Siegel, D. (2011). Mindsight: The new science of personal transformation. New York, Bantam Books.

Siegel, D. & Bryson, T. P. (2011). The whole brain child: 12 revolutionary strategies to nurture your child’s developing mind. New York, Delacorte Press.