Pain and empathy

Photo by Jeff Riedel for the New York Times

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?

Summer updates

I have been traveling for a lot of work-related duties this summer, and have a lot to process. Unfortunately, much of my thoughts are too personal to share on a public blog and although I’ve not been too shy in the past to voice my thoughts on a wide range of topics, I am somewhat torn between sharing some of my thoughts on this blog and protecting people’s privacy. If I can figure out a way to write some of my thoughts without being too publicly invasive, I’ll do so. It would be good to figure out a more consistent groove on the blog either way.

Just some highlights:

• I spent a week in California at an adoption family camp, where I was privileged to be one of the keynote speakers, facilitated three workshops for parents, two workshops for the teens, and one workshop for the teens and their parents. By far the best part of going to Pact Camp is the opportunity to be with other adult transracial adoptees who are creating, sharing, advising, counseling, educating and mentoring adopted children and youth and their adoptive parents. One of the things that has been difficult is the in-between state we adult transracial and international adoptees who work with adopted individuals and families find ourselves. We are often considered less expert than the Professionals and Adoptive Parents who do the same work. We are also routinely criticized by other adult adoptees for working at camps such as Pact because we are seen as perpetuating the adoption industry. It is such a thin tightrope that we walk. I’m eternally grateful that I have found a cohort of adult transracial and international adoptee professionals that just get it, and with whom I can share both the joys and the frustrations of doing this work.
• I attended the Summer Institute for Indian Child Welfare in my home state of Minnesota. For several days I learned about best practices in tribal child welfare services by those who are the experts – the tribes. I have to say I was very, very impressed by the speakers and the special opportunities for learning that I was privileged to be invited to participate. One of the biggest takeaways from this conference was that not only are some of the tribes that took over their child welfare services from the state governments doing exemplary work in their communities, that the outside world should be implementing their practices. Shouldn’t every child have active efforts conducted on their behalf? Shouldn’t every placement be determined on a hierarchy of the best interest for a child’s continuation with their family and community (placement first with family, extended family, community, and with new resources outside the community as a last resort)? My greatest frustration in leaving this conference was the huge disservice our child welfare service practices have done to children and families. What arrogance do we as a system of care have that we think children thrive better when completely severed from their families and communities, not to mention cultures? I challenge any adult to think about what it would be like to be forced to move away to a strange new place and start over without anything from your former life and prohibited from talking to anyone from your former life – family, friends, colleagues, everyone – and told to be grateful for it. Imagine being in a witness protection program only you had no choice over whether you wanted to be in the witness protection program because someone else decided it was in your best interest. I would guess it would be your last choice, chosen only if there were no other options available. Now imagine that you have to do this as a child. And that, sadly, is what we are doing to thousands of children each and every day.
• I presented at a shelter that provides crisis counseling, services and beds for youth that are experiencing homelessness. I was asked to present because in the past few years, this agency has seen a big rise in the number of teens who were transracially or internationally adopted. These teens have either run from their adoptive homes or were kicked out by their adoptive parents. While reunification is the goal, the counselors have been challenged by the difficulty with working with the adopted youth and his or her parent(s). One staff person told me that nearly all the youth they saw at the center during one recent month were adopted.
• I am continuing to work on my dissertation proposal as well and hope to be finished in early September, so I can begin to collect data for my research and thesis. I am also continuing with my “day job” which is to coordinate the Permanency and Adoption Competency Certificate through my university, that will begin this fall.

So in a nutshell, that’s what I’ve been up to this summer. Hope summer has been good for you as well.

Could you make it?

In the past twenty-plus years that I have been a working adult, there have only been two short periods of time in which I had full-time, above minimum-wage, benefits-earning employment. There are a number of reasons for this – the major one being that I did not have a college degree until I was 35 years old. I worked a lot of retail jobs or jobs where I took care of other people, often those who were vulnerable, such as adults in a group home or day care settings. My first full-time with benefits job was as a tailor for a major department store, so although I had benefits I still made only slightly above minimum wage and a huge portion of my earnings went to daycare expenses. Employment at most of my jobs meant working nights and/or weekends.  I remember when I first started my first full-time, post-MSW job in a child welfare organization and had weekends off and finally realized what everyone else meant by looking forward to the weekend.

Last night I had an appointment with a tax accountant. Last year was the first time I used a professional to complete my taxes. Just the idea of having the privilege of paying someone to do my taxes made me reflect on my employment history and what it means to be a middle-class person.

This past week, my friend and colleague Ericka tweeted about this website, a joint effort between McKinney and Urban Ministries of Durham called SPENT.

The aim of this interactive activity is to get people to think about homelessness and poverty and how, even trying to do the “right” things, a person can find themselves spiraling into poverty. Through SPENT, players are asked to make choices with their opportunities and money should they find themselves suddenly unemployed with only $1000 in the bank. Will they make it through the month with any money left?

I’ve been lucky – I had a partner who has always had stable employment and that helped. In addition, with the exception of when our daughter was born and we didn’t have enough insurance to cover the hospital bills which meant we were paying off hospital bills for years, for the most part since then we have been fairly healthy and have not had significant out of pocket health care bills. Somehow we always managed. There were times when between the two of us we worked four to five full and part-time jobs at one time in order to make ends meet; when we were hoped the $50 after paying our bills was enough to cover our expenses until next payday – like gas for our shared car (considering ourselves lucky if it didn’t break down); when I learned how to stretch our groceries, and only bought thrift-store clothing – and not because it was the “fashion” but because we had no other option.

I often wonder, when I encounter new MSW students, how many of them have personally known poverty. I wonder if they know what it is like be poor. I have been poor, but I have never been in poverty.

I love this interactive game, and I think it’s a brilliant combination of social media technology and social justice education. I think every BSW and MSW student should play this game and it should be required in social work programs.

To try SPENT for yourself, click here.

A new year begins

I’m not a New Year’s Resolution type of person – for many years, as a younger adult, I chose instead to write letters to myself, similar perhaps to the holiday newsletters that people sometimes include in their cards around Christmastime. These letters were retrospective reflections of the past year – the ups and the downs – and thoughts about how I could encourage myself to continue with the things that went well and working towards changing what didn’t work for me. Over the years I would re-read the past year’s letters and reflect on what had (or more often, hadn’t) changed over the years.

After having children and getting busier with life, I stopped writing those letters. A year ago, inspired by a friend of mine, I began a new New Year’s tradition – rather than vague goals and a list of tasks or things to do, I choose a word that I want to guide my actions over the coming year.

Last year’s word was “intention.” I had been feeling pulled in many directions, feeling like I was bad at saying “no” to things even though with a full-time graduate school schedule, 20 hour a week Research Assistant position, and parenting two teenagers, I didn’t have the time to do everything I was being asked to do on a volunteer basis. Sometimes when you work really hard to get to a point of competency, the push-pull of suddenly being asked to contribute to a lot of things by Important People is both a blessing and a curse. Having a well-known blog and all that came with it certainly added a lot of wonderful things to my life but it also contributed a lot of stress and uncompensated time that often took me away from the things I should have been focusing on instead.

So, I chose the word “intention” in order to fill in the sentence “I want to live my life with _______.” Having a guiding word really helped me make some tough decisions. Rather than doing things because I felt obligated, out of guilt, or just because the opportunity was presented to me, I began to ask myself if doing this particular task was an intentional thing or if I was just going with what someone put in front of my face. I ended up cutting out several items from my life and while it was difficult at times, it was absolutely the right thing to do.

So as we approached the beginning of 2011, I began reflecting on what I would choose for my guiding word for the year. I decided it would be “compassion.” Compassion for others, of course, but also compassion for myself too. As my family and friends would say, I am often my own worst critic (and I have a pretty sharp tongue). I want my guiding word to help me reflect thoughtfully about the actions I take this year, and think about whether they are compassionate to me and to any other people who are involved. This is not to say that I will be a doormat or let people walk over me; that would not be compassionate to anyone.

Rather, since the purpose of compassion is to feel the suffering of others – I am operationalizing “compassion” by thinking of it in terms of trying to think about other people’s perspectives and not jumping to conclusions or taking personally actions of others.

Finally, although I don’t typically make “resolutions” I do admit I have a small goal I want to do this year – blog more! I’ve had a good “break” from the time-consuming blogging of my past blog and want to blog more than I have on this blog over the past six months or so.

Are you a resolution type of person? Or do you have any other New Year’s goals? I’d love to hear about them!