Sunday, January 30, 2011

HR3: A lil weekend activism.

Hey everyone. I'm taking a short break from packing (moving, ugh) to write this blog post and make a couple phone calls.

Do you have a couple minutes? Sady Doyle recently published a list of Dems. who support HR3. If you're not sure what HR3 is, here's a nice primer from Mother Jones.

I'd appreciate it if y'all could take a second and contact one or two of them and tell them that this is not okay. HR3 is not about saving tax payers money (fyi, 191 abortions were paid for by Medicaid in 2006... we're talking fractions of pennies compared to the debt we're in [source]).

According to this bill, most rape survivors weren't "really" raped, and they will be denied coverage for abortion from their own PRIVATE insurance. So, tax payers won't be saving money AND the government is regulating private insurance. WTF, GOP (and the dems on the list, too!)?

Saturday, January 29, 2011

A quick expression of glee.


I love the internet.

I received some really awesome responses to my call to action. Y'all are beautiful. I'm looking forward to working with everyone.

I am considering starting a Google or Yahoo group. I am wondering about names though. Social Workers Against Size Discrimination? The Size Diversity Social Work Coalition? Social Work Size Action Initiative (or Network...ooh)?

Do you have an awesome name suggestion? I really love the kind you can some how verbalize instead of having to say each letter individually. I think names are important because I think it will really set the tone for the group. For example--size acceptance vs. fat acceptance vs. size diversity (the last one being a fav. of mine).

Anyway, suggest away. Names can always be changed down the line as the group dynamics begin to unfold.

Friday, January 28, 2011

A call to action.

Hey! All you fat-friendly, size diversity-supporting, amazing social workers! Get at me.

I want to create a collective. I'm not sure what it's going to look like yet, but I think it's needed. There are reasons I fell in love with social work: its dedication to social justice, teaching about privilege, eradicating and confronting all the-isms in the world that most people would rather sweep under the rug. There's just one -ism social work has avoided: sizeism.

Fortunately, social work is a profession where I think the people in power are willing to listen. But first, we need something to say and we need people to say it.

If you are interested in organizing with me, email me at fatsocialworker (at) gmail dot com. Why can't social work schools teach about size? Why can't we talk about Health at Every Size as being THE ethical way to approach working with *all* clients? NASW has begun to speak on obesity issues. They recognize the "multifaceted" nature of "obesity"--why not recognize the ethical way of viewing obesity, the one that honors self-determination?

Lessons in loss

The pretty much new blog has been kind of quiet. That's to be expected, considering I'm a grad student who has a penchant for biting off more than I can chew :D

It's also been a rough month for me, both personally and professionally. My placement has to be one of the most difficult internships imaginable (besides perhaps working in a hospice). I'm placed in a domestic violence shelter. It's a short term, emergency shelter. Clients have about 135 days to stay there before they're sent back to the homeless processing center in NYC to be placed in yet another shelter. My first batch of clients are beginning to terminate right now, and I'm feeling all kinds of conflicted about that.

There's one client in particular that is difficult. She's in her early-40s, with an adorable daughter. She's relentlessly positive when most others would be breaking down, and she's a devoted mother, always putting her precocious 3 year old above all else. She's discharging today. And she's not really sure where she's going. She's undocumented. That means she can't get documented employment, and thus is not qualified for the only housing program worth pursing. She gets something like $18 in public assistance. She's in the middle of a custody battle with a man who threw her down two flights of stairs, with a man who brought her here from her home country where she had a rewarding career, with a degree that is no good here, when she didn't speak a word of English (oh, did I mention she's amazingly intelligent? Taught herself English in only a few years, and she speaks beautifully).

To say there's a lot of counter-transference going on in this case would be a gross understatement. During my time as her counselor, she has transformed into a mother figure. For someone like her, I think this was very beneficial because she is a nurturer and her self-esteem is rooted in feeling like she is a good nurturer. Her daughter also reminds me a lot of myself at that age. The dynamic of our relationship, however, brings up a lot of my issues with my mother. She reminds me of what could have been if x, y and z didn't happen. It's shown me that I haven't grieved over the loss of my mother-daughter relationship. My mother isn't dead, or anything. I don't mean to give that impression. She's just unable to provide guidance and comfort for me, because she can't even provide it for herself. I haven't come to terms with this, and I think this client made me feel comforted.

I was a very parentified child. My mother was in an abusive relationship. She was always so fragile, and I was her protector. The client's daughter feels the same way about her mother. She once drew a picture of two people: a really tall person and a really short person. She identified the really tall person as herself. The short person was her mother. When asked why, she said it's because she needs to protect her mommy from the monster. I can't say I didn't feel the same way about the client during our relationship. We once spent an extraordinarily long day together in court, and I remember looking over at her. She had her head between her hands, and she looked so worn, so exhausted. Underneath her strong exterior, she really was struggling with everything. I recognized immediately how I felt at that moment, and it was exactly how I would feel when I would find my mom crying over the stove, in her room, where ever. I wanted to save her.

I think this termination has been harder on me than on her. I want to keep in touch, but I can't. I want to help her after she leaves, but I can't. I want to hand her a green card, but, yeah, I can't.

Losing this client and the few others who will be gone by the week's end hurts. I am queen of abandonment issues, plus I have a 1 o'clock appointment to euthanize my sick cat today. I'm ready for 2012 already.

Thursday, January 6, 2011

On self-care, health and body privilege

riots not diets recently reblogged a post that read like this:

I think that what's being said here touches on some interesting points, but I still think it misses the mark to a degree. First, you're right--it's no one's business what you do with your body. But I don't actually think as a society we value "taking care of yourself." When people say "taking care of yourself," what they're really saying is "Please change yourself so that I am less uncomfortable with how you are." Those two are not synonymous. I'd argue that as a society we do not encourage people to take care of themselves enough.

Taking care of yourself, or self-care, does not necessarily mean dieting or exercising to lose weight or to get healthier or to change your different body (whether differently abled or fat or too skinny or whatever). Self-care might mean reminding yourself that these messages that society sends you are absolute B.S. Self-care might mean relaxing or taking a bath (not for hygienic reasons, but because it feels good). Self-care means valuing yourself in spite of the fact that society says you aren't worthy. If you don't perform self-care, you will (and I say this from my own personal reflections) experience burn-out and depression. Some people can and do experience ill-health because they do not take care of themselves. I have been there. Self-care has and will help me in the future.

If you don't take care of yourself, how can you have patience and kindness for very long? That's just what I don't get. It's a lesson that I continue to learn more and more every day, and it's not something that is not exclusive only to people with body privilege or monetary privilege or any other kind of privilege (except, perhaps, mental health privilege). Be kind to yourself first in the way you know how, in a way that is comfortable for you, in a way that is right for you and your health as is.

Oh, and just one thing to add... Being disabled? It doesn't mean someone is unhealthy. It's an easy assumption to make, but its just that: an assumption.

Tuesday, January 4, 2011

ATTN NYC Social Workers: Workshop on Racial Microaggressions

I attended what I presume to be the mini-version of this workshop at the RISE Conference a few months ago. It was definitely enlightening. I can't compare it to the other very popular anti-racism workshop (Undoing Racism) because I haven't taken it, but the men who orchestrated this workshop were excellent teachers. I look forward to it, and I love supporting RISE with everything they do if I can.

Here's some info:

Kick off the New Year with some anti-racist practice with the RISE community!

Racial Microaggressions: Real Pain, Invisible Scars
Saturday, January 29, 2011
Downtown Brooklyn
Learn about racial microaggressions. Discuss how they impact you and your work. Practice confronting them. Build your community of radical allies.

After the success of the Racial Microaggressions workshop at the 2010 RISE conference, we are back with an extended version! This day-long workshop will:

* Explore how people of color experience and white people perpetuate racial microaggressions in personal and professional settings
* Address how people and communities of color have been conditioned to engage in racial microaggressions toward one another
* Examine the role of media, language, and societal/institutional norms in encouraging racial microaggressions
* Practice tools for interrupting racial microaggressions when they happen

When: Saturday, January 29, 2011.

Where: Long Island University, Downtown Brooklyn Campus. (More location details to come!)

Time: 9:00 am- 4:00 pm

Cost: No Cost- $15. Please pay at the level you can afford. All of our funds go entirely into operating expenses. Lunch will be provided.

Check out the details on our website or register online now! Space is very limited. Sliding scale based on ability to pay: $0-$15

This will be an experiential workshop for people with a foundational understanding of systemic/institutional racism. In order to have a rich conversation we are committed to recruiting a racially diverse group of participants. Please check out our workshop guidelines here for more information about the day.

Happy New Year from RISE!

RISE Organizing Committee
Organizing Collective
RISE: Social Work to End Oppression

Monday, January 3, 2011

Clients and weight loss. How is the HAES approach appropriate for social work?

I was going to reply to some comments left on the last article, but the reply became so long, I thought an entire post would be appropriate.

Here's the scenario: A client comes in and wants to lose weight. Simple enough, right? Except for the fact that the client wants your help in losing weight. The client's goal is to lose weight and is looking to you for support. How do you give that in the case that you do not believe in diets and you fundamentally believe the client would be putting themselves in harm's way by going on a diet?

I wanted to make this post in order to brainstorm up strategies for dealing with this situation. Here's a few scenarios. Please comment your own ideas, or if you have an objections/improvements to what I am posting here. Please only comment suggestions if you believe in the Health at Every Size (HAES) philosophy. Learn more about HAES here at the Association for Size Diversity and Health's page on HAES Science and also with this excellent PDF by Dr. Jon Robison, PhD, MS.

Strategy #1: Support them fully on their diet quest.
The NASW Code of Ethics states: "Social workers respect and promote the right of clients to self­determination and assist clients in their efforts to identify and clarify their goals." One way of interpreting this means we give referrals to weight loss clinics, and provide them with any tools they need to lose weight. We word the goal as "weight loss."

Strategy #2: Discuss and explore thoughts on weight loss and body image
I think this needs to happen regardless of what strategy one decides to take. Why does this person want to lose weight? What is it that they expect to happen if the weight loss goal is achieved? Many people who are trying to lose weight are actually wanting to improve other parts of their life, such as romantic love, friendships, family relations, employment, or overall satisfaction in life. It is important that the client have realistic expectations about what would result in weight loss. Weight loss is not a magic wand.

Strategy #3: Assist the client in reworking the goal to something more obtainable
De Jong and Miller wrote in an article about the solution-focused approach that best practice is starting with small, concrete goals. Rather than listing weight loss as a goal or focusing on that, begin with a smaller goal such as learning how to cook a healthy meal or finding an enjoyable, affordable exercise routine. I think this will help reinforce healthy habits or help the client find joy in facilitating health into their lives.

Strategy #4: Explain what may happen if the client goes on a diet
Is it unethical to tell the client that diets typically don't work? Would it be promoting one's own agenda too much to say, "Look, I am more than willing to support you on your weight loss goal. But first, let's talk about how weight loss actually works." Granted, we are not nutritionists. But it's not like this information isn't out there, confirmed in peer-reviewed articles that we've all read (or should read... maybe I will post some recommendations in the next blog post). I don't think the purpose here should be to discourage the client at all! I think it should be giving the client the same information we have so that they can make an informed decision and so that we are providing the best tools for them to enact their self-determination.

Strategy #5: Make HAES referrals
This won't be easy in most places. HAES professionals are not always easy to come by. ASDAH can help, but if you don't live in NYC like me, but rather somewhere like Iowa, you may not have as many referrals. I would suggest though that there are HAES professionals out there that don't even know they are HAES professionals. Let's pick up our phones and directly talk to nutritionists and therapists who specialize in dealing with food issues. I think we'd be surprised how many professionals would a take a HAES approach with a client without even calling it that. Referring to a nutritionist and a therapist (if you are not one yourself) who specializes in these concepts is supporting the client in his/her goals. I think this is putting them in better hands than a referral to Weight Watchers would be. Referrals to YMCAs for exercise are always a good idea for clients, weight loss goal or not, IMHO.

So I'm dying to know what you all think! Would you use these strategies or try something else? Am I saying something completely unethical or am I being too conservative in my strategies?

De Jong, P. & Miller, S. (1995). How to interview for clients strengths. Social Work 40(6), 729-736. Available for download here.

Sunday, January 2, 2011

The New Year's ReVolution

As I grow older, it's sort of hilarious how laughable New Year's Resolutions have become in my life. They are always, without fail, body related somehow. I think it's that time of year that we all resolve to become more in control of our lives, as if the New Year is some kind of Saturn Return and that our goals *must* be accomplished within a certain amount of time, or else we are unsuccessful and doomed to repeat our failures indefinitely. And honestly, if dieting is your New Year's Resoultion? Yeah, that's probably what's gonna happen.

The last time I made a weight-loss related New Year's Resolution was in 2008-2007. I wasn't "dieting"--no, I was a good fattie and I was going to make better *LIFESTYLE CHOICES*. I was going to eat fresh fruits and vegetables and go to the gym more often, because that was surely going to help me shed 60 lbs. Getting my thyroid medicated? Oh, that wasn't a priority at all. I was going to look like a Fitness Mag cover model by 2009, and my life was going to be oh so much better. My relationship wouldn't be in the crapper anymore, and I would have a better grip on what I was doing in life, all because of a good ol' NYR to LOSE WEIGHT.

It didn't work. I stuck with it for awhile. And honestly, I do still use a lot of the habits I learned, such as eating more whole grain foods and getting more fiber in my diet. But I think I maybe lost 5 lbs and my boyfriend and I broke up by year's end, and it still took me a whole year to figure out what I was doing (you know, without dieting, and the answer to that question changes every day). All in all, everything turned out okay though. But you know what I won't get back? All of that time spent anguishing over calories. All that time standing in front of a mirror pinching my belly fat and imagining it melting right off. That never happened, and I actually gained weight.

I feel better than ever; I eat what I want when I want, and the only times I don't feel healthy is when I don't do that. I've considered myself interested in fat acceptance for years now, but I think it was my last New Year's Resolution ever in 2008-2009 to stop torturing myself over my weight and to enjoy it that I actually FINALLY stuck to a resolution. Resolving to no longer resolve hatred towards my body was the best decision I ever made.

It's not to say resolutions are bad. But why do we frame them the way we do? Why are we always fixing something bad about ourselves, instead of resolving to continue to nourish what is already amazing about ourselves? I currently am a case manager at a domestic violence shelter. I think about what my biggest gripes are with how the system works--it's so punitive. It's so focused on what clients are NOT doing instead of celebrating the amazing things they accomplish every day (um, duh, they left an abusive relationship!!!). I am so unabashedly confidident in my clients and positive. I always frame goals in a way that they are obtainable and positive.

This is where the idea of weight loss and social work intersect. As I close out, I ask, if we as social workers are to present obtainable goals for our clients, can we recommend weight loss? Should a social worker ever recommend weight loss (especially considering by and large we are not medical experts)? What damage could be done by a social worker recommending weight loss to a client?