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Witness to Witness Update
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July is BIPOC Mental Health Month and we are taking this moment to appeal to our generous donors to help us sustain our effort to support clinicians who work with historically marginalized communities, many of whom come from the same communities they serve. These clinicians serve a population with little or no access to remote work, precisely the people who had the highest mortality during the COVID pandemic. At the Witness to Witness Program (W2W), we work tirelessly to design programs that address the exhaustion, moral distress, anger and despair that these dedicated clinicians experience doing their challenging jobs. Of course, they also experience the deep satisfaction of knowing they are saving and improving lives. We try to acknowledge this duality that they experience daily in their work.
We have developed a wealth of comprehensive resources to deliver important content for our constituency. The most exciting of these is the launch of our W2W podcast. Aptly named "We Do Hope," the six-part series presents easy-to-absorb material through a conversational format, briefly exploring topics such as microaggressions, chronic sorrow, and self-compassion. We publish timely articles each month on the MCN blog, one of which was a deeply-researched post following the mass shootings in Buffalo and Uvalde. All of our interactive webinars and slide decks are available online, as are over 40 resources that we developed this year, most of which are now in Spanish. And we publish this bi-monthly Update.
We have exciting plans for the coming year, including revised goals to expand our impact and reach more people than ever before. We are partnering with Global Giving, the leading crowdsourcing platform trusted by nonprofits. Currently, they are offering a wonderful incentive: matching donation amounts up to $200 made by first-time donors to Global Giving who commit to recurrent giving. That means if you use the Global Giving link here,
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and want to give W2W $100, if you select “give $25 four times,” Global Giving will double your $100 contribution and W2W will receive $200.
With your help we can contribute to the well-being of communities that have suffered far too long from systemic and historical barriers, negatively impacting their physical and mental health. We join with other organizations in the hope that the benefits of attention to BIPOC Mental Health this July will spread throughout the year.
As ever, in my second Update of the month, I present my monthly MCN blog. Claire, who edits the blog, laughed out loud. I hope you will too!
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Coping Strategies: Reflecting on (and Chatting with) Newly Formed Habits, Plus Six Tips to Break the Ones You Don’t Want
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I’m 75 years old and I cannot remember a period of time as packed with big changes out in the world I live in as those of the past seven years. The gut-wrenching, nerve-wracking, upsetting, infuriating, depressing news has led to my developing a new set of coping strategies – and I believe that many others have, too.
For example, prior to the 2016 election, I rarely watched television and didn’t know much about any of the popular shows. Now I can discuss episodes of all available seasons of The Great British Baking Show, comment on my favorite bakers, and even recall the most beautiful showstoppers and the hardest technical challenges! And that is not the only show I can cite chapter and verse on. In the last few years, I began to use TV to decompress. In the past, I might have read a book to unwind. Now, it’s unlikely I can focus sufficiently at 8 PM for reading to soften my edges and prepare me for bed.
Most people I know in recent years have formed a habit they didn’t have before. In a hilarious article in McSweeney’s, Emily Delaney gives voice to her afternoon nap in a piece titled, “I’m a short afternoon walk and you’re putting way too much pressure on me.” Her walk’s voice says what many of these new habits might:
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"Now, I’m both your leisure activity and your only form of exercise. I’m the last thing tethering you to reality, yet your only way of escaping it. I’m the singular effort you make to maintain your sanity and your sole means of experiencing joy, hope, and happiness. It feels as if I’m your lover, friend, and therapist all wrapped into one, and, frankly, it’s making me uncomfortable."
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I use an afternoon nap to escape not just the problems at hand but the headache I can feel coming on as I slog through them or bat at them. My afternoon nap might complain to me the way Delaney’s walk does. My nap might say:
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"Do you really think that falling asleep is going to erase your worries and ease your heart, mind, and soul? Don’t you recall that when you wake up from me, in that first fully conscious moment, you are worse off than when you lay down? Don’t you think it might be better to forge ahead and take care of some of what you are trying to push aside, and spend the time solving not avoiding problems?"
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How should I respond to my afternoon nap? Tell the nap that the hour of relief is worth the pain of the return to reality? Ask if the nap hears the same answer from most others who employ a nap in that manner?
I asked a few friends whether they had noticed any new habits creeping into their daily routine in the last few years. I got an earful. One friend talked about snacking, but didn’t want to hear what snacking said. Instead, my friend said it might be better to hear from the thirty pounds that were new additions to her sturdy body. This is what my friend reported that those pounds had to say:
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"I’m delighted to have met your acquaintance and I really do hope you will let me become a permanent resident. You are so good about meeting my preferences! I’m happy to sit most days on a comfortable chair or couch and know that every hour or so, some delicious morsel will course through my cells. Yum! I think we have the beginnings of a lasting friendship."
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Another friend told me my question had struck her just as she had returned from her doctor who had given her a two-week order to refrain from using her thumb to text. She told me she hadn’t really thought she might have to let texting know the bad news, but now that I had framed my comment to her the way I had – asking if she had noticed a new steady relationship forming over the last seven years -- she realized she was going to have to inform texting that this wasn’t a permanent break-up but a short interlude, a vacation, from each other.
It is also true that some people reported habits that help them cope, but not ones they intend to limit or get rid of. One friend mused that while her interactions with her dog may be helpful to her -- and she is in the habit of interacting with her, loving her, throughout the day --she certainly is not about to change that behavior! On the contrary, she notes that like nap or afternoon walk, dog doesn't reply to her questions or frustrations. Just a turn of her head or a low growl lets her know dog is listening, which is all she needs.
Many people have developed habits they would not have developed under less stressful circumstances. Whether politics, COVID, or something else, there has been much to handle on a daily basis. We are all witnesses to other people’s tragedies through many more channels of information than ever before. We may also do work that puts us in close proximity to people suffering pain, hardships, and trauma. We try to cope and naturally some of our new habits are not helpful in the long run, even if they may be soothing in the short run.
If there is one habit you think you would like to change, here are some tips to do so:
- Start off with the right attitude toward yourself, one of self-compassion. Imagine you are a young child and you are gradually going to wean that child off its bottle. It will go more smoothly if you are kind and gentle.
- Cut yourself slack. Be clear at the outset that you will have setbacks. Expect that. When they happen, be understanding. Applaud the direction you are headed, not the timing of your arrival.
- See if you can identify the cue that makes you want to use the habit you wish to change. If you can, see if you can imagine doing something other than the habit at that time.
- Start by identifying one small modification that may start change happening. Set a realistic rate of change, maybe one change every few days.
- If you must set concrete goals, set them with reasonable time frames and doable markers of progress.
- Reward yourself by noticing and acknowledging any small changes you have made in your preferred direction.
Always remember it is the turtle, not the hare, that wins the race. If we remain patient with ourselves, eventually we can replace habits we don’t like with ones we do. And think of how those interviews with those new habits will go!
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And because I cannot stop myself from also presenting important articles, here are a few:
I am very excited to feature the recently published article, “Development of the Resistance and Empowerment Against Racism (REAR) Scale,” by a multi-cultural group of academics. I am particularly pleased about this research because it moves the idea of resistance from the personal to the systemic. It also includes a conceptualization of empowerment as a collective as well as an individual process that is congruent with work I have done with the witnessing model for decades.
In their words, “we conceptualized resistance against racism as a type of (pro)active coping that includes and extends beyond managing the personal experience of racism to incorporate approaches that challenge the existence or acceptance of the oppressive demands made within a racialized system (Hollander & Einwohner, 2004).” Their construct of resistance expands on proactive coping by “aiming to address the negative effects of a systemic problem (racism), challenge the existence of the injustice, and emphasize collective over individual action and motivation…. Resisting racism involves empowerment where the lack of power is systemic. The goal often extends beyond what is personally meaningful or rewarding, positioning resistance against racism as a type of activism that is also a coping response for a collective goal.”
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The New York Times published an article on the significant uptick in prescriptions for anxiety, depression and A.D.H.D. in the last couple of years. Some notable statistics reported in the article are from Express Scripts: “Among Americans ages 20 to 44, numbers of A.D.H.D. medications went up 7 percent from 2017 to 2019, but they increased by 16.7 percent from 2019 to 2021. Just under 77 million prescriptions were written for A.D.H.D. stimulant medications in 2021, nearly six million more than in 2020 and eleven million more than in 2017. … Antidepressants continue to be the most commonly prescribed of these medications in the United States, and their use has become only more widespread since the pandemic began, with an 8.7 percent rate of increase from 2019 to 2021, compared with 7.9 percent from 2017 to 2019, according to Express Scripts.”
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I think it is interesting to look at the two articles above together. Medication represents an individual solution to a felt sense of a lack of mental wellness. Resistance, as defined above, involves awareness of and participation in the collective. Resistance to any negative force – racism or sexism or transphobia, for instance – confers benefits when it is part of collective action with others. I have always been an advocate for people using medication when other modalities fail to achieve well-being. During the pandemic, many of the collective and group experiences that can mitigate stress and despair have been lacking, leading people to try individual solutions since collective activities are less available. I hope that this will change.
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When I was a child, I used to spend most afternoons at the public library, curled up on a chair in the children’s room, a large room with bow shaped windows facing the street. I read every one of the orange covered biographies by the time I was eight and needed to wander into the adult stacks to find books that captivated me. Others my age will remember those biographies with their silhouette portraits of the featured American and maybe also remember the librarians who helped us find our favorite books. My librarian allowed me to take out books restricted to adults, for which I was also so grateful. Now librarians are coming under attack in the culture wars. This sobering Report identifies that 68.5% of urban library workers “had experienced violent or aggressive behavior at their libraries from patrons, but a significant percentage of responses (22%) indicated that they experienced violent or aggressive behavior from their coworkers.”
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Finally, I think it is interesting to look at the next two articles together. Research on post-traumatic growth has “demonstrated” growth after trauma but recently, a new group of researchers has cast doubt on the findings, noting serious flaws in the methodology. I studied this area in depth over a decade ago and came to the same conclusion. I presented my thoughts about this at a 2010 symposium in South Africa. I had also been skeptical about the literature on spirituality and health outcomes, but here, it seems, I am mistaken. A recent literature review has found benefits of spirituality and spiritual community for serious illness and health. Tracy Balboni, lead author and senior physician at the Dana-Farber/Brigham and Women’s Cancer Center and professor of radiation oncology at Harvard Medical School, states: “Our findings indicate that attention to spirituality in serious illness and in health should be a vital part of future whole person-centered care, and the results should stimulate more national discussion and progress on how spirituality can be incorporated into this type of value-sensitive care.”
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As ever, take care, stay well and stay in touch.
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Associate Clinical Professor of Psychology,
Harvard Medical School, 1981-2017
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