As part of my "to-do" list today, I went looking for information for my supervisee (I supervise, now!) about NPI's and CAHQ numbers, vaguely remembering a past blog about it, and re-stumbling upon my old ramblings. It seems I have been so busy for the past, hmmm, year? that I have had nothing to say. I think it is an indication of my creativity overall taking a back seat to the effort it takes to progress my career and personal life. I am hoping (knock on wood?) things are beginning to normalize and give me the luxury again. Creativity, unless it is your vocation (which for me robs much of the appeal and inspiration), really is a luxury. My paints, drawings, pastels, charcoals, papers and sketchbooks and canvases have been tightly sealed awaiting some extra energy or attended to passion. I guess my blog is also a part of that.
My past year of "busy" has given me many positive changes. In acronyms I have left and IOP/PHP and moved to an OMHC. In translation, I left working for the hospital and now work for an outpatient clinic. It sounds less exciting, but it is actually a greater clinical variety and professional challenge, and something I enjoy much more than all the politicking of working for a hospital. My population served and so professional capacities have grown from past work focused with pregnant substance abusers, to now include adults, children, men and women of all diagnoses. I have seen such a variety of life: from political refugees to war veterans, foster children to children with autism, divorcees to single parents, people grieving for lost pets to others grieving for losses more traumatic in nature, people with medical or developmental problems that make them non-verbal to others who hear voices around them all the time. I run groups, but only with a topic I choose and attendees that want to be there.
I work closer to home now and actually have a house instead of an apartment for the first time in a decade, and can look over my lake from my bedroom. I come home to the same stinky white dog, but now also to a husband. I have stopped seeing a therapist and my own symptoms seem to be in mental health remission. I learn every day more about home repair from my house, more about love and relationships from my husband, more about life and gratitude from my patients.
And so the stage is set for my new introspections: from the outside through her large office windows, we see a tired but happy looking young, but now slightly older therapist, as evidenced by the crinkles starting to form at her eyes when she smiles. Her eyes are, of course, still blue, but wiser and more self-assured. The expression is calm and confident: the kind that says, "Everything you are saying and feeling is important, and don't worry, I've heard worse." She sits attentively facing her patient, a sad looking, older man who is talking slowly while staring at the wall. She says something to him. He lifts his head, nods, and squares his shoulders...
Wednesday, April 3, 2013
Monday, February 20, 2012
You're an *!&@^#%!! Charlie Brown
I tend to arrive to the hospital around 730am each morning to have time to answer phone calls, emails, and check in with my fellow therapists before beginning the day. Sometimes we talk about our lives and sometimes we are putting out fires the patients have proverbially set already that day. Today I was listening to one of my coworker's political rants.
This particular coworker tends to take small amounts of information to feel fully informed, and promptly steps up on his soapbox and rant. I find this completely annoying, to say the least. Today's tirade was about 30 minutes he had watched of a documentary about "Freakonomics." Apparently this is a book put together by an author and economist, which, more succinctly than he put it, is about correlation not equaling causation. Any good grad student knows this rule since the beginning of their first statistics class. My coworker was convinced it meant that just because we think crime decreases with the increasing number of police officers, doesn't mean that the reality isn't that there were just fewer criminals born because abortion was legalized twenty years before. (Don't worry; the silliness of this bold opinion is where I am going with this.)
I have another coworker who firmly believes that (in my words, not hers) the more you enable a patient, the more you are helping them. This is a bit harsh to say in contrast to the goodness of her intentions, but it is accurate also serves to illustrate my point. Both coworkers are completely closed to any sort of outside opinion or feedback. Both workers are convinced and convicted that they are completely and entirely correct in their positions. I actually see this equally in my patients all the time. They are living on the street, homeless, and without any major support of any kind, but cannot seem to see any explanation to their situation other than they were treated unfairly.
There is something to be said for feeling passionately about something. There is something to be said for feeling strongly about and defending your viewpoint or even your worldview. However, I firmly believe, if you aren't at least willing to listen to AND consider other perspectives, you will remain stuck and enclosed in one point of view. We see this in the adamant political fool, the too-tenderhearted therapist, the victim of circumstance patient, and many others. Doctors, lawyers, professors, therapists, children, parents and all of us can fall into the trap of being too stuck on the defense to accept that someone else might feel adamantly different for another completely valid and good reason.
It fascinates me that anyone (but so many people!) can be so sure that they've got it right, that they assume that any digression from their theory is wrong. All or nothing thinking, as my therapist frequently accuses me of. For those of you not entrenched in psychobabble like us mental health professionals, we call this a cognitive distortion, or "stinkin thinkin." It is a maladaptive thought pattern that leads us around in circles, or towards bad decisions and bad emotions.
Bottom line, whether or not you are one hundred percent correct and everyone else is wrong, that the earth does revolve around the sun, perhaps that crazy woman in the corner may also be right when she mumbles that the sun is just a star. Even if she is not, could we not open our minds to more possibilities by at least considering it? After all, Charlie Brown couldn't have always been the victim; he must have been an !@#*%$$!! to somebody.
This particular coworker tends to take small amounts of information to feel fully informed, and promptly steps up on his soapbox and rant. I find this completely annoying, to say the least. Today's tirade was about 30 minutes he had watched of a documentary about "Freakonomics." Apparently this is a book put together by an author and economist, which, more succinctly than he put it, is about correlation not equaling causation. Any good grad student knows this rule since the beginning of their first statistics class. My coworker was convinced it meant that just because we think crime decreases with the increasing number of police officers, doesn't mean that the reality isn't that there were just fewer criminals born because abortion was legalized twenty years before. (Don't worry; the silliness of this bold opinion is where I am going with this.)
I have another coworker who firmly believes that (in my words, not hers) the more you enable a patient, the more you are helping them. This is a bit harsh to say in contrast to the goodness of her intentions, but it is accurate also serves to illustrate my point. Both coworkers are completely closed to any sort of outside opinion or feedback. Both workers are convinced and convicted that they are completely and entirely correct in their positions. I actually see this equally in my patients all the time. They are living on the street, homeless, and without any major support of any kind, but cannot seem to see any explanation to their situation other than they were treated unfairly.
There is something to be said for feeling passionately about something. There is something to be said for feeling strongly about and defending your viewpoint or even your worldview. However, I firmly believe, if you aren't at least willing to listen to AND consider other perspectives, you will remain stuck and enclosed in one point of view. We see this in the adamant political fool, the too-tenderhearted therapist, the victim of circumstance patient, and many others. Doctors, lawyers, professors, therapists, children, parents and all of us can fall into the trap of being too stuck on the defense to accept that someone else might feel adamantly different for another completely valid and good reason.
It fascinates me that anyone (but so many people!) can be so sure that they've got it right, that they assume that any digression from their theory is wrong. All or nothing thinking, as my therapist frequently accuses me of. For those of you not entrenched in psychobabble like us mental health professionals, we call this a cognitive distortion, or "stinkin thinkin." It is a maladaptive thought pattern that leads us around in circles, or towards bad decisions and bad emotions.
Bottom line, whether or not you are one hundred percent correct and everyone else is wrong, that the earth does revolve around the sun, perhaps that crazy woman in the corner may also be right when she mumbles that the sun is just a star. Even if she is not, could we not open our minds to more possibilities by at least considering it? After all, Charlie Brown couldn't have always been the victim; he must have been an !@#*%$$!! to somebody.
Wednesday, October 12, 2011
A Public Service Announcement for Would-Be Private Practitioners
Just on the off chance that anyone comes accross this and needs this information, let me save you what amounted to about 3 hours of research. There is apparently no easily accessible place online where all this vital information is availible together.
If you are considering a mental health private practice, there are some logistics to consider before jumping in. Amongst these of course is how to obtain financial reimbursement for services. In order to be paid for your hard work in private practice you essentially need three numbers. These numbers can take up to 3 months to apply and be approved for so this should be a FIRST STEP in working towards a private practice. Why won't anybody tell you this!? I got the information through extensive phone calls to insurance companies, grilling other professionals, emailing professional organizations and career centers and lots of googling. Ladies and gentlemen, the research shows:
For private practice billing and insurance reimbursement you basically need three separate numbers:
In order to bill in private practice on sliding scale or fee for service (without in insurance reimbursement) you need to apply for a small business id at:
http://www.irs.gov/businesses/small/article/0,,id=98350,00.html
In order to bill for state (Medicare or Medicaid) reimbursement, you need an NPI#. More information available at:
https://nppes.cms.hhs.gov/NPPES/Welcome.do
In order to bill private insurance companies, you need a CAQH# which in turn each individual private insurance company has to approve for reimbursement (i.e. once you have the CAQH, you use it to apply one at a time to private insurance companies you want to use for reimbursement- you would do this online at each private insurance company’s website). More information available at:
http://caqh.org/ucd_health_participating.php
Just in case this spares some other poor soul all the frustration and confusion of obtaining BASIC information. Geez.
If you are considering a mental health private practice, there are some logistics to consider before jumping in. Amongst these of course is how to obtain financial reimbursement for services. In order to be paid for your hard work in private practice you essentially need three numbers. These numbers can take up to 3 months to apply and be approved for so this should be a FIRST STEP in working towards a private practice. Why won't anybody tell you this!? I got the information through extensive phone calls to insurance companies, grilling other professionals, emailing professional organizations and career centers and lots of googling. Ladies and gentlemen, the research shows:
For private practice billing and insurance reimbursement you basically need three separate numbers:
In order to bill in private practice on sliding scale or fee for service (without in insurance reimbursement) you need to apply for a small business id at:
http://www.irs.gov/businesses/small/article/0,,id=98350,00.html
In order to bill for state (Medicare or Medicaid) reimbursement, you need an NPI#. More information available at:
https://nppes.cms.hhs.gov/NPPES/Welcome.do
In order to bill private insurance companies, you need a CAQH# which in turn each individual private insurance company has to approve for reimbursement (i.e. once you have the CAQH, you use it to apply one at a time to private insurance companies you want to use for reimbursement- you would do this online at each private insurance company’s website). More information available at:
http://caqh.org/ucd_health_participating.php
Just in case this spares some other poor soul all the frustration and confusion of obtaining BASIC information. Geez.
Monday, June 27, 2011
Feeling Put-Upon
GRRRRRRRR DEFinately feeling a certain kind of way today. Feeling very much PUT UPON by others.
Ever ask yourself (albeit selfishly) "why don't I ever spend any time doing what I want? Why am I constantly doing things that make me unhappy that others want me to do!?" FEELING that way today!!$%#!
AMONGST the people making me feel put upon are people I spend the most blood sweat and tears trying to help, make right or reconcile with. I don't understand, and I believe I forever won't, why people PURPOSELY make things EXCEEDINGLY difficult FOR THEMSELVES. KNOWINGLY. When the options are A-relax, or B- get crazy; they opt for B EVERY TIME.
Ever have something come along and just take the wind out of your sails? Suddenly everything gets 100% harder. Depression and the death of a pt will do that to you. Add to that this exasperation and exhaustion of being put upon and try to stay afloat. Try to keep your social life afloat. Your personal life. Your family life. EX-AS-PER-ATED. Just plain ANGRY!!!??$?$$$@@@!!!!
So here is my personal recommendation, world. Next time you have options to either, A-relax, or B- get crazy, go against the gut and choose A. Sit down with a nice cold beverage and inhale, exhale; inhale, exhale....
HONESTLY!!!!!
Ever ask yourself (albeit selfishly) "why don't I ever spend any time doing what I want? Why am I constantly doing things that make me unhappy that others want me to do!?" FEELING that way today!!$%#!
AMONGST the people making me feel put upon are people I spend the most blood sweat and tears trying to help, make right or reconcile with. I don't understand, and I believe I forever won't, why people PURPOSELY make things EXCEEDINGLY difficult FOR THEMSELVES. KNOWINGLY. When the options are A-relax, or B- get crazy; they opt for B EVERY TIME.
Ever have something come along and just take the wind out of your sails? Suddenly everything gets 100% harder. Depression and the death of a pt will do that to you. Add to that this exasperation and exhaustion of being put upon and try to stay afloat. Try to keep your social life afloat. Your personal life. Your family life. EX-AS-PER-ATED. Just plain ANGRY!!!??$?$$$@@@!!!!
So here is my personal recommendation, world. Next time you have options to either, A-relax, or B- get crazy, go against the gut and choose A. Sit down with a nice cold beverage and inhale, exhale; inhale, exhale....
HONESTLY!!!!!
Tuesday, March 8, 2011
Thank God for Running and Puppies
I have been thinking often at work what things in life the women I work with who are chemical dependent replace with drugs. When do we get our natural "high"? What are they missing or giving up for the chemical fix? I don't mean lifestyle. That's a given. I mean what are our moments of natural high that they instead strive to acheive with drugs?
I think I am in another cycle of my depression. God knows I have lived with my old friend long enough to know the disease well. Once symptoms fearful and desperate, now I recognize the lack of energy, motivation and enjoyment as like trying to run through water, slowing me down. I cuddle up with a good book more, I enjoy long hot showers, I pull out my puzzle books and buy my favorite doughnuts. I excuse myself to hunker down as long as I am fulfilling (somehow!) my other basic responsibilities.
I got to work today at 630am. I had so much to do and was getting so behind, as every waking moment at work I have a patient in my office, paperwork tends to just pile up and wait. This morning, sitting on my butterfly rug on my floor pillow with a laptop and my files and papers across the floor, I forced myself through typing and typing and typing of notes, records, documentation. Since I came in so early, I left at 4pm instead of the usual 430pm (a whole half hour-yippee!!) This meant I would get home before the sun went down. To me this means one and only one thing: I get to run around my lake before dark.
Anyone who has been depressed for any reason can tell you that depression is crippling. It overtakes you so you literally can barely do anything except curl up and wait it out, hoping you do nothing destructive. Often it gets so bad that your mind becomes paralyzed for thought and you cannot keep a single thing in your spiraling mind. Its like trying to tread water in a whirlpool. Your best saving grace, other than medications I suppose, is to have a couple coping mechanisms that you can always turn to, that always work. Of these I have just one.
When my mind is paralyzed and my body depressed, I know only to do one thing. Lace up my running shoes, flick on my ipod, and start running. Though metaphorical and healthy, the literal focusing on nothing but physical sensation and breathing calms and centers my soul. Doing this outside with the sky over my head is my zen: there is nothing like it in all this world. When I am running I have nothing in my mind but calm focus and simple purpose to keep moving forward. Working through the physical pain of my muscles and lungs cures some of the emotional ache, and the simplicity of the exercise (just breathe and keep moving) grounds and centers me. Eventually, the endorphins get pumping and my measly, tiny amounts of dopamine and seratonin get their lazy butts to work. I smile. I feel happy.
Today when I was running around my lake feeling my muscles work up a hill and straining to keep my breath even with my stride I thought, "this is the first time I have felt happy all day." It is not necessarily that my depression makes me miserable all day anymore. I have learned to cope beyond that point. However, no matter what I try, running is the only thing that brings back the "happy." Otherwise, it's just numbness, spiraling and paralysis. It is my natural high. My addiction, I suppose, for my body and mind crave it now and want nothing else for relief of the depression.
Well, almost nothing else. I have to make a little plug for my sweet sweet puppy. Though I could go on about the therapeutic benefits of animals, suffice it to say that there is something very special about never having to go through anything alone. No matter how mopey or grumpy I feel, I always have a little white bundle of fur at my side who couldn't be more thrilled in the world to be there.
Thank you, God, for my beautiful runs and my little puppy.
I think I am in another cycle of my depression. God knows I have lived with my old friend long enough to know the disease well. Once symptoms fearful and desperate, now I recognize the lack of energy, motivation and enjoyment as like trying to run through water, slowing me down. I cuddle up with a good book more, I enjoy long hot showers, I pull out my puzzle books and buy my favorite doughnuts. I excuse myself to hunker down as long as I am fulfilling (somehow!) my other basic responsibilities.
I got to work today at 630am. I had so much to do and was getting so behind, as every waking moment at work I have a patient in my office, paperwork tends to just pile up and wait. This morning, sitting on my butterfly rug on my floor pillow with a laptop and my files and papers across the floor, I forced myself through typing and typing and typing of notes, records, documentation. Since I came in so early, I left at 4pm instead of the usual 430pm (a whole half hour-yippee!!) This meant I would get home before the sun went down. To me this means one and only one thing: I get to run around my lake before dark.
Anyone who has been depressed for any reason can tell you that depression is crippling. It overtakes you so you literally can barely do anything except curl up and wait it out, hoping you do nothing destructive. Often it gets so bad that your mind becomes paralyzed for thought and you cannot keep a single thing in your spiraling mind. Its like trying to tread water in a whirlpool. Your best saving grace, other than medications I suppose, is to have a couple coping mechanisms that you can always turn to, that always work. Of these I have just one.
When my mind is paralyzed and my body depressed, I know only to do one thing. Lace up my running shoes, flick on my ipod, and start running. Though metaphorical and healthy, the literal focusing on nothing but physical sensation and breathing calms and centers my soul. Doing this outside with the sky over my head is my zen: there is nothing like it in all this world. When I am running I have nothing in my mind but calm focus and simple purpose to keep moving forward. Working through the physical pain of my muscles and lungs cures some of the emotional ache, and the simplicity of the exercise (just breathe and keep moving) grounds and centers me. Eventually, the endorphins get pumping and my measly, tiny amounts of dopamine and seratonin get their lazy butts to work. I smile. I feel happy.
Today when I was running around my lake feeling my muscles work up a hill and straining to keep my breath even with my stride I thought, "this is the first time I have felt happy all day." It is not necessarily that my depression makes me miserable all day anymore. I have learned to cope beyond that point. However, no matter what I try, running is the only thing that brings back the "happy." Otherwise, it's just numbness, spiraling and paralysis. It is my natural high. My addiction, I suppose, for my body and mind crave it now and want nothing else for relief of the depression.
Well, almost nothing else. I have to make a little plug for my sweet sweet puppy. Though I could go on about the therapeutic benefits of animals, suffice it to say that there is something very special about never having to go through anything alone. No matter how mopey or grumpy I feel, I always have a little white bundle of fur at my side who couldn't be more thrilled in the world to be there.
Thank you, God, for my beautiful runs and my little puppy.
Wednesday, February 9, 2011
My Afternoon off...
Every now and again I get burnt out at work. The patients I have come in cycles- new ones at the beginning of their pregnancy with all their needs and new problems, then these same patients after delivery with the CPS involvement and custody issues. At the peaks of these two cyles, I tend to have my moments of burn-out. Having just finished a CPS/delivery wave, now I am in the new patients, new problems wave. Also, one of the six therapists left, leaving five of us to manage all the patients. My caseload is new, and it is rising.
There are various causes of exhaustion on different days. On Mondays, I have two hours of back-to-back art therapy group that I plan and run. It may sound easy, but it is its own version of chaotic managing needy and unruly patients, keeping a topic relevant to them, following rules like sedation protocols, and making sure my supplies don't disappear. Tuesday, I was feeling emotinoally exhausted; just sad. Sad for the women trying so hard to kick addiction with the odds and a terrible life history up against them. Sad from patient after patient sitting in my office crying and crying. Sad from seeing some women so far gone into their addiction that their prognisis as poor on a good day. Sad sad SAD.
Today I am a mixture of the two. After a patient, a group, clinical rounds and methadone rounds this morning, I asked my supervisor for permission to retreat home for the rest of the afternoon. To relax? Nope. To do three weeks of case notes I have fallen behind on and can't get done at the office because of constant other things to do.
SO here is my afternoon off to recalibrate and recuperate from work: millions of work case notes. SIGH. At least Zorro is here and he doesn't shoot dope, nod out, eat benzos or smoke crack. Or grass. Or snort. Or take pills. You get the idea.
There are various causes of exhaustion on different days. On Mondays, I have two hours of back-to-back art therapy group that I plan and run. It may sound easy, but it is its own version of chaotic managing needy and unruly patients, keeping a topic relevant to them, following rules like sedation protocols, and making sure my supplies don't disappear. Tuesday, I was feeling emotinoally exhausted; just sad. Sad for the women trying so hard to kick addiction with the odds and a terrible life history up against them. Sad from patient after patient sitting in my office crying and crying. Sad from seeing some women so far gone into their addiction that their prognisis as poor on a good day. Sad sad SAD.
Today I am a mixture of the two. After a patient, a group, clinical rounds and methadone rounds this morning, I asked my supervisor for permission to retreat home for the rest of the afternoon. To relax? Nope. To do three weeks of case notes I have fallen behind on and can't get done at the office because of constant other things to do.
SO here is my afternoon off to recalibrate and recuperate from work: millions of work case notes. SIGH. At least Zorro is here and he doesn't shoot dope, nod out, eat benzos or smoke crack. Or grass. Or snort. Or take pills. You get the idea.
Monday, February 7, 2011
The Color Test
| Click'>http://www.colorquiz.com/cgi-bin/results.cgi?do=print_blog&picked1=1,5,4,2,3,0,7,6&picked2=1,5,2,4,3,7,6,0&sex=f&blog_name=Cindy">Click here to read the rest of the results. |
Thursday, January 27, 2011
Doing laundry
Though I had amibivalent feelings about the snow day when I woke up this morning and saw my little Accent would not make it on the snowy roads to Bayview, I ultimately decided none of my patients would make it in through the snow either and to enjoy the rare break (though pto paid for) of a snow day.
I remember in grad school writing a post in a spare moment grabbed in a coffee shop between two jobs and my classes, where I fantasized about having a day off to do laundry and be domestic. This morning as I looked around my cluttered and very lived-in apartment, with it's piles of laundry, mountains of dishes, carpet in much need of vacuuming, tables in need of dusting, bathrooms of scrubbing, and peices of my daily life scattered all around, I felt some much needed sympathy for myself and how much I give of myself at my job. Though always worrying I am never doing enough, I give every iota of emotional and cerebral energy I have every day to my women. Evienced by everything askew in my apartment, I get home and barely have the energy to wolf down some take out, pack tomorrow's lunch and crack open a book before I fall asleep.
Today with the clean white snow on the ground trapping me inside with my puppy, I took out some chicken to thaw for dinner, set some water to boil for tea and enjoyed a breakfast that wasn't just a travel mug and a granola bar on the road. I did some sketching and drawing over a liesurely breakfast, put on some sweats and began to tackle the disarray of my apartment. How liesurely and therapuetic it felt! To engage myself in something where the outcome simply reflected the energy invested: I cleaned and my apartment got cleaner. Imagine that principle simply demonstrated to the frustrated therapist! Sigh. What a reward. Though I still have chicken to marinate, and laundry to fold and put away as the tired washer and dryer finishing shaking them clean(-ish), I am so enjoying the relative predictability and reliability of my simple apartment and finally fulfilling some domestic responsibilities.
While I'm on this- I was thinking the other day how in my flurry of hard work to establish myself as an independent adult in the past few years, working several jobs at a time, taking classes, trying to license and ever move up the job ladder, I haven't had time for much else other than this thought: "Cindy, you MUST succeed!" Having come to a relatively comfortable place after all that, the next phases of my life are much on my mind. Maybe one of the biggest questions on a single woman my age's mind in this day and age is the "to work, or not to work" while having a family question. For me it is not so much a question of desire (of course I want to stay home!) but of necessity. Though I have molded my career from what I may have dreamed to become to what will come closest to that and best accomodate a family life, the question of how it will all balane out causes me angst. I'm sure any therapist, friend or mother would tell me that is a healthy thing. SIGH. The double shift...
On a lighter tangent, I often joke with my friends and my sweet boyfriend that my doggy (an eternal puppy in my mind) is my practice baby. Though I am in my mommy prime and my hormones scream "BABIES BABIES BABIES!" (not lessened by working with only pregnant women all dasy) I am luckily able to staunch much of the urge by being a puppy-mom. Go ahead, make fun, tell me he's just a dog, but I'll tell you what, he's a damn happy one, and he gives me more psychological stability and therapy than many wasted dollars and hours historically have. That said, here is my lighter tangent. A list of ways being a puppy-mom is preparing me to be a real mom:
1) As soon as I put his toys away, they are IMMEDIATELY strewn accross the apartment again, even if they are toys he hasn't touched in ages.
2) Because of number one, I am skilled at vacuuming around toys (usually)
3) I have to plan my trips ahead and find babysitters if I will be away for too long
4) He has more toys and clothes than he will ever use
5) I have the vet on speed dial
6) Sometimes he really doesn't want to do something and gives me attitude
7) I have to accept that some things about this little monster will never change
8) Whenever he wants ANYTHING, its, "Hey mom! Hey Mom! Hey Mom!!"
9) He decides to make noise RIGHT at the best part of the show or movie I'm watching
10) If he's sick or having nightmares, or needs anything, I dont sleep
11) Those little eyes get me every time
12) To him, me getting comfortable and settled on the couch is an indication that it is time to take him outside
13) I have to discipline him for things he does that I also think are kinda cute
14) I have to watch what I say around him so he doesn't get the wrong idea ("walk"? "treat"?)
15) I have to make sure he is properly sociallized with other good puppies
16) I could go on, but most importantly he is my little buddy and we love each other
Thanks for reading my ramblings on a satisfyingly restful day!
I remember in grad school writing a post in a spare moment grabbed in a coffee shop between two jobs and my classes, where I fantasized about having a day off to do laundry and be domestic. This morning as I looked around my cluttered and very lived-in apartment, with it's piles of laundry, mountains of dishes, carpet in much need of vacuuming, tables in need of dusting, bathrooms of scrubbing, and peices of my daily life scattered all around, I felt some much needed sympathy for myself and how much I give of myself at my job. Though always worrying I am never doing enough, I give every iota of emotional and cerebral energy I have every day to my women. Evienced by everything askew in my apartment, I get home and barely have the energy to wolf down some take out, pack tomorrow's lunch and crack open a book before I fall asleep.
Today with the clean white snow on the ground trapping me inside with my puppy, I took out some chicken to thaw for dinner, set some water to boil for tea and enjoyed a breakfast that wasn't just a travel mug and a granola bar on the road. I did some sketching and drawing over a liesurely breakfast, put on some sweats and began to tackle the disarray of my apartment. How liesurely and therapuetic it felt! To engage myself in something where the outcome simply reflected the energy invested: I cleaned and my apartment got cleaner. Imagine that principle simply demonstrated to the frustrated therapist! Sigh. What a reward. Though I still have chicken to marinate, and laundry to fold and put away as the tired washer and dryer finishing shaking them clean(-ish), I am so enjoying the relative predictability and reliability of my simple apartment and finally fulfilling some domestic responsibilities.
While I'm on this- I was thinking the other day how in my flurry of hard work to establish myself as an independent adult in the past few years, working several jobs at a time, taking classes, trying to license and ever move up the job ladder, I haven't had time for much else other than this thought: "Cindy, you MUST succeed!" Having come to a relatively comfortable place after all that, the next phases of my life are much on my mind. Maybe one of the biggest questions on a single woman my age's mind in this day and age is the "to work, or not to work" while having a family question. For me it is not so much a question of desire (of course I want to stay home!) but of necessity. Though I have molded my career from what I may have dreamed to become to what will come closest to that and best accomodate a family life, the question of how it will all balane out causes me angst. I'm sure any therapist, friend or mother would tell me that is a healthy thing. SIGH. The double shift...
On a lighter tangent, I often joke with my friends and my sweet boyfriend that my doggy (an eternal puppy in my mind) is my practice baby. Though I am in my mommy prime and my hormones scream "BABIES BABIES BABIES!" (not lessened by working with only pregnant women all dasy) I am luckily able to staunch much of the urge by being a puppy-mom. Go ahead, make fun, tell me he's just a dog, but I'll tell you what, he's a damn happy one, and he gives me more psychological stability and therapy than many wasted dollars and hours historically have. That said, here is my lighter tangent. A list of ways being a puppy-mom is preparing me to be a real mom:
1) As soon as I put his toys away, they are IMMEDIATELY strewn accross the apartment again, even if they are toys he hasn't touched in ages.
2) Because of number one, I am skilled at vacuuming around toys (usually)
3) I have to plan my trips ahead and find babysitters if I will be away for too long
4) He has more toys and clothes than he will ever use
5) I have the vet on speed dial
6) Sometimes he really doesn't want to do something and gives me attitude
7) I have to accept that some things about this little monster will never change
8) Whenever he wants ANYTHING, its, "Hey mom! Hey Mom! Hey Mom!!"
9) He decides to make noise RIGHT at the best part of the show or movie I'm watching
10) If he's sick or having nightmares, or needs anything, I dont sleep
11) Those little eyes get me every time
12) To him, me getting comfortable and settled on the couch is an indication that it is time to take him outside
13) I have to discipline him for things he does that I also think are kinda cute
14) I have to watch what I say around him so he doesn't get the wrong idea ("walk"? "treat"?)
15) I have to make sure he is properly sociallized with other good puppies
16) I could go on, but most importantly he is my little buddy and we love each other
Thanks for reading my ramblings on a satisfyingly restful day!
Tuesday, June 15, 2010
A Good Intervention
I think as a therapist most of the interventions we try fall flat- even really good ones. It’s a tricky dance of meeting the client where they are in their lives, interpreting from that where they are in a present moment, and inferring from there where they need to be directed to explore. If we ever hit those three things with precision, we still have to have it phrased and timed in a way that the patient can hear and will go with us on. Needless to say again, this rarely turns out as we so eloquently design it to. Every once and awhile, we get lucky. Usually it is not when or where you would expect. Today I had a good intervention where all those factors were in alignment, and I feel that it actually was an important and useful intervention to the patient.
I was in a family session with my patient and her significant other. They were going back and forth about the fast approaching delivery of their child. My patient was passionately trying to communicate how well she had been doing in the program (which she really has) and how committed she is to changing; how hard she was working to beat her addiction, take care of her unborn baby, and fight her mental illness. Her partner was adamantly trying to communicate he wanted to be sure she was really committed and would be there for the baby and his concerns about the new financial responsibilities. I watched them do this song and dance for about five minutes or so. Then I said,
“You two have had this discussion before, haven’t you?” They said,
“Yes, many times.” I said,
“I find usually when we get into these discussions, we do it because there is something specific we are trying to get the other person to say to us, somewhere we want the other person to meet us. We will have the same discussion over and over again, getting nowhere, until we hear what we need to.” Then I asked each one of them by their name, “What is it you need to hear from [the other]?”
They paused for a moment, then said the most profound, simple and beautiful things to each other. The heated discussion became a true cathartic moment between the couple. I know they really did all the work, but my therapist heart felt proud having had a part in facilitating that moment as each person finally heard what they so badly needed to hear from the other. The sweet thing was the other person meant it all along, never knowing how healing a simple string of words were to the other.
“I know you can do this. I believe in you. I support you.”
“I will be there for my baby. I am not telling you, I am letting you know that this is the beginning of me showing you.”
I was in a family session with my patient and her significant other. They were going back and forth about the fast approaching delivery of their child. My patient was passionately trying to communicate how well she had been doing in the program (which she really has) and how committed she is to changing; how hard she was working to beat her addiction, take care of her unborn baby, and fight her mental illness. Her partner was adamantly trying to communicate he wanted to be sure she was really committed and would be there for the baby and his concerns about the new financial responsibilities. I watched them do this song and dance for about five minutes or so. Then I said,
“You two have had this discussion before, haven’t you?” They said,
“Yes, many times.” I said,
“I find usually when we get into these discussions, we do it because there is something specific we are trying to get the other person to say to us, somewhere we want the other person to meet us. We will have the same discussion over and over again, getting nowhere, until we hear what we need to.” Then I asked each one of them by their name, “What is it you need to hear from [the other]?”
They paused for a moment, then said the most profound, simple and beautiful things to each other. The heated discussion became a true cathartic moment between the couple. I know they really did all the work, but my therapist heart felt proud having had a part in facilitating that moment as each person finally heard what they so badly needed to hear from the other. The sweet thing was the other person meant it all along, never knowing how healing a simple string of words were to the other.
“I know you can do this. I believe in you. I support you.”
“I will be there for my baby. I am not telling you, I am letting you know that this is the beginning of me showing you.”
Sunday, May 30, 2010
Burn-out, Compassion Fatigue and Transference
I have been struggling with my new job this past week intensely and it has taken me some time to organize my thoughts. This past week my meltdowns have had everything to do with the coworkers, and nothing to do with the patients. That's a good diagnostic tool for indicating a major internal problem for the institution, I feel.
The problem is not that my coworkers are bad people. Quite the opposite, actually. They are wonderful people and I have fell into friendship or rather professional camaraderie with them with ease. I admire them as individuals, I admire their life and professional track records. It stops there. It used to make me frustrated but now I just feel extremely angry on this point.
One coworker, working as a contractual employee (fancy wording for more skilled temp workers) complains constantly about how horrible Johns Hopkins is to work for, how tough our particular unit within Johns Hopkins is, and how it is bum-luck to be a therapist all together. I have deduced from his complaints that really he is unhappy about not having benefits from his contracting management company (transference), exhausted from the number of patients on his case load (burn-out) and running out of sympathy for a population in substance abuse he has based his professional career upon (compassion fatigue).
A second coworker, working into her third year in this unit of Johns Hopkins cannot stop putting down the program she works for as "horrible" with terrible management and as a "ceiling-job" or job you just take for awhile before jump-starting to your actual career. Deducing her statements I found she is just carrying almost twice the caseload she should (burn-out), is rewarded minimally as all therapists are, but with no training to help her deal with this (transference) and with no training on this topic either, over empathizes with her patients to the point where she can be cold and unfeeling towards them and others now (compassion fatigue).
A third coworker, finishing her first year, worked 9 years previously for Baltimore City Department of Social Services. She believes this job to be easy to get and a huge backward step in her career; a holding place for her while she goes to school to get other certifications. I don't need to break down where her horrible attitude is from. All three problems (burn-out, compassion fatigue, and transference) probably happened in her first two months at DSS.
So enter brand new employee, freshly licensed, fresh out of grad school, ecstatic to begin her professional career with Johns Hopkins with other hard-working, highly qualified professionals surrounding her. Finally the hard work, money, hard work, studying, hard work, job interviews and hard work have paid off. In the first month, other than a complete lack of training or support of any kind, she hears from her coworkers she is at a dead-end job that requires no special knowledge, certification or trainings which is basically a holding place for many and a giant step backward for her, working for the horrible agency in the worse employer, Johns Hopkins. Leave it to the new, frazzled and heartbroken employee to be a professional, trained therapist to break down the feelings communicated and deduce the actual culprits. Not Johns Hopkins, not the unit, not the management, but our good old friends burn-out, compassion fatigue and transference. Not that it helps a whole heck of a lot to know this and still be stuck in this horrible working environment.
My sister gave me some good insight to all of this. She said, and I agree, that it doesn't matter who works around you. It doesn't matter what their attitudes are, what their licensing is (or isn't) or how they try to bring you down. What matters in the end is what you came there for: to help women that are in need. Regardless of the qualifications of others, I have to have confidence that my qualifications make me better trained to be able to meet that goal and avoid the three things that so quickly decapitate a less well prepared therapist. Pride be damned!
The ironic thing is, and in school they do not teach you this, the attitudes brought on by my coworkers are transferable to me if I do not pay attention to them and deal with them in the appropriate way. Much as I believe theirs has been, my vision can be skewed to make my own self miserable. Their anger and disdain and negativity can create transference in me of my job only one short month in. Their attitude has the potential to ruin it all; burn me out and get me on board their sinking ship, and in time, I believe that it will. There are only so many times you can be hit and remain standing.
So what to do?
The problem is not that my coworkers are bad people. Quite the opposite, actually. They are wonderful people and I have fell into friendship or rather professional camaraderie with them with ease. I admire them as individuals, I admire their life and professional track records. It stops there. It used to make me frustrated but now I just feel extremely angry on this point.
One coworker, working as a contractual employee (fancy wording for more skilled temp workers) complains constantly about how horrible Johns Hopkins is to work for, how tough our particular unit within Johns Hopkins is, and how it is bum-luck to be a therapist all together. I have deduced from his complaints that really he is unhappy about not having benefits from his contracting management company (transference), exhausted from the number of patients on his case load (burn-out) and running out of sympathy for a population in substance abuse he has based his professional career upon (compassion fatigue).
A second coworker, working into her third year in this unit of Johns Hopkins cannot stop putting down the program she works for as "horrible" with terrible management and as a "ceiling-job" or job you just take for awhile before jump-starting to your actual career. Deducing her statements I found she is just carrying almost twice the caseload she should (burn-out), is rewarded minimally as all therapists are, but with no training to help her deal with this (transference) and with no training on this topic either, over empathizes with her patients to the point where she can be cold and unfeeling towards them and others now (compassion fatigue).
A third coworker, finishing her first year, worked 9 years previously for Baltimore City Department of Social Services. She believes this job to be easy to get and a huge backward step in her career; a holding place for her while she goes to school to get other certifications. I don't need to break down where her horrible attitude is from. All three problems (burn-out, compassion fatigue, and transference) probably happened in her first two months at DSS.
So enter brand new employee, freshly licensed, fresh out of grad school, ecstatic to begin her professional career with Johns Hopkins with other hard-working, highly qualified professionals surrounding her. Finally the hard work, money, hard work, studying, hard work, job interviews and hard work have paid off. In the first month, other than a complete lack of training or support of any kind, she hears from her coworkers she is at a dead-end job that requires no special knowledge, certification or trainings which is basically a holding place for many and a giant step backward for her, working for the horrible agency in the worse employer, Johns Hopkins. Leave it to the new, frazzled and heartbroken employee to be a professional, trained therapist to break down the feelings communicated and deduce the actual culprits. Not Johns Hopkins, not the unit, not the management, but our good old friends burn-out, compassion fatigue and transference. Not that it helps a whole heck of a lot to know this and still be stuck in this horrible working environment.
My sister gave me some good insight to all of this. She said, and I agree, that it doesn't matter who works around you. It doesn't matter what their attitudes are, what their licensing is (or isn't) or how they try to bring you down. What matters in the end is what you came there for: to help women that are in need. Regardless of the qualifications of others, I have to have confidence that my qualifications make me better trained to be able to meet that goal and avoid the three things that so quickly decapitate a less well prepared therapist. Pride be damned!
The ironic thing is, and in school they do not teach you this, the attitudes brought on by my coworkers are transferable to me if I do not pay attention to them and deal with them in the appropriate way. Much as I believe theirs has been, my vision can be skewed to make my own self miserable. Their anger and disdain and negativity can create transference in me of my job only one short month in. Their attitude has the potential to ruin it all; burn me out and get me on board their sinking ship, and in time, I believe that it will. There are only so many times you can be hit and remain standing.
So what to do?
Wednesday, May 12, 2010
Why, Baltimore?
Why, Baltimore, do you sell drugs for pain and suffering? Drugs for stealing, drugs for sex, drugs for more drugs and money?
Why Baltimore, do you sell drugs to your children and have children selling your drugs?
Why, Baltimore, do you sell drugs to your pregnant women, to your women whom you abuse and get pregnant? To the babies in their addicted mothers who are born addicted?
Why, Baltimore, do you fill your streets with pain and poverty, AIDS and tragedy? Murders, suicides, overdoses and somewhere in between?
Why, Baltimore, do you foster racial hate, sex and gender hate and hate for no reason at all?
Why, Baltimore, do you fill your cold empty streets, your dirty and condemned row homes, your vacant and crumbling buildings with crackheads, addicts and the homeless?
That you helped create?
For those who were born into drugs. Those born into poverty. Those born into the streets.
For those abused by their loved ones, those abused for love. For all those lives ruined by all types of abuse.
For those that know nothing else. For those doing only what they know. For those using all they have ever experienced to stop their pain.
Find yourself out of the pain of the city.
Reach towards those that love you. Reach towards those that will always be there for you. Reach for those who gave you a chance.
Reach towards someone who has been there before. Reach for someone who has succeeded. Reach for someone clean from using, healed from hurting and working for something better.
Reach for those that want to help you. Reach for professionals who give their careers and lives to help you. Reach for programs, reach for churches, reach for caring and safe strangers.
Reach for change and don't give up. You will find yourself in a different city.
Why Baltimore, do you sell drugs to your children and have children selling your drugs?
Why, Baltimore, do you sell drugs to your pregnant women, to your women whom you abuse and get pregnant? To the babies in their addicted mothers who are born addicted?
Why, Baltimore, do you fill your streets with pain and poverty, AIDS and tragedy? Murders, suicides, overdoses and somewhere in between?
Why, Baltimore, do you foster racial hate, sex and gender hate and hate for no reason at all?
Why, Baltimore, do you fill your cold empty streets, your dirty and condemned row homes, your vacant and crumbling buildings with crackheads, addicts and the homeless?
That you helped create?
For those who were born into drugs. Those born into poverty. Those born into the streets.
For those abused by their loved ones, those abused for love. For all those lives ruined by all types of abuse.
For those that know nothing else. For those doing only what they know. For those using all they have ever experienced to stop their pain.
Find yourself out of the pain of the city.
Reach towards those that love you. Reach towards those that will always be there for you. Reach for those who gave you a chance.
Reach towards someone who has been there before. Reach for someone who has succeeded. Reach for someone clean from using, healed from hurting and working for something better.
Reach for those that want to help you. Reach for professionals who give their careers and lives to help you. Reach for programs, reach for churches, reach for caring and safe strangers.
Reach for change and don't give up. You will find yourself in a different city.
Wednesday, April 28, 2010
Prego Therapy
I had every intention today of going to a cute cafe on the medical campus after work, or even a Borders or Panera closer to home, to sit down, read paperwork, sign up for benefits, and write a thoughtful blog. At the end of the day today I was so exhausted (as immersion into brand new experiences will tend to do to you) that I just went home. And ate sushi with some friends.
By the way, 895 really is the way to go to miss traffic.
After my first two days of training at Hopkins HR department, with my badge and my title and my benefits, I felt so accomplished, big-headed and proud. I am a Johns Hopkins therapist. I am only 25 years old. I was the youngest in my class of professionals in my training. I must have done some things right. I must be good at what I do. Some of that may have been deserved. Some of it was benign and naive happiness. All of it was naive.
Today was my first day on my unit. At the end of the day I felt inadequate, underexperienced, unprepared, adolescent (in my field/ability), and overwhelmed. My new unit is medical unit extended from the main hospital. Complete with doctors, psychiatrists, clinics, labs and an inpatient wing, one of the other wings is labeled "mental health" and is where the therapist offices are. Where my office is. All of the sections of the floors, as in many hospitals, are accessible only by keys and keycards, which we carry with our badges around our necks at all times.
I don't know what the point of this blog entry is about other than to give you a taste of my new work environment and my accompanying fears and uneasiness. The pride and excitement have taken a temporary backseat. I am worried now that I am in this position with so much trust, so much responsiblity, so much influence, if I am too young, too inexperienced and naive to do it well. There is such an overwhelming amount of things to learn and know. There is such an overwhelming amount of things to do and challenges to overcome. I am just realizing the size of the task and high demands of the career I worked so hard to get. I now have to prove to myself that this is where I belong and that I can measure up!
By the way, 895 really is the way to go to miss traffic.
After my first two days of training at Hopkins HR department, with my badge and my title and my benefits, I felt so accomplished, big-headed and proud. I am a Johns Hopkins therapist. I am only 25 years old. I was the youngest in my class of professionals in my training. I must have done some things right. I must be good at what I do. Some of that may have been deserved. Some of it was benign and naive happiness. All of it was naive.
Today was my first day on my unit. At the end of the day I felt inadequate, underexperienced, unprepared, adolescent (in my field/ability), and overwhelmed. My new unit is medical unit extended from the main hospital. Complete with doctors, psychiatrists, clinics, labs and an inpatient wing, one of the other wings is labeled "mental health" and is where the therapist offices are. Where my office is. All of the sections of the floors, as in many hospitals, are accessible only by keys and keycards, which we carry with our badges around our necks at all times.
I don't know what the point of this blog entry is about other than to give you a taste of my new work environment and my accompanying fears and uneasiness. The pride and excitement have taken a temporary backseat. I am worried now that I am in this position with so much trust, so much responsiblity, so much influence, if I am too young, too inexperienced and naive to do it well. There is such an overwhelming amount of things to learn and know. There is such an overwhelming amount of things to do and challenges to overcome. I am just realizing the size of the task and high demands of the career I worked so hard to get. I now have to prove to myself that this is where I belong and that I can measure up!
Monday, April 26, 2010
Multiculturalism and Counseling
The article I promised:
An important concern in the contemporary field of psychology is multicultural diversity. This is defined as cultural/racial/ethnical general belief systems; a given set of beliefs attributed to a given society (Sue and Sue, 1999)1. Currently the field of psychology is seen as very Westernized or based on Western cultural values. This presents a problem to practicing counselors as they attempt to apply Western cultural values to a variety of belief systems. The issue is also an important topic in current research. This article reflects upon the recognized characteristics of culture as seen in contemporary psychology and defined by research. It includes my suggestion for a small but important alteration to the concept of culture to better apply the principles discussed in these articles to culturally diverse approaches to treatment in mental health.
Sue and Sue (1999) use clinical examples to divide cultural barriers into three main categories: culturally-bound values, class bound values, and language barriers. Each category represents a group of differences between Westernized cultural beliefs and those of other cultural groups. Cardemill and Battle (2003)2 highlight six main steps to effective multicultural counseling. The six steps include suspending preconceptions about race, ethnicity, and beliefs, acknowledging power dynamics, and continued education about cultural diversity. They suggest that knowledge about cultural issues is not necessarily adequate, and counselors need to understand tactful and appropriate ways to address culture in therapy. Cardemill and Battle emphasize the need for counselors to overcome limitations of their own culture in order to successfully help diverse clientele.
In an article entitled, “White Privilege: Unpacking the Invisible Knapsack” by Peggy McIntosh (1989)3, the predominance of Western culture in daily society is examined in a very different way. Instead of looking at the therapeutic process and how it has been shaped by Western cultural values, McIntosh reveals an alarming list of privileges intrinsic to the cultural majority. She compares the implicit system of white privilege to the operation of the current gender system: males, just like whites, reinforce their unearned power through ignorance of its source. In other words, McIntosh feels it is necessary to fully recognize benefits based on skin color and race in society, before one can change the differential power dynamic.
Psychology can be ineffective for large populations simply due to ignorance of varying viewpoints. It is my opinion that though simple to address through education and application of knowledge of multicultural issues in a therapeutic setting, the basic definition of culture is subsumed in this approach. Given this definition of the problem, I believe a pattern of beliefs and behaviors emerges (see Figure 1). The process is relatively simple. A person has their individual knowledge and beliefs based on their life experiences. This in turn affects the way this person views other people. The way that this person views other people is attributed to racial/ethnical attributes, and generalized to form stereotypes. These stereotypes become widespread and distorted. Due to these stereotypes, the next individual’s viewpoint is altered to include specific expectations based on race and ethnicity. These beliefs reflect ignorance and incorrect information, and need to be changed through an understanding of cultural diversity. Learning about cultural diversity may remove old beliefs, but instates new beliefs which are still tied to race and ethnicity. Therefore, I believe the tendency for this individual to incorrectly assume information about a person based on race and ethnicity is reinforced.
In this way, I conclude that cultural understanding perpetuates the survival of stereotypes based on race and ethnicity (Figure 1). Ethnicity refers to a cultural group to which one is bound by location and/or birth. It is determined by popular practices within a certain region, and the spread of those cultural practices within groups around the world through immigration and emigration. Cultural beliefs based on ethnicity are often related to history and tradition. Race, on the other hand, refers to physical attributes common to a group of people. It is determined by genetics, especially as dominant or recessive traits are expressed repeatedly within certain groups. Cultural beliefs have nothing to do with race, but are often attributed to race by society. It is clear then that when discussing cultural beliefs intrinsically neither ethnicity nor race predetermines systems of belief. Therefore, it is my opinion that it is not logical to include ethnicity and/or race as a basis on which to pin cultural belief systems.
More simply put, though many beliefs have a history and are rooted in traditions, this does not necessarily affect those who chose to adopt a given belief system. Furthermore, the physical appearance of a person has no bearing on what belief system they choose to adopt, other than those projected onto them by society. I feel that it makes sense to separate cultural belief systems from any type of ethnical or racial interpretation.
If cultural assumptions come about due to ignorance, yet they cannot be interpreted racially or ethnically, how are cultural misconceptions and understandings resolved? Just as suggested by Sue and Sue (1999) and Cardemill and Battle (2003): education and exploration. Only a slight modification is needed in each of these processes to avoid the recapitulation of false assumptions (see Figure 2).
Essentially, the beginning of the process of enculturation cannot be changed. What I think can be changed is the approach taken to identify individual cultural beliefs and how they relate to the belief systems of others. My revision is simple: instead of learning about cultural beliefs in relation to specific populations of people based on ethnicity and race, learn about cultural beliefs as extant, general groupings of belief systems. In this way ignorance of cultural variety can be decreased without reinforcing any type of assumptions (Figure 2).
Remember, it is not just that inappropriate stereotypes need to be unlearned, but also that it is necessary to eliminate cultural assumptions completely. Here is an example of a stereotype as it relates to incorrect cultural assumptions:
Ryan grew up in Chicago’s inner city. He lived with his mother, and has never met his father. His mother has struggled to hold down several different jobs simultaneously to provide for both her drug habit and her son’s needs. As a means of coping, Ryan joined a gang and dropped out of school. He dresses in gang-related clothing and paraphernalia. Despite this, he greatly respects his mother, and occasionally attends church with her. What race and/or ethinicity would you assume Ryan is? What are his cultural beliefs?
Ryan is in fact a Caucasian American citizen born in New York City to an upper-middle class family. It is fairly obvious that the example above is an exaggerated stereotype of many minority classes, when in fact this is not necessarily the case. However, after knowing that Ryan is white, does it seem less odd that he goes to church on Sundays? This is because it is assumed he is Christian since he is Caucasian.
The reason this is assumed is for reasons very similar to those pointed out by McIntosh (1989). It is not recognized that certain features and belief systems commonly associated with race/ethnicity can be an incorrect or even detrimental assumption. Cardemill and Battle point out the importance of using cultural assumptions as guidelines only, and that not everyone from a given ethnic or racial group fits within these boundaries. However, I argue that ethnicity and race are completely independent from belief systems, and should therefore be separated in definition.
The second part of resolving cultural misconceptions in counseling is in application. As explained by Cardemill and Battle (2003), knowing correct cultural information is only half the battle. There is another important piece: incorporating that information into the counseling session, to benefit the treatment of the client. Cardemill and Battle (2003) and Sue and Sue (1999) agree that this incorporation step is generally exploration.
I believe exploration involves listening to the client and guiding them in an understanding of their own belief systems. Just as we may not necessarily be aware of our own enculturation, so the client may benefit from becoming aware of theirs. As the client explores and understands their own cultural beliefs, we, as culturally educated therapists can reference the body of information we have acquired about common cultural practices to guide the exploration process. In this way we can be objective, tactful, and more aware of the nuances of belief affecting the behaviors and experiencing of the client. To a certain extent, regardless of cultural values, all experience is unique to each individual’s perception of that event (Figures 1 and 2) and the therapeutic process can only be helped by a better understanding of these perceptions.
Footnotes
1Sue, D.W. & Sue, D. (1999). Barriers to effective multicultural counseling and therapy.
In Sue, D.W. & Sue, D (Eds.), Counseling the culturally different: Theory and
practice (pp. 53-73).
2 Cardemil, E. V. & Battle, C. L. (2003). Guess who’s coming to therapy? Getting
comfortable with conversations about race and ethnicity in psychotherapy.
Professional Psychology: Research and Practice, 24, 278-286.
3McIntosh, Peggy (1989). White privileges: Unpacking the invisible knapsack. Peace and
Freedom, 10-12.
An important concern in the contemporary field of psychology is multicultural diversity. This is defined as cultural/racial/ethnical general belief systems; a given set of beliefs attributed to a given society (Sue and Sue, 1999)1. Currently the field of psychology is seen as very Westernized or based on Western cultural values. This presents a problem to practicing counselors as they attempt to apply Western cultural values to a variety of belief systems. The issue is also an important topic in current research. This article reflects upon the recognized characteristics of culture as seen in contemporary psychology and defined by research. It includes my suggestion for a small but important alteration to the concept of culture to better apply the principles discussed in these articles to culturally diverse approaches to treatment in mental health.
Sue and Sue (1999) use clinical examples to divide cultural barriers into three main categories: culturally-bound values, class bound values, and language barriers. Each category represents a group of differences between Westernized cultural beliefs and those of other cultural groups. Cardemill and Battle (2003)2 highlight six main steps to effective multicultural counseling. The six steps include suspending preconceptions about race, ethnicity, and beliefs, acknowledging power dynamics, and continued education about cultural diversity. They suggest that knowledge about cultural issues is not necessarily adequate, and counselors need to understand tactful and appropriate ways to address culture in therapy. Cardemill and Battle emphasize the need for counselors to overcome limitations of their own culture in order to successfully help diverse clientele.
In an article entitled, “White Privilege: Unpacking the Invisible Knapsack” by Peggy McIntosh (1989)3, the predominance of Western culture in daily society is examined in a very different way. Instead of looking at the therapeutic process and how it has been shaped by Western cultural values, McIntosh reveals an alarming list of privileges intrinsic to the cultural majority. She compares the implicit system of white privilege to the operation of the current gender system: males, just like whites, reinforce their unearned power through ignorance of its source. In other words, McIntosh feels it is necessary to fully recognize benefits based on skin color and race in society, before one can change the differential power dynamic.
Psychology can be ineffective for large populations simply due to ignorance of varying viewpoints. It is my opinion that though simple to address through education and application of knowledge of multicultural issues in a therapeutic setting, the basic definition of culture is subsumed in this approach. Given this definition of the problem, I believe a pattern of beliefs and behaviors emerges (see Figure 1). The process is relatively simple. A person has their individual knowledge and beliefs based on their life experiences. This in turn affects the way this person views other people. The way that this person views other people is attributed to racial/ethnical attributes, and generalized to form stereotypes. These stereotypes become widespread and distorted. Due to these stereotypes, the next individual’s viewpoint is altered to include specific expectations based on race and ethnicity. These beliefs reflect ignorance and incorrect information, and need to be changed through an understanding of cultural diversity. Learning about cultural diversity may remove old beliefs, but instates new beliefs which are still tied to race and ethnicity. Therefore, I believe the tendency for this individual to incorrectly assume information about a person based on race and ethnicity is reinforced.
In this way, I conclude that cultural understanding perpetuates the survival of stereotypes based on race and ethnicity (Figure 1). Ethnicity refers to a cultural group to which one is bound by location and/or birth. It is determined by popular practices within a certain region, and the spread of those cultural practices within groups around the world through immigration and emigration. Cultural beliefs based on ethnicity are often related to history and tradition. Race, on the other hand, refers to physical attributes common to a group of people. It is determined by genetics, especially as dominant or recessive traits are expressed repeatedly within certain groups. Cultural beliefs have nothing to do with race, but are often attributed to race by society. It is clear then that when discussing cultural beliefs intrinsically neither ethnicity nor race predetermines systems of belief. Therefore, it is my opinion that it is not logical to include ethnicity and/or race as a basis on which to pin cultural belief systems.
More simply put, though many beliefs have a history and are rooted in traditions, this does not necessarily affect those who chose to adopt a given belief system. Furthermore, the physical appearance of a person has no bearing on what belief system they choose to adopt, other than those projected onto them by society. I feel that it makes sense to separate cultural belief systems from any type of ethnical or racial interpretation.
If cultural assumptions come about due to ignorance, yet they cannot be interpreted racially or ethnically, how are cultural misconceptions and understandings resolved? Just as suggested by Sue and Sue (1999) and Cardemill and Battle (2003): education and exploration. Only a slight modification is needed in each of these processes to avoid the recapitulation of false assumptions (see Figure 2).
Essentially, the beginning of the process of enculturation cannot be changed. What I think can be changed is the approach taken to identify individual cultural beliefs and how they relate to the belief systems of others. My revision is simple: instead of learning about cultural beliefs in relation to specific populations of people based on ethnicity and race, learn about cultural beliefs as extant, general groupings of belief systems. In this way ignorance of cultural variety can be decreased without reinforcing any type of assumptions (Figure 2).
Remember, it is not just that inappropriate stereotypes need to be unlearned, but also that it is necessary to eliminate cultural assumptions completely. Here is an example of a stereotype as it relates to incorrect cultural assumptions:
Ryan grew up in Chicago’s inner city. He lived with his mother, and has never met his father. His mother has struggled to hold down several different jobs simultaneously to provide for both her drug habit and her son’s needs. As a means of coping, Ryan joined a gang and dropped out of school. He dresses in gang-related clothing and paraphernalia. Despite this, he greatly respects his mother, and occasionally attends church with her. What race and/or ethinicity would you assume Ryan is? What are his cultural beliefs?
Ryan is in fact a Caucasian American citizen born in New York City to an upper-middle class family. It is fairly obvious that the example above is an exaggerated stereotype of many minority classes, when in fact this is not necessarily the case. However, after knowing that Ryan is white, does it seem less odd that he goes to church on Sundays? This is because it is assumed he is Christian since he is Caucasian.
The reason this is assumed is for reasons very similar to those pointed out by McIntosh (1989). It is not recognized that certain features and belief systems commonly associated with race/ethnicity can be an incorrect or even detrimental assumption. Cardemill and Battle point out the importance of using cultural assumptions as guidelines only, and that not everyone from a given ethnic or racial group fits within these boundaries. However, I argue that ethnicity and race are completely independent from belief systems, and should therefore be separated in definition.
The second part of resolving cultural misconceptions in counseling is in application. As explained by Cardemill and Battle (2003), knowing correct cultural information is only half the battle. There is another important piece: incorporating that information into the counseling session, to benefit the treatment of the client. Cardemill and Battle (2003) and Sue and Sue (1999) agree that this incorporation step is generally exploration.
I believe exploration involves listening to the client and guiding them in an understanding of their own belief systems. Just as we may not necessarily be aware of our own enculturation, so the client may benefit from becoming aware of theirs. As the client explores and understands their own cultural beliefs, we, as culturally educated therapists can reference the body of information we have acquired about common cultural practices to guide the exploration process. In this way we can be objective, tactful, and more aware of the nuances of belief affecting the behaviors and experiencing of the client. To a certain extent, regardless of cultural values, all experience is unique to each individual’s perception of that event (Figures 1 and 2) and the therapeutic process can only be helped by a better understanding of these perceptions.
Footnotes
1Sue, D.W. & Sue, D. (1999). Barriers to effective multicultural counseling and therapy.
In Sue, D.W. & Sue, D (Eds.), Counseling the culturally different: Theory and
practice (pp. 53-73).
2 Cardemil, E. V. & Battle, C. L. (2003). Guess who’s coming to therapy? Getting
comfortable with conversations about race and ethnicity in psychotherapy.
Professional Psychology: Research and Practice, 24, 278-286.
3McIntosh, Peggy (1989). White privileges: Unpacking the invisible knapsack. Peace and
Freedom, 10-12.
Recant
So my last post was a bit bitter and I realized I probably worried some people that I hadn't been successful in my job search. Luckily the rant has a happy turnaround. Let me take a moment to set the record straight. Finding a full time job is a full time job, but if you put in that much effort, it will pay off. Hopefully my professional experiences at my new place of employment with Johns Hopkins will inspire some new insightful things to say and a revival of my dying blog.
I know I also told some of you I signed a contract to be published in a monthly psychology publication. I submitted my first piece last month, but it may be that the funding for the publication fizzled before the publication got started. We'll see. Either way, I'll try and remember to post the article I submitted in the near future on multiculturalism in counseling.
Until then...
I know I also told some of you I signed a contract to be published in a monthly psychology publication. I submitted my first piece last month, but it may be that the funding for the publication fizzled before the publication got started. We'll see. Either way, I'll try and remember to post the article I submitted in the near future on multiculturalism in counseling.
Until then...
Monday, March 8, 2010
It's a jungle out there.
It has been almost a year since my last post, and for my excuse I say, "It's a jungle out there."
My last post was about a month after finishing grad school. Since then I have invested my energy in advancing in my job and licensing as a therapist. This achieved, I should be a happy 20-something enjoying my young career.
Except that I'm not. For all those living under a rock, let me enlighten you: there are no jobs available. There are no jobs to be found. All the promises in grad school of "becoming a therapist" upon getting your diploma became transparent to me after the first month of job searching with no luck. There are few if any jobs for what you want and those that exist have a horde of applicants so large, you'd have to be Einstein to get them. Good luck all.
Except bad luck all! I deserve the job! Here I am licensed, ready the be therapeutic, without any options. So for all of you who think a grad degree or a license is all the hard work, it isn't. It's just the beginning. Remember the excitement of finally getting into college? Finally getting into grad school? Finally getting your internship? Finally graduating? Finally licensing? Still you have nothing. The most important step: finally having a job.
That pays you what you deserve? Let's just cut our losses at employed.
My last post was about a month after finishing grad school. Since then I have invested my energy in advancing in my job and licensing as a therapist. This achieved, I should be a happy 20-something enjoying my young career.
Except that I'm not. For all those living under a rock, let me enlighten you: there are no jobs available. There are no jobs to be found. All the promises in grad school of "becoming a therapist" upon getting your diploma became transparent to me after the first month of job searching with no luck. There are few if any jobs for what you want and those that exist have a horde of applicants so large, you'd have to be Einstein to get them. Good luck all.
Except bad luck all! I deserve the job! Here I am licensed, ready the be therapeutic, without any options. So for all of you who think a grad degree or a license is all the hard work, it isn't. It's just the beginning. Remember the excitement of finally getting into college? Finally getting into grad school? Finally getting your internship? Finally graduating? Finally licensing? Still you have nothing. The most important step: finally having a job.
That pays you what you deserve? Let's just cut our losses at employed.
Thursday, June 18, 2009
Thoughts on love...
Love is one of those amorphous philosophical concepts that is hard to describe, understand conceptualize, talk or think about. In some of my reading for an online class, I came across a chapter in the textbook about many models and ways to think about love. A few of them caught my eye and interest:
The Greek Model.
In Greek, there are six different types of love…
Eros- passion, commitment, and physical attraction (“we were meant for each other!”)
Ludus- less commited style; love is a game to be played with numerous partners (“I love to love.”)
Mania- obsessiveness, possessiveness, jealousy.
Pragma- practical loving; partners chosen according to carefully established set of criteria.
Agape- needs of the lover put before one’s own needs
Storge- love based on strong and enduring friendship
I have to admit, I’m a hopeless, helpless romantic. I love to be in love (not in a ludus way). I think I’m a helpless Eros. I would be better off if I would let reason and previously established criteria pick my partners, but this rarely is the case with me. I don’t know. Many of these seem to apply in almost a hierarchy of love-needs. Eros first, because first and foremost I am a passionate, committed lover. Agape style comes with that for me- I will always sacrifice myself for those I love. Storge applies third because my lover usually becomes my best friend. Pragma only in the sense that I have cut-off or rule-outs. Interesting if not particularly insightful.
The Chemistry of Love Model.
Medical science suggests a model called the chemistry of love…
In this model there are four basic principles organized step-wise which explain the process of falling and being in love. First, genetics, psychological experiences, and evolution imprint us with a basic set of attraction criteria. This first step is called imprinting. Second, phenylethylamine, dopamine and norepinephrine, natural amphetimines in the brain, produce feelings of euphoria and elation. This step is called attraction, and can last two to three years before it starts to wane. Third, endorphins flow into the brain leaving the lovers with a sense of security, peace and calm. This stage, attachment, represents the state of being in love. Fourth, the infamous brain chemical of love and sex, oxytocin, is released by the brain’s pituitary gland which produces more relaxed feelings, and a sense of satisfaction and attachment. Oxytocin is also called the “cuddle chemical” for these reasons.
Many if not all of us have spent a significant portion of our lives asking “why this” and “why that” about love. At least these models help me bring some sense to the crazy world of love- maybe they will help you, too! Next time you are falling in love, you can either id your “love type” or track the brain chemicals at fault. Not so easy to explain falling out of love, though chemically losing all those endorphins and adrenaline is painful. Ask any drug user all about it? (Another interesting model is the addictions model of love extrapolating the withdrawal concept to rebounding etc. A bit of a stretch to me, but interesting, nonetheless).
Some say love is dying out from dating and intimacy; romanticism is becoming an increasingly rare point of view. I tend to agree. Some of the wonderful mystique of love and intimacy between couples these days is ruined and replaced by conflicting and/or negative ideas about gender differences, sexual thrills and emphasis on instant and self-gratification (i.e “me” over “we”). Ever watch a historical movie and wish for that romance again? I was watching Casanova today, and I wished for that time again (some parts of it). Even though Casanova was rakish or what have you, I could’ve enjoyed that kind of courtship. What am I saying. I have my very own, modern-day, Don Juan (minus the conquests? you get the idea!)
The Greek Model.
In Greek, there are six different types of love…
Eros- passion, commitment, and physical attraction (“we were meant for each other!”)
Ludus- less commited style; love is a game to be played with numerous partners (“I love to love.”)
Mania- obsessiveness, possessiveness, jealousy.
Pragma- practical loving; partners chosen according to carefully established set of criteria.
Agape- needs of the lover put before one’s own needs
Storge- love based on strong and enduring friendship
I have to admit, I’m a hopeless, helpless romantic. I love to be in love (not in a ludus way). I think I’m a helpless Eros. I would be better off if I would let reason and previously established criteria pick my partners, but this rarely is the case with me. I don’t know. Many of these seem to apply in almost a hierarchy of love-needs. Eros first, because first and foremost I am a passionate, committed lover. Agape style comes with that for me- I will always sacrifice myself for those I love. Storge applies third because my lover usually becomes my best friend. Pragma only in the sense that I have cut-off or rule-outs. Interesting if not particularly insightful.
The Chemistry of Love Model.
Medical science suggests a model called the chemistry of love…
In this model there are four basic principles organized step-wise which explain the process of falling and being in love. First, genetics, psychological experiences, and evolution imprint us with a basic set of attraction criteria. This first step is called imprinting. Second, phenylethylamine, dopamine and norepinephrine, natural amphetimines in the brain, produce feelings of euphoria and elation. This step is called attraction, and can last two to three years before it starts to wane. Third, endorphins flow into the brain leaving the lovers with a sense of security, peace and calm. This stage, attachment, represents the state of being in love. Fourth, the infamous brain chemical of love and sex, oxytocin, is released by the brain’s pituitary gland which produces more relaxed feelings, and a sense of satisfaction and attachment. Oxytocin is also called the “cuddle chemical” for these reasons.
Many if not all of us have spent a significant portion of our lives asking “why this” and “why that” about love. At least these models help me bring some sense to the crazy world of love- maybe they will help you, too! Next time you are falling in love, you can either id your “love type” or track the brain chemicals at fault. Not so easy to explain falling out of love, though chemically losing all those endorphins and adrenaline is painful. Ask any drug user all about it? (Another interesting model is the addictions model of love extrapolating the withdrawal concept to rebounding etc. A bit of a stretch to me, but interesting, nonetheless).
Some say love is dying out from dating and intimacy; romanticism is becoming an increasingly rare point of view. I tend to agree. Some of the wonderful mystique of love and intimacy between couples these days is ruined and replaced by conflicting and/or negative ideas about gender differences, sexual thrills and emphasis on instant and self-gratification (i.e “me” over “we”). Ever watch a historical movie and wish for that romance again? I was watching Casanova today, and I wished for that time again (some parts of it). Even though Casanova was rakish or what have you, I could’ve enjoyed that kind of courtship. What am I saying. I have my very own, modern-day, Don Juan (minus the conquests? you get the idea!)
Tuesday, June 9, 2009
Travel Diary of my 10ish Day Trip to Nicaragua
I kept a small journal with me to record daily my adventures in Nicaragua. Maybe from reading my small anecdotes I can take you with me for a few minutes to the beautiful tropical country...
to share sooner these were typed in haste so please excuse my typos...
Saturday, May 30, 2009 (Maryland, USA to Managua, Nicaragua)
Woke up 3am left for BWI by 330. Took the Econopark bus (pay me for advertising!) from the lot where we parked Mario's BMW to the BWI airport terminal. Plane left 6am. Lugged one roller board and my one "personal item" around the airport and onto the plane. Slept on Mario's shoulder. Plane landed 9am in Miami (your- ami?) Called my sister because we were in the same state. Waited with Mario in Miami terminal until our connection flight left at 1pm for Managua. Plane was a HUGE A330 airbus (first plane I ever rode with 2 aisles and 3 rows of seats!) Slept on Mario's shoulder. Arrive in Managua 2 1/2 hours later which is 130pm Managua time. Went through thermoscanner testing body temperature as part of swine flu screening and you could see the outline of my underwear through my dress (when we arrived there were no documented cases of swine flu in Nicaragua- the first case was documented a few days later in a trucker's daughter). Mario made jokes about people with nipple rings and other piercings to be discovered by the scanner. Customs, immigration; Mario's family (2 sisters Jessly and Jessica, Mom and grandparents) met us at the gate and dropped us with luggage at Mario's tio's Alvero y Carolina's beautiful condo/ 1-story town house. No airconditioning, all doors and windows open- typical in Nicaragua. Beautiful patio. Went to lunch in an open-air restaurant with Mario's family. Ate carne asada. Went to Mario's mom's house, Patricia (Patty). Jessica and Jessly live there and share a tiny room. Jessly showed me things she bought for the wedding and her favorite shoes. Jessica made us cake and brought us sweet tea. Went to an outdoor mall to buy gift for Abuela for mother's day, that day (different date in Nicaragua than the states- and a very important celebratory holiday). Went with Patty and 2 sisters to Abuela's house and met extended family and friends for the celebration. Tired and hot (no airconditioning anywhere, 90* F). Attempted to talk to Mario's uncles, aunts and friends in Spanish. Left late back to Carolina y Alvero's to sleep. You can hear many bugs chirping at night through the open windows and little lizards living on the warm stone walls inside the houses. They make smooching sounds.
Sunday, May 31, 2009 (Managua a Montelimar)
Woke up to a chorus of birds, many of which I never heard before. Packed a small bag, then sat outside on Carolina y Alvaro's back patio and ate breakfast. They drink a delicious chocolate/coco drink here. Saw black birds with yellow breasts. Met Alvaro y Carolina's parrot. Drove to Patty's house and picked up Jessica. Left for Barcel`o hotel at Montelimar beach. Drive was one hour. Roads a mess. After awhile they were made of concrete bricks. Better condition but very bumpy. Saw lots of poverty on the drive. Road shared by people walking, in wagons, on bikes, on horseback, with chickens, cows, sheep, and huge bulls (ox?) pulling carts, stray starving dogs straggling everywhere. Thin and dilapidated or improvised houses along the way- many have no electricity or running water (most probably don't, by the looks). Very humble people with very little means. Saw women and children bathing in a river. Arrive to hotel. Check-in and eat lunch. Relaxed in a hammock between two almond trees on the beach. Dozed-off listening to Mario and Jessica catch-up. Went and checked out our cabanas. Changed into swim suits. Relaxed in the pool. Walked down the beach and played in the surf. Watched the sun set. Watched at least 20 crabs scurrying across the sand. Went back to the cabanas and changed for dinner. Walked to dinner. While I am up filling my plate at buffet a woman comes by the table and tells Mario and Jessica to ask me to participate in the Miss Barcel`o contest that evening at 9p. Reluctantly I agree. Rush back to cabana to fix hair. Back to restaurant/casino/pavilion for contest. Don't participate because I am the only gringa and don't speak enough Spanish. Watch the contest anyway. Walk back to cabanas late stopping along the way to watch the moon and distant lightning reflecting on the ocean. Back at the cabanas I showered and collapsed into the giant bed.
Monday, June 1, 2009 (Montelimar a Managua)
Wake up 9am-ish. Dress and pack up my suitcase. While I'm preparing Jessica arrives. She, Mario and I go to breakfast. After breakfast (which was at an open-air restaurant on the beach) we return to the cabanas and put on bathing suits. We go straight to the beach. Play in the surf. Then back to the hammocks. I snooze more to the chatter of two siblings. We rush to check out of our rooms then go to the pool. We have spanglish conversations about everything and try to help Mario swim. We leave the pool and change into dry clothes for lunch. We eat at the same open-air, beach side restaurant. During lunch we spot some distant rocks on the beach. After lunch we walk out to explore them. On the way I look for and find beautiful shells and a sand dollar- gifts for my mom. Lots of little crabs- hermit crabs, sand crabs, etc- scurry around. Standing pools of water by the rocks hold little fish. On the way back, we take a different route and find at the resort two huge red/yellow/blue parrots. After cooing at them I open my eyes enough to see also two green parrots and a toucan!!! Finally I'm pried away from the birds. We walk back to the hotel and leave. In the hotel (remember no AC) there are stairs and an elevator. We always take the stairs because imagine a tiny, packed, no-AC elevator. Mario and Jessica call it the "microondas." Drive back to Managua. Same sights on the drive back. I take pictures of a herd of cows in our path. A man walks down the road past bulls tied and tagged for sale. One lunges at the man- doesn't attack. Scares the guy. We laugh. Mario drives me around the city showing me sights. We stop at a military base on the highest point of the city (which less than a week after was attacked by killer African bees sending 70-ish people to the hospital) to watch the sun set. We drive to Patty's house to drop off Jessica. No one's home. Drive back to Carolina y Alvaro's. Meet the maid and talk for awhile (as in many Latin American countries, it's standard for even middle and lower middle class families to have live-in maids from the lower classes) with Carolina. After awhile I feel overwhelmed by all the Spanish and excuse myself to shower (no hot water in the showers here because 90*F no AC- I still don't like cold showers). After, the maid has made me dinner and Patty has arrived. We all talk. I try my first zapote fruit- it is pink with a huge pit and tastes like pumpkins. We plan a trip for the next two days to a coffee farm in the mountains called Selva Negra. Jessica y Patty leave. The rest of us go to bed. I am writing to the sounds of many insects, a few birds, and the kissing lizards.
Tuesday, June 2, 2009 (Managua a Matagalpa)
Woke up to the bird chorus and a very confused rooster around 7am. Carolina's maid prepared us breakfast of eggs revueltos con tomates, arroz frijoles (gallo pinto) and freshly made tortillas. Packed another small suitcase and left with Mario around 9a for Matagalpa a la Selva Negra; a 5th generation German owned coffee farm in the mountains. The drive was different because it was on a road used by truckers coming from Honduras. Small and pretty towns and beautiful landscape during the 2 1/2 hour drive. The end was straight up the mountain, then through a 1km dirt road- the only road in and out of Selva Negra. We arrived and checked in. We stayed at a tiny, moss and vine covered caban~a nestled in the jungle on the farm's property. You can hear birds, frogs, monkeys y mas aqui. We wandered around and took pictures or the beautiful and romantic land. Then we went horseback riding around the farm and jungle with a local guide. It was my first time on a horse!! I loved it. It was so beautiful, wild and peaceful. After the horses, we ate lunch at an open air cafe over the lake. I had the Nica-German salchichas y jugo de maricuya (frutas de calala y azucar-calalas son nativos de Nicaragua). After lunch we went back to ride horses again. I rode a different horse which was brown and white and necio y traigon tambien. This time I rode free of the help of the guide. The ride was some mountain trails, some horse trails, and some dirt road. We saw goats, baby cows, and chickens along the way. Mario and the guide chatted about post-communist regime and war during the '80s- the mountains we were in were battleground then. Many locals were forced into fighting for the communists- basically thrown into the front lines as targets to protect the trained communist soldiers. Two of Mario's uncles were recruited for this and amazingly survived, but are "changed" from the horrors they saw and experienced. The guide lost many friends. We returned from the horse ride just in time for the rain to start. The rainy season-now- is considered winter in Nicaragua, even though temp is always 80-90*F. It is cooler -70s- up here in the mountains. We dashed back to the cabana and snuggled up to wait out the rain to a chorus of monkeys in the nearby jungle. We woke up in time for dinner and ate at the same open-air cafe. We laughed at the European tourists there trying to get online with their Macbooks. There is nothing to do up here after dark, so we went back to the cabana and managed to find one clear TV channel showing Nicaraguan news. Nicaraguan news in uncensored-someone is shot, you see the dead body sprawled on the road- we saw such a shot during the evening news that night. Amazingly, the cabana has hot water (I really didn't have my hopes up here because the water runs fresh from the mountains) but it had hot water. My first hot shower yet!! I took a long one. Now I"m resting in one of the two rooms in the tiny cabana. Outside is nothing but jungle- it's una selva negra (muy, MUY negra). So peaceful and isolated nestled in this beautiful mountain. I am going to snuggle up under the old wool blanket on the small bed and read myself to sleep to the sounds of selva negra.
Wednesday, June 3, 2009 and through to morning, Thursday, June 4, 2009 (Matagalpa a Managua)
A little bit scary sleeping in the dark, remote jungle. Woke up early to grab breakfast at the lake restaurant before our scheduled tour of the farm. During breakfast I accidentally ate "queso de cabesa de cerdo" or basically pig brain cheese. Ugh. The tour left at 9am, and me, Mario and another blonde also named Cindy (in her 40s from Canada) went by van with the farm's owner on the tour. Lots of stores because his motto was "you learn more from anecdotal history." The farm is like it's own mini-society. Two hundred workers and their families live, work and go to school there. It was begun by the owner and his wife in the 70's (the resort part) and amazingly the communists left the farm alone during the revolution. The farm began with an Austrian woman who in the 1800s, rode into town alone with "one leg on either side of her horse." Scandalous! Her hard work and recruitment of other German, European and local families made the farm. Hence the blonde latinos with German ancestry in Matagalpa. Because of this mixing, notoriously beautiful women come from these mountains. Currently the farm is run by husband and wife and 4 other women. They are very advanced and giving their employees room and boar, salary and retirement. Special care is paid to raising self-esteem in the women on the farm and fighting machismo- 42% of the full time workers are female. They are given tasks that are specified for them because they are the best for that job, and specifying these tasks for women only help raise the women's self esteem. Special attention also on organizing events (i.e. sport events) to fill employee's free time and therefore reduce alcoholism. Really beautiful place. Not to mention the breathtaking mountainside the farm is nestled on. They do more than coffee including farming, raising pigs, and cattle. All food served on farm is fresh from the farm. Two hours later the tour ended. Mario and I decided to try our luck hiking through the jungle. The altitude, mud from yesterday's rain and otherwise treacherous path made it a tough climb up the mountain- and even tougher back down. At the top, the trail ended at a cliff- we stopped and took pictures before climbing back down again. After the hike we tried to get as much mud off of us as possible before stopping for lunch. After we ate it threatened to rain so we checked out of our cabana and began the drive home. More breathtaking countryside. We went back to Carolina y Alvaro's and showered and dressed for the evening. It was a 3 hour drive from Matagalpa back to Managua so after showering we were hungry again and ate the dinner the maid prepared us. That is when things started to get bad. The plan was to meet with Jessly and Jessica and go out to a club, but my stomach was feeling weird after dinner (even after the Pepto I took) so we went to their house and just hung out together with Patty, too. Towards the end of the night my stomach was really hurting bad so I had Mario take me back to Carolina's. None too soon. I lost everything in my body immediately in both directions. I spent the rest of the night sick and weak in the bathroom. By morning, Carolina (who is a doctor) had left to work but a worried Mario called her for advice- turns out I have some bacteria or parasite. I'm lying here sick as a dog while Mario scrambles to find me the anti-parasites, anti-nausea, rehydrating things Carolina says I need :(
Thursday, June 4, 2009 (Managua)
Sick day. Laid around Carolina's apartment until around 3pm when I got dressed for the civil ceremony for Jessly. The official plan was to go to the salon with Mario's abuela for nails and facial, then to the civil ceremony by 7p. Picked up Mario's abuela and went to the salon. Was waiting for nails and fading fast. Mario took me back to Abuela's house, skipping the salon, so I could lay on his abuela's bed where there was airconditioning and hopefully recover there for the civil ceremony by 7p. "La lloya", the family's parrot, was chattering outside the window saying "pobrecita la lloyita" and meowing like the cats that stalk her cage at night. I smile despite the pains in my stomach. At 630p Mario and Abuela get back from the salon and I still feel miserable. I concede the civil ceremony, and Mario drops me back at Carolina's to rest on his way to the ceremony. I fight off nausea and try to sleep. Around 12am I am poked awake and Mario launches into a story about the civil ceremony from hell. Aparently, and he had to retell me later, Patty, over a confusion over who was driving whom to the ceremony (cars are shared and people pick each other up etc) didn't arrive until an hour late. They held up the ceremony waiting, and finally started by 8pm. Shortly after the ceremony began, everyone already frustrated, the groom, Javier, passes out, hitting the table on the way to the ground. Chaos ensues while everyone rushes to his side and he is carried off to an empty room to recover. Half an hour later, he comes back and the ceremony begins again. Shortly after it resumes for the second time, a loud hissing emits from the main house (the ceremony is held in the back yard of Javier's mom's house) and someone comes running from the house yelling, "It's a gas leak! Everyone get away from the house!" Everyone goes running from the yard and down the street before the poor maid sent back to check finds out it's just a boiler leaking steam. After everyone is found and brought back to the yard, the ceremony begins for the third time. At this point the speaker is cut off by the audience yelling to him to just have Javier and Jessly sign the papers before something else can happen!! Bummer I missed that :( After being regaled with the excitement at the civil ceremony, I fight against the heat and pain in my stomach, struggling to go back to sleep, at least still with a smile on my face.
Friday, June 5, 2009 (Managua to Masaya y Catarina)
Woke up feeling much improved and decided to go to volcan Masaya y Catarina market. Picked-up Jessica and went to a grocery store for bottled water, gatorade, and safely prepackaged snacks for me to eat. Mario's while family is now rallying around how to take care of their gringa, and I"m hardly allowed to eat anything not bottled or packaged. Drove up to volcan Masaya. Lava rock everywhere. Masaya is an active volcano that erupted about 100 years ago. At the top we got out to look at its crater. The first thing I noticed was the smell. I can't describe it other than it was strong, maybe a little like sulphur, and you could feel it in your throat. Smoke and steam were pouring out of the crater- I guess it was that. Beautiful view. Since I was already weakened from being sick, I couldn't stay up there in the fumes for very long before feeling light headed, so we left after some pictures to Catarina. Catarina is a small artisian based city situated looking over a crater of an inactive volcano turned to a lake. It was a lovely town. A group of local young boys followed me around whistling and calling me "clase rubia" meaining big or tall blonde. Mario said they may not have seen a blonde before- wierd sticking out so much like this! Bought gifts from local artisians who were calling me "dura esta merchanta" or the tough customer- I guess I was picky. We had dress fitting for bridesmaids gowns and wedding dress rehearsal at 5p back in Managua, so we left Catarina with just enough time to get to the church for the rehearsal. The fitting and rehearsal were long and hot both- dominated by the bridezilla and drama. After those and a brief visit to the Abuelos, we found a pizza hut (I so badly wanted American food) and brought it back to Patty's house to eat with Mario, his mom, and his sisters. We had barely gobbled it down when Mario said, "ella esta cansada y inferma- nos vamos pues," or something to that effect, and we rushed out. Come to find out the Spanish conversation I wasn't following while gobbling my pizza was Jessly complaining and bridezilla-ing, and Mario had had enough. Back to Carolina's to sleep and snuggle up after a long day. There is a crazy rooster here added to the menagerie of night sounds that totally must be blind. It's hot- I miss AC and American food (and American driving- you should see the drivers and roads here in Managua!)
Saturday, June 6, 2009 (Managua- wedding mayhem)
Bridezilla part two. Woke up around 8am. Picked up breakfast and went to Patty's house. Ate breakfast with Jessica and Patty while Mario worked on their computers. Dozed until 12pm then left with Jessica and Mario to the hair salon. The salon was a nightmare for the civil ceremony day making everyone late- but I took heart today because I got worked on right away- so I thought. Rolled my hair in pin curlers and then sent me to wait. Two hours later still waiting and un cuchon says, "voy a maquillarte." I think, "great- my first professional makeover!" He takes me to a side room for thirty minutes working on his masterpeice before putting a mirror in front of my face. !Que horror! I looked like a drag queen, clown, totem-pole, middle-school art project freak. In the meantime my stylist looks for me, I'm MIA, so he moves on to someone else. It is after 3p and we were suppsed to be at the dressmaker by 3p for finishing touches on the dresses. I told the "artist" to take it all off (the makeup) and by the time my hair was done it was almost 4p. At least the hair looked ok. We left for the dressmakers'. None of the dresses for the six bridesmaids are done yet. It is 4p on the day of the 7p wedding and the dresses are not yet sewn. Ridiculous. I'm told mine will be ready in an hour so Mario finds us some late lunch then runs us to a nearby different salon to have someone else do my makeup again. The makeup artists all commented on my big blue eyes and in 15 minutes I was done. Still a bit heavy for my taste, but everyone loved it so I smiled and thanked them. Back by 5p to dressmaker, back to Carolina's to change by 6pm- Mario is set to arrive at the wedding with the bride by 630p and he isn't dressed yet. Tuxedo pieces fly on his way out the door- he has to meet Jessly at the hotel and arrive with her to walk her down the aisle. At 6:57p Mario's abuelos finally arrive at Carolina's to pick me up and run me to the church- luckily we still arrive before the bride. I'm shoved towards the other bridesmaids and a boquet of lillies are thrust into my hands. Three bridesmaids of six didn't make it because their dresses weren't done yet. Bride arrives. I stick out as the only blonde in the processional and stand teary-eyed watching my sweetheart proudly walk his sister down the aisle and give her away. We sit together in the front row and the ceremony passes quickly- it was very beautiful. Recessional. Everyone crams into cars to go to the reception. They have good food but I am under strict Fuentes family regulations to only eat bread and rice. Dancing, music, fold dancers, live music, singing, celebrating and eating carry through the night until 2am. I dance with Mario and realize for the first time what a good dancer he is. I cut a rug wigh his aunts and Abuela (oh btw, did I mention also blubber all over myself while snapping pictures of Mario having the first dance with his sister? He is not just a son and brother but also father to his sisters and support to his mom. Beautiful to see how much they all love each other). Tired and hot, Mario and I leave the reception and get home to Carolina's around 3am. Little lizards skitter around on the walls kissing the air goodnight.
Sunday, June 7, 2009 (Managua)
Got up around 10am this morning and managed to stomach huevos revueltos for breakfast. A lunch for the new couple is scheduled by the groom's family at their house at 1p. Mario and I go to his mom's and he works on computers again. We don't get out the door to the lunch until 2p. Start times seem farily relative here. Again I am restricted on food- this time by Jessly- to bread and cheese and a warm can of soda (no ice) for lunch. We spend the afternoon between the party and the bride's mom's house (Patty). Coming and going to parties is quite an ordeal here- kissing everyone hello and goodbye. It's sweet and warming though, and I like it. The party is- like everything in Nicaragua- outdoors or "indoors," which is in the house with all doors and windows open to the feel of an American patio. I spend the afternoon working on my Spanish. Later we return again and stay late at Mario's mom's for more computer work, getting back to Carolina's 11-ish. I scarf a late-night dinner of a can of Campbell's soup, a welcome change from all the break and crackers. I collapse into sleep, too tired to pack yet.
Monday, June 8, 2009 (Managua to Miami)
The plan today is to leave Nicaragua at 1:30p and arrive at Baltimore 11-ish p. We wake early and pack, and after thanking Carolina (Alvaro was not home) we leave for Mario's abuelos' house. We pick up his abuela and have her driver take us down the block to a local bakery called the Margarita for breakfast. We chat in the open-air cafe over pan dulce and drinks (I had a bottle of soda- actually cold this time). I ate una "oreja" y pan dulce con "sweet milk" which is caramel. I forgot the name of it but it was flaky, gooey, and delicious. We left around 11:30am to Abuela's house again. About noon Patty, Jessica and Jessly arrive to accompany us with his abuelos to the airport- a tration here for a big family send-off. The bride brings left-over wedding cake. She has been calling me her "cun~iz" which Mario told me is an affectionate way to say "sister-in-law," also slang for brother's girlfriend. Two cars of Fuentes leave with us to the airport. We check our bags then sit for drinks with Mario's family. After goodbye kisses and tears, Mario and I board the plane and leave Nicaragua. We arrive to Miami about 7pm (losing 2 hours to time zones). We were sitting by the emergency door on another A330 (ps- these are on the news as unsafe right now) and one of the flight attendants sat facing us during landing and take off and we were chatting with him before gettin goff the plane and joining the melee towards immigration. Turns out there was no rush. Mario and I seperated at immigration into "residents" and "citizens" lines, making faces at each other accross the crowd, arriving at our respective immigration officers at the same time. I get grilled but go through and pass just in time to hear his officer say "step aside." He gives me a confident smile and a shrug as I am pushed forward by the crowd. After passing the exit guard I wait at the top of the down escalator, eyes locked on Mario. I figure he has been randomly flagged for carry-on search or something (we don't have our full luggage yet). The exit officer sends me down the escalator and frustrated, I wait at the bottom now helpless and separated from my sweetheart. I stand as our while flight followed by captain and crew clear immigration and descend the escalator. I start to panic. An hour passes. I fight back tears and waves of panic. Somehow I have the presence of mind to hear someone announce in Spanish to pick up baggage at claim eight to clear cultoms and they are starting to confiscate remaining bags. I tear my eyes off the escalator and rush to the baggage claim, hauling our four suitcases onto a hand cart, I run back to the escalator. Another hour. All that are left are me and a handful of other worried-looking people at the bottom of the escalator. We've already missed our connecting flight. A third hour ticks by. I start thinking of worst case scenerios. Another worried woman grills a passing guard who says he can tell her nothing. I am angered by my own helplessness. A flight from Haiti arrives and begins trickling through immigration and coming down the escalator. Finally, I see my Mario and run to him, leaving the luggage temporarily behind. We share a sweet moment and many kisses of relief. He had been held over an almost 2 year old traffic ticket. Exhausted and full of relief to be arm-in-arm, we trudge through customs and to the American Airlines missed flight counter, temporarily ignoring the significance of the discrimination we both just suffered from (especially him, pobrecito). Next flight to Balitmore tomorrow at 12p. We change tickets, recheck bags, feed our growling stomachs and take a shuttle to a nearby hotel. I collapsed into fitful sleep, waking often and feeling scared forgetting where I was.
Tuesday, June 9, 2009 (Miami to Baltimore)
(written in airport before safe arrival home to Baltimore):
An unexpected 11th day of our trip. After grabbing the hotel's continental breakfast and checking out we shuttled back to the airport. I'm at our departure gate now waiting to board, ready to be home. Work and kennel have been called and upon arrival to Baltimore around 3p, I have a puppy to pick-up and the rest of the day to rest, and reflect upon my travels.
Hopefully once I have had time to digest, I will be able to write a follow-up blog summarizing my thoughts on this amazing trip!!!
to share sooner these were typed in haste so please excuse my typos...
Saturday, May 30, 2009 (Maryland, USA to Managua, Nicaragua)
Woke up 3am left for BWI by 330. Took the Econopark bus (pay me for advertising!) from the lot where we parked Mario's BMW to the BWI airport terminal. Plane left 6am. Lugged one roller board and my one "personal item" around the airport and onto the plane. Slept on Mario's shoulder. Plane landed 9am in Miami (your- ami?) Called my sister because we were in the same state. Waited with Mario in Miami terminal until our connection flight left at 1pm for Managua. Plane was a HUGE A330 airbus (first plane I ever rode with 2 aisles and 3 rows of seats!) Slept on Mario's shoulder. Arrive in Managua 2 1/2 hours later which is 130pm Managua time. Went through thermoscanner testing body temperature as part of swine flu screening and you could see the outline of my underwear through my dress (when we arrived there were no documented cases of swine flu in Nicaragua- the first case was documented a few days later in a trucker's daughter). Mario made jokes about people with nipple rings and other piercings to be discovered by the scanner. Customs, immigration; Mario's family (2 sisters Jessly and Jessica, Mom and grandparents) met us at the gate and dropped us with luggage at Mario's tio's Alvero y Carolina's beautiful condo/ 1-story town house. No airconditioning, all doors and windows open- typical in Nicaragua. Beautiful patio. Went to lunch in an open-air restaurant with Mario's family. Ate carne asada. Went to Mario's mom's house, Patricia (Patty). Jessica and Jessly live there and share a tiny room. Jessly showed me things she bought for the wedding and her favorite shoes. Jessica made us cake and brought us sweet tea. Went to an outdoor mall to buy gift for Abuela for mother's day, that day (different date in Nicaragua than the states- and a very important celebratory holiday). Went with Patty and 2 sisters to Abuela's house and met extended family and friends for the celebration. Tired and hot (no airconditioning anywhere, 90* F). Attempted to talk to Mario's uncles, aunts and friends in Spanish. Left late back to Carolina y Alvero's to sleep. You can hear many bugs chirping at night through the open windows and little lizards living on the warm stone walls inside the houses. They make smooching sounds.
Sunday, May 31, 2009 (Managua a Montelimar)
Woke up to a chorus of birds, many of which I never heard before. Packed a small bag, then sat outside on Carolina y Alvaro's back patio and ate breakfast. They drink a delicious chocolate/coco drink here. Saw black birds with yellow breasts. Met Alvaro y Carolina's parrot. Drove to Patty's house and picked up Jessica. Left for Barcel`o hotel at Montelimar beach. Drive was one hour. Roads a mess. After awhile they were made of concrete bricks. Better condition but very bumpy. Saw lots of poverty on the drive. Road shared by people walking, in wagons, on bikes, on horseback, with chickens, cows, sheep, and huge bulls (ox?) pulling carts, stray starving dogs straggling everywhere. Thin and dilapidated or improvised houses along the way- many have no electricity or running water (most probably don't, by the looks). Very humble people with very little means. Saw women and children bathing in a river. Arrive to hotel. Check-in and eat lunch. Relaxed in a hammock between two almond trees on the beach. Dozed-off listening to Mario and Jessica catch-up. Went and checked out our cabanas. Changed into swim suits. Relaxed in the pool. Walked down the beach and played in the surf. Watched the sun set. Watched at least 20 crabs scurrying across the sand. Went back to the cabanas and changed for dinner. Walked to dinner. While I am up filling my plate at buffet a woman comes by the table and tells Mario and Jessica to ask me to participate in the Miss Barcel`o contest that evening at 9p. Reluctantly I agree. Rush back to cabana to fix hair. Back to restaurant/casino/pavilion for contest. Don't participate because I am the only gringa and don't speak enough Spanish. Watch the contest anyway. Walk back to cabanas late stopping along the way to watch the moon and distant lightning reflecting on the ocean. Back at the cabanas I showered and collapsed into the giant bed.
Monday, June 1, 2009 (Montelimar a Managua)
Wake up 9am-ish. Dress and pack up my suitcase. While I'm preparing Jessica arrives. She, Mario and I go to breakfast. After breakfast (which was at an open-air restaurant on the beach) we return to the cabanas and put on bathing suits. We go straight to the beach. Play in the surf. Then back to the hammocks. I snooze more to the chatter of two siblings. We rush to check out of our rooms then go to the pool. We have spanglish conversations about everything and try to help Mario swim. We leave the pool and change into dry clothes for lunch. We eat at the same open-air, beach side restaurant. During lunch we spot some distant rocks on the beach. After lunch we walk out to explore them. On the way I look for and find beautiful shells and a sand dollar- gifts for my mom. Lots of little crabs- hermit crabs, sand crabs, etc- scurry around. Standing pools of water by the rocks hold little fish. On the way back, we take a different route and find at the resort two huge red/yellow/blue parrots. After cooing at them I open my eyes enough to see also two green parrots and a toucan!!! Finally I'm pried away from the birds. We walk back to the hotel and leave. In the hotel (remember no AC) there are stairs and an elevator. We always take the stairs because imagine a tiny, packed, no-AC elevator. Mario and Jessica call it the "microondas." Drive back to Managua. Same sights on the drive back. I take pictures of a herd of cows in our path. A man walks down the road past bulls tied and tagged for sale. One lunges at the man- doesn't attack. Scares the guy. We laugh. Mario drives me around the city showing me sights. We stop at a military base on the highest point of the city (which less than a week after was attacked by killer African bees sending 70-ish people to the hospital) to watch the sun set. We drive to Patty's house to drop off Jessica. No one's home. Drive back to Carolina y Alvaro's. Meet the maid and talk for awhile (as in many Latin American countries, it's standard for even middle and lower middle class families to have live-in maids from the lower classes) with Carolina. After awhile I feel overwhelmed by all the Spanish and excuse myself to shower (no hot water in the showers here because 90*F no AC- I still don't like cold showers). After, the maid has made me dinner and Patty has arrived. We all talk. I try my first zapote fruit- it is pink with a huge pit and tastes like pumpkins. We plan a trip for the next two days to a coffee farm in the mountains called Selva Negra. Jessica y Patty leave. The rest of us go to bed. I am writing to the sounds of many insects, a few birds, and the kissing lizards.
Tuesday, June 2, 2009 (Managua a Matagalpa)
Woke up to the bird chorus and a very confused rooster around 7am. Carolina's maid prepared us breakfast of eggs revueltos con tomates, arroz frijoles (gallo pinto) and freshly made tortillas. Packed another small suitcase and left with Mario around 9a for Matagalpa a la Selva Negra; a 5th generation German owned coffee farm in the mountains. The drive was different because it was on a road used by truckers coming from Honduras. Small and pretty towns and beautiful landscape during the 2 1/2 hour drive. The end was straight up the mountain, then through a 1km dirt road- the only road in and out of Selva Negra. We arrived and checked in. We stayed at a tiny, moss and vine covered caban~a nestled in the jungle on the farm's property. You can hear birds, frogs, monkeys y mas aqui. We wandered around and took pictures or the beautiful and romantic land. Then we went horseback riding around the farm and jungle with a local guide. It was my first time on a horse!! I loved it. It was so beautiful, wild and peaceful. After the horses, we ate lunch at an open air cafe over the lake. I had the Nica-German salchichas y jugo de maricuya (frutas de calala y azucar-calalas son nativos de Nicaragua). After lunch we went back to ride horses again. I rode a different horse which was brown and white and necio y traigon tambien. This time I rode free of the help of the guide. The ride was some mountain trails, some horse trails, and some dirt road. We saw goats, baby cows, and chickens along the way. Mario and the guide chatted about post-communist regime and war during the '80s- the mountains we were in were battleground then. Many locals were forced into fighting for the communists- basically thrown into the front lines as targets to protect the trained communist soldiers. Two of Mario's uncles were recruited for this and amazingly survived, but are "changed" from the horrors they saw and experienced. The guide lost many friends. We returned from the horse ride just in time for the rain to start. The rainy season-now- is considered winter in Nicaragua, even though temp is always 80-90*F. It is cooler -70s- up here in the mountains. We dashed back to the cabana and snuggled up to wait out the rain to a chorus of monkeys in the nearby jungle. We woke up in time for dinner and ate at the same open-air cafe. We laughed at the European tourists there trying to get online with their Macbooks. There is nothing to do up here after dark, so we went back to the cabana and managed to find one clear TV channel showing Nicaraguan news. Nicaraguan news in uncensored-someone is shot, you see the dead body sprawled on the road- we saw such a shot during the evening news that night. Amazingly, the cabana has hot water (I really didn't have my hopes up here because the water runs fresh from the mountains) but it had hot water. My first hot shower yet!! I took a long one. Now I"m resting in one of the two rooms in the tiny cabana. Outside is nothing but jungle- it's una selva negra (muy, MUY negra). So peaceful and isolated nestled in this beautiful mountain. I am going to snuggle up under the old wool blanket on the small bed and read myself to sleep to the sounds of selva negra.
Wednesday, June 3, 2009 and through to morning, Thursday, June 4, 2009 (Matagalpa a Managua)
A little bit scary sleeping in the dark, remote jungle. Woke up early to grab breakfast at the lake restaurant before our scheduled tour of the farm. During breakfast I accidentally ate "queso de cabesa de cerdo" or basically pig brain cheese. Ugh. The tour left at 9am, and me, Mario and another blonde also named Cindy (in her 40s from Canada) went by van with the farm's owner on the tour. Lots of stores because his motto was "you learn more from anecdotal history." The farm is like it's own mini-society. Two hundred workers and their families live, work and go to school there. It was begun by the owner and his wife in the 70's (the resort part) and amazingly the communists left the farm alone during the revolution. The farm began with an Austrian woman who in the 1800s, rode into town alone with "one leg on either side of her horse." Scandalous! Her hard work and recruitment of other German, European and local families made the farm. Hence the blonde latinos with German ancestry in Matagalpa. Because of this mixing, notoriously beautiful women come from these mountains. Currently the farm is run by husband and wife and 4 other women. They are very advanced and giving their employees room and boar, salary and retirement. Special care is paid to raising self-esteem in the women on the farm and fighting machismo- 42% of the full time workers are female. They are given tasks that are specified for them because they are the best for that job, and specifying these tasks for women only help raise the women's self esteem. Special attention also on organizing events (i.e. sport events) to fill employee's free time and therefore reduce alcoholism. Really beautiful place. Not to mention the breathtaking mountainside the farm is nestled on. They do more than coffee including farming, raising pigs, and cattle. All food served on farm is fresh from the farm. Two hours later the tour ended. Mario and I decided to try our luck hiking through the jungle. The altitude, mud from yesterday's rain and otherwise treacherous path made it a tough climb up the mountain- and even tougher back down. At the top, the trail ended at a cliff- we stopped and took pictures before climbing back down again. After the hike we tried to get as much mud off of us as possible before stopping for lunch. After we ate it threatened to rain so we checked out of our cabana and began the drive home. More breathtaking countryside. We went back to Carolina y Alvaro's and showered and dressed for the evening. It was a 3 hour drive from Matagalpa back to Managua so after showering we were hungry again and ate the dinner the maid prepared us. That is when things started to get bad. The plan was to meet with Jessly and Jessica and go out to a club, but my stomach was feeling weird after dinner (even after the Pepto I took) so we went to their house and just hung out together with Patty, too. Towards the end of the night my stomach was really hurting bad so I had Mario take me back to Carolina's. None too soon. I lost everything in my body immediately in both directions. I spent the rest of the night sick and weak in the bathroom. By morning, Carolina (who is a doctor) had left to work but a worried Mario called her for advice- turns out I have some bacteria or parasite. I'm lying here sick as a dog while Mario scrambles to find me the anti-parasites, anti-nausea, rehydrating things Carolina says I need :(
Thursday, June 4, 2009 (Managua)
Sick day. Laid around Carolina's apartment until around 3pm when I got dressed for the civil ceremony for Jessly. The official plan was to go to the salon with Mario's abuela for nails and facial, then to the civil ceremony by 7p. Picked up Mario's abuela and went to the salon. Was waiting for nails and fading fast. Mario took me back to Abuela's house, skipping the salon, so I could lay on his abuela's bed where there was airconditioning and hopefully recover there for the civil ceremony by 7p. "La lloya", the family's parrot, was chattering outside the window saying "pobrecita la lloyita" and meowing like the cats that stalk her cage at night. I smile despite the pains in my stomach. At 630p Mario and Abuela get back from the salon and I still feel miserable. I concede the civil ceremony, and Mario drops me back at Carolina's to rest on his way to the ceremony. I fight off nausea and try to sleep. Around 12am I am poked awake and Mario launches into a story about the civil ceremony from hell. Aparently, and he had to retell me later, Patty, over a confusion over who was driving whom to the ceremony (cars are shared and people pick each other up etc) didn't arrive until an hour late. They held up the ceremony waiting, and finally started by 8pm. Shortly after the ceremony began, everyone already frustrated, the groom, Javier, passes out, hitting the table on the way to the ground. Chaos ensues while everyone rushes to his side and he is carried off to an empty room to recover. Half an hour later, he comes back and the ceremony begins again. Shortly after it resumes for the second time, a loud hissing emits from the main house (the ceremony is held in the back yard of Javier's mom's house) and someone comes running from the house yelling, "It's a gas leak! Everyone get away from the house!" Everyone goes running from the yard and down the street before the poor maid sent back to check finds out it's just a boiler leaking steam. After everyone is found and brought back to the yard, the ceremony begins for the third time. At this point the speaker is cut off by the audience yelling to him to just have Javier and Jessly sign the papers before something else can happen!! Bummer I missed that :( After being regaled with the excitement at the civil ceremony, I fight against the heat and pain in my stomach, struggling to go back to sleep, at least still with a smile on my face.
Friday, June 5, 2009 (Managua to Masaya y Catarina)
Woke up feeling much improved and decided to go to volcan Masaya y Catarina market. Picked-up Jessica and went to a grocery store for bottled water, gatorade, and safely prepackaged snacks for me to eat. Mario's while family is now rallying around how to take care of their gringa, and I"m hardly allowed to eat anything not bottled or packaged. Drove up to volcan Masaya. Lava rock everywhere. Masaya is an active volcano that erupted about 100 years ago. At the top we got out to look at its crater. The first thing I noticed was the smell. I can't describe it other than it was strong, maybe a little like sulphur, and you could feel it in your throat. Smoke and steam were pouring out of the crater- I guess it was that. Beautiful view. Since I was already weakened from being sick, I couldn't stay up there in the fumes for very long before feeling light headed, so we left after some pictures to Catarina. Catarina is a small artisian based city situated looking over a crater of an inactive volcano turned to a lake. It was a lovely town. A group of local young boys followed me around whistling and calling me "clase rubia" meaining big or tall blonde. Mario said they may not have seen a blonde before- wierd sticking out so much like this! Bought gifts from local artisians who were calling me "dura esta merchanta" or the tough customer- I guess I was picky. We had dress fitting for bridesmaids gowns and wedding dress rehearsal at 5p back in Managua, so we left Catarina with just enough time to get to the church for the rehearsal. The fitting and rehearsal were long and hot both- dominated by the bridezilla and drama. After those and a brief visit to the Abuelos, we found a pizza hut (I so badly wanted American food) and brought it back to Patty's house to eat with Mario, his mom, and his sisters. We had barely gobbled it down when Mario said, "ella esta cansada y inferma- nos vamos pues," or something to that effect, and we rushed out. Come to find out the Spanish conversation I wasn't following while gobbling my pizza was Jessly complaining and bridezilla-ing, and Mario had had enough. Back to Carolina's to sleep and snuggle up after a long day. There is a crazy rooster here added to the menagerie of night sounds that totally must be blind. It's hot- I miss AC and American food (and American driving- you should see the drivers and roads here in Managua!)
Saturday, June 6, 2009 (Managua- wedding mayhem)
Bridezilla part two. Woke up around 8am. Picked up breakfast and went to Patty's house. Ate breakfast with Jessica and Patty while Mario worked on their computers. Dozed until 12pm then left with Jessica and Mario to the hair salon. The salon was a nightmare for the civil ceremony day making everyone late- but I took heart today because I got worked on right away- so I thought. Rolled my hair in pin curlers and then sent me to wait. Two hours later still waiting and un cuchon says, "voy a maquillarte." I think, "great- my first professional makeover!" He takes me to a side room for thirty minutes working on his masterpeice before putting a mirror in front of my face. !Que horror! I looked like a drag queen, clown, totem-pole, middle-school art project freak. In the meantime my stylist looks for me, I'm MIA, so he moves on to someone else. It is after 3p and we were suppsed to be at the dressmaker by 3p for finishing touches on the dresses. I told the "artist" to take it all off (the makeup) and by the time my hair was done it was almost 4p. At least the hair looked ok. We left for the dressmakers'. None of the dresses for the six bridesmaids are done yet. It is 4p on the day of the 7p wedding and the dresses are not yet sewn. Ridiculous. I'm told mine will be ready in an hour so Mario finds us some late lunch then runs us to a nearby different salon to have someone else do my makeup again. The makeup artists all commented on my big blue eyes and in 15 minutes I was done. Still a bit heavy for my taste, but everyone loved it so I smiled and thanked them. Back by 5p to dressmaker, back to Carolina's to change by 6pm- Mario is set to arrive at the wedding with the bride by 630p and he isn't dressed yet. Tuxedo pieces fly on his way out the door- he has to meet Jessly at the hotel and arrive with her to walk her down the aisle. At 6:57p Mario's abuelos finally arrive at Carolina's to pick me up and run me to the church- luckily we still arrive before the bride. I'm shoved towards the other bridesmaids and a boquet of lillies are thrust into my hands. Three bridesmaids of six didn't make it because their dresses weren't done yet. Bride arrives. I stick out as the only blonde in the processional and stand teary-eyed watching my sweetheart proudly walk his sister down the aisle and give her away. We sit together in the front row and the ceremony passes quickly- it was very beautiful. Recessional. Everyone crams into cars to go to the reception. They have good food but I am under strict Fuentes family regulations to only eat bread and rice. Dancing, music, fold dancers, live music, singing, celebrating and eating carry through the night until 2am. I dance with Mario and realize for the first time what a good dancer he is. I cut a rug wigh his aunts and Abuela (oh btw, did I mention also blubber all over myself while snapping pictures of Mario having the first dance with his sister? He is not just a son and brother but also father to his sisters and support to his mom. Beautiful to see how much they all love each other). Tired and hot, Mario and I leave the reception and get home to Carolina's around 3am. Little lizards skitter around on the walls kissing the air goodnight.
Sunday, June 7, 2009 (Managua)
Got up around 10am this morning and managed to stomach huevos revueltos for breakfast. A lunch for the new couple is scheduled by the groom's family at their house at 1p. Mario and I go to his mom's and he works on computers again. We don't get out the door to the lunch until 2p. Start times seem farily relative here. Again I am restricted on food- this time by Jessly- to bread and cheese and a warm can of soda (no ice) for lunch. We spend the afternoon between the party and the bride's mom's house (Patty). Coming and going to parties is quite an ordeal here- kissing everyone hello and goodbye. It's sweet and warming though, and I like it. The party is- like everything in Nicaragua- outdoors or "indoors," which is in the house with all doors and windows open to the feel of an American patio. I spend the afternoon working on my Spanish. Later we return again and stay late at Mario's mom's for more computer work, getting back to Carolina's 11-ish. I scarf a late-night dinner of a can of Campbell's soup, a welcome change from all the break and crackers. I collapse into sleep, too tired to pack yet.
Monday, June 8, 2009 (Managua to Miami)
The plan today is to leave Nicaragua at 1:30p and arrive at Baltimore 11-ish p. We wake early and pack, and after thanking Carolina (Alvaro was not home) we leave for Mario's abuelos' house. We pick up his abuela and have her driver take us down the block to a local bakery called the Margarita for breakfast. We chat in the open-air cafe over pan dulce and drinks (I had a bottle of soda- actually cold this time). I ate una "oreja" y pan dulce con "sweet milk" which is caramel. I forgot the name of it but it was flaky, gooey, and delicious. We left around 11:30am to Abuela's house again. About noon Patty, Jessica and Jessly arrive to accompany us with his abuelos to the airport- a tration here for a big family send-off. The bride brings left-over wedding cake. She has been calling me her "cun~iz" which Mario told me is an affectionate way to say "sister-in-law," also slang for brother's girlfriend. Two cars of Fuentes leave with us to the airport. We check our bags then sit for drinks with Mario's family. After goodbye kisses and tears, Mario and I board the plane and leave Nicaragua. We arrive to Miami about 7pm (losing 2 hours to time zones). We were sitting by the emergency door on another A330 (ps- these are on the news as unsafe right now) and one of the flight attendants sat facing us during landing and take off and we were chatting with him before gettin goff the plane and joining the melee towards immigration. Turns out there was no rush. Mario and I seperated at immigration into "residents" and "citizens" lines, making faces at each other accross the crowd, arriving at our respective immigration officers at the same time. I get grilled but go through and pass just in time to hear his officer say "step aside." He gives me a confident smile and a shrug as I am pushed forward by the crowd. After passing the exit guard I wait at the top of the down escalator, eyes locked on Mario. I figure he has been randomly flagged for carry-on search or something (we don't have our full luggage yet). The exit officer sends me down the escalator and frustrated, I wait at the bottom now helpless and separated from my sweetheart. I stand as our while flight followed by captain and crew clear immigration and descend the escalator. I start to panic. An hour passes. I fight back tears and waves of panic. Somehow I have the presence of mind to hear someone announce in Spanish to pick up baggage at claim eight to clear cultoms and they are starting to confiscate remaining bags. I tear my eyes off the escalator and rush to the baggage claim, hauling our four suitcases onto a hand cart, I run back to the escalator. Another hour. All that are left are me and a handful of other worried-looking people at the bottom of the escalator. We've already missed our connecting flight. A third hour ticks by. I start thinking of worst case scenerios. Another worried woman grills a passing guard who says he can tell her nothing. I am angered by my own helplessness. A flight from Haiti arrives and begins trickling through immigration and coming down the escalator. Finally, I see my Mario and run to him, leaving the luggage temporarily behind. We share a sweet moment and many kisses of relief. He had been held over an almost 2 year old traffic ticket. Exhausted and full of relief to be arm-in-arm, we trudge through customs and to the American Airlines missed flight counter, temporarily ignoring the significance of the discrimination we both just suffered from (especially him, pobrecito). Next flight to Balitmore tomorrow at 12p. We change tickets, recheck bags, feed our growling stomachs and take a shuttle to a nearby hotel. I collapsed into fitful sleep, waking often and feeling scared forgetting where I was.
Tuesday, June 9, 2009 (Miami to Baltimore)
(written in airport before safe arrival home to Baltimore):
An unexpected 11th day of our trip. After grabbing the hotel's continental breakfast and checking out we shuttled back to the airport. I'm at our departure gate now waiting to board, ready to be home. Work and kennel have been called and upon arrival to Baltimore around 3p, I have a puppy to pick-up and the rest of the day to rest, and reflect upon my travels.
Hopefully once I have had time to digest, I will be able to write a follow-up blog summarizing my thoughts on this amazing trip!!!
Thursday, May 7, 2009
Idealism v Realism
With the recent changes in elected officials in our country, I have been thinking a lot about this theme. What seems so obvious to me but not to many others (especially in my age group- so frustrating!) is that idealism and realism are NOT THE SAME in politics. How is this not intuitive? Anyone who has taken statistics knows the expression "correlation does not equal causation." Let me amend that idealism does not equal realism!! They are actually totally opposite terms in my mind. Not that I'm jaded.
In undergrad a professor told me the expression that was something to the effect of, "when you are young if you are not politically left-ist you have no heart; when you are older if you are not politically right-ist you have no brain." This is exactly what I mean about idealism vs. realism. Let me explain why I am thinking about this.
So I have a professor who teaches Multicultural Counseling (amongst other courses) in my graduate program. As a part of her required syllabus she wants us to attend a political advocacy training session at the American Psychological Association headquarters in Alexandria, VA, this coming Tuesday. Which is great. HOWEVER, it also recently came to my attention that after this training, we will be required to go to Capitol Hill and advocate for bill HR 3014 on the Health Equity and Accountability Act. So. We are required to advocate for HER political agenda. No problems with that, right? Obviously wrong.
First of all, this is manipulation. 99% of my classmates are going to not read the legislation and blindly advocate for a bill about which they have no idea nor opinion because our professor made it an assignment. No one wants to make s**** for the professor (plus I think in general we are a Nation of blind policy followers). So a bill is getting support because she is manipulating a class who in true form neglects to think for themselves. Second of all, as the professor for the multicultural counseling class, this professor herself claims to be very multiculturally aware. This requires respect, awareness, knowledge, etc for all viewpoints, according to her (does it not, class?) This is what she preaches to us. So explain to me how it is not hypocritical for her to expect is to be sheep and follow her political beliefs. Explain to me how this is being respectful or even aware of differing political beliefs in her classroom. You can't because it isn't. Now any of us who do have the ability and gumption to think for ourselves are in the awkward position of being difficult and standing up to our professor, even to the point where our grades are in jeopardy.
So idealism vs. realism. The bill, and in my opinion much of the current, new and promised policy of our new administration is idealistic. Thus, by definition, it is not realistic. Which is a better policy to enact? Logically only the realistic will work. However, those of us with enough of our brains about us to think this way are heartless because obviously views on policy equate personal values.
The bill she is asking us to support is about extending mental health services to under served, minority populations. Great. Wonderful value. I have no problem with this value. But this is not the same as policy! The value is idealist, therefore corresponding policy cannot be! Idealistic policy does not work! (even ultimately turning socialist, right?) Nothing about the policy is realistic, but because I voice this, I do not have a heart and obviously don't care about diversity. SO FRUSTRATING! In an effort to attack this issue in some way shape or form, I have been reading the bill, public opinion, scholarly and newspaper reports about the bill all day. I put together a list of problems with the bill. Since nothing I found online did this (having to do with avoiding the values judgment?) I feel the need to. The eight-points I argue are below for your consideration. The format is first a statement from the bill, followed by an argument for that statement. And please, USE YOUR HEAD AND THINK ABOUT THINGS!!! Just because it sounds "so nice!" does not mean it will actually help anybody, so you are not automatically a nice person for supporting it. Just kind of a lemming (because we need more of those.)
Points against HR 3014:
1) “Provides for grants for strategies to eliminate racial and ethnic health and health care disparities.”
“Health Equity and Accountability Act of 2007 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to establish the Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care.”
Where is the funding coming from? Either me or the mental health agencies; neither of us have money to spare nor need to be told how to use what we do have (why does the government never trust the individual to spend their own money appropriately!? I work hard for my own money and choose how much I can afford to share and who to share it with- the government has no right to make this decision for me; this sounds like socialism!!!)
2) “Improving racial and ethnic minorities’ access to primary care services.”
Should the government have the right to force businesses to pay for additional mental health insurance plans? If so, the businesses will have to limit the number of people they can afford to hire. The first employees to be cut will be the entry level folks, which are typically the minority types listed as in need for advocacy.
3) “Requires the establishment of an Office of Minority Health within specified agencies.”
Where does the money come from to hire the required multicultural liaison to make sure the policies stipulated in the bill are followed? From the agency. This ultimately takes money from the agency reducing the number of cts they can see or reducing the salary of the already underpaid therapists at any federally funded agency. This means:
a. Therapists will quit/leave/be fired from the agency.
b. Other important agency projects such as individual agency plans to reach out in the best way possible to the particular needs of their local communities, will be abandoned in place of the more blind government stipulations.
c. More therapists will opt for independent practice where many/most don’t take insurance further reducing the available services for those underserved.
4) “Provides for the establishment of health empowerment zone programs in communities that disproportionately experience disparities in health status and health care.”
Adding more regulations does not mean change will happen, but it does mean the government gets more control over what goes on in your agency. Just by giving us a list of rules does not change the knowledge base or ability of anyone/thing in the center to reach out to those underserved. Rather, it makes the agency struggle to meet specific number requirements leaving the original problem mostly unsolved (i.e. did we get at least 8 Latinos through the door this month? Never mind if we helped them, spoke Spanish, etc.)
5) “Directs the President to execute, administer, and enforce provisions to address environmental justice in minority and low-income populations.”
This is giving the government more power which I am slow to do unless I feel that it is absolutely the best and only solution. I don’t believe it is so in this situation.
6) “Requires the Secretary to establish: (1) an Office of Health Disparities within the Office of Civil Rights; and (2) civil rights compliance offices in each HHS agency that administers health programs.”
Is this the best solution to this problem? I don’t think so. Better solutions:
a. New standards and ethics of practice from professional organizations (requires no/MUCH LESS money to enforce, can include the important educational pieces)
b. More education for agencies based on particular agency needs (i.e. does this center need Spanish language classes? Does this need to expand to more accessible locations in the inner-city?)
c. Individual therapists and agencies taking it on themselves to offer sliding scale, reduced fee, or pro-bono sessions for underserved populations
d. Individual agency programming to reach out to underserved communities (energy and funds going here rather than trying to meet blanket and federally enforced expectations).
7) “Directs each federal health agency to implement a strategic plan to eliminate disparities and improve the health and health care of minority populations.”
This entire bill pays homage to the never-ending problem of the government thinking it knows best what is better for everyone. This is specifically NOT the case when considering diversity, because this will not be universal so federal standards are myopic and do not apply. Therefore the government is not in a place to create and enforce regulations about strategic plans to reach out to the diversity minority populations.
8) “Enhancing diversity in the healthcare workforce.”
I have a problem with the stipulation to enhance diversity in the mental health workforce because I feel that this discriminates against me. Directly, if this goes into effect, as a white female, I will automatically be LESS QUALIFIED BY NO FAULT OF MY OWN (reverse discrimination?) to be hired into a federally funded agency. If there is a specific criterion for a certain number of multicultural individuals in a federally funded agency that trades traditional hiring techniques such as choosing the most qualified, to doing your best to number-grab. It also has no regard for diversity populations in which the center is located (i.e. is four white people and one Latino representative of the population in this city more than one Asian person, one Latino person, and one white person? Etc). This also assumes that multicultural training and education are worthless (i.e. in lieu of multi-culturally competent counselors as a recommendation/requirement, we are just going to judge based on background; in other words multicultural competence doesn’t better qualify someone to work with diverse populations; rather they must be a member of that group to understand/be able to help). This should not be federally regulated, by decided based on needs by individual community centers.
In undergrad a professor told me the expression that was something to the effect of, "when you are young if you are not politically left-ist you have no heart; when you are older if you are not politically right-ist you have no brain." This is exactly what I mean about idealism vs. realism. Let me explain why I am thinking about this.
So I have a professor who teaches Multicultural Counseling (amongst other courses) in my graduate program. As a part of her required syllabus she wants us to attend a political advocacy training session at the American Psychological Association headquarters in Alexandria, VA, this coming Tuesday. Which is great. HOWEVER, it also recently came to my attention that after this training, we will be required to go to Capitol Hill and advocate for bill HR 3014 on the Health Equity and Accountability Act. So. We are required to advocate for HER political agenda. No problems with that, right? Obviously wrong.
First of all, this is manipulation. 99% of my classmates are going to not read the legislation and blindly advocate for a bill about which they have no idea nor opinion because our professor made it an assignment. No one wants to make s**** for the professor (plus I think in general we are a Nation of blind policy followers). So a bill is getting support because she is manipulating a class who in true form neglects to think for themselves. Second of all, as the professor for the multicultural counseling class, this professor herself claims to be very multiculturally aware. This requires respect, awareness, knowledge, etc for all viewpoints, according to her (does it not, class?) This is what she preaches to us. So explain to me how it is not hypocritical for her to expect is to be sheep and follow her political beliefs. Explain to me how this is being respectful or even aware of differing political beliefs in her classroom. You can't because it isn't. Now any of us who do have the ability and gumption to think for ourselves are in the awkward position of being difficult and standing up to our professor, even to the point where our grades are in jeopardy.
So idealism vs. realism. The bill, and in my opinion much of the current, new and promised policy of our new administration is idealistic. Thus, by definition, it is not realistic. Which is a better policy to enact? Logically only the realistic will work. However, those of us with enough of our brains about us to think this way are heartless because obviously views on policy equate personal values.
The bill she is asking us to support is about extending mental health services to under served, minority populations. Great. Wonderful value. I have no problem with this value. But this is not the same as policy! The value is idealist, therefore corresponding policy cannot be! Idealistic policy does not work! (even ultimately turning socialist, right?) Nothing about the policy is realistic, but because I voice this, I do not have a heart and obviously don't care about diversity. SO FRUSTRATING! In an effort to attack this issue in some way shape or form, I have been reading the bill, public opinion, scholarly and newspaper reports about the bill all day. I put together a list of problems with the bill. Since nothing I found online did this (having to do with avoiding the values judgment?) I feel the need to. The eight-points I argue are below for your consideration. The format is first a statement from the bill, followed by an argument for that statement. And please, USE YOUR HEAD AND THINK ABOUT THINGS!!! Just because it sounds "so nice!" does not mean it will actually help anybody, so you are not automatically a nice person for supporting it. Just kind of a lemming (because we need more of those.)
Points against HR 3014:
1) “Provides for grants for strategies to eliminate racial and ethnic health and health care disparities.”
“Health Equity and Accountability Act of 2007 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to establish the Robert T. Matsui Center for Cultural and Linguistic Competence in Health Care.”
Where is the funding coming from? Either me or the mental health agencies; neither of us have money to spare nor need to be told how to use what we do have (why does the government never trust the individual to spend their own money appropriately!? I work hard for my own money and choose how much I can afford to share and who to share it with- the government has no right to make this decision for me; this sounds like socialism!!!)
2) “Improving racial and ethnic minorities’ access to primary care services.”
Should the government have the right to force businesses to pay for additional mental health insurance plans? If so, the businesses will have to limit the number of people they can afford to hire. The first employees to be cut will be the entry level folks, which are typically the minority types listed as in need for advocacy.
3) “Requires the establishment of an Office of Minority Health within specified agencies.”
Where does the money come from to hire the required multicultural liaison to make sure the policies stipulated in the bill are followed? From the agency. This ultimately takes money from the agency reducing the number of cts they can see or reducing the salary of the already underpaid therapists at any federally funded agency. This means:
a. Therapists will quit/leave/be fired from the agency.
b. Other important agency projects such as individual agency plans to reach out in the best way possible to the particular needs of their local communities, will be abandoned in place of the more blind government stipulations.
c. More therapists will opt for independent practice where many/most don’t take insurance further reducing the available services for those underserved.
4) “Provides for the establishment of health empowerment zone programs in communities that disproportionately experience disparities in health status and health care.”
Adding more regulations does not mean change will happen, but it does mean the government gets more control over what goes on in your agency. Just by giving us a list of rules does not change the knowledge base or ability of anyone/thing in the center to reach out to those underserved. Rather, it makes the agency struggle to meet specific number requirements leaving the original problem mostly unsolved (i.e. did we get at least 8 Latinos through the door this month? Never mind if we helped them, spoke Spanish, etc.)
5) “Directs the President to execute, administer, and enforce provisions to address environmental justice in minority and low-income populations.”
This is giving the government more power which I am slow to do unless I feel that it is absolutely the best and only solution. I don’t believe it is so in this situation.
6) “Requires the Secretary to establish: (1) an Office of Health Disparities within the Office of Civil Rights; and (2) civil rights compliance offices in each HHS agency that administers health programs.”
Is this the best solution to this problem? I don’t think so. Better solutions:
a. New standards and ethics of practice from professional organizations (requires no/MUCH LESS money to enforce, can include the important educational pieces)
b. More education for agencies based on particular agency needs (i.e. does this center need Spanish language classes? Does this need to expand to more accessible locations in the inner-city?)
c. Individual therapists and agencies taking it on themselves to offer sliding scale, reduced fee, or pro-bono sessions for underserved populations
d. Individual agency programming to reach out to underserved communities (energy and funds going here rather than trying to meet blanket and federally enforced expectations).
7) “Directs each federal health agency to implement a strategic plan to eliminate disparities and improve the health and health care of minority populations.”
This entire bill pays homage to the never-ending problem of the government thinking it knows best what is better for everyone. This is specifically NOT the case when considering diversity, because this will not be universal so federal standards are myopic and do not apply. Therefore the government is not in a place to create and enforce regulations about strategic plans to reach out to the diversity minority populations.
8) “Enhancing diversity in the healthcare workforce.”
I have a problem with the stipulation to enhance diversity in the mental health workforce because I feel that this discriminates against me. Directly, if this goes into effect, as a white female, I will automatically be LESS QUALIFIED BY NO FAULT OF MY OWN (reverse discrimination?) to be hired into a federally funded agency. If there is a specific criterion for a certain number of multicultural individuals in a federally funded agency that trades traditional hiring techniques such as choosing the most qualified, to doing your best to number-grab. It also has no regard for diversity populations in which the center is located (i.e. is four white people and one Latino representative of the population in this city more than one Asian person, one Latino person, and one white person? Etc). This also assumes that multicultural training and education are worthless (i.e. in lieu of multi-culturally competent counselors as a recommendation/requirement, we are just going to judge based on background; in other words multicultural competence doesn’t better qualify someone to work with diverse populations; rather they must be a member of that group to understand/be able to help). This should not be federally regulated, by decided based on needs by individual community centers.
Sunday, March 22, 2009
Thinking about being busy
Sometimes I think about all the things we have to do in order to have time for the few moments in life that make us so happy. I have been seeing up to seven clients a day lately (in seven hour work days even) plus my full course load, thesis and weekend job. Sometimes after six or seven hours of work on my thesis, I feel that good moment of accomplishment. Sometimes out of seven clients, on will tell me that day that counseling is helping them and thank me, and I feel that moment of accomplishment. What about everything else? What about once the commuting, the dirty clothes and dishes that need to be washed, the other household stuff that needs to happen, the dog that needs to be walked, the running/working out daily...? Out of all of the hours and hours of stuff we have to do, how many moments during those hours are we living for? I'm rambling here.
This weekend I didn't have to work. Today it was 60*. I savored the beautiful moments I spent outside at the lake with my sweet boyfriend and my manoso puppy. I had those moments, and they flew by. Everything we did today made those moments. And the time flew. It flew away.
Yet the hours of things I do for moments like this drag on.
Not sure where I was going with this...
This weekend I didn't have to work. Today it was 60*. I savored the beautiful moments I spent outside at the lake with my sweet boyfriend and my manoso puppy. I had those moments, and they flew by. Everything we did today made those moments. And the time flew. It flew away.
Yet the hours of things I do for moments like this drag on.
Not sure where I was going with this...
Wednesday, February 4, 2009
The Internship Double Standard
After a confusing meeting with my internship supervisor today, I was sitting alone in my office trying to understand why I felt so angry and defeated by such a stupid meeting.
This morning my supervisor visited the main office location for the agency, to meet with her supervisor. She came back from the meeting later this afternoon and said we needed to "talk about some things." My stomach dropped to my feet. I had spent ALL MORNING reading the mountains of books, magazines, and articles my supervisor gives me every time we meet, diligently taking notes and wracking my brain for ways to apply what I was learning, and be a better counselor at the agency. What could I have possibly done wrong, out of everything I was trying to do right?
The substance of the meeting was that I had entered a "do not schedule" hour on my calendar for tomorrow. I did this early this morning upon seeing my calendar with five back-to-back clients, three of which were brand new intakes, thinking I would need the time to digest, conceptualize and do paperwork. I thought it was the responsible thing to do to not take on more than I could handle and give myself enough time to plan and organize my learning around each new case. Apparently, I was wrong. The meeting turned into disdain for "laziness" at putting that block in my calendar. Why would I do that? I already have one hour for dinner and paperwork that day. Why can't I have back-to-back clients, six of them, the rest of the day?
The reason why is because I am an intern. First and foremost, I am NOT PAID. Second, I am not yet a professional. I am expected by my graduate program to see four clients per week, and at internship, am being finger-pointed for not doing six clients per day.
First I was angry. I work so hard to do everything perfect, and I messed up because I held an hour of my schedule free on the computer this morning? I get a boss lecture because of that? Second, I was defeated. There is no way I can EVER be good enough for this agency. EVERYTHING I do is on trial. It's like they are looking for things to criticize me on, and there's just no defeating that. Third, I was angry. I am being held to a professional standard, being given s**t even for trying to meet this ridiculous standard, all the while being micromanaged like the most incapable intern. This is infuriating! If I am going to be held to professional expectations, which, given my positions as an INTERN is inappropriate (as well as probably unethical for the clients) at least give me some respect to think for myself and be a professional. Let me put the damn spot in my calendar. You can't demand professional while talking down your nose at me because of a block on my calendar.
They just want to have their cake, and to eat it too. They want the free labor (as much of it as they would get from a paid person) while still being able to condescend and micromanage, giving me no credit or trust that I am capable of making really any good decisions on my own in the agency.
!!!!!!!!!!!!!!!!
This morning my supervisor visited the main office location for the agency, to meet with her supervisor. She came back from the meeting later this afternoon and said we needed to "talk about some things." My stomach dropped to my feet. I had spent ALL MORNING reading the mountains of books, magazines, and articles my supervisor gives me every time we meet, diligently taking notes and wracking my brain for ways to apply what I was learning, and be a better counselor at the agency. What could I have possibly done wrong, out of everything I was trying to do right?
The substance of the meeting was that I had entered a "do not schedule" hour on my calendar for tomorrow. I did this early this morning upon seeing my calendar with five back-to-back clients, three of which were brand new intakes, thinking I would need the time to digest, conceptualize and do paperwork. I thought it was the responsible thing to do to not take on more than I could handle and give myself enough time to plan and organize my learning around each new case. Apparently, I was wrong. The meeting turned into disdain for "laziness" at putting that block in my calendar. Why would I do that? I already have one hour for dinner and paperwork that day. Why can't I have back-to-back clients, six of them, the rest of the day?
The reason why is because I am an intern. First and foremost, I am NOT PAID. Second, I am not yet a professional. I am expected by my graduate program to see four clients per week, and at internship, am being finger-pointed for not doing six clients per day.
First I was angry. I work so hard to do everything perfect, and I messed up because I held an hour of my schedule free on the computer this morning? I get a boss lecture because of that? Second, I was defeated. There is no way I can EVER be good enough for this agency. EVERYTHING I do is on trial. It's like they are looking for things to criticize me on, and there's just no defeating that. Third, I was angry. I am being held to a professional standard, being given s**t even for trying to meet this ridiculous standard, all the while being micromanaged like the most incapable intern. This is infuriating! If I am going to be held to professional expectations, which, given my positions as an INTERN is inappropriate (as well as probably unethical for the clients) at least give me some respect to think for myself and be a professional. Let me put the damn spot in my calendar. You can't demand professional while talking down your nose at me because of a block on my calendar.
They just want to have their cake, and to eat it too. They want the free labor (as much of it as they would get from a paid person) while still being able to condescend and micromanage, giving me no credit or trust that I am capable of making really any good decisions on my own in the agency.
!!!!!!!!!!!!!!!!
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