bearing suffering and bearing witness

At our Grand Rounds this week, Jodie Wigren MSW, Ph.D. from the Trauma Center talked about the intersection of psychodynamic and trauma theory in working with survivors of trauma. She summarized in a beautiful way the interesting phase shift in this work:

First patients learn to bear suffering and then learn to bear witness.

In and earlier posting, I wrote about the other side of this dynamic, the therapist's learning to sit with the affect (feelings, suffering) in order to share in the bearing witness. I going to add this quote to my repertoire.

the absence of a postive

In recent years, I came across this statement in an clinical study on happiness (I've since lost the reference - if you know it please pass it along):

The absence of a positive is more strongly felt than the presence of a negative.

I found myself saying this to a group I consult to as they were discussing the changes they anticipate with this most recent round of funding cuts. They (and the rest of us) are facing or will soon face not having something or the access to something that we had grown to count on as essential in our being able to do our work in a sustaining manner. That loss will be felt and cause anxiety - look at discussions about the prospects of cutting entitlements! However, when we learn to live with things that we experience as negatives, we adapt and accept.

Is there something to learn from this? One of the challenges of losing the things we have come to count on will dealing with how we feel about it. We need to maintain our perspective. Maybe we also need to look at those things that we think of as negatives and ask if there is something we can do about them.

It takes a village to treat a patient

I borrow this borrowed phrase to try to capture the concept behind a role of a group consultation. For over a decade, I am privileged to be in a supervision group with a gifted supervisor and trusted colleagues where we have been working together to become better clinicians and to get sage advice on how to proceed with very challenging patient situations. These are the typical and essential roles of a good supervision. However, in recent years we have come to appreciate a different type of role our group can serve. We have brought some of our patients to our group supervision for a consultation with the group, but also to create a broader support for the clinician and the patients. We’ve noticed that these patients feel more understood and better supported because “the group” is there encouraging them on to do the hard work and that their therapist has “the group” for support and guidance. Over the past year it has helped a couple of my patients to integrate an important element of self-care by knowing that there was “a village” looking out for them.