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Bloody Knuckles and Broken Hearts — Social Workers Bring Personal Experience To Their Work
By J. Scott Janssen, MSW, LCSW
As soon as my fist slammed into the concrete wall I knew I’d made a mistake. This awareness didn’t stop me from smashing my other fist into the wall before slamming the door of my graduate student apartment in Syracuse, hopping into my ’68 Dodge and speeding out onto the New York State Thruway headed for Rochester. 

My consciousness seemed to separate from my body as though I were watching things from some distance. My mind filled with thoughts of getting my hands around the neck of the drunk driver I’d just learned had killed my uncle. Looking back, I can imagine how I must have looked in that moment–angry, aggressive, blood dripping from knuckles to elbows, a mind clouded by thoughts of revenge. Were some innocent social worker to have encountered me in this state I can only imagine his assessment. Impulse control issues? Anger management challenges? Inability to self-regulate?  Intent to harm? Socially disruptive behavior? Maladaptive defenses when stressed? 

As the miles flew by thoughts turned to my uncle. When was the last time I’d seen him? What had we talked about? Memories flooded in. When I thought about my mother having lost her only sibling the tears started flowing. The anger lifted. I felt myself come back into my body.

Nearly 30 years later that day stands as one during which I learned a great deal about being the social worker I have since become. It reminds me of the importance of looking beneath the surface, staying alert to impulses and expressions of love and connection, however routine or cryptic, and to never underestimate the power of laughter or the role of the mysterious.

The Surface Is Just the Surface
The moment my anger subsided and the dissociative fog began lifting has always reminded me to not be fooled by the surface of things. When people are hurting or afraid, the surface can be a stormy place where things like anger and conflict can easily capture our attention. Looking into the face of such storms it is easy to be captivated by their intensity and believe we have seen into the heart of things.

If we look only on the surface, however, we may miss what lies beneath.  On my way to Rochester I was literally blinded with rage. But beneath the rage was sadness and disbelief. Beneath these were deeper things still—the love for my mom that had me racing for home, existential questions about meaning and loss, uncertainty how to respond to an event that was all but incomprehensible.

These deeper realities were at the center. The anger which appeared so definitional of who I was in that moment was just a passing phantom. For an attuned social worker, my anger may have given insight into my defensive style when in emotional pain or offered clues as to how best to approach, but I was not my anger. I was my broken heart. I was my love for family. I was that young man whose world had been rocked off its hinges and whose mental map of the world had been momentarily tossed into the winds.

It is the nature of our profession that we see people when they are in the pitch and fury of crises, psychological and emotional pain, confusion and fear. As we enter clients’ lives it is good to pause before drawing any conclusions, bringing compassion for all we encounter, even the most fiercely angry. To see the human being struggling beneath the storm we may, at times, have to look very deeply and patiently. 

Getting to the Heart of Things
By the time I pulled into my parents’ driveway the blood had stopped dripping from my knuckles and dried into crimson rivulets crisscrossing my forearm. I had no idea what to say or do. Part of me wanted to leave, avoid the situation, plead the demands of graduate school, but I knew I had to show up, however ill-equipped and self-conscious I felt.

Mom appeared listless and unfocused when she saw me. Something about my suddenly appearing on the doorstep didn’t compute. Having gained experience in subsequent years working with people in traumatic situations I now recognize the dazed state and psychic numbing that so often attend deep shock. I told her I was sorry and that I loved her. I gave her a hug. It was all I knew to do. No therapeutic conversation processing things, no helpful strategies about emotional and psychological grounding. Just a hug and an “I love you.”

As she focused, she became visibly concerned, realizing I’d hurt my hand. I tried to stop her as she hurriedly gathered a wet cloth, bandage, and medical tape. Even though her brother had just been killed here she was worried about my cut knuckles. She would hear no protest as she carefully cleaned and wrapped my injured fingers.  

When it was bandaged nice and neat, Mom, Dad and I talked a short time. I don’t remember what we said. In less than 30 minutes I was on my way back to Syracuse but in that short time everything that needed to be communicated had been. At its heart, the message was love.

It’s another moment that helps me as I stand beside clients and families in similar situations. Much of what is communicated within families at these times is done without words, and it is easy to miss important communications when one is distracted by grief and sadness or when tempers are frayed. It is easy to misread words and gestures intended as concern when the situation is charged with fear and old patterns are being triggered.  

As social workers we must spend time focused on the pain and fear, but it can also be important to help people catch the telling gesture of support, the simple action that communicates volumes. We may be in a position to help a client stuck behind a wall of depression or distrust start to feel the love and fidelity hidden behind words and actions that may be coming across as clumsy in the fatigue-soaked, nerve-wracking days of an ongoing crisis. We may be able to encourage a loved one to put the internal dialogue of self-criticism on hold and affirm the power of simply showing up and doing one’s best however ill-prepared or powerless one may feel and however overwhelming the problems may seem.  

This is not to suggest that expressions of love and solidarity are an easy panacea for life’s sometimes furious pain or that they are necessarily plentiful. Some families have struggled with physical, emotional and/or psychological violence. Some have been cut by the haunting legacy of betrayal, substance abuse or severed relationships. Some have become stuck in entrenched transactional patterns that have calcified into chains that may seem unbreakable. But even when these issues arise we may still find fugitive moments of connection. Sometimes I’ll ask families, “So why are you still together, struggling beside each other at such a stressful situation? Why didn’t you just write each other off?” Sometimes the answer comes down to love, sometimes courage, spiritual strength, hope, or core values like duty, compassion, or forgiveness. Whatever the language, these are the kinds of things we may follow down into the heart of the matter, and by doing so we may find that we have found a place beyond words.

The Power of Laughter
The drive back to Syracuse was long but not as long as the seminar I wound up sitting through that afternoon. Things were mentally fuzzy. It seemed as though some internal circuit breaker had been thrown, shutting off sensation and emotion, leaving an inner landscape of muted gray. Still, the familiar rhythm of the classroom was comforting, like some island of normality in a churning sea.

Afterward I walked with my friend Margaret, not saying much. As we wandered down Marshall Street a car approached from behind, its horn blaring. Someone in the passenger seat shouted at us and, in my thrown-off state, I spun around with fists raised in fighting position growling out a threat. As I spun I saw the smiling face of a friend suddenly go pale, his head retracting quickly into the car as it raced away.      

As I pieced together what had just happened Margaret started laughing so hard she doubled over. When she finally caught her breath all she could manage was a single question before once again unraveling into hysterical laughter: “Did you see the look on his face?”  

Soon we were both laughing. By the time we could finish a sentence without falling into hysterics, I felt a sense of well-being and calm. There was something about laughter that connected me with an inner place of peace and balance. Maybe there’s something about being able to laugh that calms the system. Maybe when we laugh in the midst of crisis or pain it activates resilience and puts things that seem insurmountable into perspective. Maybe it just feels good, connects us to others or reminds us that the river of life, however difficult the currents, will continue to wind and flow.  

Despite the sadness often in the backdrop of our work there is still room for laughter. Most clients I’ve known, however off balance, have had an inner sense of core identity not defined by their problems or challenges. A “real self” within, which at times could be felt and expressed. Sometimes I ask clients, “When do you feel most like your real deep-down-inside self?” The answers vary but often boil down to one or more of the following: When I feel or express love; when I experience beauty or the connection with the transcendent; when I laugh. Accompanying people in crisis as we do, social workers are well positioned to identify these pathways when they arise and encourage clients and their families to follow them into a deeper connection with resilience, wholeness, and each other. When humor emerges as such a pathway, as long as it is not at another’s expense and does not reinforce some negative belief or pattern, we may serve our clients as well by being ready to join them in their laughter as by being ready to listen in the presence of their tears.

Philosophers’ Stone
There is vast and important literature reminding social workers that personally significant and emotionally intense experiences need to be processed and any residual energies tracked. We need to be self-aware as we engage clients whose circumstances or personalities may cause things like counter-transference or over-identification, or which might stimulate our own defenses. It’s imperative that we do our best to uncover, explore, and track these potential triggers.

But here’s the rub: much has also been written about the ways our personal wounds and struggles can become a source of compassion, empathy, and courage. It’s the paradox of a profession focused on working with people who are suffering. Though we try to be as objective as possible, every time we enter the life of a client we bring more than our skill and knowledge; we bring every experience we’ve ever had—every memory, heartbreak, relationship, every hope and fear and triumph.  

It would be nice if there were some philosophers’ stone we could use to transform all painful experiences into wisdom. But there is no such shortcut. Figuring out how to unlock the power of such experiences to deepen our lives and work, rather than having them strung out as trip wires can be a long, hard process. Have I done this in the case of my uncle’s death, transmuting life’s hard edges into wisdom and compassion? It’s probably not a question that can be answered with a simple “yes” or “no” but I’ve tried.

— J. Scott Janssen, MSW, LCSW, had been a hospice social worker for 20 years but is currently a private practice social worker in Hillsborough, NC. He authored the book The Dawn Is Never Far Away: Stories of Loss, Resilience, and the Human Journey.