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Walking the Rope Bridge: Responding to Clients’ Divisive Language and Behavior
J. Scott Janssen, MSW, LCSW

The conversation between me, a hospice social worker, and Henry, an 85-year-old patient with prostate cancer, had suddenly changed. It was as if someone turned a dial, replacing what had been a routine dialogue with loud static. My mind cast about four ways to respond, but Henry didn’t seem to notice. He continued talking after making the statement that plunged me into an awkward internal state: “Let me tell you a story that’ll show you just how stupid black people are.” I wondered if he realized that I stopped nodding my head and that my eyes hardened and my jaw slightly tightened.

For years I’ve been trying to discover the best way to respond to statements like this, statements that divide and create separation on the basis of race, gender, class, or sexual orientation. And for years I’ve struggled with a fundamental tension that often accompanies these moments. On the one hand, Henry was dying and as his social worker I was there to help him cope with the challenges of this final leg of his journey. I wasn’t there to change his beliefs about race. He wasn’t asking me to help him understand the negative toll such beliefs have had over the years on those who are their target as well as those who espouse these beliefs. On the other hand, such statements violate personal and professional values about inclusiveness, respect, and equality that are important to me.

Remaining silent in the face of such comments felt like a betrayal of these principles and ran the risk of appearing to give tacit acceptance to something I find deeply objectionable. However, voicing my objections in such situations causes me to run the risk of inserting my agenda over that of my patient and undermining important relationships that allow me to help the people I serve use what time we have together in a manner that moves toward meaning and peace as their lives draw to a close.

Fundamentally, it’s an ethical question. Do I raise an objection and set some limits, thereby holding fast to the values of equality, social justice, and advocacy? Or do I let such statements go in the interest of the values of nonjudgment and acceptance of those whom I serve? Is there a way to do both?

The Rope Bridge
At times like these, it feels like I’m walking over an abyss on a rope bridge and winds are blowing from either side. On one side, the winds are pushing me to ignore such comments and not get sidetracked or jeopardize the relationship. The danger of these winds is that I may be swept into the abyss of compromised principle and missed opportunities to help patients find insight and new understanding. The process of dying can be transformative. Old ways of thinking, however entrenched, can be transformed when patients have the courage to look at them.

On the other side, winds are pushing me to speak, not to miss an opportunity to explore such statements and beliefs down to the root or, at very least, make it clear that I consider such language and commentary unacceptable. The danger here is that I may fall into the abyss of conflict and judgment and run the risk of having a patient hang up on me the next time I call to offer a visit.

When I was a new social worker, my response to these moments was to not respond. I ignored such statements and language, thinking that if I called people on it I would create tension and have to deal with a conversation that would likely be as uncomfortable for me as it would be for them. Somehow I convinced myself that if I ignored these statements, they would go away. I fortified this approach with rationalizations such as, “She’s old; she grew up in a different world” or “He’s dying; there’s no point opening that can of worms.”

The problem with this strategy was that not responding did not always stop the behavior. Sometimes, rather insidiously, it seemed to affirm it. Some appeared to view the fact that I let such speech go by as evidence that I was comfortable with it. When this happened, I would often find myself at a fork in the road where I was forced to make a conscious decision to either accept or challenge such statements and beliefs.

These moments of decision usually came in one of two forms. In the first form, someone would say something like “You know how black people are, don’t you?” often using the “n-word” instead of black people. Then they would look at me for some sign of agreement. In the second form, they would make a hurtful statement in the guise of a joke, then look to see if I smiled or laughed. In these cases, failing to response is no longer a neutral stance intended to avoid conflict; it is a stance that challenges. In such moments, there was no hedging; I had to decide.

It was during these moments of decision that my discomfort peaked. I admit there was part of me that just wanted to go along with what was being said, just nodding and smiling. I’m sorry to say that, as a young social worker, there were times when I did just that. Afterwards, I’d agonize about having done so, knowing I had taken the easy road of avoiding potential conflict rather than the more difficult road of speaking up. Looking back, I see that these times were essential in motivating me to explore and gain insight into my willingness to acquiesce and my lack of confidence in discussing these issues when they arose.

Breaking the Silence
In time, I found the confidence not to nod or smile. In fact, I would nonverbally try to communicate sadness or disappointment in what I had just heard. Often there was an awkward pause. Now and then people would push me to affirm what they’d said. At these times the only thing to do was to take the plunge and tell them I disagreed with them and that I did not find such statements humorous.

Initially, I braced for anger, confrontation, and broken relationships. In most cases, though, the firestorm I anticipated never happened. There were some who took offense at my refusal to validate what they’d said; some even attempted to bully me into agreeing with them. These exchanges could be nerve-racking and, at times, I found my own temper rise, and I had to restrain myself from attacking back. At other times I wondered what I had done wrong; surely a better social worker could have avoided such a percussive situation and still gotten the point across.

In retrospect, I’m grateful for these sharper exchanges. They helped me to identify some of my own buttons and calibrate my words a little better in situations where such advocacy might be met with verbal aggression. I’m also grateful that these extreme reactions stand in stark contrast to the majority of situations where, although there were some awkward moments and sometimes the trust that had been built appeared to be damaged, relationships were not destroyed. Most patients did not slam the door in my face. Some even appreciated my candor.

As my confidence grew, I began routinely communicating my disagreement nonverbally or telling people, gently but firmly, that I preferred they not use such language or make such statements in my presence. It was scary at first. After all, I was a guest in their homes, and I was often much younger than the patients I was serving. As I practiced, I became less self-conscious, and those strained breaks that sometimes occurred in the conversation produced less anxiety.

It was in these breaks that I began inviting people to look more closely at their experiences and beliefs regarding race, gender, or sexual orientation. What relationships did they have with people of other races when they were growing up? What messages did they receive from their parents about race, gender, or sexual orientation? Had they ever thought about the impact of such language on the people who were targeted? Sometimes I would question the apparent incongruity of divisive language and beliefs with values patients had earlier espoused or experiences they had shared.

I have to concede, most people wanted nothing to do with such explorations, but I made the invitations anyway. Every now and then, when someone reflected on such matters with an open mind and seemed to gain insight or empathy, it made all the awkward moments worthwhile. There were a few who, when I called the next time to offer a visit after such a conversation, told me not to come back. But most people respected, or at least abided by, the boundaries I had drawn.

Seeking New Strategies
Challenging racist and homophobic beliefs still feels intimidating at times. I’m always looking for better, more seamless ways of doing it. One strategy I’ve been experimenting with recently is using humor and playfulness to create a wedge to help people step back and look at their words, thoughts, and behaviors from a different perspective. Of course, racism and sexism are no laughing matters, and it is important not to convey that you are taking these lightly or in any way condoning them. In some instances, though, I’ve been able to use humor to bring the issue up while mitigating the extent to which doing so is perceived as threatening or judgmental.

I decided to try this strategy with Henry. When he finished the story that he claimed proved that blacks have inferior intelligence (a fairly generic story about a utility worker who had a hard time finding where their electric cable was buried), I held my hand up to interrupt. I shook my head and made a bitter facial expression as if I’d just taken a big bite of lemon. I scratched my head and in a voice that I hoped would convey bewilderment and confusion said, “Henry, you don’t actually believe that story has anything at all to do with him being black, do you?”

The question startled him. It wasn’t where he’d expected me to go. He looked a bit uncomfortable and appeared to be preparing to defend himself. I smiled, opened my eyes wide, and said in a playful way, “Oh come on, Henry.”

At this point in the conversation, I was ready to go in any direction Henry might move. There is no guarantee people will see such playfulness as a nonthreatening way to raise an issue often loaded with emotion and freighted with unexamined automatic beliefs. And besides, most people know that even though I’m glossing the surface with apparent levity, I’m being deadly serious. If Henry took offense or pushed back, so be it.

Engaging Moments
I’m not suggesting the reader go out and start cracking jokes in the face of these complex issues. I’ve been using humor for many years with hospice patients and families but only recently have I tried using it selectively with divisive language. Such an approach will not be part of every social worker’s style or in his or her comfort zone.

What I’m suggesting is that we engage these moments in a way that allows us to find our balance when we are out on the rope bridge. How do we express the values of inclusiveness, racial and social justice, equality, and advocacy in situations where doing so may appear to jeopardize, at least in the short run, our intentions to build trusting, nonjudgmental relationships where people can feel free to say whatever is on their mind? And if we have to give ground on one side or the other, which side do we give ground on and why? It’s an ongoing dance, far more art than science, where we try our best over time to balance these values with wisdom and integrity.

I’m still exploring, still learning, still trying to figure things out. Perhaps some would see my use of humor with Henry as an elaborate form of defensiveness whereby, on some unconscious level, I’m attempting to manipulate him into agreeing with me that his beliefs are unfounded whether or not he is sincere. I don’t think this is the case, but who knows, these issues can be confusing and multifaceted. They can unearth and challenge personal and professional vulnerabilities, insecurities, assumptions, and defenses. As with our clients and patients, we are on a journey. We would do well to be both honest and compassionate with ourselves. I’m still looking for that one best way to handle these moments. Frankly, they still scare me. The more I explore them the more I doubt there is any one best way. The only thing I’m certain about is that it’s important to keep trying.

Henry paused and lowered his head. I wasn’t sure what he was thinking. After silently turning things over in his mind, he finally said, “Well, I guess it says more about humans than it does about blacks, doesn’t it?”

I asked him what he thought it said about humans, bringing a serious tone now that the door was open. He wasn’t sure. I asked him to tell the story from the point of view of the utility worker, but he pleaded ignorance. He wanted to leave the subject behind, but not before shrugging his shoulders and adding, “I guess the moral of the story is that we can all be pretty ignorant sometimes, no matter what color we are.”

I nodded my head, “Yeah, Henry, that’s for sure. But sooner or later, if we keep working at it, we find our way, don’t you think?”

— J. Scott Janssen, MSW, LCSW, has been a hospice social worker for 20 years and currently works for Duke Hospice in Durham, NC. He is author of the book The Dawn Is Never Far Away: Stories of Loss, Resilience, and the Human Journey.