Developing programs for older adults in a faith community

I have worked in all areas of nursing, from staff and head nurse positions to faculty and administrative positions, but my work as a parish nurse, particularly with our community of older adults, is one of the most challenging and rewarding areas of nursing practice I have ever experienced. Recently, one of our independent older adult parishioners, Marge, suddenly had a marked decrease in her ability to function, which was precipitated by two trips to the hospital and surgery. She went from living independently to living in a skilled care unit, no longer able to walk or perform activities of daily living without assistance. I had known Marge for only 2 years. When she became ill, I visited her weekly during the last 4 months of her life, as she had no family in the area. During my visit one evening as I helped Marge get ready for bed, she left me with a very poignant memory. After sharing some hair-raising stories about her care at this facility, she said, "Georgine, you're my best friend. You're the only one I can tell these things to and I know you understand."     

MARRIAGE AND FAMILY THERAPISTS WORKING WITH FAMILY VIOLENCE: STRAINED BEDFELLOWS OR COMPATIBLE PARTNERS?: A COMMENTARY ON AVIS,KAUFMAN, AND BOGRAD

Thelma is frustrated. She wants to go away for the weekend but approaching her husband with the idea seems impossible. Feeling annoyed, irritated, and trapped by her inability to discuss her plans, she yells at him instead. Responding in a tone that is both controlling and parental, he admonishes, "Didn't I tell you not to yell at me." As if she had forgotten about her feelings and her needs, she meekly replies, "I'm sorry, I didn't want you to be late." For those not familiar with the movie Thelma and Louise , Thelma does eventually summon up enough courage (with the support of her friend Louise) to leave, escaping from her chauvinistic and abusive husband on an exciting albeit brief adventure.     

Muriel Dimen: Teacher,Mentor, Psychoanalytic Scholar

ABSTRACT

This essay is split in content and intent. In the first part, I share my reflections from my long personal relationship with Muriel Dimen, who taught, supervised, and mentored me as a young candidate and beginning scholar. In this part, I try convey how staunch and thorough her commitment, how extraordinary her generosity was in supporting the intellectual development of a new generation of emerging psychoanalytic thinkers and theorists.

The second part, written in an entirely different tone, takes on the body of work Dimen produced in the last decade of her life, which focused on sexual boundary violations. This work highlights the hybridity of her thinking and the brilliance of her mind. I flesh out the genealogy of her reflections on this topic and discuss in some depth how her last, posthumously published paper changes the terms of the conversation in this very difficult matter. In this topic, as she had previously done in many others, Dimen’s contribution introduced an entirely novel way to think about the recalcitrant problem of sexual abuses in the consulting room.     

视界

26岁的黄诗琦为87岁的外婆拍摄了两组照片，上传到网上后感动了众多网友。一组是外婆去年初的样子：活泼可爱，健步如飞；另外一组是她外婆去年8月突发脑溢血后，现在的样子：神情恍惚，几乎站不起来。“还是那个地方，但外婆已经不是当初的外婆……你答应过要等我结婚生子，所以你要好好活着，健康活着……2014年，我们一起努力，孝不能迟。”黄诗琦为这些图片配上“最珍贵时刻”的标题。     

Home Is Where She Is

ABSTRACT

I have written this paper with the intention of reading it out loud to you. As I was writing this paper, I imagined your skin, that soft outer membrane of your body. I imagined my tongue moving to shape my words, all the while carefully shifting my teeth out of the way. I imagined having these words thump under your skin and tremble your presence to the beat of our hearts. Because this paper was supposed to have you feel me and my people. And by “my people,” I truly mean everyone around me, including you. So, this paper is essentially about us, you and me. You know, I just had a feeling that you might know us, but you do not feel us. I just had a feeling that you have got to feel how we are. … Do you hear me? Because, only then, can we finally, start.     

Mutuality in Relationships with Health Care Providers

Abstract

I have had a mobility impairment for many years and have experienced repeated trauma at the hands of medical personnel. They have withheld anesthesia and postoperative pain medication, insisting that I had no pain. Physicians have also refused to believe that I have been physically active, and have minimized the degree of impairment that I described. They hold the same biases about people with disabilities as do most people: that we are lazy and weak, and that we do not try hard enough. Despite my ongoing attempts at self advocacy, my orthopedist has made unilateral decisions about my treatment goals and the management of my diseased joints. These have caused me to wear out other joints, until I am significantly impaired and can work only a few hours a week. He then began to treat me differently, since his preconceptions prevented him from seeing me as an individual with unique abilities facing attitudinal and physical barriers. Our relationship was the only tool available to me to attempt to break down his prejudices to stop the harm he was causing me. I will describe a series of oppressive medical provider relationships. I will then demonstrate my attempts to assert myself as an essential mutual partner in decisions about my goals, and show the limitations of this approach in the presence of a great power differential.     

不论距离多远,心在一起

日本姑娘岩崎春香被网友亲切地称作“香香”,她曾以志愿者的身份,在北京中日友好医院当了一年半的护士。香香见证了中国抗击新冠肺炎疫情的强大决心和不懈努力。2021年由始,查查分享了她的新年愿望:尽管距离遥远,她愿新的一年越来越好,未来有机会再回到中国,看望她的同事、朋友。     

‘So Much We Still Don't Know’: An Interview with Averil Earnshaw

I was independently told about Averil Earnshaw by three different people in the same six month period. Each of them had heard, or heard of, Averil's presentations on the theme of time-linked intergenerational repetitions, and knew of my own interest in repeating patterns in families. Averil very willingly granted me the interview that follows, and in the course of talking with her, I began to realise that Averil's was yet another story of someone who had formulated an original hypothesis based on repeated clinical observation, and had the courage to present it to gatherings of her peers, only to encounter skepticism, lack of interest, or charges of ‘idiosyncrasy’. Despite Averil's best efforts to show that her hypothesis was consistent with the direction of Freud's own thinking, the psychoanalytic movement had greeted it lukewarmly, and it seemed to me that perhaps it might be of more interest to readers of this Journal, since the older and more psychoanalytically-influenced generation of family therapists (e.g. Bowen, 1978; Skynner, 1976) recognised the general principle of repeating patterns across generations, although not the very particular temporal law that Averil has suggested. The Earnshaw hypothesis is simply enough stated: the emotional and intellectual crises of adults’ lives (including onset of mental and physical illnesses, creative break-throughs and creative blocks) are time-linked to major events in the lives of their same-sex parents at the same age. Often, though not always, says Averil, one experiences a crisis when one is the same age as one's same-sex parent was at the time of the birth of one's next sibling, or even when one is the same age as one's parent was at one's own birth. Averil's short bookTime Will Tell (1995) illustrates this hypothesis with some fifty brief case studies based on biographical data from the lives of famous individuals, as well as with a number of cases from her clinical practice, and examples from her own life. Averil herself recognises that her hypothesis needs to be rigorously tested on a wider sample, but to date, those who have criticised it as ‘merely anecdotal’ have not been willing to undertake such a study.     

Contradictions of state socialism: the case of Poland*

This article originates from an invitation to give a paper at the Polish Academy of Sciences in Warsaw m the Autumn of 1980. As then drafted, the paper consisted mainly of a discussion of the writings of selected Polish and British sociologists on the structure and workings of contemporary state-socialist societies, and it was my intention to revise it for submission to the Sociological Review as a sequel to, and commentary on, the article by Christopher G.A. Bryant published in the issue of February, 1980.¹ On return from Warsaw, I decided against doing so for two reasons: first, it seemed to me that the writings which I had taken as my starting-point were too remote from the actual course of events in Poland; second, I did not see how I could use the many informative conversations about those events which I had had with Polish sociologists and others in an academic journal article. On further reflection, however, I do not believe that either of these reasons should prevent my attempting to set out and justify my view of the implications for sociological theory of the Polish case, even though it is based in part on non-documentary sources and (more seriously) I lack the knowledge of the language which would give me direct access to the documentary ones. In what follows, accordingly, I first outline the framework within which the forms and distribution of power in state-socialist societies in general and Poland in particular can, in my view, best be analysed; I then set out in slightly more detail what I see as the reasons why events in Poland between 1956 and 1981 followed the course they did; and I conclude with a brief discussion of what I believe to be the principal weakness in the recent British sociological literature on state socialism insofar as it relates to the Polish case.     

Briefly Noted

Last week, Safehouse, a Philadelphia nonprofit that will open a supervised injection site in the city (see ADAW, Oct. 15, 2018), has hired an executive director, Jeanette Bowles, Ph.D. According to radio station WHYY, Bowles will help with fundraising and finding a site. “I believe in it so much,” Bowles said. “We see this working in other places, and the evidence supports it so strongly, that we don't have progress in public health without some controversy and scrutiny accompanying it.” Whether the Department of Justice will allow the site to operate remains unclear. “I've joined the team that respectfully disagrees with the Justice Department,” Bowles said. “Sitting in the office and doing the work separate from the community has never been my approach or style,” she said. “Being embedded with the community and developing those relationships and having my feet on the ground has always been most important to me. That's how the best public health work is done, through building bridges with community members.” Bowles earned a bachelor's degree from Temple University; obtained his master's in social work from the University of Pennsylvania; did postdoctoral work at the University of California, San Diego; and for her Drexel dissertation focused on opioid overdoses in the Kensington section of Philadelphia. The city, in giving the go‐ahead for the injection facility, said it would have to be run by a private nongovernmental entity.     

Troubling Whiteness: Commentary on Harris's “The House of Difference”

This article focuses on Harris's (this issue) understanding of racialized subjectivity as a socially constructed phenomenon where fantasies about race are transmitted intergenerationally. I was raised as a “white” South African and I had two vivid associations to Harris's proposal that a “psychose blanche,” an invisible repository of unsignified, racially inflected thoughts, feelings, and selves exists at the heart of “whiteness.” In both cases I recalled a scene from my youth where I was taught that whites in apartheid South Africa deserved punishment and would receive this “come the revolution.” These lessons were crucial building blocks in the formation of my racialized subjectivity, and I describe and interrogate them in an attempt to add further variety and color to the landscape that Harris so deftly draws as she resignifies her “whiteness.”     

A TOOL FOR TRAINING SUPERVISORS: USING THE SUPERVISION FEEDBACK FORM (SFF)

As the field of supervision and training has evolved, there has been a growing recognition of and appreciation for the skills required to be an effective supervisor or trainer (Liddle, Breunlin, & Schwartz, 1988). This new awareness has pointed to the need for effective methods and tools for training family therapy supervisors. One of the tools I developed to improve my supervision complete to give me feedback on my supervision. This article describes how developing and using an SFF was valuable to me in my training as a supervisor. Based on my experience, I believe the SFF could be a useful tool in training other supervisors.     

Love and Alcohol: Performance in the Fiction and Life of Writer-Singer Nataliia Medvedeva

Abstract

The multifaceted Russian author, singer, and actress Nataliia Medvedeva’s (1958–2003) creative output was synonymous with performance. Her image became iconic in worldwide popular culture as the carefree, smiling young woman on the cover of the New Wave rock group “The Cars”’s eponymous 1978 album. Then Medvedeva was twenty years old and had been living in the United States for about three years; she returned to Russia in 1994 after nineteen years abroad, mainly in the US and France, and died at the age of forty-four, possibly of a fatal mixture of alcohol and tranquilizers. By the time of her death, Medvedeva—author, poet, journalist, singer, musician, model, and designer—was, and remains, an enigmatic yet colourful figure of the Russian émigré and post-Soviet literary, music, and cultural scenes.

From an early age in Leningrad, she showed an aptitude for constructing performance and (re)presenting herself. This article suggests that Medvedeva used her early autobiographical writing as a method of thinking through her ideas and beliefs about the nature of performance, especially as it related to perceptions of the sexual, sexuality, and shocking-ness, as well as to the relationship between the audience and herself, indeed, between society and the self. To support my thesis, I focus, in particular, on her autobiographical novel Liubov’ s alkogolem [Drunk Love, 1987?, 1995, 2001], as well as foundational ideas from the field of performance studies.     

COMMENTARY (12 YEARS ON) ON ‘THE CONTRIBUTION OF OBSERVATION TRAINING TO PROFESSIONAL DEVELOPMENT IN SOCIAL WORK’ BY JUDITH TROWELL AND GILLIAN MILES

This article aims to stimulate discussion about relationships between the lives of professionals and of service users. The idea is that when parallels are explored and developed, power dynamics between professionals and social workers are reduced, the quality of interaction and work with service users can be improved, and professionals can also be helped in overcoming difficulties in their own lives. I start with an outline of my own personal background and highlight my development throughout, including my emerging identity as a Buddhist. I discuss a case study involving ‘Sally’ and her family and our work together while I was a social work assistant in a Children and Family's team. I try to show the interconnections between the different difficulties that we faced and how that informed my work. I look at some of the benefits, pitfalls and boundaries of working from the point of view that service user and professional are both working to overcome their problems. I also interweave interactions I had at the time with Carlos, a drug user friend in a crisis and the impact he had on me. Because I include my own situation I have called this article a ‘case experience’.

Throughout I refer to Buddhist and psychoanalytic thinking and particularly to agreement between the two around ideas that inner‐resistance is the main barrier to personal evolution. I argue that faith is the key to unlocking resistance, and that faith should be understood as the development of a belief within people that they are able to progress rather than be destroyed in the face of inevitable problems.     

Katabasis,adult betrayals and liminal identities in China Keitetsi’s Child Soldier: Fighting for My Life

In Child Soldier, China Keitetsi recounts her experiences as a child and a soldier during Yoweri Museveni’s guerrilla war against then Ugandan president, Milton Obote. Drawing on key debates on literary representations of katabasis, this paper examines Keitetsi’s portrait of adult betrayal and parental abuse of children at home, and as child soldiers. I argue that Child Soldier is a text that lends itself to a katabatic analysis, and that Keitetsi is a katabasist who frames her experiences as a child and a soldier “within the narrative structure of a descent into Hell and return” . I argue that “hellish” elements in the memoir are more than just incidental: they point to a world where tenderness and love have long given way to cruelty and cynicism, and where madness and violence and despair are the order of the day. I also draw on Sigmund Freud and Homi Bhabha’s notions of the unhomely, to suggest that the memoir introduces interesting parallels between the unhomeliness in the home and that brought on by the civil war. Subconsciously, then, examining the memoir under the tropes of katabasis and the unhomely allows us to view her life as floating in-between the child she wishes she should have been and the abused and rejected young woman she becomes.     

Little Theories and Big Problems: Chicago Sociology and Ethnic Conflicts*

Since this society is oriented toward a specific theory, I thought I ought to say something about theories in general and our little theory in particular. Let me get that off of my chest. I am not overly fond of terms like “theory” and “theorist,” both of which seem to suggest the importance of the person who claims the identity more than anything else. They are pompous terms. To the extent that we are thoughtful about what we are doing and how we are going about it, all sociologists are theorists and methodologists. But if that is all we are, then we are literally people of no substance. We have no substantial knowledge of or concern for the empirical world. The little theory we share is extraordinarily empirical. It is, as one of its most prominent practitioners called it, a “grounded theory” ( Glaser and Strauss 1967 ). I confess that several years after receiving my degree I had no real sense of what symbolic interaction was and how it might differ from other theoretical orientations. Arnold Rose enlightened me on this when he asked me to submit a paper for a new collection he was editing ( Rose 1962 ). I was pleased and flattered. Rose was a mentor of mine, and I had never before been asked to contribute to an edited volume. But I was unsure of what would be appropriate for a book about symbolic interaction. I screwed up my courage and asked Arnold: “Exactly what is symbolic interaction”” He shrugged off my ignorance, turned on his heels, and muttered over his shoulder, “It is what they do at Chicago.”     

Generating Hypotheses From Rachel's Strong Profile

To formulate my reaction to the case materials for Rachel, I imagined how I might use the available information to prepare myself to see Rachel for career counseling. Rachel's case presents an excellent illustration of how the Strong profile can be used to generate hypotheses about the career conflict she is experiencing, how career counseling might progress, and potential issues to explore with her in counseling. Furthermore, Rachel's case provides an example of how information from her profile might be integrated with other available case information. I have divided my reaction into two sections: pre-session preparation, and issues to explore with Rachel in counseling.     

From Clinician to Researcher: The Challenges and Rewards

After many enjoyable years of practice, I made a decision to retire, and felt the need for new but related interests. I knew it was going to be research because I have long considered the progress of my clinical work from that aspect. As a student, I had been trained in quantitative method, and I expected to experience a culture shock when ‘permitted’ to relax my previous research mode, with its dependence on statistical approaches based on preemptive hypotheses, to undertake a qualitative methodology novel to me.