The Jewish Mother Syndrome

You might be thinking of the quintessential, “honey, don't leave the house without earmuffs because you lose 90% of the heat in your body through your head” or, “honey, make sure to Lysol the toilet seat before you sit on it with the seat cover” or “go wash your hands, that's filthy!”. I could go on and on. My father passed along the three generation tradition of carrying Wet Ones in the car. They serve as both cleaning your car, as well as your hands. And in case you have to run to the hospital, you couldn't not have Wet Ones in the car.

No, I'm not talking about the silly Jewish mother quirks. I'm talking about having a bit of prudence. A bit of common sense. I'm talking about some balance. “The topic for today is, What is safety in social work, discusssss” -member Mike Myers in the Barbra Streisand skit on SNL?



Is it making sure not to drink and drive after unleashing all the crap that happened at work with friends at the bar? Probably not. Although, you should be careful about that, the last thing you want is a DUII just because your supervisor is a bitch. That would really show her. Hey boss, I can't come in to lead group tomorrow because I have to BE in group. Whose the asshole now?

Is it watching out for the sole acupuncture needle (acupuncture is sometimes done in the ears at substance abuse treatment for cravings) lying at an awkward angle on the floor waiting to transmit Hep C or something to the next foot that passes by? Most likely not, but be careful for those too. I knew someone who freaked out and went to the hospital because she poked herself with a needle.

Is it watching out for clients who like to slosh their urine sample and giggle and grin with their two front teeth while they watch you get mad and tell them to act like a ten year old rather than a four year old. Or is it watching them spill the urine all over the bathroom floor and leave it so that it can cause an accident. Or maybe touching the UA cup, and then shaking another client's hand, who proceeds to rub his nose and eat his booger with his finger. Nope, another base covered. These are all probably normal thoughts of any Jewish social worker. WASH YOUR HANDS, CARRY LYSOL AND WATCH OUT FOR GERMS!

Side note- one of my favorite sanitary experiences at work was when I got pink eye. I had never had pink eye before- makes you think a little harder about where you put your hands and when you wear leather gloves (no finger prints and a fashion statement- I had a separate pair for work). It started acting up during a group and I had white crap seeping out of my eye. That day, I was leading my favorite group, one made up of 6-12 bipolar women, all of whom were a total hoot, but impossible to calm down. I spent most of the groups screaming over them to shut up and let each other talk about the topic. Try getting 12 manic women to talk about a topic. It's a fascinating thing. So, this group while I was wiping my eye, I let them lead themselves. The topic was abuse. One started out complaining about her boyfriend who was arrested for 10 charges of rape and beastiality and by the end of the hour - flowers and smells of North Dakota. I don't know how they got there and didn't feel like asking them to back up considering that my eye was seeping wipe liquid as avidly as something out of a porn video. EW. Needless to say, it only took a few eye drops and my doctor to tell me to watch out for bacteria. So Jewish neuroticism SERVES A PURPOSE! Every other staff member in the office got pink eye and hooray for my gloves! And no, I was not willing to share my $40 eye drops freak! Get your own!

Okay, seriously now.

Is safety keeping ourselves protected from threats by our clients? That seems to be the most basic of safety issues. If our clients are drunk and threatening to gun down the entire police force (with a real registered gun), we should have a safety plan and a supervisor willing to back up our efforts, especially if we are isolated in our offices. Right? Before I reveal the details of this gorgeous and juicy story, I'd like to back up. (Scene from Fight Club at the beginning where Tyler is bleeding out of his head and starts to tell his story- record scratches and rewind goes X5)

Social workers, psychiatrists, nurses, psychologists and all other helping professionals all represent something to the average client who walks through the door. They are authority. Authority, while it means REBEL! $&%*%$ da police (I'm sure someone has been to a hip-hop show), also means safety and rules. Structure enforces staff authority and reassures patients they are receiving “professional” help (Yalom, 2002). Hence, authority means that there's the big man telling people what's up. And he's a bad ass. In fact, he's a Terminator. Maybe we don't like what the big man has to say, but then we can rebel against what he has to say. If we rebel too far, we take consequences. We might get kicked out, we might get arrested. This is the reality of life. We need to live within some constraints, otherwise nothing makes sense and everyone is in a constant state of anxiety. Kind of like me at my job! Reassurance denotes safety. Structure, is therefore a part of safety.

There are numerous other elements that might create safety in a setting. The physical setting might influence client and staff behavior. Depending on how the office is set up, a client or staff member might feel more safe. Example, my office was facing a window, which I chose to keep the blinds open all the time because we all need natural light, (not like my vampire supervisor who preferred to sit in the back room with the blinds shut). This, of course, was a sacrifice, where I had to literally kick people out of my office all the time because everyone always knew when I was in, what I was doing and could see me from outside. Plus, I was the first person they saw when they walked in if I was not with a client with the door closed. So, it was Grand Central at rush hour. Not necessarily the safest place and a great place to make clients feel welcome! It's like they run the place with chaos! Clients love that. Yes, you guys, that was sarcastic.

On the other extreme (more extremes!), there was the infamous asylum which was created to enforce physical boundaries to preserve staff safety from potentially violent patients (Foucault, 1975). So, One Flew Over the Cuckoo's Nest was sad because they kept lobotomizing all the patients, but it served a purpose. Probably to protect the overly neurotic hospital workers. Couldn't you just hear Nurse Ratchett? “That toilet seat was left up over night- you're going to get lobotomized". Hell, she might have had a case of OCD. One thing is for sure. The first and foremost concern was with staff safety. Okay, I'm not condoning Nurse Ratchett's behavior. Simply saying that it was telling of the times. She was acting out of fear.

We don't need to head back into One Flew Over the Cuckoo's Nest but c'mon now? Where have the “good old family values gone”? Sorry to be quoting Bush, but sometimes we really need to realize that extremes are a problem! Especially when you can't be on both sides of them. As my mentor told me (from the last post), I enjoy spending times with both extremes almost to flaunt the opposite extreme to each of them. It's my way of educating everyone about other ways of life. However, if someone goes off the deep-end either way, all hell breaks loose. Think Ann Colter in a lesbian and gay parade.

While State Hospitals continue to enforce the extreme asylum structure, outpatient agencies have gotten so lax about their rules- what rules – that they jeopardize, not only their clients, but the staff as well. I'll refer right now to the issue about the street kids- have we crossed so far over to the dark side of the client that we can't see the importance of a more traditional approach to clients who are criminals and are potentially violent and explosive?

Instead, we decide to take their side, even if the violence is against us. I would love a political cartoon about a social worker trying to help a meth'd out client trying the strangle her. Her little bubble above her head would say, “I totally see where he's coming from. His dad abused him. I forgive him”.

So, I'm going to tell you a story that completely freaked me out. I believe social workers have completely lost their marbles. Remember how I talked about the authority figure of the "big man"? Basically, this is what happens when the big man is a bottom (for those of you who don't get gay humor, that means he likes to be dominated).

So, I did an assessment with a client who was drunk. When he told me he had a plan to gun down the police force and had a weapon, I took this seriously- he had access (that's a big word in social work that you pay attention when you assess people for suicidality or homocidality. If they have access, that means they could really do it!) I left the session and consulted my supervisor. In my opinion, the client should not be allowed into outpatient treatment because he refused to stop drinking and it could trigger other clients. In her opinion, shrug. Okay, my heart was racing, I was in crisis mode. I suggested “we need to talk to him together and call the cops, considering he drove here and he's drunk, or we just need to get him out of here”. She suggested, “you could tell him that he can't have anything to drink three hours before group”. What about RIGHT NOW? And did I hear you right? There was no rule on alcohol limit for groups? This guy is here on probation and we can't mandate him to go to a detox before attending outpatient treatment? Moreover, if he came to group and made these type of threats, what would the clients do, how is that a safe environment?

Regardless of my pummeling of questions, she stayed in her office, nonplussed. I returned to try and resolve the situation independently and the client was uncooperative and growing angry. Well, duh. How would you react when the big man is a 115 pound woman, who regardless of the muscle, she's only 5'6 and doesn't exactly look like she could take you out, is telling you, “no you can't come to group tonight because you're loaded- the breathylyzer said” and “I am refusing you services here until you go to detox”. How do you tell Ted Nugent on crack that he's also drunk and grandiose?

In the midst of my thoughts, "could I take him?" my supervisor, passes by in the hallway, witnessing this interaction- the client hostile, while not explosive and me trying to de-escalate the situation while explaining we would call the police if he insisted on driving home. Total scene from CSI. I wish. Needless to say, she basically undermined all the work I did with the client and told him to show up for the group that I was running that evening. I felt like I was in the Twilight Zone. The world narrowed to a single point of light- you know the one when you are about to undergo surgery? Actually, I wouldn't know because I never did, but I saw it in a movie. I was waiting for the client to go, “SORRY” and put my red pawn back on the start sign.

So, quickly. What happened? Who's the good mom or the bad mom? Hmmm. Let's see. The one who sends him to jail and refuses to let him into treatment, or the one who's never met him, but told him to go ahead and come back to group. Oh, I'm SURE that any client in their right mind would be, “oh you really taught me a lesson. I'm going to jail to learn it. Bless your heart”. No, I would imagine the gun would most likely be turned on me. Now, maybe this is the Jewish mother in me, but honestly, I don't think so. What happened next was even better.

After he left, I was shaking. She went back to her office and I went back to mine. I was stunned, to some extent. I couldn't really move. I just sat at my desk, not only in disbelief of what had transpired with the client, but all the implications of what had transpired with my supervisor. After five minutes, I got up and asked her to talk. I told her how upset I was and she nodded. She had no idea what happened. Finally, I upped the ante and said I refused to run group that night. She acted like I was crazy. “I've never seen you so upset about something”. What? This guy had access to a gun, made a threat, was actively homocidal and drunk and you don't actively participate in getting rid of him, even after I asked you for help, plus there's no safety protocol. She tells me that she'd never had to deal with a situation like this. I'm thinking, oh right because you let clients run all over you and tell you what to do. We were not treating victims or harmless immobile people, we were treating criminals. There needed to be rules. Where was the Terminator? All I needed was back up on my rule setting. Once again, I was the non-conformist in the agency of addicts.

With no response, or inertia, such as demonstrated so beautifully by my supervisor, we were left with one angry, frustrated, and scared provider, who had a serious problem and was left out on a limb with a dangerous client.

Back to the idea of extremes, procedures and rules were apparently too certain at our agency, so we didn't have any. Plus, the agency said that if they set a rule, there was always an exception. For me, there were no exceptions. This is where you are a a hard ass. For my supervisor, well, we'll never know what was happening up there, but more importantly, for the agency, there would always be an exception and an hour long convo about how not to set rules.

Them: “It seems like you really handled the situation well”.
Me: “Well, actually, I think this was one of the most poorly handled situations. This should be a team effort, if someone is threatening. The clinician needs to be backed up. Not the client”.
Supervisor: “I would totally back up whatever you suggested”.
Me: exasperated, “Well, when I went into your office twice- which I never do -and asked you for your advice, I felt that was asking for help and you knew what I was trying to accomplish with him”.
Them: Don't be so hard on yourself (talking to me). You did everything you could have.
Me: We really need some rules here.
Them: Rules could work. But let's talk about that because some rules are too harsh and rules are meant to be broken.

Was that a straight answer? I'm confused.



For those of you who are wondering, that is Elron Hubbard.

Inevitably, we came up with some cheesy word that was supposed to mean that there was a crisis ensuing, which of course, we never used- and we were supposed to get some phone system in the group room to be able to ask for help- never happened. No surprise considering that after a year and a half, the only time that we could watch a movie in group was if someone decided to bring in their computer.

All I have to say is, “such a problem”.

To end this post, while many say that paranoia, and Jewish neuroses are bad things, they also seem to serve as a protective mechanisms. Right? My anxiety told me to de-escalate the client, take him into the hallway and go ask for help. Moreover, it offered some more paranoid revelations, like, “he could bust out his GAT right here and open fire on the whole place”. While I didn't think about using Lysol to spray in his eyes, I was aware that I needed help. When help wasn't provided, there was no safety.

My question is, do newly trained practitioners have to rely on anxiety to protect them from harm or is it easier to move up the ladder? At some point, that anxiety is going to become unmanageable, their problem, rather than a simple agency change. Why not simply enforce a god damn rule, higher a “big man” with an opinion who is NOT a bottom (someone with an opinion should be hard and strict, but soft when needed) who cannot be swayed, instead of burning out all of your workers who actually DO something?