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A Shining Affliction

Book Club’s Meetings, Discussions, and Questions

Meetings and Discussions

            The meetings and discussions of book club are summarized in the blog which is included with this one page summary.  Because members of the group live in different cities and have busy schedules, the group decided it would be most efficient to have our primary discussions about reading and content happen on the blog.  The blog fostered some interesting discussion and provided a touchstone for what members discussed casually about the book on Wednesdays when everyone was at school.  Additionally the group chose to have one meeting at school on Wednesday November 17^th.  At this meeting the group discussed the content and format for our final group presentation.  We identified a number of interesting and not necessarily answerable questions that arose for the group as we read.  We will present these questions to the class as well as what each of us took away from reading the book, as closure to our presentation. 

Questions

 -On touch: Is Annie's use of touch in her therapy with Ben ok? What about Blumenfeld's use of touch with Annie and Melanie's use of touch which she began with and then took away?
-Was it ethical of Annie to practice with Ben, knowing her mental health history? Additionally how do we balance the personal and professional self and it’s affecting countertransference, when working with clients?
-Should Annie have informed her supervisors of her mental health history in the beginning, or after her episode in the book, or at all? Noting that she had lost so much in the past from this kind of disclosure, where is the line between fostering support and knowledge by disclosing and maintaining personal and professional privacy?

final thoughts

I just finished reading the book and I, like you Raina, really appreaciated the epilogue and how Annie is so transparent about her apprehension around psychotherapy and its uses/misuses.  It is interesting to think about her relationship with Melanie and how Melanie was perhaps not ready to take on a client like Annie and then, how Annie writes about how she may have not been ready to meet with a client like Ben. There are all kinds of ethical issues here.  I think it might be interesting to 1. provide a brief synopsis of the book 2.  discuss examples of "trauma informed treatment", i.e. play and art therapy as well as Annie's own psychoanalytic type therapy 3.  discuss ethical considerations related to the NASW code 4. pose a question to the class--I like the idea of asking about how our own "stuff" gets in the way, should countertransference be considered something that needs to be quickly dealt with (like Annie mentions in the end), should our own life experiences remain unknown to the client? 

-Emily

Book Club Preperation for Next Week

Hello fellow bloggers!!! Raina and I were talking in class last week regarding the presentation piece of our book club. Here are some directions that we came up with, but of course open to interpretation and further ideas.

Raina and I both saw a slew of ethical concerns raised by the therapeutic relationship between Annie and Melissa so we thought this would be a good direction to go into especially considering the topic of vicarious trauma and parallel processing. So for next week:

-Prepare something to share based on ethical concerns that were presented in the book.
-Potential overarching question - How do we draw on your own experience of balancing the personal and professional self in relation to working with clients?

Raina, If I missed something please feel free to add.

Peace,

Deidre.

Meeting

Hi all,

Didn't have your emails, or I couldn't find them ;)  I am currently sitting here and my car is broken.  I live in the far SW and unfortunately buses only run during rush hour in my neighborhood so I am unable to come to class tonight...I could actually get to class, but would be unable to get home.  Anyway...wanted to make sure that we are meeting next Wednesday not this Wednesday.  Hopefully it is on the 17th and I will be there.  If by chance it was tonight...I would love to meet with someone to get the info.  Thanks so much!

Kelesy

Deidre's Thoughts

       As I read on to chapter 66 (pg. 214) it is evident that Annie is now exploring her past trauma of abuse by her father and borrows from Virginia Wolf to help articulate her experience. It is no wonder that she was able to relate so wholly to Ben's experiences as an infant and was so pushed to the edge by a relationship that should have offered such safety in nature but was sadly convoluted by an inexperienced therapist.
      Annie's experience with her therapist Melanie is  a prime example of the importance of consistent supervision especially when someone is new to providing therapy. Safety for the client and clinician is paramount in providing adequate treatment. Unfortunately, in Annie's case she became severely triggered by Melanie's lack of boundaries in the beginning and then further damaged when Annie felt Melanie pull away when Melanie became more aware of her enmeshment with Annie.

Raina just completed the book

Along with Play therapy for trauma informed tx I think we could also add in art therapy.

In looking over the code of ethics a couple ethical considerations stood out to me. I really appreciated Annie's afterward. Above all else I think through her writing Annie is trying to inform practitioners to "do no harm".

1) 1.04 Competence

(a) Social workers should provide services and represent themselves as competent only within the boundaries of their education, training, license, certification, consultation received, supervised experience, or other relevant professional experience.

In the case of Annie's therapist, Melanie, it seems like she started working with Annie when she was very young and did not have to tools or capacity to be of assistance to someone with such a complex trauma as Annie.  This is illustrated in her initial 'promise' to adopt Annie and then creating retroactive boundaries that not only harmed the therapeutic relationship, but also deeply harmed Annie.

2) Conflicts of Interest
(c) Social workers should not engage in dual or multiple relationships with clients or former clients in which there is a risk of exploitation or potential harm to the client. In instances when dual or multiple relationships are unavoidable, social workers should take steps to protect clients and are responsible for setting clear, appropriate, and culturally sensitive boundaries. (Dual or multiple relationships occur when social workers relate to clients in more than one relationship, whether professional, social, or business. Dual or multiple relationships can occur simultaneously or consecutively.)

For the same reason stated above.

3) 1.10 Physical Contact

Social workers should not engage in physical contact with clients when there is a possibility of psychological harm to the client as a result of the contact (such as cradling or caressing clients). Social workers who engage in appropriate physical contact with clients are responsible for setting clear, appropriate, and culturally sensitive boundaries that govern such physical contact.

In the book Annie describes Melanie 'touching' her early on in their relationship and how when she pulled back later on and developed prof boundaries this really harmed Annie.

4) Termination of Services  (b) Social workers should take reasonable steps to avoid abandoning clients who are still in need of services. Social workers should withdraw services precipitously only under unusual circumstances, giving careful consideration to all factors in the situation and taking care to minimize possible adverse effects. Social workers should assist in making appropriate arrangements for continuation of services when necessary.

Melanie could not allow herself to be at fault, even partially for the therapeutic relationship going awry and terminated services without this closure, leaving Annie to deal with the baggage and not taking responsibility for her action/inaction.

p 145

Hi all,

I just started the book this weekend and was so enthralled that I just kept on reading!  I probably should have stopped to write down some of my ideas here, but I was really captivated by the book.  A few thoughts...

I find Annie to be a great writer...probably a big reason the book is so hard to put down :-)

I also admire Annie's persistence, passion and drive to not only help Ben, but also in discovering her own past trauma.  At the same time I find myself concerned with boundaries and wondering where good support in Annie's life is, especially as she seems to be re-experiencing with Ben.

Sorry if this seems disjointed, trying to look back at my scribbles in the margins of the book.

I found Annie's description of a experiencing a psychotic episode to be fascinating and insightful....very helpful  in my understanding.

That's all I can decipher from my notes at the moment.  I will check in later.  Happy reading!!

Kelsey

Chapter 45

I have just reached chapter 45 (pg. 122) and Annie is being released from the hospital or rather they are telling her to leave because insurance is no longer funding her treatment. This whole section of the book was very confusing to me and often left me feeling uncomfortable and sad. Now that I write about it the author was most likely trying to convey what Annie was experiencing at the time of her hospitalization. But, I am glad to be moving on in the book and find it comical that Annie's doctor recommended to her to stay away from psychotherapy. I cant imagine that psychotherapy is the cause of Annie's mental break but maybe more will be revealed soon...

Oh yeah! and who's Melanie? And why does Annie think that she killed her?

Just read this week's readings

Well, there is a lot from this week' readings that we can incorporate into the presentation as outlined by Dawn!

Jen

Jen's comments up to p.178

Yes, this is a book that is hard to put down!  The vivid picture that Annie depicts is so useful to see the ways in which a child healing from trauma tries to rework life.  I continually find myself amazed at the brain and, if I may, the soul.  Working out trauma includes lots of talking/processing as one tries and tries to get a handle on it for mental health.  That is clearly what Ben wants too-he "places himself in danger over and over again" (p.58) . Annie also tells us that it will be months of her telling and retelling Blumenfeld her story before she has a new understanding. 

I became worried for Annie earlier in the book as she seemed to be having difficulties separating herself from Ben.  Where are the other professionals in Annie's life such as her supervisor, Mary Louise or even her family to help her put on the breaks?  I guess I shouldn't be blaming them and perhaps Annie had a great way of hiding her inner life.  I also want to understand Melanie better.  What is her stuff?  She might benefit from some therapy!

Now in her work with Blumenfeld I am so curious to know if find out about Annie's past.  What happened to her at a young age?  When did she become so drawn to Frued?  Her pain clearly drives her to deep understanding. 

As for a "trauma informed treatment example" as needed for the presentation we can include play therapy.

Just started

Hello everyone!

My book just came in the mail so I am just beginning.  It seems like it should be a quick read though; I'm excited to get started.

Kelsey

Up to Pg 214

I can not seem to put this book down. 

Annie seems to be re-enacting her trauma, along with Ben as they play.  In a previous post I was admonishing Annie for not seeking supervision, guidance, or counseling for everything that was coming up for her.  Now I understand that Annie has been struggling with disassociation since she was a child, and that disassociation helped her to reconcile her abuse at such a young age.  Furthermore, she felt like her therapist Melanie wasn't listening to her. I think this is what Prof Williamson was getting at when she said this book talks about the importance of boundaries.  It seems like Annie's therapist had poor boundaries to begin with and harmed their relationship irreparably through attempting to enforce seemingly arbitrary rules on the relationship after being so forthcoming with her 'love' from the start. Through the therapists interactions she seems to have re traumatized Annie, thus leading to her hospitalization.

I am not sure if these interactions would have been different had she been seeing a social worker or a therapist who had an aptitude for assessing a person in environment, rather than Melanie who degraded Annie for not attaching and moving away.  Melanie seemed to be so caught up on these themes that she completely missed the struggles Annie was facing in her work with Ben and  her doctoral program. Not to mention the many attachments Annie had to friends and family.  It  seems as if Melanie was so caught up in one story-line for Annie, that even when Annie so desperately wanted to rewrite her narrative Melanie could not create a space for that.

It is only after Annie starts to see Dr. Blumenfield that her shattered pieces start to come together to create a coherent narrative. It will be interesting to see how boundaries will come into play, as Annie continues her work with Ben. 

up to pg. 131

I have been wondering how Annie has managed to go through the stress of school and life in general and not have any symptoms or awareness that somethings was a bit off.  Perhaps, being a writer and artist has sustained her this long.  Anyway, I am really happy that she did not take Dr. Connelly's adivice to simply take the medication and stop doing any form of psychotherapy.  Annie clearly wants to know what is going on with her mind.... who wouldn't?  It is interesting that this is his advice.. when was the book written?  ok.. so seems like 1995, and that makes sense to me now.  I think (and hope) that we are realizing that psychotropic medication is not, and will never be, enough.  I am really looking forward to seeing what unfolds with Annie's therapy with her new analyst. 

Also.. just was looking at the syllabus and with the end of term "book report" we are supposed to include "commentary on trauma informed treatment examples from the novel" and include "special consideration to the NASW Code of Ethics."  Any thoughts on the trauma informed treatment examples?  I guess with Ben, the treatment is very psychodynamic in nature with a great deal of analysis and thought put into Ben's particular way of interacting during therapy, relating his actions, words, etc. to past traumatic events.

-Emily

I'm on pg 47

It seems like the author has multiple early warning signs of transference of her own experience onto Ben's experience.  These come in the form of 'dreams', overwhelming emotions, disconnection from her peers, and insomnia.  I thought it was interesting how she decides to seek extra psycho-analytic supervision, but does not share these experiences with her supervisor. Instead on pg 37 she states "I do not mention this world too much alive in my own therapy".  It seems like she is becoming more and more overwhelmed by her own experiences and is attempting to "treat" them with music and art.

Wow, I spoil some stuff so don't read this if you're not to page 131.

Ok everyone. First Emily kicks butt for setting this up, thanks Emily!

I got the book in the mail a few days ago, read about ten pages before class yesterday and am now on page 130. Fast read, homies.

I just want to comment on a few things.
First I definitely compare myself to Annie's commitment, dedication and very unique style of work (and find myself lacking!). I do not relate at all to her diligence and fascination with Freud, although I admire the knowledge she describes acquiring, beginning in her adolescence, and how she seems to use it to order her world. I also think, however, that she uses it to buffer herself from whatever crazy reality she doesn't want to deal with that is her own.

Also, I've read through the part where Annie has a psychotic episode and am just at the point where she is starting to emerge on the other side while working with Dr. Blumenfeld. Interestingly I just had a class on psychosis yesterday and she hits on some themes of psychosis, as she abstractly is describing to the reader what her world was like when she was committed. She describes the sense that other people are putting words in her head (pg 103), and she is hallucinating not only seeing other people and hearing voices, but also the smell of burning seems to be a thematic hallucination.She also goes through the process called "clanging" where similar sounding words are strung together (pg 112), she talks about her "word salad" which apparently is an actual "psychosis" word, on page 126.

In terms of themes, Annie's seem to include:

Burning smells (maybe from Ben's story of the house burning as a baby in foster care?)
angels
black birds and weeping (118)
Any additions to this list?

I am fascinated by 1) her awareness that she has a hidden past and that she has been in this hospital with Dr. Michael Connelly before and
2) that she is alluding to some repressed or subconscious memories that are now what are surfacing.

Ok, now, to end my long post: I just got to the part where she tells her doctor she held Melanie hostage with a gun and knife! Or tried to kill her? Ack! I can't wait to find out what happens next!
Molly

I have read to Chapter 18

I am really enjoying reading this book.  It has been great to read something that strays from theory and presents a real life story.  I think that Annie Rogers is an excellent writer and I like how she is slowly unfolding her own personal narrative as she tells the reader about her work with Ben.  Ben reminds me of some of the children I used to work with many years ago when I was a residential counselor.  I appreciate Annie's incredible patience with him and her staunch desire to help him.  Despite the fact that her training seems to have been largely psychodynamic, she is willing to step out of the box and to follow Ben's lead with treatment.  I like how she acknowledges (on pg. 20) that her "training isn't the only source" of her "knowledge."

-Emily

So my first attempt at blogging

Hello fellow bloggers...

So I have received my copy of A Shining Affliction and it is going to be a fast read, haveing already made it to page 50. I find the manner in which the author is allowing us to be observers in her sessions with Ben to be fascinating and helpful in the clinical sense. I look forward to hearing everyone's reaction to the book so far. See you soon!

Deidre.

this a test

hey

Hey Everybody!

So.. I think we are all set to start blogging.  I think this book is going to be quite interesting and I've wanted to read it for a while so I'm excited to start and to be able to share my thoughts with all of you!

-Emily

So.. I think we are all set to start blogging.  I think this book is going to be quite interesting and I've wanted to read it for a while so I'm excited to start and to be able to share my thoughts with all of you!

-Emily