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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