Quote of the day - Emotional labor

I am reading Dr. Sanda Bloom and Brian Farragher's new book, Destroying Sanctuary:The Crisis in Human Service Delivery Systems, New York: Oxford University Press, 2011.

Here is their dedication:

"This book is dedicated to the administrators, managers, direct and indirect care staff in our healthcare, mental health, and social services who, every day, are willing to take on the emotional labor of doing whatever they can do to relieve the suffering of those in their care."

Throughout my career I have been so blessed and at time appalled by the behavior of the co-workers with whom I have worked. Human service work is extremely demanding and undervalued by our society. Those who would serve stimatized populations often share in the stigma themselves. They usually are poorly paid, with long hours, and under very oppressive and judgmental circumstances. Highly over regulated and poorly reimbursed by policy makers and managers who often have never done the work, or left it because they were not well suited for it and decided that an administrative career was less stressful and more rewarding than providing clinical service.

I myself have followed a parallel path continuing to do clinical work while moving up the ranks of supervisor, Program Director, Deputy Director, and Executive Director. I still do clinical work because it is my first love and it keeps me grounded as go about designing and evaluating and obtaining resources for service delivery systems at a management level.

Many of the clients we serve "...have been exposed to significant adversity usually beginning in childhood. That adversity had changed them, had played a determining role in their cognitive, emotional, behavioral, social, and moral problems.

...

That shift was best captured by one of my colleagues, Joe Foderaro, when he noted that we seemed to have changed the foundational question asked of troubled people, "What's wrong with you?" to the very different question, "What happened to you.?"

Sandra Bloom, M.D., Destroying Sanctuary, p.xv

As servants addressing the emotional needs of distressed clients we deal not only with current symptoms, crises, dysfunction, pain, suffering, but we are seeing the consequences of many years of trauma. The vicarious trauma experienced by the professional witness can be cumulatively burdensome and the organizational support is often lacking as requirements and expectations for productivity, paperwork, regulatory compliance, and competence exceeding knowledge and skills can be ennervating and toxic without understanding and support of enlightened supervision and management.

I have rarely received this kind of support in my career except for one period in the 80s when for about 4 years I had an excellent supervisor, Dr. Susan McDaniel from whom I not only learned the skills of family systems therapy, but the lesson "Dave, if you're not having fun, you're not doing it right."

Her statement has stayed with me for almost 30 years and I will share the story of its delivery later on.