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1.
Fam Process ; 62(1): 6-34, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36543761

RESUMO

I have been working with a model of witnessing for more than 30 years (Weingarten, 2000a). In this article, I add layers to its conceptualization by discussing several related concepts: the implicated subject (Rothberg, 2019) and ethical loneliness (Stauffer, 2015) among them. What distinguishes the Witnessing Model positions from the implicated subject is that the implicated subject is always aligned with power and/or domination, whereas a witness may not be. Certain responsibilities accrue if we take our implication seriously. Just as I have suggested there are steps one can take from positions two, three and four of the Witnessing Model to enter, return or remain in the aware and empowered position, a position from within which accountability is more likely, I offer ideas about how one can respond accountably when one acknowledges one's implication. Throughout this article, I raise questions, some of which I cannot answer. For instance, can empathic repair be undertaken by one party to a ruptured relationship, one segment of a society, without an unfolding process of mutual recognition and compassion? The contemporary moment in which we are living presents us with dire outcomes if the answer is "no." The entire article is an extended meditation on the following central question: How can we, implicated subjects, practice solidarity to diminish ethical loneliness and create movement toward the personal, interpersonal and structural changes necessary to address the truths that our implication entails?


Assuntos
Justiça Social , Responsabilidade Social , Humanos
3.
J Marital Fam Ther ; 46(4): 561-576, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33141963

RESUMO

The status of immigrant families resettled to the United States in the past decade has been fraught with upsurges of governmental policies that have systematically increasing the levels of oppression, violence, and abuses of human rights. The socio-political-economic toll of xenophobic practices on specifically targeted immigrant populations is magnified by the psychological and relational impact they have on individuals, families, and communities. This manuscript is conceptualized as an ongoing call for social action and specific mobilization by mental health professionals in response to the increasing threats to civility and dignity faced by various immigrant communities. The paper is organized in three sections: (a) an overview of the effects of immigration policy on immigrant family experiences; (b) the impact of mental and relational health on immigrant populations; and (c) elaborations of three exemplar community projects designed to support immigrant families. The manuscript concludes with a discussion exploring avenues for promoting a stronger base for solidarity and social action.


Assuntos
Emigrantes e Imigrantes/psicologia , Emigração e Imigração/legislação & jurisprudência , Família/psicologia , Pessoal de Saúde , Serviços de Saúde Mental , Ativismo Político , Desenvolvimento de Programas , Xenofobia/psicologia , Adulto , Humanos , Estados Unidos
4.
Fam Process ; 59(3): 883-897, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32621761

RESUMO

The Witness to Witness Program (W2W), based on Weingarten's witnessing model (2000, 2003, 2004), began in July 2018 and originally was established to support healthcare workers and attorneys (our partners) who were experiencing empathic distress working with people involved in various stages of the detention process. The W2W program evolved to offer four primary components: clinician listening sessions geared to deep understanding of the person's story of their work and its challenges; an inventory of the person's current internal and external resources both in the present and in the past; help with removal of barriers to those resources; and development of a personal toolkit to handle stress. Additional services available to partners and their organizations included psycho-educational webinars, facilitated peer support groups, and organizational consultations to foster trauma-sensitive and resilience-hardy work environments. In March, after lockdowns due to the coronavirus pandemic, W2W pivoted to focus on handouts and webinars addressing how to cope with distress and moral injury, maintaining resilience, coping with grief, and dealing with multiple losses caused by the pandemic. Disaster sparked collaboration and innovation. A train the trainer model was developed to reach more community health workers providing services to the Latinx community dealing with losses similar to those experienced by the clients they serve. W2W continues to create virtual communities of support. In doing so we practice doing reasonable hope together (Weingarten, Family Process, 2010, 49, 5).


El "Programa de testigo a testigo" (Witness to Witness Program, W2W), basado en el modelo de testigos de Weingarten (2000, 2003, 2004), comenzó en julio de 2018 y se creó originalmente para apoyar a los trabajadores sanitarios y a los abogados (nuestros socios) que estaban sufriendo distrés empático al trabajar con personas implicadas en varias etapas del proceso de detención. El programa W2W evolucionó y ahora ofrece cuatro componentes principales: sesiones de escucha con el clínico orientadas a una comprensión profunda de la historia del trabajo de la persona y sus dificultades; un inventario de los recursos externos e internos actuales de la persona tanto en el presente como en el pasado; ayuda con la eliminación de obstáculos para acceder a esos recursos; y desarrollo de un conjunto de herramientas personales para manejar el estrés. Otros servicios disponibles para los socios y sus organizaciones fueron seminarios web psicoeducativos, grupos de autoayuda con facilitadores y consultas organizacionales para fomentar entornos de trabajo donde se priorice la sensibilidad al trauma y la resiliencia. En marzo, después de los confinamientos por la pandemia del coronavirus, el W2W dio un giro para centrarse en folletos y seminarios web que abordan cómo afrontar el distrés y el daño moral, mantener la resiliencia, afrontar el duelo y soportar numerosas pérdidas causadas por la pandemia. La catástrofe generó colaboración e innovación. Se desarrolló un modelo para capacitar a los capacitadores a fin de llegar a más trabajadores sanitarios de la comunidad que prestan servicios a la comunidad latina a la hora de afrontar pérdidas similares a las sufridas por los pacientes a quienes atienden. El W2W continúa creando comunidades virtuales de apoyo. Al hacerlo, ensayamos una esperanza razonable juntos (Weingarten, 2010b).


Assuntos
Infecções por Coronavirus/psicologia , Pessoal de Saúde/psicologia , Doenças Profissionais/terapia , Pneumonia Viral/psicologia , Psicoterapia/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Adaptação Psicológica , Adulto , Betacoronavirus , COVID-19 , Infecções por Coronavirus/epidemiologia , Feminino , Pesar , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/psicologia , Pandemias , Pneumonia Viral/epidemiologia , Avaliação de Programas e Projetos de Saúde , Resiliência Psicológica , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/psicologia , Estados Unidos/epidemiologia , Local de Trabalho/psicologia
5.
Fam Process ; 57(2): 572-586, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29492967

RESUMO

"Take care of yourself" may be one of the most ubiquitous phrases spoken to people who are ill or to their caretakers. Yet few people who offer it as a balm consider what the self experience is of the person to whom the injunction is offered. We unravel some of the paradoxes inherent in the phrase, illustrating complexities that arise in the context of a life-threatening diagnosis. To illustrate the relational nature of the self, we analyze a partial transcript of an interview conducted in 1988 with the authors-a family therapist mother who had recently undergone surgery for breast cancer and her then 9-year-old daughter. We also examine the role of time in the interview. We propose that unlike PTSD when the past invades the present, in life-threatening illness the future is foreclosed, leading to distortions in current perception and behavior. The second author presents a follow-up to the interview and relates it to her current experience as a mother with chronic health issues. We close with suggestions for clinicians.


Assuntos
Doença Aguda/psicologia , Doença Crônica/psicologia , Autocuidado/psicologia , Autoimagem , Incerteza , Adulto , Idoso , Criança , Feminino , Previsões , Humanos , Mães/psicologia , Núcleo Familiar/psicologia
6.
Fam Process ; 56(1): 262-277, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-26576686

RESUMO

We are a mother and daughter, both health care professionals, who offer a follow-up to an article we published twenty years ago about the impact of each other's ongoing, serious medical problems on our relationship. In this article, we contribute a long-term perspective on the differences between having an illness that is well or poorly understood by medical professionals and the lay community. We also discuss health in the context of identity formation and life stage, as during this interval the daughter left home, graduated college, married, and had two children. Also in this period, the mother survived a third breast cancer and other life-threatening illnesses. We discuss the impact of these experiences on each other and in other important relationships in our lives. Current discourses on daughters of breast cancer survivors do not fit our experience and we speculate about why our story differs. We find that although we continue to contend with serious medical issues that impact our own, each other's, and our families' lives, nonetheless, our lives are rich, rewarding, and "appropriate" for our life stage. That is the news.


Assuntos
Filho de Pais com Deficiência/psicologia , Doença Crônica/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Núcleo Familiar/psicologia , Feminino , Humanos
7.
Fam Process ; 55(2): 195-210, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-26118842

RESUMO

There are a great many useful articles on the dynamics and pragmatics of reflecting teams but few articles address what constitutes a good or inept reflection and why. I provide a conceptual model for thinking about what a good reflection does, distinguishing it from a nice reflection. With some further refinements in place, I then illustrate how reflections can be part of any relationship, not just clinical ones. We have opportunities to make them and to recognize when others make them to us. By using examples from my personal life-as a grandmother, daughter, radio listener, cancer survivor, and client-I attempt to ease the personal/professional binary, a project of mine for the last 35 years. In the second part of the article, I address how writing can serve reflection. Although best offered at the moment one is called for, it is never too late for a reflection. Writing allows people to offer reflections after the fact to those who have shared their stories. Sometimes, it is to ourselves we offer those reflections, when the reflector has long since dropped the thread of obligation or interest. I provide an example of working with iconic imagery to unpack meaning so that reflection can eventually take place, allowing integration to proceed, facilitating the strange becoming the familiar.


Assuntos
Imagens, Psicoterapia/métodos , Pensamento , Redação , Humanos
8.
Fam Process ; 52(3): 355-67, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24033235

RESUMO

In the territory of violence and despair, hope is rare. Recent work on hope has shifted attention from hope as a feeling to hope as a practice that people can do together. This case report of a family exposed to domestic violence highlights the role played by a South African police officer in the mother's actions to separate from the context of violence. As a witness to the violence, the police officer acted from an ethic of justice and an ethic of compassion. Outsider witnessing of a counseling session resulted in the recruiting of a community of acknowledgement for the mother, the police officer, and an Assistant Commissioner of Police. Listening carefully and doing hope together gave rise to alliances against practices of violence. As a step of accountability, the authors used reflexive practices to question their responses and to avoid colonizing practices.


Assuntos
Violência Doméstica/legislação & jurisprudência , Violência Doméstica/psicologia , Prova Pericial/legislação & jurisprudência , Esperança , Polícia , Adolescente , Adulto , Ira , Criança , Transtorno da Conduta/prevenção & controle , Transtorno da Conduta/psicologia , Transtorno da Conduta/terapia , Comportamento Cooperativo , Aconselhamento , Violência Doméstica/prevenção & controle , Empatia , Feminino , Humanos , Comunicação Interdisciplinar , Masculino , Terapia Narrativa , Poder Familiar/psicologia , Polícia/educação , Carência Psicossocial , Características de Residência , Justiça Social/legislação & jurisprudência , Responsabilidade Social , Apoio Social , África do Sul , Voluntários
9.
Fam Process ; 52(1): 83-101, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25408091

RESUMO

The threat of no longer being the person one wants to be hovers over each ill person and plays out relationally. The dynamic interplay of this experience of self-loss and other-loss (Roos, 2002; Weingarten, 2012) has a significant impact on couples, both of whom may come to have both experiences. In this article, I focus on the couples' experience of self- and other-loss in the context of chronic illness, in which one person's experience flows into and informs the other's. In particular, I describe how asymmetric acknowledgment of self-loss and other-loss adds to the misery of couples who are already challenged by poor health. Physical pain also makes dealing with self- and other-loss harder. Therapists can serve couples better if they take a fully collaborative stance; appreciate the dilemmas of witnessing; help couples distinguish new trauma from retraumatization and fear; work with the weaver's dilemma and the boatman's plight (Weingarten, 2012); and are comfortable with discussion of end of life issues.


Assuntos
Doença Crônica/psicologia , Terapia de Casal , Adaptação Psicológica , Emoções , Características da Família , Medo , Identidade de Gênero , Humanos , Casamento/psicologia , Autoimagem , Assistência Terminal/psicologia
10.
Fam Process ; 51(4): 440-55, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23230977

RESUMO

People who live with a painful gap between who they have been and who they are now, of who they dreamt themselves to be and who they still long to be, are living with chronic sorrow. Chronic sorrow is a normal, nonpathological state of pervasive, continuing, periodic, and resurgent sadness related to the ongoing losses associated with illness and disability, in this case not loss of an other, but loss of self (Roos, 2002). Focusing on the lives of four women, one of whom committed suicide, I explore the macroprocesses that invade the experience of even so personal an experience as self-loss. The role of the therapist is made transparent through anecdotes and by discussing implications for clinical practice.


Assuntos
Doença Crônica/psicologia , Psicoterapia , Adulto , Anedotas como Assunto , Feminino , Pesar , Humanos , Acontecimentos que Mudam a Vida , Pessoa de Meia-Idade , Relações Profissional-Paciente , Autoimagem
11.
Fam Process ; 49(4): 543-58, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21083554

RESUMO

Four action researchers present a case study of a project conducted by members of a national family therapy organization and members of a local family therapy institute, which describes their efforts to collaborate with local disaster recovery workers 2 years after Hurricane Katrina. The aim of the collaboration was to create a local action research team to study best practices that strengthen resilience after disaster. The authors discuss choice points and dilemmas faced in finding collaborative partners and in clarifying what constitutes an invitation to work in a community. The case study illuminates tensions and understandings between outsiders and a community still facing the long-term effects of a disaster.


Assuntos
Serviços Comunitários de Saúde Mental/organização & administração , Redes Comunitárias , Pesquisa Participativa Baseada na Comunidade , Tempestades Ciclônicas , Pessoal de Saúde , Desenvolvimento de Programas , Serviço Social/organização & administração , Redes Comunitárias/ética , Redes Comunitárias/organização & administração , Comportamento Cooperativo , Planejamento em Desastres/organização & administração , Pessoal de Saúde/educação , Pessoal de Saúde/ética , Pessoal de Saúde/psicologia , Necessidades e Demandas de Serviços de Saúde/organização & administração , Humanos , Louisiana , Desenvolvimento de Programas/métodos , Resiliência Psicológica/ética , Capacidade de Resposta ante Emergências/organização & administração , Sobreviventes/psicologia , Tempo
12.
Fam Process ; 49(1): 5-25, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20377632

RESUMO

Hope may be the most laden shorthand term of all time. Everyone wants it; few know how to articulate what it is. Although family therapists frequently work to restore hope with hopeless families, they have contributed little to the abundant literature on hope. I present a new conceptualization of hope-reasonable hope-that reflects how family therapists think and practice. By subscribing to reasonable hope, clinicians enhance their ability to offer accompaniment and bear witness to clients. I describe clinical practices that, informed by reasonable hope, also facilitate its cocreation. Finally, I suggest supports for clinicians who practice reasonable hope.


Assuntos
Adaptação Psicológica , Atitude Frente a Saúde , Relações Familiares , Terapia Familiar , Apoio Social , Estresse Psicológico , Humanos , Relações Interpessoais
13.
Psychotherapy (Chic) ; 47(3): 371-84, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22402093

RESUMO

Therapists working with clients with severe trauma histories over long periods of time may find themselves managing traumatic events in their own lives-illness, divorce, death-at the same time as they are assisting their clients to live productively with their painful pasts. While a few accounts exist describing how therapists deal with single overwhelming events, very little has been written about how therapists manage ongoing or prolonged episodes of severe stressors with a busy clinical practice of clients with severe trauma histories. Yet, we know that support for therapists is crucial to longevity in the field and we also know that learning from the experience of others is a highly recommended form of support. This paper is an account by a senior clinician of how she has maintained a productive clinical practice despite personal losses. Therapists who struggle with personal losses probably deal with choices related to self-disclosure more than therapists who do not have such experiences; they have repeated opportunities to establish appropriate and effective levels of self-disclosure for them and the people with whom they work. The paper presents a template for thinking about the risks and benefits of self-disclosure while at the same time modeling a level of self-disclosure that may be beneficial to therapists looking for examples.


Assuntos
Atitude do Pessoal de Saúde , Pessoal de Saúde/psicologia , Transtornos Mentais/terapia , Relações Profissional-Paciente , Psicoterapia , Humanos , Acontecimentos que Mudam a Vida , Autorrevelação , Estresse Psicológico/psicologia
14.
Fam Process ; 45(3): 277-88, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16984070

RESUMO

Hate may be the most dangerous of all emotions for the survival of the planet. The author addresses two questions: What obscures hate when it is actually present? and What masquerades as hate but isn't? Using illustrations from a wide range of fields, the author contends that discerning hate is both essential and far trickier than we think. She concludes by asserting that overcoming hate requires imagination. We must learn to imagine a world without hate and unimagine a world with hate.


Assuntos
Ódio , Saúde Global , Humanos , Política , Pobreza , Violência
15.
Psychiatry ; 68(1): 17-27, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15899707

RESUMO

This study describes the effects of a psychoeducational multiple-family group program for families of people with severe mental illness in post-war Kosovo that was developed by a Kosovar-American professional collaborative. The subjects were 30 families of people with severe mental illnesses living in two cities in Kosovo. All subjects participated in multiple-family groups and received family home visits. The program documented medication compliance, number of psychiatric hospitalizations, family mental health services use, and several other characteristics, for the year prior to the groups and the first year of the groups. The families attended an average of 5.5 (out of 7) groups, and 93% of these families attended four or more meetings. The uncontrolled pre- to post-intervention comparison demonstrated decreases in medication non-compliance and hospitalizations, and increases in family mental health service use. The program provided training for mental health professionals, led to policy change in the Ministry of Health, and resulted in dissemination to other community mental health centers. This study provides preliminary evidence that a collaboratively designed and implemented psychoeducational, multiple-family program is a feasible and beneficial intervention for families of people with severe mental illness in impoverished post-war settings.


Assuntos
Terapia Familiar , Educação de Pacientes como Assunto , Psicoterapia de Grupo , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Guerra , Adulto , Antipsicóticos/administração & dosagem , Terapia Combinada , Comportamento Cooperativo , Feminino , Humanos , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/estatística & dados numéricos , Cooperação do Paciente/psicologia , Readmissão do Paciente/estatística & dados numéricos , Esquizofrenia/diagnóstico , Iugoslávia
16.
J Marital Fam Ther ; 30(1): 45-59, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14763208

RESUMO

In this era of globalization, when news about political violence can haunt anyone, anywhere, those whose families have suffered political violence in the past are particularly vulnerable to current distress. Skilled in understanding transgenerational processes, family therapists need to be familiar with the mechanisms by which children are exposed to the effects of political violence suffered by their elders-that is, the ways in which they become their witnesses. This article presents a framework for understanding how the trauma of political violence experienced in one generation can "pass" to another that did not directly experience it, and proposes a model to guide clinical intervention.


Assuntos
Proteção da Criança , Vítimas de Crime/psicologia , Relação entre Gerações , Transtornos de Estresse Pós-Traumáticos , Estresse Psicológico , Crimes de Guerra , Adulto , Criança , Proteção da Criança/psicologia , Competência Clínica , Relações Familiares , Humanos , Transtornos de Estresse Pós-Traumáticos/etiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Guerra
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