Three Brutal Thoughts

 

The 'Brutal' room- a goldfish bowl.

Thought One

Michael McWatters, writes a poignant piece on his visits to state buildings with his son.  It reminded me of when my NHS service took on an American  child psychotherapist to run our small psychotherapy service.  She took one look at the standard NHS furniture and said it wouldn't do.  She then ordered fine upholstered chipendaleque fare and kicked out the plastic monstrosities.  There was one room in our building that was for ever to be a little piece of 'private' American quality.  Except when she retired the furniture in her room began to scatter round the building so we now have rooms with plastic chairs, and one of Lucy's chairs, like a throne.  Now as part of the assessment we see if the child chooses the throne, or steers clear of it.  

I noted that within the British culture there is an acceptance of NHS style, which is slightly down at heel.  We expect no less.  Cheap and cheerful. It takes an outsider to 'see' and question.  

Thought Two

Four kind people produced a staff well-being booklet for which they were highly commended.  It was very fine, and included pages of 'adult' colouring, for relaxation.  It struck me that the four were all women, and the entire content of the booklet was written from a female perspective.  The picture were all very feminine in content. I thought that it was interesting that if this had been four men, and the booklet had been entirely male in focus, this would not have gone unnoticed.  We have a majority female workforce.  I noted that rank is important.  The feminine booklet is far less offensive than a masculine one would be, because of the power differential.  It illustrates to me the fact that gender equality has not been reached.  When it becomes an issue that the booklet has a female focus may be the day we can say equality has been reached.

Thought Three

What is Social Worker?  We have just set up a Social Work group in CAMHS.  As a colleague once said, "the best job in the world, in the worst circumstances."  

We have been asking that question.  What do Social Workers offer to CAMHS?  June Thoburn suggests that Social Workers are not clinicians, but 'creative helpers'.   I think of social work as a profession that does not fit in with the ways of the world.  It is an uncomfortable profession.  My colleague has a PhD in Social Work.  It's like the Community Care cartoon of the man at the party who has a bleep.  The bleep goes off.  People gather round.  What is it?  Are you a doctor?  Is this an emergency?  No I am a Social Worker.  Next picture he is on his own in the middle of the room with a "what did I say?" expression.

I think of the health service as having an age old 'cast system'.  Everyone knows where they stand.  Then a social worker comes along.  like a European, it must fit at the bottom of the system, and yet it  has this unquantifiable power.  Social Workers live with 'cognitive dissonance'.

Social Work is a systemic practice.  It tries to see the whole world all at the same time.  It is a profession where power dynamics are important.  If often acts as a check to other systems which gives it its abrasive quality.  As June Thoburn discusses in her Community Care interview, Social Worker is part of the state, so all relationships are skewed.  It is a profession with nebulous power. The sense of 'they might remove your children' is the sort of power used by colonial forces to control fast populations.  All you need is that 5% risk for the threat to be powerful enough to cause fear.  It's not a healthy way, but it is a reality, and Social Work acts as the State's fall guy.  

No Social Work in Soviet Russia.  Social work was seen as the instrument of the bourgeois to control and manage the poor.  Perhaps so, but it fits well with the Western notion of individualism.  We have a personal health and welfare system, not a 'social one'.  We solve our problems first via the individual.  In Japan it is the opposite.  The idea behind Social Work is to create a socially harmonious society, that maximises the potential of the society to perform well.  Here social work is not based on the deficit, or the charity model, but on the idea of creating an efficient and productive society.  

Are we looking for a happy medium?