Healing. But First, Grieving

Individually and collectively we need a time of healing, physically, emotionally, and spiritually. 2020, the Year of the Metal Rat, has been a year like no other. The multiple upheavals and uncertainties have taken a large toll on us. We need a time for grieving all that we have lost and continue to lose. Not only the hundreds of thousands of Americans who have already died of COVID-19, but also the mounting job losses, increases in domestic violence, gun-related violence, and social isolation, especially for our elderly and other high-risk people. As we enter the darkest days of the year here in the Northern Hemisphere, alongside a second wave of COVID-19 infections and deaths, we need ways of staying hopeful, strong, resilient, and resistant.

What we are experiencing is not simple grief. It is complicated grief. As the Mayo Clinic writers put it, “Complicated grief is like being in an ongoing, heightened state of mourning that keeps you from healing.” Risk factors for complicated grief include social isolation, past history of depression and PTSD, adverse childhood experiences, and other stressors like financial hardships. Medical treatment for complicated grief includes, not surprisingly, grief counseling and cognitive-behavioral counseling. But other treatment interventions known to build resilience and lessen the negative effects of complicated grief are arts-based therapies, narrative storytelling, and other meaning-making activities.

The feminist environmental health and justice writer Terry Tempest Williams, said recently in an interview with Pam Houston, referring to both the very real effects from climate collapse (fires in the West and unrelenting hurricanes in the South) and the pandemic, “We haven’t grieved for it, for the people lost, and if you don’t think that won’t come back at us sideways (well, you’re wrong).”

Key references/sources:

Martha Kent , Mary C. Davies, “Resilience Training for Action and Agency to Stress and Trauma: Becoming the Hero of Your Own Life,” in The Resilience Handbook, eds. Kent, Davies, and Reich, (Routledge, 2013), 227-44.

Josephine Ensign, Soul Stories: Voices from the Margins, (University of California Medical Humanities Press, 2018).

Start with Compassion

The unique Little Free Libraries around Seattle, including the one pictured here, are wonderful community assets. In a Little Free Library near my home I found, read, and returned a gorgeous hand-made journal intentionally left there by an older woman who is homeless. She considers these journals to be her published memoirs. I thank her for sharing her artistic and writerly talents, as well as her astute insights into the “homelessness industrial complex” of Seattle. Reading her journal provided me with a window into her world.

I admire the work of Seattle architect Rex Holbein, his daughter Jenn LaFreniere, and other people at the Seattle non-profit Facing Homelessness who help match homeless people, including homeless mothers with small children, with homeowners who have built backyard accessory dwellings for them. Called the “Block Project,” it has the motto “Yes, in my backyard,” as opposed to the usual “not in my backyard” NIMBY-ism. It requires the buy-in of people in the neighborhood, or at least the city block, where a formerly homeless person will live. Their aim is to have a homeless person or family supported by an entire community, recognizing that homelessness is not just “houselessness” as many advocates now claim. Homelessness is about the lack of interpersonal affiliations, connections, and supports that make a house a home. Although this is not something I can see myself doing anytime soon, I like that the Block Project and Facing Homelessness exist in my city. It gives me hope that we can become better versions of ourselves, a better version of our city.

In this I am reminded of the words of Rev. Craig Rennebohm, who began a still-thriving street-based mental health outreach program for homeless people in Seattle. I had the pleasure of interviewing him for the oral history component of my Skid Road project in February 2016. He said, “I realized that if we can’t bring some level of peace to our neighbors on the streets, in our communities, there’s no hope for us being a more peaceable presence in the world. We need to learn how to be peaceable and healing at the most fundamental levels of our common life–as families, as neighbors, as cities and towns–communities.”

Here’s to a peaceable and healing and compassionate year ahead.

Beyond Endurance Test

img_0959-1 — Untitled, oil on canvas. Erika Kahn. Photo credit: Josephine Ensign/2017.

These dark, uncertain times demand our full attention, compassion, and capacity to endure beyond what we previously thought we could endure. And by this I do not mean passive suffering or some sick, masochistic hair-shirt sort of endurance. Nor do I mean resilience, the saccharine notion that the human body, the human psyche, and even entire communities (or countries) can be like heated metal—stressed and stretched but not broken—that they can bounce back, return to steady state, and perhaps be stronger and wiser for the experience?

Paul Farmer, physician and global health expert, reminds us that, “The capacity to suffer is, clearly, part of being human. But not all suffering is equal, in spite of pernicious and often self-serving identity politics that suggest otherwise.” (1)

Trauma never happens in isolation. An individual trauma ripples outwards as well as inwards. Suffering from trauma is always a social process; recovering from trauma is always a social process.

Resilience, either from an individual or a community (or country as we are now facing), even if it were possible, would it be desirable? If most traumas, most disasters, are at least partially caused by and certainly compounded by social (in)justice issues, do we want to return to normal, to the status quo after our worlds, our bodies, our communities have been shaken to the foundations, have been seared by fire, have been permanently altered and scarred? Skirting close to the danger of glorifying trauma, of feeding an addiction to the pain and suffering so overly abundant in our world, is the recognition that individual and community healing “means repair but it also means transformation—transformation to a different moral state.” (2) And it means enduring, going on, doing what we can individually and collectively to transform the world for the better.

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Adapted from my book manuscript for Soul Stories: Voices from the Margins.

Sources for quotes:

Paul Farmer. “On suffering and structural violence: a view from below.” In: Violence in War and Peace. Edited by Nancy Scheper-Hughes and Philippe Bourgois. (New York: Blackwell Publishing, 2004). pp 281-289. Quote is from p. 288.

Veena Das and Arthur Kleinman, “Introduction,” in Remaking a World: Violence, Social Suffering, and Recovery, ed., Veena Das, Arthur Kleinman, Margaret Lock, Mamphela Ramphele, and Pamela Reynolds (Berkeley: University of California Press, 2001), 23. (Quote is from “Introduction” pp. 1-30. Quote is from p. 23)

See also: Arthur Kleinman, “The art of medicine: how we endure” The Lancet. January 11, 2014. Vol 383. pp 119-120.

On Faith

Camp Hanover chapel by the lake: My shadow

“What about your faith? Where is it now? And what do you think is the role of faith in doing health care and social justice work with people marginalized by poverty and homelessness?”

These are some of the most oft-asked questions at author readings for my nonfiction book, Catching Homelessness: A Nurse’s Story of Falling Through the Safety Net. The questions typically come from people who have read my book, or who at least know what it is about. Because at the personal narrative level, my book is about my growing up in—and finally getting out of— the Bible Belt South, surrounded (and sometimes suffocated) by conservative Christian values. It is also about my work as a nurse with people experiencing homelessness in my hometown of Richmond, Virginia in the 1980s. I worked for an evangelical Christian health care clinic until I was mandated to provide what I viewed (and still view) as unethical care: being asked to pressure patients with HIV/AIDS to repent of their “sins” before they died, and being prohibited from providing my female patients with pregnancy options counseling. There were, of course, other factors in my life, but because of this I lost my job, family, and home and became homeless for six months. I also lost my faith.

The truth is that I have never found my faith again. I do have a deep and rich spiritual life, and I am grateful for many of the faith-based experiences of my childhood. For many years after my own spiral into and back out of homelessness, I held a deep suspicion towards any explicitly faith-based organization or person. I have, thankfully, grown past that, and I have respect for the people and organizations that “live their faith” in humanistic and non-dogmatic ways.

This past Sunday, being back in Richmond, I was invited to talk about my book with the adult Sunday School class at my childhood Presbyterian church. With some trepidation, I accepted, and I am glad I did. They were a warm and welcoming group with many excellent questions, including ones on how they could be more effective at preventing homelessness. And sitting in the front row was my Junior HighSchool and Sunday School teacher, Betsy Rice, smiling and cheering me on. She reminded me that I organized a sit-in to protest something in her math class and that she let me get away with it. Betsy, who is now close to 100 years old, has organized a church outreach program to the adult group homes near the church. She helps provide on-site activities and mentoring services for a very marginalized population literally next door to the church. She is an inspiration and reminds me of the good things that a living faith or a living spirituality can do in this world.