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What Brought Me Here?: Self-of-(Medical Family) Therapist Exploration

Posted By Jackie Williams Reade, Tuesday, January 31, 2012
Last week's Growing MedFT blog by StephanieTrudeau-Hern reinforced my sense that the self-of-therapist in the MedFT realm is an important conversation that we need to have more often. As a MedFT in pediatric palliative care, I am often asked about why I chose this field and how I can stay in a job where I daily encounter children and their families struggling with life-and-death issues. My reason for entering the field is clear as I was profoundly impacted by witnessing my paternal grandfather dying of pancreatic cancer while I was in college. For me, it was a lived experience in how consuming and lonely the illness and death of a loved one can be and that experience became the foundation of my career as I now seek to help others navigate their own illness.

As to my reason for how I can stay in this job? Not just stay physically in the job, but rather stay compassionate, open, able to think outside of my own grief and assist where needed, and maintain capacity to love and grow in my personal life is the more difficult question to answer. I find a common response to how to stay in this kind of job is to disconnect, distance, and protect yourself. While part of me agrees that these ways of coping are needed at times, I think the more effective way to work in challenging healthcare settings is to do the opposite, which is: connect, get closer, and be vulnerable with yourself in terms of how these experiences are affecting you.

To be compassionately present to the suffering of patients, their family members, and the healthcare team members we work with we need to understand our experiences of suffering, illness, and the healthcare system. We need to pay attention to what happens when we’re suffering, afraid, angry, or feel out of control - what happens in our body and mind - so we aren’t unconsciously causing harm to the healing process of another or ourselves.   While personal healthcare
"What brought me here?” is a good question to ask ourselves when we find we are stifled, overwhelmed, numb, scared, or angry as we interact with a patient, family member, or healthcare team member.
 experiences (good and bad) of ourselves, loved ones, and individuals with whom we work can be our most powerful generators of passion, empathy, and resilience, they can also be the first things that get in our way when we are working in the healthcare system.

While many of us spend months in Master’s programs discussing our assumptions, biases, and family of origin issues as they relate to our typical family therapy cases, I find we do not give the same quality or quantity of time to discussing these same concepts in terms of how they relate to working in healthcare. Do we recount the health history and its impact on ourselves and our loved ones? Do we discuss our reactions to the power dynamics and hierarchy that is often found in the medical setting? Are we exploring our own feelings of burnout, vicarious trauma, and compassion fatigue with safe colleagues and mentors? Being a MedFT is not just applying my skills in the medical setting, but rather it requires learning an entirely new system that requires re-evaluation of our beliefs and values as we sit with patients and caregivers who are often suffering in each area of the biopsychosocial-spiritual framework. Not to mention our attunement to our colleagues who are experiencing their own suffering. As MedFTs it can be an overwhelming challenge to assimilate all of these experiences.

I have now been working in pediatric palliative care and pediatric oncology for the past 15 years and the first 5 years were the most difficult by far as I struggled to make sense of the tragedy of childhood cancer and figure out my own dance (as Stephanie so eloquently refers to it) of engaging, distancing, crying, yelling, coping, and building my capacity for the significant burden of the work. I have read many books along the way that have helped me with some of this exploration, but a recent read I want to recommend to you is: "Beliefs” by Lorraine M. Wright, Wendy L. Watson, and Janice M. Bell. It is a wonderful resource to continue your thinking about the power of illness experiences and their impact on our beliefs and those of our clients.

"What brought me here?” is a good question to ask ourselves when we find we are stifled, overwhelmed, numb, scared, or angry as we interact with a patient, family member, or healthcare team member. Examining the events in our lives that are influencing our responses in the healthcare context is worthwhile work. While it’s not fair to assume we won’t ever be afraid, angry, or vying to control the outcome when faced with a situation that is challenging, what we can do is explore and recognize those experiences that impact our clinical capacity in the healthcare arena and continue our self-of-(medical family)-therapist work.

So… What brought you here? Why are you a Medical Family Therapist and how has that shaped your current practice?

Jackie Williams Reade, PhD is a Postdoctoral Fellow at Johns Hopkins University in Baltimore, MD. She received her Master’s in MFT from Seattle Pacific University and her PhD in Medical Family Therapy at East Carolina University. She is also the administrator of the Medical Family Therapy Group on Facebook.

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Randall Reitz says...
Posted Tuesday, January 31, 2012
I have often pondered that exact question. I believe that being raised in a family that was deeply affected by illness is what drew me to the field. I was studying pre-dental at BYU and hating all the chemistry. I was required to take a family studies course to fill a GE requirement and loved it. Within 3 weeks I had switched majors to Human Development with a plan to complete graduate work in MFT.

My program at Indiana State had no inkling of MedFT or collaborative care, but from day 1 I knew I was going to do research on MFT with families with a child with diabetes. I knew it was right because it was my own brother with diabetes who had brought me here.
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