In honor of my cousin Brian
Admittedly, this blog is difficult for me to write so I’ve been avoiding it, although it should have taken precedence. My cousin, Brian, is a heroin addict living in recovery. I am not ashamed of my cousin, quite the contrary, I am proud of and inspired by him. My challenges with writing this blog center on re-living the emotional heartache I experienced during the times he was actively addicted. It was just a very sad time of my life in and of itself. Thankfully my cousin exudes strength and is in recovery; however his addiction is something he must confront daily. Let me start by talking about my dear cousin. Picture an adult-sized teddy bear come to life; that’s my cousin. There’s a sweet softness in his nature that is deeply hidden; he typically portrays himself and is believed to be the tough guy. That soft side is now more evident, if you pay attention, since he has become a husband and father. You see it every time he picks up one of his children or sits with his wife when she gets ill due to a multitude of health problems. That softness, derived from his ability to be caring and accept all without judgement, makes him that familiar teddy bear, ready to provide comfort when needed. Brian’s birthday is the day before mine and we would always celebrate together. He kindly never made an issue about the fact that I ruined his fourth birthday party when my mom went into labor. It is actually something special that our birthdays are so close together. My first unofficial job was walking around our neighborhood with him delivering newspapers. A joker in nature, he would make me laugh. His laugh, is more like a chuckle that pokes at you to laugh with him. People would confuse us constantly as twins. We resemble each other more so than we do our actual siblings. We always treated each other as siblings too: Brian, my sister, and Brian’s brother. This was largely in part because the majority of our family lives in Italy, so all we had growing up was each other. One of his mottos was “don’t mess with my cousin or I’m going to mess with you” and typically when he was around, people would leave me alone. He was always there to give me advice and it was vastly apparent how much he wanted to protect me. Who is to say what happened exactly or why, but at a young age my cousin got involved in using and selling drugs, mostly marijuana and then coke as he grew older. He dropped out of high school a few days before my sister’s wedding, one of the only times in our whole lives that family from Italy made the trip to visit us in Pittsburgh. He was pulled into the drug culture, and shared with me that being viewed as “cool” and that fast cash were definite motivators to get involved and further his engagement with drugs. Things went from bad to terrifying when I was an undergraduate student. He went from using cocaine to abusing heroin. It was as if my cousin disappeared. He was there physically, but inside he was unreachable. A sort of sad and distracted emptiness resided within. Even his physical form rapidly deteriorated- he went from being a roly-poly teddy bear to an eye-dazed skeleton. He lived in his car and robbed convenient stores, unarmed, in Oakland. I was actually employed at one of those stores shortly before and blamed myself for informing him that the cameras were fake. He eventually got caught, was sentenced to three years in prison, three years parole, and three years of probation. All of which, he successfully completed. His stint in prison was transformative. He started his recovery process and obtained his GED. He was released, got married, has two kids, and is now steadily employed full-time. Although finding employment and housing was very much a challenge at one point. He still attends meetings and works at his recovery. His prison time also metamorphosed me through some soul-searching. I started asking “WHY?!?” about so many things and not only needed, but required an answer. My answer was social work. Ever since the day social work answered me, I have been fully committed to my profession. My cousin’s experience was very formative in both my decision to be and my development as a social worker. I brought with me an understanding on how to relate and treat others in a non-judgmental manner because of him. He taught me the power of self-determination. He made the choice to overcome his addiction; not a single human being can take credit for his profound transformation. He taught me that life hurts sometimes, but these instances are temporary, and also opportunities to grab onto and manifest more strength. He magnified the impact of adversity and also instilled within me a desire to make society better by helping people in need. He forced me to think even more critically about stigma and the disillusionment it causes. There is nothing, not one thing wrong with my cousin; how society has treated him is wrong, simply because he has an addiction, actually a disease, which led him to prison. My cousin is wonderful as a matter of fact and I love him very much. He gave me the greatest gift of all by nudging me towards social work. Social work, this magnificent discovery, gave me my profession, my soul’s purpose, my niche, a written code of ethics that embodies who I am as a person, and truly one of the only things in life that makes absolute sense to me. The people (professors, professionals, clients, and now students) I have encountered throughout my years as a social worker rejuvenate me repeatedly. My cousin, Brian, has indirectly through me, impacted the lives of so many people in such a positive way because of his journey. For example, I have warned adolescents about the nature of heroin addiction. I have given hope by telling his story. I have treated people having addiction issues with dignity and worth, knowing that there’s nothing wrong with them, just like my cousin. I emphasize the power of self-determination to students. I respect self-determination in my own practice as a social worker. I write and in the future will conduct research to ignite societal change. Brian truly deserves to be honored because as he said, “85% of people that go to prison end up back in prison. I’m one of the 15% that didn’t go back”. I honor him too because he gifted me with my life’s purpose and taught me how to be an impactful social worker. Brian is now helping people directly though his blog post. Brian shared his thoughts about addiction and how society can change to help people both actively addicted and living in recovery. Brian had these things to say:
Based on my conversations with Brian, I decided to make a few phone calls and gather more information about rehabs in Athens and one in Pittsburgh. In Athens, only one facility accepts Medicaid or Medicare. This facility is also the only one that accepts people without insurance. Typically the wait list is long and reaching them on the phone was impossible. It was through a privately-funded outpatient center in Athens did I even find out that only one provider accepts Medicaid/Medicare/fee-for-service. They told me to go there and show up at this facility if I wanted to speak with someone. This private treatment center also shared with me the cost of their own treatment. Although this facility only provides outpatient services, the cost of treatment ranges from $4,000-$7,000 per week depending upon the needs of the consumer. A sober living agency that provides no treatment whatsoever shared that to enter their program you must pay $770 up front and then $160 per week to stay there. As I was unable to reach the one provider that does accept Medicaid/Medicare/fee-for-service, I can’t actually speak to their treatment cost. I got similar information from the organization in Pittsburgh about cost, but was informed that many facilities in Pittsburgh accept Medicaid/Medicare. This provider also shared that rehabs throughout Pittsburgh will accept a person without insurance so long as they apply for Medicaid beforehand. County funds are used across the state to pay until Medicaid benefits start. However, admission to rehab and its associated delays is contingent upon what type of health insurance or lack thereof one has. Wait lists range typically from a few days to a couple of weeks. Sometimes those with insurance end up paying a great deal of money and aren’t admitted immediately to the inpatient center because of their insurance. The range in cost is widely dependent on the type of insurance. Out-of-pocket costs to attend this treatment facility are $4,760 for a week of detox, $3, 892 for a week of rehab, and $15, 568 for a full month of rehabilitation. Looking at these numbers, reminds me of what my cousin Brian said that “it’s cheaper to use than it is to get help”. Those of you reading, what do you think needs to change to help people actively addicted, living in recovery, and also their family members? My cousin Brian made better suggestions about what needs to change than I could think of myself. The only thing I can think of adding is making sure that we honor people living with addiction. In my own life, I would like to use this blog to honor my cousin Brian. I also want to thank him for being who he is and helping me find social work. Thank you!
0 Comments
It is my opinion that consumerism has created a current society that not only increases the prevalence of eating disorders, but also perpetuates them. The newest version of the Diagnostic and statistical manual of mental disorder, better known as the DSM-V (2013), is the first DSM to include binge eating as a mental health disorders. The unrevised version of its predecessor, was the first to include a category for eating disorders, but only classified anorexia nervosa and bulimia nervosa as said disorders (DSM-IV, 1994). I believe the changes in the DSM, reflect patterns of consumerism in society. Consumerism has promoted obesity and correspondingly idealized the size-zero body (Kroner, 20111; POPA, 2012).
According to the National Institute of Diabetes and Digestive and Kidney Diseases (2010), more than two out of three adults are overweight and one in three adults are considered to be obese. Correspondingly, youth statistics suggest that almost one in three children are considered overweight and one in six are obese (NIH, 2010). Based on these statistics, roughly 33.3% of the total population is overweight. Media, and particularly marketing within media, influences the overweight structure of our society. Within the United States, marketing strategies intentionally target youth consumers due to their impulsive decision-making in order to increase spending on junk food (Kroner, 2011). Quality of food and its availability is also stratified in the United States, making it much easier for the rich members of society to access organic and healthy foods (Kroner, 2011). The median income for American households overall is $54, 462, but lower for minorities; for example it is 35,398 for African American families and $42,491 for Hispanic families. This suggests that parents must sacrifice quantity over quality to feed their families, which leads to the purchasing of over-processed food (Kroner, 2011). The National Association of Anorexia and Associated Disorders (ANAD) (2015) reports that roughly 30 million Americans meets criteria for one of the three eating disorders. Of great concern is the fact that eating disorders have the highest mortality rate of any mental health disorder (ANAD, 2015). Clearly this is a problem worth addressing in American society, and particularly its media where the most harm is done. The media serves to influence the prevalence of this disease by presenting idealistic and often unrealistic suggestions of the ideal body; only 5% of American woman are the size portrayed by media and advertising (ANAD, 2015). This creates a quandary where 42% girls between first and third grade want to be thinner and 81% of 10 year old females express a desire to lose weight (ANAD, 2015). The aftermath of all eating disorders is quite destructive in nature for a lot of reasons. Firstly, although only 4% of the population is diagnosed with anorexia nervosa, the mortality rate for this disease is incredibly high (ANAD, 2015). Secondly, a variety of negative health factors are associated with being overweight. Thirdly, although many children and adults are considered as overweight or obese, they confront stigma on a daily basis. Why?!?! This makes absolute no sense to me. Admittedly, I was morbidly obese as a child and weighed at least 45 pounds more than I do now as a 10 year old, so I am biased. I got so sick of the bullying, name-calling, crying, and having my petite older sister knock on neighborhood children’s doors that I started making difficult life-style changes around 11. I also had health problems where I had to get blood drawn every few months because of alarmingly high triglyceride levels; they were in the 700s. I needed to lose weight and I wanted to lose weight so I went to a nutritionist based upon severe ushering by my pediatrician. I had my first stint of vegetarianism suggested by conversations I had with my nutritionist. At one point, although I am ashamed to admit it, I was also purging. My sister and brother-in-law intervened quickly, and my difficult weight loss took on a healthier form. I learned to love vegetables, stopped drinking soda, and exercised every day. To be honest, the remnants of my childhood obesity and its bullying continue to mold my image of self. I am the first to admit that I have body dysmorphia, but I am aware of it and avoid mirrors to mitigate its negative impact. I make a conscious effort not to engage in an unhealthy thought process where I end up feeling bad about myself. I eat a vegan diet (this February is my 6 year anniversary) due to spiritual and ethical reasons that resonate deep within me and the journey I have lived as a person. To be honest, I felt out of balance each time I wasn’t practicing some sort of vegetarianism. I exercise because I enjoy it and my dog doesn’t give me a choice. I also buy vegan cookies weekly, okay truthfully it's at least 3-4 times per week, which I should cut back on more because of cost than because of calories. I also eat kettle-cooked potato chips when I have a craving. However, my journey is my own, and should by no means dictate how other people live. Meaning, eat what makes you happy and creates balance in your own lives. I share my story to create some reflection about what we as a society can do differently. I can say that words and looks were very cutting when I was overweight. I cried a lot, which is why my sister knocked on neighbors’ doors yelling at them. So first and foremost, how can we make people feel beautiful no matter their size? Stigma is such a hurtful element of our society, why can’t we just let it go and embrace differences? How can we change these media images that influence females of all ages to desire an idealistically, sometimes even impossible, size-zero body; now becoming a problem for males too? What if we got rid of shows, like the Big Losers, or at least changed the title? I mean really, who came up with that title? What if we stopped promoting dieting and just taught healthy eating or moderation? To be truthful, although I did the same thing, I was a little disappointed when Jennifer Hudson lost weight. She was a positive and realistic role-model for some young African American females experiencing problems with weight. However, her weight loss, was a healthy choice that will promote the longevity and overall well-being of her life. Obesity is a problem that negatively impacts positive health and life outcomes (NIH, 2010). There are many health problems associated with obesity, such as heart disease, chronic pain, diabetes, high cholesterol, just to name a few. Anorexia, many times leads to death. Our bodies require food as an energy source. There are also health problems associated with bulimia, such as an eroded esophagus. How can we a society portray realistic body images in the media? How can we as a society confront marketing strategies that lure American consumers’ into becoming overweight and/or obese? Can we even limit the selling or over-selling of over-processed food? Can we make organic and healthy options more appealing and affordable please? Can we advertise those options instead? What if we modeled American McDonalds after McDonalds found in Italy and other parts of the world? They serve fresh food! Really, I think our society and the the media that influences it, should promote the notion of balance and moderation when it comes to eating. How do we create balance in society despite American consumerism? How can we promote being healthy, instead of idealizing thinness and marketing towards obesity? People, and our children especially, are suffering because of unchecked media marketing and the idealization of extreme thinness. I promote that we as a society teach self-love by embracing any and all sizes. I also suggest that we stop promoting dieting, juice cleanses, junk food, and instead honor healthy balanced lifestyles. Lastly, we should make healthy eating and exercise both affordable and accessible to all income levels. I end with reminding all reading that eating disorders have the highest mortality rate of any mental illness. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, D.C: American Psychiatric Association. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, D.C: American Psychiatric Association. Kroner, C. (2011). The Body Politic: Childhood Obesity as a Symbol of an Unbalanced Economy. Policy Futures In Education, 9(3), 381-391. POPA, T. (2012). Eating Disorders in a Hyper-Consumerist and Post-feminist Context. Scientific Journal Of Humanistic Studies, 4(7), 162. http://www.niddk.nih.gov/health-information/health-statistics/Pages/overweight-obesity-statistics.aspx http://www.anad.org http://www.census.gov/content/dam/Census/library/publications/2015/demo/p60-252.pdf In his book, Stigma, Goffman (1963) insinuates that those dominating society, or the majority, establish categorizations of what is normal; those people that fail to meet normative attributions set by society are often discounted and discredited. These non-normative attributes constitute what is referred to as “stigma” (Goffman, 1963, p. 3). Goffman (1963) states that stigma is” an attribute that is deeply discrediting, but it should be seen that a language of relationships, not attributes, is really needed” ( p.3).
In Strategic Interaction Goffman (1969) suggests that in everyday life, individuals must interact with and through other individuals in pursuit of fulfilling their own needs and interests. Depending on the party, or person, individuals might be confronted with help or harm contingent upon the circumstance; this requires of individuals to orient themselves to their surroundings and exercise their own unique capacities (Goffman, 1969). Thus insinuating that before one orients to situational circumstances, they must consider information being provided to them by the other person (Goffman, 1969). These interactions differ for stigmatized people as they are often confronted with disrespect and disregard (Goffman, 1963). Goffman (1963) states that “the presence of normals is likely to reinforce this split between self-demands and self” (p.7). A vast number of Americans are diagnosed with a physical or mental disability each year, which is then compounded by their daily encounters with stigma due to societal denominations of “normality”. According to the U.S. Census Bureau (2010), approximately 56.7 billion Americans identify as having any disability. Of that number, 38.3 million identify as having a severe disability and 12.3 million of them aged six and older require assistance with activities of daily living (ADLs) and independent activities of daily living (IADLs) (U.S. Census Bureau, 2010). Millions of Americans are forced to orient to the dominant members of society, while also coping with the unique challenges associated with their disability. Specific to mental health, 48.3 million Americans experience mental illness in any given year due to a variety of factors; nearly 10 million adults live with a severe mental illness (National Alliance of Mental Illness (NAMI), 2015). Alarmingly 60% of adults living with mental illness did not receive treatment; many of them are over-represented in the prison population or living homeless without adequate resources (NAMI, 2015). Suicide is the tenth leading cause of death for American adults and research shows that 90% of people having completed suicide suffered from some sort of mental illness (NAMI, 2015). Childhood prevalence of mental illness is also incredibly prominent in the United States and research shows that 50% of lifetime cases begin by the age of 14 (NAMI, 2015). Approximately one in five children live with a mental illness and 20% of that population suffer from a severe mental illness. The average delay between onset of symptoms and therapeutic treatment, when it does occur, is roughly 10 years (NAMI, 2015). This creates an American dilemma as 50% of youth living with mental illness drop out of school and 70% are involved in the juvenile justice system (NAMI, 2015). Disturbingly, suicide is the second leading cause of death for youth over the age of 10 and 90% of those youth had a mental illness (NAMI, 2015). I cannot understand the stigmatized nature of disability both as a human being reading the aforementioned stats and as a social worker. I can speak to the unrelenting strength, creativity, ingenuity, and resilience of people living with disabilities as a youth therapist and in the past, a psychiatric social worker that served adults. The best way for me to confront stigma associated with persons having a disability is to tell a few stories. Names will be changed or withheld in order to protect the confidentiality of clients and friends who inspired me through our acquaintance. As a sophomore in college, I established a dear friendship with a young man who suddenly became blind during his freshman year of college due to a very rare disease. Imaginably, his entire world was shaken and he dropped out of college although he had achieved a perfect SAT score; he relinquished his dreams of becoming an engineer. He was forced to adjust and orient himself to society as a new being without the ability of sight. Although this friend is now someone I simply and gratefully meet in passing along the streets of Pittsburgh (this break in friendship, unfortunately, was initiated when I started a new job), he was a protective and motivating force for me as an undergraduate student. He was more aware and in tune to our surroundings than me and shared that understanding. This friend has now obtained a degree, hosts a local radio show, and leads liberal political movements in Pittsburgh. His sensitivity to people, life, and ability to fight against societal injustice despite his physical disability, continues to inspire me to do and be better. My very first client as a budding social worker in 2008, was a three year old child who had suffered a major stroke at the age of six months. When I first met him, he could only speak a few words and no sentences. However, he had this unrelenting energy and desire to live and grow, probably apparent since the day of his birth. Through him, I learned the power of play. He would teach me how to communicate through games, running at the playground, jokes, and pretending to be superheroes. His family taught me the power of unconditional love and support. By the time I left him due to a promotion, he was able to speak in sentences. He grew and got stronger, better, and more lively each day. His exuberance for life was evident in every activity despite all odds. Another client, who I always refer to as Grace when speaking of her to students, taught me how to move forward more so than any other being I have had the pleasure of meeting. This girl was five when I first started working with her and to this day is the most severely abused and traumatized person I have ever encountered. She was so severely physically abused by scalding water that she wears permanent scars on her face. She was also sexually abused and resilient enough to report the abuse twice while involved in child protective services. She was hospitalized psychiatrically at the age of six. Initially and understandably, this young girl would throw tantrums at school. Chairs, desks, artwork, etc. would fly around the classroom. However, in her kindergarten class she was introduced to Pete the Cat through a Youtube video. Her life motto then became “I’m just going to keep walking along singing my song” like Pete the Cat. After being placed in a stable and safe foster home, she got better. Like my previous client, we would play, and she would heal. Every session we would sing and dance to Pete the Cat. She made so much progress and met all of her therapeutic goals that she no longer needed me as her therapist. I make sure to teach my students her motto, “I’m just going to keep walking along singing my song”. I refer to her as Grace because she taught me grace. The last client I will write about not only possesses the perfected smile, but also resides in its essence. He lives with autism in such a beautiful manner, words cannot adequately describe the joy this child brings to the world. From him, I learned the power of and wisdom associated with imagination. I remember clearly one session a few years ago where we were reading a biography about Dr. Martin Luther King Jr. After learning about Dr. King, this client was shocked that at one time in history he and I could not play together or eat at the same restaurant. He said to me, “Dr. King must have imagined a better world and that’s how he made it better. Now it’s okay for us to play because of him”. I wish I would have written down all of my client’s wise sayings because they were inspirational and resonated from a place of pure imagination. These are only a few of the many resounding stories of strength recounting the lives of people living with disabilities that I encountered personally and also early on in my professional career. Truly, I could write a story about each of my many clients from the past 7+ years, but time and space disallows such an endeavor. I will, however, suggest that we as a society re-think how we treat those people living with disabilities. Instead of stigmatizing those already faced with a magnitude of environmental and physiological challenges, we should rather, view them as muses. Within these people lies innate abilities to withstand harsh circumstances. Most importantly people living with disabilities are people distinctive because of their resilience. I will repeat something I said in a previous blog, “Differences are courageous”. Instead of discounting those that are different because of disability, we should count them as the strongest people possessing the highest levels of adaptability. We as a society must remember that being different requires courage instead of attacking those that are different, we should instead commemorate their strength. References: http://www.census.gov/prod/2012pubs/p70-131.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/GeneralMHFacts.pdf https://www.nami.org/NAMI/media/NAMI-Media/Infographics/ChildrenMHFacts10-26-15.pdf Goffman, E. (1963). Stigma; notes on the management of spoiled identity. Englewood Cliffs, N.J.: Prentice-Hall. Goffman, E. (1969). Strategic interaction. Philadelphia: University of Pennsylvania Press. |
Archives
January 2020
Categories |