1) As a young poet in 1985 I was determined to set my path toward a literary life. I had graduated from a specialized high school in New York City, with a heavy course load in the maths and sciences, and meanwhile found a devotion to writing and reading poetry. As a result of this determination, combined with a family who supported my choices—or, left me alone to make those choices—and a college (Bennington) that did not require a distribution of study across areas, I was able to create a curriculum for myself which, long before it was common for an undergraduate student to major in “creative writing,” focused on my own creative education. I left that college after three semesters and spent a few years working (at a bookstore and a health food store) and writing poetry, then returned to finish my undergraduate degree at U-Mass Amherst, where I was also able to create my own major as a student in the BDIC program (Bachelor’s Degree with an Individual Concentration), with a major entitled “Poetry and Self-consciousness.” In this major I combined courses in philosophy, psychology, comparative literature, and creative writing, placing myself and my subjectivity somewhat radically at the center, thematically and organizationally. I was trying to study myself, literally, and the limits of my subjectivity, and often wrote about anything I was asked to write about through this lens, despite this being academically unconventional. It is important in this context to relate that in my final year of high school I had experienced a severe psychedelic drug injury, with immediate and long-term effects. My focus on myself as a subject of study, academically, and in the pursuit of my own poetry, which was and is deeply confessional in nature, emerged from the damages of that experience. My professors mostly stepped out of my way. They were often baffled and exasperated, often impressed by the eccentricity and persistence of my vision for my self-education, which I was able to bring with me to a graduate program in creative writing at the Iowa Writers Workshop. It wasn’t until I was in my mid- to late-thirties, with small children, a career in small press publishing, and a late-blooming awareness of social and political contexts, that I was able to grasp the imperative for me to unwind my heart and mind from that self-focus, which has often functioned as a dissociating and divisive agent. This unwinding continued as I began to involve myself in community activism and, subsequently, to pursue a goal of re-education and initiation into more related action in the context of social change. The context of 19^th and 20^th century Eurocentric literature and ideology in which I educated myself allows for, and even encourages, a radical self-absorption that I now understand as a version of whiteness and the privileges of same.

My ability to write has been my most notable academic strength. In my pursuit of a graduate education in clinical social work, I aim to further develop my historical understandings, critical awareness, and interpersonal tools in service of making change as a clinician.

2) As a Mental Health Assistant (MHA) at an in-patient psychiatric unit, my co-workers and I were responsible for the safety of patients, the security of the locked ward, and for the overall well being of what is called “the milieu,” the daily spaces and environments through which the patients flow as they receive treatment. The understanding is that the milieu provides the patient with a therapeutic experience, in the absence of one-to-one therapy or mandatory group therapy. Thus the actions and attitudes of the MHAs and other staff, including nurses, greatly affect the patients’ access to a therapeutic experience. MHAs, meanwhile, are required only to have a high school diploma and a three-day safety training prior to beginning employment, and are in many ways ill-equipped. On this unit, to my surprise, the pervasive attitude among nurses, fellow MHAs, and even some social workers, was that patients were, overall, a nuisance. MHAs, whom patients rely on for every intimate detail of their daily experience, frequently spoke degradingly of patients, referring to them within earshot as “crazy” or “cuckoo.” Nurses routinely spoke condescendingly to patients, as though they were not ill but rather immature. Altogether the milieu showed a massive disparity between what might be optimally therapeutic for a person experiencing mental illness, and the lived experience. These are problems of structure, and of training, and of pay scale—MHAs earn less per hour than your average barista—and of legacies of systemic neglect within the social institutions that hold psych patients who are bouncing from one inadequate, overstressed response to another. As a new employee in this context I had a lot of cognitive dissonance to absorb between my desire to help and protect patients and my need to learn how to become part of the team of MHAs who are called upon to work together closely to maintain safety on the unit. One patient named Ashley had been on the unit for nine months, far longer than the average stay of three weeks. She is a 28 year old white woman, cis-gendered, who had been what was called a “frequent flyer,” often ending up in the unit after having been picked up by local police. Ashley had become addicted to crack cocaine in her teens, and spent a long time unhoused, trading sex for drugs. During this time she had experienced many traumatic events, and had been sexually harmed. Her cheeks and arms are deeply scarred from self-inflicted wounds. In her mid-twenties she had fallen, been pushed, or jumped out of a window and broken many bones, and sustained a traumatic brain injury. When she arrived back on the unit, her demeanor was as usual, which was referred to as “feral” by the staff. She would spit on people or throw drinks, and did not want to be touched or addressed. She spoke rarely and usually in curses and slurs. She was deeply paranoid and suspected her entire environment. She stayed in her room almost completely. Over several months Ashley began to emerge into the milieu more, and although at first was suspicious of me, I continued to exhibit a caring attitude toward her, and she and I slowly developed a routine, which I construed as therapeutic to her, in which she would ask me to paint her nails, and if time and other constraints allowed I would do so. She did not have a lot of ability to converse, so we would have minor exchanges but mostly sticking to the subject of her nail polish. Small affirmations and small successful exchanges seemed to me to build trust effectively with her. Notably, I was the only staff person who would engage with her willingly. Other staff seemed to take her perseverative aggressions personally, despite the damage that Ashley was carrying and her TBI. Other staff would scoff at my ministrations, explaining that they themselves would never do anything for her because she behaved so badly. It is difficult to relate this without seeming to exaggerate but this was actually the situation I encountered. One of the more difficult behaviors Ashley exhibited was an open dislike of Black staff members. Ashley seemed to live in a permanent state of traumatic event, and it seems that she had experienced many difficult interactions with many Black people, and had categorized this racially. Ashley is openly and vocally racist, and mistrusted Black people categorically, and would make this clear if assigned a nurse who was Black or a staff member who was Black. One day Ashley was in the hallway and an MHA named James, a Black Jamaican man, was sitting outside another patient’s room on a “sit,” or Constant Observation. Ashley said something derogatory about James as she walked by, and James responded by calling her several derogatory slurs. He was very angry, and continued to talk to me about Ashley in the staff area, stating that he would never do anything to help her, she didn’t deserve help. I am relating this incident not because I feel that I knew exactly how to respond to James, or to Ashley, but because I did try to ameliorate the conflict the best ways I could think of, which was to say to James that although I understood his anger, I still felt that it was his responsibility in his role to continue to treat Ashley as he would another patient, and provide her with any assistance that she needed and that was in his power to give. Later I spoke to Ashley very briefly about how she might try to realize the difference between different people, and that not all people are the people who had hurt her, which was pretty much the way she experienced her daily life, i.e., a continually refreshing fountain of violent trauma. Ashley did not habitually accept any inquiry into her experiences, but she did seem to be able to understand the suggestion I was making. James became very angry with me, and expressed that he felt that I did not and could not understand his feelings—the implication being that as a white person I could not. I acknowledged that this was true, but I held to my conviction about his responsibility. There was some stiffness between us for a short time but in the end we were able to work together and support each other as we had before. My words to Ashley did not make any miracles occur, but I like to think that just the fact that I did not allow my feelings of dismay at her racism to prevent me from trying to help her created a positive benefit for her. We continued to have an ease of exchange that to other staff and her providers had previously seemed impossible right up until she eventually demonstrated social progress to the point that she could be discharged to a group home.

3) Having completed a training to be a labor doula, several years ago I volunteered my services to a woman I know in the birth of her first child. Elly had become pregnant unexpectedly at the age of 43. A doula learns ways to provide support and comfort to the laboring woman as well as to her birth partner, and to interface between them and the other caregivers in the labor room, including the midwife or doctor as well as family members. My attitudes about birth and the medical-industrial complex surrounding birth have been influenced by my readings of texts such as Spiritual Midwifery, by Ina May Gaskin and Home/Birth, by poets Arielle Greenberg and Rachel Zucker, as well as by the important film The Business of Being Born. Additionally my own experiences of giving birth have instructed me that the more birth is approached with a sense of “the extraordinary ordinary”—honoring its deep magic and deep commonality—rather than as a medical problem, the fewer medical interventions will be called for. My conundrum was in how to sensitively approach the birth of Elly and Steven’s child, given that from the start they went down the path of medicalized birth, choosing to use an obstetrician rather than a midwife, and to give birth in a hospital rather than a birthing center. In my first meetings with them it was clear to me that if I were to try to influence these decisions, it would require me to bring a lot of new ideas to them at a time when they were already in a state of some disturbance given their unexpected new roles as parents-to-be. Elly had accepted the idea that she was “high-risk” on account of her age—although she was in good health—and Steven stated his pervasive anxiety that Elly would be in a great deal of pain during the labor and birth. They expressed to me that they were open to the idea of natural childbirth, forgoing interventions like anesthesia, but that they were also open to the idea that Elly would not be able to deal with the pain, and that because she was older, and also quite petite, childbirth would be beyond the range of her capacities. The paradigm of medicalized birth is that giving birth is a risky medical procedure and calls for hypervigilance. The paradigm of natural birth is that birth is a highly variant process that one’s own individual body is designed perfectly to do. Helping Elly and Steven deliver their son turned out to be a question of allowing them to be who they had already decided they were, in this process, and to go forward with their birth as planned. I chose not to introduce information to them about the risks they were incurring by choosing a doctor and a hospital over a midwife and a birthing center. They were already nervous, but choosing a doctor seemed to make them feel more secure, and although I have since reconsidered ways that I might have neutrally offered more information and statistics and reassurance about the norms of birth, I feel that they had in some sense made clear to me their own agency in the process, which is actually what the primary task of a doula could be considered to be: to clear the path for the birthing woman to feel that she is in harmony with her own choices. Elly called me from the hospital a week after her due date to say that her doctor had instructed her to come in for induction, which is often the first step toward cesarean section. Induction produces contractions that are not in sync with the body of either the mother or the child to be born, and often do not produce adequate dilation of the cervix. The body’s wisdoms are complex. I spent thirty-six hours in the room with Elly and Steven, helping Elly during contractions, bringing take-out food for Steven, keeping Elly’s mother out of the room (at Elly’s insistence), and staying on top of Elly’s needs and requests for water or a shower. Their son was born by cesarean section and while I do not at all conclude that, as many people say, “all that matters is that they have a healthy baby,” and strongly resist these kinds of relativist statements and am instead in favor of articulating systems that are broken so that they can be improved, I did in this case conclude that my work with Elly and Steven was not to try to pry them away from their own clear choices but to support them in finding their peace with them.

4) In 2020-2021 I served as a city council member in my home city of Hudson, NY, a small municipality of 6,500 that has experienced a gentrification process over the past ten years, accelerating dramatically during COVID. My focus as a citizen activist has been on maintaining affordability for low- and middle-income communities of color, a once significant and now diminished demographic in Hudson. As a white person coming into the midst of a long-standing community of color with an intention to “help” and to be of service, I have been continually reminded of the distance between my assumptions and what is real in others’ lives; and of the presumptions of white supremacy in our culture overall, and in the culture of low-income subsidized housing in specific, which simultaneously is life-preserving and debilitating. I continue to serve on boards at several organizations with housing-as-a-human-right as their focus, and to work in a hands-on way with community members who are experiencing rent burdens. Witnessing, collaborating with, and supporting this community as it has gone through an existentially painful displacement has created many opportunities for me to reflect and push back on my relative privilege, endeavoring to continually adjust my own sense of what is wanted and needed in the community in relation to what I am actually hearing and learning from community members themselves rather than my assumptions or ideas about what may be wanted or needed. This adjustment takes many different forms and always comes back to relationship; to listening; to responding with an awareness of the responsibility I have to use my privilege for public benefit and the need to approach cultural intactness with respect. I hope to bring this reflective and engaged capacity to my practice as a therapist in any environment.

5) In my 20 year career as the editor of a fairly influential small literary magazine and press, I was frequently asked to speak to young writers, at conferences and colleges, about various subjects pertaining to a literary career. The question often came up: whether it was wise or necessary or beneficial that a young writer should pursue a Master of Fine Arts in Creative Writing. As I had over 20 years observed a significant increase in MFA programs at colleges around the nation, as well as PhD programs in Creative Writing, I had also observed a kind of brain drain: people who write—and read—are frequently people with a strong mind, a thoughtful disposition, a creative temperament, and a caring or empathic heart. Prior to this burgeoning of the MFA program, and of creative-writing-industry related jobs, writers had not previously been held distinct from other job training and job sectors, and may in fact have often been gainfully employed in sectors in which their talents and skills—observation, analysis, synthesis, communication, compassion—might come into play within what we know as “the helping professions.” The siphoning off of a significant mass of people (approximately 20,000 persons apply to Creative Writing MFA programs annually) with these qualities—which I hope I share—into jobs within the academy or other creative writing institutions, at the time seemed to me to be bad for everyone, and it was a regular part of my talks to advise these young writers that, no, they should not consider it necessary to go through an MFA program in creative writing, but should seriously consider instead applying to a Masters Program in Social Work. This was a bold statement, coming out of my own persistent desire to learn how to help people in trouble. My thinking at the time was, like the thinking behind most seemingly outrageous statements, more than half-grounded in a serious opinion, while the remainder was grounded in a desire to provoke the formation of serious opinions in others. I seriously believe in social work as an adhesive between our public resources and our private lives, as well as a solvent for the disconnection that pains us. I have witnessed in my lifetime the dissolution of so many of the fabrics and networks that may have been holding us within a social net—so different from a social network—and have a serious desire to apply my talents and skills to the problem of how to create more safety and security for more people at all stages of development and economic strata. I believe strongly in the interdependence and intersections of our collective capacity for happiness and bring to my interest in clinical social work a fierce joy in helping wherever I can, however I can. I take pleasure in connecting persons with resources and in helping people articulate their needs and their wounds. My desire is to learn ideas, methodologies, and techniques that support persons in pursuit of mental health. The biopsychosocial model presents a holistic approach to the person and their context, their experiences in the past and in the world, and represents actually a commonsense apprehension of the factors and variables in what may be presenting as problematic in a person’s emotional life.

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