Nina Gaby

Essays, art, and healthcare


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More than the Sum of its Parts

collage 2

Book collage in process

Composite/collage. Synchronicity in text and image, transparency, translucency, opacity. How do we make it work?

In order to write in any sort of intimate way about mental health and addiction, I essentially make a hybrid of characteristics of an individual, spanning time, place, gender, symptoms. The point is to paint an accurate image of what without focusing on the who, on the why without the where. For obvious reasons, this allows me to shine a light on an issue without breaking confidentiality, and allows me to honor without alarm. I want the reader to understand what goes on for people in this world of addiction and psychiatric disturbance, within that understanding we might see impact or at least volition for change.

It’s a dilemma. CNF (creative non-fiction writers) will often say, if you can’t tell the whole truth than don’t bother writing about it. Others will find it good enough just to blur the lines. Others use permission contracts and footnotes. At conferences I’ve listened carefully to experts such as Lee Gutkind and Susan William Silverman, Dinty Moore and Jacquelyn Mitchard. My work has been picked apart by editors and lawyers. I don’t have an answer except that there are narratives that need to be told and images that need to be made.

I collage 3-D memoir from mixed media and think about whether transparency can truly exist. I work in porcelain and encaustic as well as words, all radiant in their translucency. I think about politics and the opacity that crushes us. I am proud of these stories I write about people I have been honored to know.

Here is my latest, a Monthly Muse contest winner from New Millennium Writings, “The Sum of its Parts.”

https://newmillenniumwritings.org/nina-gaby-sum-of-its-parts-musepaper-2018/

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“May I never see in the patient anything but another creature in pain.” Oath of Maimonides 1135-1204: Trauma Informed Care and Compassion Fatigue, Is there a connection?

What is to give light must endure burning.”
Viktor Frankl 1905-1997

It is National Nurse’s Week and I am preparing a presentation for our nursing staff on the phenomenon of vicarious traumatization, the subject I tackled in my last blog and most recent essay “Don’t Touch the Mustard; Notes on Being in Lockdown With my Daughter.”

Vicarious trauma is a contagion, it is what happens to nurses and other caregivers who spend time helping others move through illness and crisis. We absorb the pain that surrounds us. Its sister, compassion fatigue, is the “debilitating weariness brought about by the repetitive, empathic responses to the pain and suffering of others” (LaRowe 2005) and “very much the landscape for today’s professional” (Showalter 2010).

My hypothesis for this presentation is this-If we look at trauma differently, will we respond differently? I am briefly commenting on this in honor of nurses everywhere who risk burnout, fatal weariness, and with concern for our healthcare system which suffers from the turnover that this fatigue costs all of us.

Trauma Informed Care

“A thorough understanding of the profound neurological, biological, psychological and social effects of trauma and violence on the individual” (Jennings 2004).

“Trauma is a disease of disconnection.”
Bessel van de Kolk Lecture, October 2011

Traditional treatment demands “compliance,” how would it be different to ask for “collaboration?” Would a change in a power differential actually ease the burden on the caregiver? Or is the potential for connection threatening? This is a question begging far more time and energy than is possible for this caregiver and blogger right now.

Can symptoms be looked at as adaptive rather than destructive? Normal responses to abnormal experiences?

For traumatized patients, all behaviors were directed towards survival. Over time they may have become “dysfunctional” with high incidence of substance abuse, psychiatric symptoms, and repetition compulsion. If we intervene with a clear understanding that these symptoms were lifesaving behaviors, we can respectfully help suggest alternatives. The same alternatives that might help any one of us.

Should we say- what happened to the patient rather than what is wrong with the patient? If we practice this with others, might it be easier to look at ourselves with more compassion?

Viktor Frankl also suggests that we honestly assess whether in the same situation might we do the same thing that we see our patients doing? This would go far in reducing the ‘us and them’ mentality that often gets in our way.

And then there is humor. Wish I had more time. Suffice to say it is the rare situation, with patient or colleague, that doesn’t get a whole lot better with humor. Or food. Another subject for another blog.

I need to get this on Powerpoint. In the spirit of collaboration, I will use more questions than answers. And bring lunch.