Another Trip Around the Sun

“If it suddenly ended tomorrow, I would somehow adjust to the fall. Good times and riches and sons of a bitches, I have seen more than I can recall”.

Number 45 closed out and number 46 started with a 59 mile bike ride with the wifey. At the end of the week, on my birthday, I backpacked with my 16 year old and and then rode with my 13 year old and my wifey.

A lot of weird things have happened in five years. Covid, a shift in my faith and shift in my perspective. It is felt that truly, I am heading towards the second half of the experience and with this brings an awareness of self that was not present before. Our second daughter graduated from high school this year and for the first time in 20 years, we will only have two kids at home. The eldest is a junior in college.

What is time? “According to my watch, the time is now, past is dead and gone, don’t try to shake it, just nod your head, breathe in, breathe out, move on”

In Buddhism, the notion of impermannece is the notion of constant, continuous change. In Western philosophy, Heraclitus insisted that ever present change is the fundamental essence of the universe. He is famously known for saying that “no man ever steps in the same river twice”.

I like to make the old joke, “I do not know how to act my age, I have never been _____ before”. One must life each day this way. You really do not know how you will really act in the moment and if you continously act as you always do, never pausing to consider where you are, you run the risk of missing an experience or even worse, creating a rut in your life. I was once told by a supervisor, the only difference between a rut and a grave is the depth.

Too often, we want to live in the past or even try and mourn what we should have done; this is developmental problem for older folks. But, like the Calypso poet says, we must recognize the past is dead and gone. It informs our current and future positions, but we must not cling, for this brings us suffering.

There is a lot of serenity walking a long a forest trail. As one get’s older, there is a lot of angst and serenity in the process. I hope to lean into serenity. It is my hope that through the upcoming storms of the aging process and the memories of what should have been, that I find the “menace of the years finds and shall find me unafraid”.

Margarita at Margaritaville, Cleveland
Cheeseburger in Paradise

The Joy of Being

Mudita is the Sanskrit and Pali word for Joy. Specifically, it implies a sympathetic or vicarious joy or the joy that comes from delighting in the well being of others. This is perhaps one of my favorite spiritual practices.

Let me share a recent picture my father sent me of a black capped chickadee:

Giannamore , G. (n.d.). photograph, Erie.

Perhaps one of my favorite birds is the Chickadee. Full of life, you will often see it flitting around in all types of weather. One can even put bird seed in their hand and have the Chickadee eat the seed out of the person’s hand. For me, the Chickadee embodies joy.

The spiritual practice of joy enhances happiness and counters feelings of sadness and sorrow. As a mental health therapist, I hear a lot of bad things, and to focus on what makes me happy, even a funny thing a client says and reflecting back to the client lightens the sometimes heaviness of a session.

Mary Ann and Frederic Brussat offer that “joy is an essential spiritual practice growing out of faith, grace, gratitude, hope and love. It is the pure and simple delight in being alive. Joy is our elated response to feelings of happiness, experiences of pleasure, and awareness of abundance”(Brussat, 2023). The Brussat’s also allude to Mudita in their explanation of joy.

Thich Nhat Han reminds us that every twenty four hours we are blessed with a new opportunity to see the joy in all that is around us.

In this morning’s devotions by Mathew Fox, he writes of Joy as experienced by Thomas Aquinas. Fox offers that Aquinas “proposed that “Sheer Joy is God’s and this demands companionship.” The purpose of the universe is Joy”. (Fox, 2023). If one understands that God is Love and all that God creates is done out of love, then it is not a huge leap to understand the notion of the universe being Joy.

While things may seem dire right now, look beyond what you are told to see. There is a world beyond what your phone wants you to see. I have found in my practice of joy and along with it, gratitude, a smile towards a stranger and words of compassion can brighten the mood of any person. There is much pleasure in making others happy and it is such an easy practice, just smile and offer an assuring word. Look for the beauty, the random dandelion growing through the crack in the sidewalk, the song of red wing blackbird signalling warmer days, the coo of a baby learning from her environment.

We are all beings of unexhaustable joy. We have unfortunately had much of this extinguished by being told we are too emotional, too full of energy or some other well meaning words meant to shape us into a model of humanity that does not truly capture who we really are: sons and daughters of the awakened ones, the Buddhas and bohdisattvas or Christ bearers and saints.

May you find joy in your steps today, may peace and joy brighten your paths.

Cultural Sensitivity and the Therapeutic Relationship

 

The decade of my youth was the 80’s. I grew up on the lower Eastside of Erie, Pennsylvania and had the stereotypical kids on the block existence growing up.  Being an inner-city kid, I had plenty of friends who grew up in the “projects” who, other than having stories of fathers not being present or mothers who had gone to jail or being raised by grandparents, were just like me.  Except for our skin color. I had many friends in elementary school who were black and brown, of Hispanic cultural heritage. My high school years were the 90’s and with it came several refugee crisis’s including immigrants from Vietnam, Africa and the Middle East, many of whom became acquaintances and were people of color. While I had this awareness of a cultural and color difference, my own white cultural and religious orientation, seeped in racism colored my awareness until I would get to college. 

Forty-six years later, I find myself in private practice and on occasion working with someone of color/culturally different than me. At a point in time in my career, I was also a pastor and as I have come to a greater awareness of how my religion has done so much harm to the native people of this country and the many people of color we brought here, this all aggregates into a larger awareness of how privileged I am and makes cultural sensitivity all the more important.  

There have been many changes in how we address culture in the twenty-three years I have been out of college. Twenty-three years ago, homosexuality and transgender were still diagnosable mental health/ behavioral health concerns and from a religious point of view for me, a moral failing. My own diagnosis of Attention Deficit Hyperactivity Disorder was seen as a retardation all the way up to my senior year of high school. In several church communities I have served in, including the community I currently live in, racist and gender intolerance continue to have a presence. 

This begs the question, how does a white inner-city boy with two Master’s degrees possibly interact with someone of color or cultural differences? One answer that has stood out for me is a sense of vulnerability and willingness to let the client lead the session from their point of view. Secondly to this, then is to ask clarifying questions about the cultural relevance of a particular therapeutic technique or modality. Research appears to support my observations. Cultural competence in therapy involves a mental health professional understanding the beliefs, backgrounds, and values of their clients — this includes their culture, race, ethnicity, socioeconomic status, and sexuality. 

 In an article in the journal, Collegian, the authors offer that “Limited guidance exists on culturally sensitive communication related to interactions between clinicians, patients and families” (Brooks, Manias and Bloomer, 2019). Written in 2019, this article takes what is already known about cultural competence in health care: 

  • Understanding the concept of culturally sensitive communication is essential for clinicians to increase their awareness and understanding of best practice when communicating with culturally diverse patients and families. 
  • When culturally sensitive communication is used, patients are likely to experience a more positive and beneficial relationship with clinicians, and better health outcomes 

What this article’s research adds is:  

  • Ideally, the nature of culturally sensitive communication should be determined by the recipient of care, be individualized and holistic, and incorporate any cultural considerations necessary. 
  • The defining attributes of culturally sensitive communication explored and explained in this paper, aid in establishing and maintaining a trusting therapeutic relationship. 
  • This concept analysis enhances understanding of culturally sensitive communication and the benefits and challenges to its use in healthcare 

The outcome of the paper is that it shows that “By using culturally sensitive communication, patients should experience better outcomes; families should be more actively involved in healthcare, and staff should feel less emotional, with less physical and psychological distress. Further research is needed to gain an understanding of current communication and decision-making practices” (Brooks, Manias and Bloomer, 2019). 

With the different clients that I have worked with over the years who are culturally different than me, specifically those that I do not encounter in the helping profession often, (most notably, Asian, Pacific Islanders, people of Middle Eastern background and Indian), I will often try and look for culturally relevant approaches prior to the first session and in establishing rapport, confirm what is appropriate for the client moving forwards.  

Using this approach, the therapist cultivates a self-awareness of their cultural socialization and helps them begin to understand that no matter how open one may be other cultural experiences, there is a distinct difference. Secondly, this approach, which is rooted in humility, opens the door to curiosity. Curiosity for much of the work I do is often encouraged as a way to help others truly understand what is really going on with their mental health. When the therapist and client are curious together, this vulnerability can begin to break down walls and provide a path to healing. Thirdly, this approach embraces a growth mindset. When I came to private practice, I had only worked with children and youth. Being challenged to work with adults and even adults of color and of mixed cultural backgrounds helped me grow professionally and personally. It helped me truly embrace how interconnected we all are.  

The goal in culturally responsive therapy is demonstrating integration. Georgetown University’s National Center for Cultural Competency has a checklist available to self-assess the inclusiveness of your practice. 

References: 

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/j.colegn.2018.09.007 

 

 

 

 

 

 

 

Cultural Sensitivity and the Therapeutic Relationship 

Rob Giannamore, LPC   

 

The decade of my youth was the 80’s. I grew up on the lower Eastside of Erie and had the stereotypical kids on the block existence growing up.  Being an inner-city kid, I had plenty of friends who grew up in the “projects” who, other than having stories of fathers not being present or mothers who had gone to jail or being raised by grandparents, were just like me.  Except for our skin color. I had many friends in elementary school who were black and brown, of Hispanic cultural heritage. My high school years were the 90’s and with it came several refugee crisis’s including immigrants from Vietnam, Africa and the Middle East, many of whom became acquaintances and were people of color. While I had this awareness of a cultural and color difference, my own white cultural and religious orientation, seeped in racism colored my awareness until I would get to college. 

Forty-six years later, I find myself in private practice and on occasion working with someone of color/culturally different than me. At a point in time in my career, I was also a pastor and as I have come to a greater awareness of how my religion has done so much harm to the native people of this country and the many people of color we brought here, this all aggregates into a larger awareness of how privileged I am.  

There have been many changes in how we address culture in the twenty-three years I have been out of college. Twenty-three years ago, homosexuality and transgender were still diagnosable mental health/ behavioral health concerns and from a religious point of view for me, a moral failing. My own diagnosis of Attention Deficit Hyperactivity Disorder was seen as a retardation all the way up to my senior year of high school. In several church communities I have served in, including the community I currently live in, racist and gender intolerance continue to have a presence. 

This begs the question, how does a white inner-city boy with two Master’s degrees possibly interact with someone of color or cultural differences? One answer that has stood out for me is a sense of vulnerability and willingness to let the client lead the session from their point of view. Secondly to this, then is to ask clarifying questions about the cultural relevance of a particular therapeutic technique or modality. Research appears to support my observations. Cultural competence in therapy involves a mental health professional understanding the beliefs, backgrounds, and values of their clients — this includes their culture, race, ethnicity, socioeconomic status, and sexuality. 

 In an article in the journal, Collegian, the authors offer that “Limited guidance exists on culturally sensitive communication related to interactions between clinicians, patients and families” (Brooks, Manias and Bloomer, 2019). Written in 2019, this article takes what is already known about cultural competence in health care: 

  • Understanding the concept of culturally sensitive communication is essential for clinicians to increase their awareness and understanding of best practice when communicating with culturally diverse patients and families. 
  • When culturally sensitive communication is used, patients are likely to experience a more positive and beneficial relationship with clinicians, and better health outcomes 

 

 

 

 

What this article’s research adds is:  

  • Ideally, the nature of culturally sensitive communication should be determined by the recipient of care, be individualized and holistic, and incorporate any cultural considerations necessary. 
  • The defining attributes of culturally sensitive communication explored and explained in this paper, aid in establishing and maintaining a trusting therapeutic relationship. 
  • This concept analysis enhances understanding of culturally sensitive communication and the benefits and challenges to its use in healthcare 

The outcome of the paper is that it shows that “By using culturally sensitive communication, patients should experience better outcomes; families should be more actively involved in healthcare, and staff should feel less emotional, with less physical and psychological distress. Further research is needed to gain an understanding of current communication and decision-making practices” (Brooks, Manias and Bloomer, 2019). 

With the different clients that I have worked with over the years who are culturally different than me, specifically those that I do not encounter in the helping profession often, (most notably, Asian, Pacific Islanders, people of Middle Eastern background and Indian), I will often try and look for culturally relevant approaches prior to the first session and in establishing rapport, confirm what is appropriate for the client moving forwards.  

 

 

 

Using this approach, the therapist cultivates a self-awareness of their cultural socialization and helps them begin to understand that no matter how open one may be other cultural experiences, there is a distinct difference. Secondly, this approach, which is rooted in humility, opens the door to curiosity. Curiosity for much of the work I do is often encouraged as a way to help others truly understand what is really going on with their mental health. When the therapist and client are curious together, this vulnerability can begin to break down walls and provide a path to healing. Thirdly, this approach embraces a growth mindset. When I came to private practice, I had only worked with children and youth. Being challenged to work with adults and even adults of color and of mixed cultural backgrounds helped me grow professionally and personally. It helped me truly embrace how interconnected we all are.  

The goal in culturally responsive therapy is demonstrating integration. Georgetown University’s National Center for Cultural Competency has a checklist available to self-assess the inclusiveness of your practice. 

References: 

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/j.colegn.2018.09.007 

Providence and the Gift of Grace

The late Thich Nhat Hahn once was quoted to offer this meditation: 

Every morning, when we wake up, we have twenty-four brand-new hours to live. What a precious gift! We have the capacity to live in a way that these twenty-four hours will bring peace, joy, and happiness to ourselves and others. Peace is present right here and now, in ourselves and in everything we do and see. The Question is whether or not we are in touch with it. We don’t have to travel far away to enjoy the blue sky. We don’t have to leave our city or even our neighborhood to enjoy the eyes of a beautiful child. Even the air we breathe can be a source of joy. We can smile, breathe, walk, and eat our meals in a way that allows us to be in touch with the abundance of happiness that is available. We are very good at preparing to live, but not very good at living. We know how to sacrifice ten years for a diploma, and we are willing to work very hard to get a job, a car, a house, and so on. But we have difficulty remembering that we are alive at the present moment, the only moment there is for us to be alive. Every breath we take, every step we make, can be filled with peace, joy, and serenity. We need only to be awake, alive in the present moment. … 

This week I want to look at the Christian experience of Providence as it is related to the spiritual practice of Grace. Secondary to the practice of grace is mystery and cultivating an acceptance of living with unknowing. Grace is a gift of God or a gift from the divine. It comes to us at God’s initiative there are some things we can’t do about grace. We cannot earn it. We cannot control it. We don’t have to deserve it.  

Providence then is the quality in divinity on which humankind bases the belief in a benevolent intervention in human affairs and the affairs of the world. This belief will change between the context and culture in which it is experienced. Providence can also be seen as the forseeing care and guidance of God or nature over the creatures of the earth.  

I like this second though better because I feel it better ties into this notion of an open and relational God. Too often these days, I run into people who continue to present with a notion of God that was handed to them that no longer fits their world view. Did God provide us with all this suffering? There is then a slippery slope that happens with some Christian circles. First, we talk about God’s grace, a loving, maybe an omnipotent God and then they will slip into the “God will not give you more than you can handle” and this is where things seem to go off the rails.  

In the Talmud, providence is summarized in the dictum of Akiva (Avot 3:15): “All is foreseen, but the freedom of choice is given, and the world is judged with goodness, and all is in accordance with the works”. There is a balance between freedom of choice and predestination. Some things do happen for a reason, but we also have a choice in how we deal with those things.  

Openness to receiving the sacred presence of the divine in our life is how grace works. This receptivity helps us let go of the feelings that we must have screwed something up, that we are bad, that we are sinful. As the sun rises and falls each day, grace too, happens.