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Kaethe Weingarten PhD- Guest
In this episode, Kaethe discusses the history of developing her conceptualization of four witness positions, and how witnessing effects people differently depending on their sense of empowerment/disempowerment and awareness. She discusses how she submitted her book, Common Shock: Witnessing Violence Every Day, two days before 9-11 and editors had difficulty understanding the ideas. By September 13, they deeply understood the experience of witnessing. She discusses the development of her Witness-To-Witness (W2W) Program, and how it has supported professionals working with adults and children in various stages of the immigration process who suffered as a result of many policies. Her social justice and larger systemic work helps lawyers, clinicians, childcare workers, and a multitude of other service providers working with people made vulnerable by national, state and local policies. Her work creates Reasonable Hope. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Dr. Keith Sutton, Psy.D: (00:22)
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area and the director of the Institute for The Advancement of Psychotherapy. Today, I'll be speaking with Kaethe Weingarten, Ph.D., who is a psychologist and director of the Witness-To-Witness Program for migrant children's networks. Kaethe's work focuses on the development and dissemination of a witnessing model. Part of her work is on the effects of witnessing violence and trauma in the context of domestic, interethnic, racial, political, and other forms of conflict. She has published numerous articles, chapters, essays, and books, including her book, Common Shock Witnessing Violence Every Day. And she serves on the editorial boards of five professional journals. She has taught and spoken in numerous contexts in the United States and internationally as well as founded and directed the program and families, trauma and resilience at the Family Institute of Cambridge. Let's listen to the interview. Okay, well welcome. Hi Kaethe, Thanks for joining us today.
Kaethe Weingarten, Ph.D.: (01:27)
My pleasure.
Dr. Keith Sutton, Psy.D: (01:29)
So I heard a bit about your work from a mutual colleague of ours. Becky Pizer, who's over at the Wright Institute and involved with our organization, The Association of Family Therapists, Northern California, also, AFTA the American family therapy academy. And in a conversation with her, I was talking and she was saying about how her recent interests have been in kind larger systemic and social justice work. And, I was asking about maybe talking about some of this and she was saying, “actually, you know, Kaethe would be a great person to discuss this with.” And the innovative work that you're doing with your Witness-To-Witness program so I'd love to hear more about that. And particularly too, I always like to hear people's story about, you know, kind of the evolution of their career and their thinking and kind of what led up to the work that they're doing now. So, nice to meet you Kaethe, and thank you for taking the time.
Kaethe Weingarten, Ph.D.: (02:23)
Well, nice to meet you and for giving me this opportunity to situate the work that I'm doing now in essentially a life story in an autobiography and a professional biography as well. So, I do feel, and you're a family therapist as am I, that my family position set me up for both the politics of my work and the social justice aspect. But the particular content because I think more than anything, I was in fact, a witness in my family. So, I'm going to say a little bit about what I mean by a witness and, you know, I think to link it to the current moment because it's a difficult concept. The easy thing to say is that I have been working on a model of witnessing for the last 30-35 years.
Kaethe Weingarten, Ph.D.: (03:29)
I think it actually started in the early 1970s when I was a witness to my mother's cancer diagnosis and the way it was handled in our family. But I think it's easy to say that the witnessing model has to do with combining bystander theory and trauma theory which is the conceptual or theoretical foundation of the model of witnessing that I'm using. But I think that I could just give you the example that is pretty much in every mainstream media account that I have been reading this past week really working around the Derek Jovin trial. It has named the witnesses on the stand and the young woman, Darnell Fraser, as a bystander, and to me, this is absolutely the incorrect term to understand her experience. She was absolutely a witness.
Kaethe Weingarten, Ph.D.: (04:43)
And in my model, there are four positions, not one. And the position that she was in, as were so many of the other people who were there and then who took the stand. And then as well as, a global audience who either actually saw the video or heard about it. We were in the aware but disempowered position, and the effects on people, of being in an aware but disempowered position are similar to but not identical to being a victim of violence and, or violation. And the other position in the model, they're four, but just to be sure to connect it to current events, the police officers were in the most dangerous position. The fourth position, which is unaware of what they were doing, presumably or at least that was what they said, but empowered to do exactly what they did.
Kaethe Weingarten, Ph.D.: (05:50)
They were authorized by the state, but they were witnesses to somebody who was dying and they were unaware. So many people, when I initially talk about witnessing go, “well, you know, what's the difference between that and being a bystander”, but I think most people viscerally, and physically know the difference in themselves. You know we were not bystanders. We were brought into an experience that was horrific and traumatizing. As it was traumatizing for so many people in the world. And just one other example, and then I can kind of go back to the biography. But you know, the heart of what I do and what I'm talking about is witnessing. I finally, you know, after a decade submitted a book proposal which is the book Common Shock, but I submitted it on September 8th.
Kaethe Weingarten, Ph.D.: (06:56)
I submitted it to four publishers in New York City, on September 8th, 2001. And on September 10th, my agent said, “I don't really understand. It's a great proposal, and we're not getting any offers.” On September 13th there was a bidding war for the book and every single person said, “now I understand. Now I understand because September 11th had happened.” And so what had been kind of an odd usage of a term for them suddenly they actually understood viscerally also. That, yes, they were witnesses. They were not bystanders and, you know, there was a lot to understand about it. So that's just to kind of state from the beginning that all of the work that I've been doing really for the last 30-35 years has been about witnessing and primarily in two domains. So if I go back to the first thing that I said, which is about being a witness in my family, I was not a bystander.
Kaethe Weingarten, Ph.D.: (08:13)
I tell you that I was impacted by, you know, the dynamics that I observed in my family. So I guess to kind of speed forward I feel really fortunate that my clinical degree was in a program called clinical psychology and public practice. So right from the beginning, my clinical orientation was always about, and my professors were completely committed to social justice work, public practice, and how to make clinical training responsive to the larger issues of our day and of our time. And I graduated in 1974 or, I mean I got my Ph.D. from Harvard in 1974. Then as I mentioned my mother was diagnosed for the first time with cancer in 1974. And that was an era in which there were laws in New York state where somebody had to be informed of their diagnosis, it was discouraged to tell somebody their prognosis.
Kaethe Weingarten, Ph.D.: (09:39)
And the logic at the time was that it would take hope away and then, you know, they would decline. So my sister, who's older than I, but she and I were violently in disagreement with my mother's physicians and my father who went along with and respected the physicians. And so we, you know, there was a kind of an added layer for me of being aware that my mother was dying but disempowered and helpless in relation to being able to be in conversation with her about that. And there were all kinds of moments that were just excruciating because she was confused about what was happening and didn't really, you know, she didn't have a frame to understand what was happening.
Kaethe Weingarten, Ph.D.: (10:48)
So I would say that kind of, from that point in 1979, my husband and I had our second child and she was born with a very rare genetic disorder that required multiple hospitalizations and procedures. And at that time, I mean, you may remember the history of how the DSM has evolved over time. But it wasn't until in the 1990s, that if you were a parent of a child, let's say you had a child who was going through chemotherapy or some horrific operation, and you were a witness to that. There was nothing in the DSM that indicated that you might have symptoms of trauma or be traumatized by that. There was no concept for that. Well, I knew that I was completely traumatized by having a doctor tell me when my child was four hours old that she might not live.
Kaethe Weingarten, Ph.D.: (11:59)
She's now I should say a social epidemiologist tenured professor at San Jose State. She did live, but it took a long time. It took a lot of years before we knew what that trajectory was going to be. So the witnessing model kind of developed in two arenas. One was what it means to be a witness in the context of medical illness. Dying in death and then what it means to be a witness in the context of violence and violation. And in particular, I was the clinical director of a sexual abuse team in the Boston region. So I was very interested, particularly in the experience of the non-offending parent who was, you know, again in the witness position. So I was interested in these issues of violence and violation and at a kind of a domestic level, but then also kind of scaling up in post-conflict societies. I had some experience with and then did an intensive study of five different genocides, where again, it seemed to me that the concept of a witness was crucial to understanding what was happening.
Kaethe Weingarten, Ph.D.: (13:31)
In the late 1990s, I began doing work in South Africa. That was a location where it was really possible to put together the construct of witnessing both in the illness domain, which had been a really important strand of my career because that was the era of the aids pandemic when antiretroviral medications were not available in South Africa but it was also both a conflict zone sure and a post-conflict zone in terms of the apartheid era. And so the witnessing paradigm probably in South Africa, more than anywhere else, was completely understandable to everybody. It was such a strong fit for them. They got it absolutely immediately and it really permitted tri-racial conversations. Not just dialogues but, you know, conversations amongst Africans and Afrikaners and English-speaking people in a way that prior language terms hadn't been as effective, particularly the concepts of bystander or beneficiary.
Dr. Keith Sutton, Psy.D: (15:11)
Yeah.
Kaethe Weingarten, Ph.D.: (15:11)
Was often a roadblock to the kinds of working alliances that people absolutely desperately needed to have to deal with the aids pandemic. But the concept of witnessing and that it's possible that somebody would witness something and actually freeze. In other words, once you incorporate trauma theory.
Dr. Keith Sutton, Psy.D: (15:35)
Yeah.
Kaethe Weingarten, Ph.D.: (15:35)
You understood that there were multiple positions, fight, flight, freeze, FAW, and flounder that you know, could arise out of being in the witness position suddenly. Avenues of communication open that had really been closed to people or that's what I've been told. So I think that's just an answer to one question.
Dr. Keith Sutton, Psy.D: (16:04)
No, this is good. In part, I wanna just make sure that I'm comprehending the witnessing because actually when I was originally thinking of witnessing and your witness-to-witness program, I was thinking of my past narrative therapy training. And kind of the concept of witness and kind of bringing witness into, you know, either through reflecting team or into the session or somebody from the larger system. But it sounds like what you're saying is that the witness position is really kind of the variance of those who may not have necessarily been even directly experiencing the trauma themselves, but then kind of witness to it. But that witness is the experience of trauma. You know, they may not have been in the building at 9/11, but watching on TV or being in the area or being a first responder. This idea of being involved and affected by and having kinda words for that.
Kaethe Weingarten, Ph.D.: (17:05)
Yeah, exactly and I'm happy to or I'm imagining some of the people listening to the podcast are wondering how it relates to the narrative or Michael White's construct of witnessing. And that's something, you know, I worked with Michael from the early 1980s on. And he was very aware of our kind of having these two different tracks, if you will, of developing the construct of witnessing. Mine really does come from, or the point of origin is around moving bystander theory and trauma theory together, merging them. And for Michael, that's not a point of origin of the construct of witnessing, but it is about reflection, and both CT and X. I have written an article called the art of reflection and that really does, I would say, merge the narrative understanding of witnessing with the witnessing model. And I also think that in the now sort of bumping, you know, ahead to the witness-to-witness project. That the way we do the work that we do is very much influenced by narrative ideas. So there's gonna be a connection, you know, that I can make for you but that, I probably wouldn't do it right at this moment.
Dr. Keith Sutton, Psy.D: (18:54)
Okay, no problem. That's coming up and actually speaking of coming up. I'm dying to hear the other two witness positions, but maybe we'll save that for a little bit later
Kaethe Weingarten, Ph.D.: (19:05)
Yeah, I think that's probably a good idea. So, the witnessing model you can think of as having two axes so it's a little bit difficult, I think, for people to hear it and imagine it. But I think of it as there four squares and across the top, that would be the word aware and unaware. And then on the left-hand side on the top would be the word empowered and on the bottom would be disempowered.
Dr. Keith Sutton, Psy.D: (19:43)
Mm. Okay.
Kaethe Weingarten, Ph.D.: (19:45)
And if you imagined then that your top left square is the coming together of an aware and empowered position. And I call that the green square because I'm kind of thinking, trying to simplify it and there's gonna be an analogy to the, you know, a traffic light. So all of the work that I've done and the witness-to-witness program comes out of a project called the witnessing project, but it all, what we're trying to do in every instance is to help people move into the aware and empowered position. Because that's really the only place in the long term. Well, certainly, well let's just say in the long term, you can only be effective if you're in the aware and empowered position.
Dr. Keith Sutton, Psy.D: (20:43)
Sure.
Kaethe Weingarten, Ph.D.: (20:44)
The one that's below, which is aware and disempowered, where I mentioned that the witnesses, and really the global public in relation to George Floyd's murder. We were in the aware and disempowered position feeling, you know, helpless, enraged, grief-stricken, furious besides ourselves and that's the yellow square. And what happens is that people, and this is now the square that you haven't heard about.
Dr. Keith Sutton, Psy.D: (21:21)
Sure.
Kaethe Weingarten, Ph.D.: (21:22)
Kind of a short-term remedy for how awful that yellow square is feeling aware, but disempowered. People will move over into thinking, you know, I can't deal with it. So they withdraw, they isolate, they numb out, and they use alcohol. This has been happening if you think about it, just sort of in terms of what we know is happening during the pandemic. You know, we have way more opioid use, way more alcohol use, obviously way more streaming internet use. And you know, some of it is taking a break from let's say you're a healthcare worker and you don't have adequate PPE, and you are disempowered by virtue of the fact that you don't have the equipment you need. You know you're, let's say you're in India, they've run out of oxygen. So you're doing your job, but you're completely aware of what's needed. You cannot provide it. You are in that yellow square, you are disempowered by virtue of the fact that you don't have the resources, the external resources you need to do your job. If that healthcare worker goes home and says, you know, “I can't deal. I just have to move out.” You know, more power to you. You know, you're gonna go back the next day. If that's what you need to do.
Dr. Keith Sutton, Psy.D: (22:59)
A mental break.
Kaethe Weingarten, Ph.D.: (23:00)
Take a break. I mean, that's probably not the best-taking care of yourself. If what you're doing is, you know, drinking a lot, or shooting up, or whatever. You can understand it, but it's a temporary fix. And the only thing that really works is to figure out ways of moving up into that green square, not moving over, even though temporarily. Yes, we all do that. You know, if I've had a 12-hour work day, I'm fine streaming some stupid Netflix show.
Dr. Keith Sutton, Psy.D: (23:39)
Sure, sure, sure.
Dr. Keith Sutton, Psy.D: (23:43)
So maybe you move over like to move over to the unaware kind of side of things,
Kaethe Weingarten, Ph.D.: (23:46)
Right, I mean, by virtue of the fact that you're unaware, you're disempowered, right? I mean, yeah. So, you know, for the most part.
Dr. Keith Sutton, Psy.D: (23:56)
So like kind of temporarily unaware, just kinda zoning out, not having to think about it, not gonna deal because the being in that disempowered. But aware, knowing that things should be different, but having no ability to make that change is just very overwhelming.
Kaethe Weingarten, Ph.D.: (24:12)
It's overwhelming, it's exhausting. It's chronically exhausting physiologically. We know that there are health consequences and physical health consequences. As well, high measures of anxiety, depression, and PTSD symptoms tend to be developing when people are in an aware but disempowered position. Yeah, and even before the pandemic, I would say that presenting this model to service providers, healthcare providers in many, many, many different parts of the world. It's actually the yellow square, that aware and disempowered position that the majority of people say they are in, you know, temporarily people can feel aware and empowered for sure. But you know, globally healthcare workers sadly are so frequently under-resourced.
Kaethe Weingarten, Ph.D.: (25:14)
Either internally they lack the training, they would love to have access to, but don't, or they lack the external resources to provide the care that they know needs to be provided. Yeah, and that's a chronically stressful position to be in. So maybe I could fast forward and just say something about, as I did say this, but I'll just say it again because it's so important. All of the work that we do in the witness-to-witness program is about simplifying and presenting ways of moving up into the aware and empowered position. And I'll kind of jump way ahead to my I think most effective statement when I do these online seminars or the peer support groups. That your brain cannot tell the difference between whether or not you have solved the biggest problems that we have.
Kaethe Weingarten, Ph.D.: (26:24)
Like, let's say world hunger, let's say your goal is to solve world hunger. Your brain cannot tell the difference between them. And when you woke up in the morning, you said you were gonna make dinner. If at the end of the day, you've made dinner, you'll get a squirt of endorphin and you will feel better. So it turns out that setting modest goals and achieving them is actually one way of creating a steady diet of feeling aware and empowered and you just feel better. So W2W is all about kind of coming up with these ways that people can move up and not rely on, you know, moving over. But then I can also tell you about, so what is W2W?
Dr. Keith Sutton, Psy.D: (27:21)
Well, and so to just see if I'm getting this right. So, I thought of climate change popped into my head, it's like when sometimes people really think about it and think about all that's going on, and then they kind of get overwhelmed. For example, how can I have an effect? There's so much that needs to be done that sometimes then they just kind of go-to tuning it out, not thinking about it, kind of avoiding it and just like, see it in the paper and like, Ooh, that's bad. And moving on versus kind of, it sounds like what you're saying is that by kind of engaging with that but then taking kind of a small action. So when the person is like, okay, I'm doing this to help with climate change even though it's a small step. It ends up giving that same kind of some more effect of moving into that kind of aware and empowered kind of quadrant.
Kaethe Weingarten, Ph.D.: (28:06)
Yes, and I mean I'm not being a fool and thinking that if everybody contented themselves with, you know, making dinner then the world would be rosy now. Saying, you know, the perspective and the objective, if you will, of this particular program, the witness to witness program, is to work with service providers and healthcare providers, childcare workers. People who are essential workers who work with the vulnerable well, who work with people who've been made vulnerable by very specific policies, including racist ones. We are aiming to help those people feel better day by day so that they can continue to provide the absolutely critical services that they do. Our goal in W2W is actually not to solve climate change but to help assist a workforce that's under tremendous, tremendous strain. So that little kind of, you know, I don't know, it isn't really foolish. It's actually the, you know, it's neurologically accurate, your brain has the difference.
Kaethe Weingarten, Ph.D.: (29:30)
And even to, you know, being able to say that is not foolish, and here's a distinction. This is one of the ideas that is also central to the program. And I know, I need to tell you what the program is but the difference between something that's small and something that's trivial. So the distinction between solving world hunger or your brain doesn't know the difference, or, you know, set a goal, say you're gonna cook dinner or, you know, say you're gonna recycle this week. Those things are small but actually, they're not trivial. And so you couldn't fool your brain into releasing those endorphins if you were doing something that was trivial. But you can, if it's something that's small and meaningful. And in the sense that it's a proxy of the greater good you're trying to achieve.
Dr. Keith Sutton, Psy.D: (30:37)
I was just thinking about this. So some of the work that I do with clients. Sometimes there's a lot of shame and a lot of that shame comes up and then leads to avoidance, which means to them more shame because they're not actually dealing with the problem and so on. And so oftentimes the way I say the anti to shame is their integrity, like kind of taking responsibility or making contact with whatever went wrong or what the problem is. Which often creates a lot of distress and then trying to do something, learn something from that, make amends and then take the next step in the right direction. So a lot of my work, for example, is with adults, with ADHD, even though they might have screwed up yesterday, I can kind of say if we can kind of then at least get on the right track today and do those things. That when we're going in the direction of our values and taking those steps in the direction of our values, we tend to feel better.
Dr. Keith Sutton, Psy.D: (31:25)
And it sounds like this is kind of a similar thing that when you're making those small steps and in the direction, your values, you're saying neurologically, it produces that reaction to feeling better. And I remember even a talk with Russell Barkley on happiness and how one researcher kind of talked about how happiness is taking the steps in the directions of your goals and values and that, those kinds of small steps produce that neurological effect. And so kind of what you're saying is now applying this to these larger, huge kinds of global societal issues. Especially for many of these, I guess they're mostly professionals, you know, professionals, especially those trying to provide these services to an overwhelming problem. Really kind of connecting them to, you know, those steps that they're taking that is towards this goal along these values. Which can help kind of sustain them or kind of, you know, help them get that experience to kind of continue to move forward rather than vacillating between overwhelmed and shutting down or kind of self-medicating or numbing.
Kaethe Weingarten, Ph.D.: (32:37)
Right, that's exactly right. So let me tell you about the origin of the W2W program. And as I had mentioned it came out of work that I had been doing for four years kind of under the umbrella of the witnessing project. That brought me to many postconflict societies and also worked with primarily hospital systems so I was always able to write about and lecture in these two domains. Witnessing in the context of illness, dying, and death and witnessing in the context of violence and violation. So, I was at an AFTA, American family therapy academy, conference in Austin in 2018. And on the day after there was a workshop and it was a workshop on what was happening at the border and there was a woman who was on the panel.
Kaethe Weingarten, Ph.D.: (33:39)
Her name is Dell Garcia, who kind of broke a little bit from her PowerPoint and with a tremendous amount of effect talked about the impact on the clinicians, the attorneys, and the service providers who were dealing with people at various stages of the detention process. We, at that moment, weren't really aware that there were children in cages. So we weren't quiet, that was not the focus of her distress, about the distress that people she was working with were feeling. But during the Q and A, I raised my hand and said, “you know, what kind of support services are there for the people working at the border?” And she said, none. '' So I said, “well, meet me during the break, meet me in the back of the auditorium, let's talk.” And so she did, we met and we exchanged cards and I said, “you know, I've developed programs like this kind of long-distance support for service providers, clinicians, and I hadn't worked with attorneys, you know, let's talk.”
Kaethe Weingarten, Ph.D.: (34:56)
So, I contacted her shortly thereafter. This meeting was at the beginning of June and really by a month later with folks at the American Family Therapy Academy, I created the witness-to-witness program. And initially, it was a program to pair and we had eight AFTA volunteers to pair individual clinicians who have experienced trauma, clinicians or clinicians who had trauma experience with people working at the border. Whether they were clinicians, physicians, social workers, or attorneys within a year, we doubled in size in terms of the number of volunteers. And by 18 months we had quadrupled in size. So we had about 40 volunteers, some of whom were bilingual, and also the work that we did proliferated because we had the one-on-one individual conversation component. We had peer support groups.
Kaethe Weingarten, Ph.D.: (36:13)
We had online seminars, you know, that's what I call them. They are webinars and consultations with the agencies on the ground. And for the first 20 months, we were focused entirely and only on people who were working in immigration. But you know, as people who, or that is to say, you know, detainees, asylum seekers who arrive at the border don't necessarily stay at the border. They can fan out all over the country. So we had W2W volunteers in every time zone, and we were working with hundreds of people, you know, who were practicing, whether they were practicing lawyers or, practicing physicians all over the country. So after the events in El Paso, the murders happened in El Paso, which was August. On the first weekend of August 2019, the request for our services just exploded.
Kaethe Weingarten, Ph.D.: (37:42)
The shooting at Walmart in El Paso in the Walmart parking lot. At one point the day, in the days after W2W was getting six requests for service per hour. So I began working 60-70 hours a week. Now I'm only working 55 hours and it's much better, much easier. But it became clear that the program was, you know, expanding and there's one person doing the administration, doing the online seminars, doing the work. You know, we had a cadre of volunteers who were, you know, doing the one-on-one, but I really needed support. And at that point, began a process and a couple of months later of looking for an organization that would sponsor and becomes the home for the W2W program.
Kaethe Weingarten, Ph.D.: (38:57)
That happened through the migrant clinicians network and it's just been, you know, kind of the formal legal process that finished in February of 2020. And at that point, I was kind of a little satellite and now I'm completely absorbed. I'm inside the tent and it's just been phenomenal to work with them. They have a 35-year history of serving populations that have been made, you know, vulnerable by very specific policies. It's a health justice, racial justice organization. All of the social justice values that animate the work of W2W fit, completely within the values of the organization.
Dr. Keith Sutton, Psy.D: (39:56)
Okay. Wow. So it sounds like the witness-to-witness work is not necessarily only kind of applicable to the folks working with migrant folks but more that it ended up kind of becoming that was kind of the origin and kind of that ended up being the housing. Is that right? But is it also something that applies to other systems or is it mostly, just generally, within the context of people working with folks with migrant issues?
Kaethe Weingarten, Ph.D.: (40:30)
We work with and I think this phrase is important. I'm making a distinction between vulnerable populations, and populations that have been made vulnerable by specifically targeted policies. So yes, folks who are migrants, agricultural workers, and farm workers, have been made vulnerable by specific policies globally, not just in the United States. But we work with the people who work with populations that have been made vulnerable. And, you know, in this now we're just focusing on the United States, there are a lot of populations that have been made vulnerable, right? So we don't only work with let's say clinicians who are working with migrants, we work with clinicians childcare, you know, people who are providing services to populations who are made vulnerable by very specific policies.
Dr. Keith Sutton, Psy.D: (41:45)
And it sounds like this also would apply to like you were saying, even the people affected by 9/11 or like, you know, shootings that happen or, healthcare workers with COVID or these kinds of things. Kind of anybody falling, you know, the support staff or the frontline workers. I guess these situations are kind of, you know, witnessing what's happening.
Kaethe Weingarten, Ph.D.: (42:16)
Yes. That's right, but I mean, not just witnessing. I mean, we work with the people providing service.
Dr. Keith Sutton, Psy.D: (42:24)
Yeah. Do you consider them witnesses? I mean, is that the cause? They're the providers of the services in that witness position?
Kaethe Weingarten, Ph.D.: (42:35)
They absolutely are. I mean, what we know is that, and the frame that we use is that they are overexposed to stories of hardship. And that takes a toll and yes we work very, very hard to help people understand that they are witnesses and that they're, you know, exhausted. They're, I mean, we work with a lot of healthcare workers. I just finished a learning collaborative for managers or people in mid-level management positions working in federally qualified health centers. And, you know, the addition of the pandemic onto the work that they do is just, you know, they're in that sandwich position. You know, having to account to, or be accountable to the CEO level or the C level and the hierarchy, but responsive to their staff who are, I mean, they're dealing of course with client populations, but so are their staff. Yes, they are absolutely witnesses.
Dr. Keith Sutton, Psy.D: (43:54)
Yeah, so tell me a little bit about it, yeah. So what does that look like? What's, you know, what does that look like when you're supporting, I was gonna say an organization, but it sounds like you're supporting a population. Like you're saying that of people that are, you know, kind of supporting this group that's in need of lawyers or childcare or clinicians or so on. You know, what does that look like?
Kaethe Weingarten, Ph.D.: (44:25)
So what W2W provides is, you know, at the moment, there are 15 online seminars that an organization can request. And they range from, how to manage stress right now, and what can you do to feel better right now, to how to understand the impact of the pandemic on children in adolescence or grief. Not just, you know, grief kind of generally, but particular forms of grief that we think have not gotten much recognition. So what is called disenfranchised grief and the kind of grief that comes from losses that you don't feel, that you can share with other people? You know, for a variety of reasons, you mentioned shame. There's a lot of shame that people feel because they do feel grief that their cat died or they can't take a trip that they wanted to. But then they compare themselves to, you know, the people who are really suffering or the people who lost, who had a partner die.
Kaethe Weingarten, Ph.D.: (45:50)
Sure there's a lot of loss that people have experienced that they don't qualify for and don't believe is legitimate. And so, you know, that's a topic, that's something that we talk about, particularly with complex. So there are these online seminars that we do. There are peer support groups where, you know, the research literature is pretty clear that peer support is probably the most effective and in some ways the most efficient way of delivering support to service providers at this time. And, you know, one of the reasons is because healthcare workers in particular attorneys also really suffer from mental health stigma. That individual therapy might really be helpful, but people are afraid to use it. They're afraid to use their insurance to pay for it because it'll be on their records.
Kaethe Weingarten, Ph.D.: (47:01)
But peer support is something that is generally felt to be legitimate by people, you know, in an organization and the research shows that it's highly effective. So that is another aspect of what we do. And in those conversations, last week I did an entire peer support group on how to understand hope, and I made the contrast. This is also something that I've been writing about for 20 years. A contrast between what I call rainbow hope which is anticipating a future that will be better, with what I call reasonable hope and reasonable hope is a practice. It's a verb. It's something that we do and it's making sense of the present now. And so talking with people about the elements of reasonable hope of which there are six, but we in the group, we talk about four. It is really helpful to people, people get the difference between rainbow hope and reasonable hope really, really quickly. And, just the idea that, yes, it's a feeling of course, but it's something that you do with others. It's a practice, it's interpersonal and you set goals and you identify pathways toward them, and you're gonna feel better.
Dr. Keith Sutton, Psy.D: (48:43)
I would actually love to hear the reasonable hope kind of what you said there.
Dr. Keith Sutton, Psy.D: (48:50)
Did you say there were six forms of reasonable hope?
Kaethe Weingarten, Ph.D.: (48:53)
There are six characteristics of reasonable hope.
Dr. Keith Sutton, Psy.D: (48:58)
What are those?
Kaethe Weingarten, Ph.D.: (49:00)
The ones that I've just mentioned.
Kaethe Weingarten, Ph.D.: (49:05)
I'm happy to, I mean, I don't know if you ever attach handouts, but I have a short three-page handout on reasonable hope.
Dr. Keith Sutton, Psy.D: (49:12)
Yeah, I could put a link to it. I haven't heard that and I like that because oftentimes, especially working with people with depression, you know, it's hard to have hope. I think, you know, I am interested to look more into that.
Kaethe Weingarten, Ph.D.: (49:29)
One of the first places in writing was where I introduced the concept of reasonable hope. I was living in Boston at the time, and I was consulted by a woman who had metastatic breast cancer. And she came, she was very depressed and she said, “I have no hope.” And I said to her, “you know, really, it's not your responsibility at this point to feel hope, it's the responsibility of your community to do hope with you.” And, you know, that really shifted the frame for her and her goal was to live. She had young children and to see both of her children graduate from high school was her goal. I'm happy to say, even though she literally died within days of the younger child graduating, she did in fact live. And she did it with the supportive community who, without a doubt did hope with her, but reasonable hope, not rainbow.
Dr. Keith Sutton, Psy.D: (50:41)
Wow. Interesting. Very, very good, very powerful. So as we're kind of nearing the end of our time here I was wondering if you could talk about maybe for some clinicians that are hearing about this, the social justice kind of movement in therapy and particularly at AFTA. I actually haven't unfortunately been as involved in the last several years. I've got young children so I've kinda scaled back a bit. But, particularly I know in AFTA there's been a lot of movement in kind of broadening systems from just kind of a family system to really kind of looking at larger systems and particularly the integration of the social justice approach therapy. I was wondering if you could talk a little bit about what that even means.
Kaethe Weingarten, Ph.D.: (51:35)
So I do feel like there are very clear social justice implications of the W2W support programs, and I can speak to some of them for our work is explicitly political.
Dr. Keith Sutton, Psy.D: (51:52)
I was even wondering for the people who don't understand what social justice therapy means.
Kaethe Weingarten, Ph.D.: (52:00)
Well, I think I'm giving you some sense of what I mean by social.
Dr. Keith Sutton, Psy.D: (52:07)
Perfect.
Kaethe Weingarten, Ph.D.: (52:08)
So we work non hierarchically and collaboratively both internally amongst our staff and externally with our partners, and we collaborate with a range of community groups. Including community health centers, organizations that support migrants, and immigrant legal organizations. We frankly discuss institutional betrayal and systems of oppression, both recent and historical, that's part of the DNA of our conversations. We focus on wellbeing. We talk with people about what they want in their lives. We specifically address health disparities, and we do so from a human rights perspective, our work is culturally respectful and linguistically appropriate. So almost all of our resources are now translated into Spanish. There are a lot of handouts on the website. There are archived webinars or these online seminars that are in both English and Spanish.
Kaethe Weingarten, Ph.D.: (53:17)
We nest ideas about individual resilience inside models of peer support, family resilience, community resilience, historical resilience, cultural resilience, and organizational resilience. So I think all of those are ways of understanding how social justice can be enacted or instantiated in direct service work.
Dr. Keith Sutton, Psy.D: (53:51)
Wonderful. Well, it sounds like you're doing wonderful work and I really appreciate you taking the time. And, it was really helpful to kind of understand that concept of witness and how you apply that into supporting, you know, all these folks that are supporting these people that end up being disempowered by particular policies. And really kind of that aspect of the social justice work that you're doing. So I really appreciate your time and thank you so much.
Kaethe Weingarten, Ph.D.: (54:25)
Thank you for giving me the opportunity.
Dr. Keith Sutton, Psy.D: (54:28)
Great, and I look forward to getting that handout on the reasonable hope and I'll definitely link to it on the website. Well, thanks a lot. I appreciate you joining us today.
Kaethe Weingarten, Ph.D.: (54:40)
Thank you. Good Bye.
Dr. Keith Sutton, Psy.D: (54:40)
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Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advancements in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area and the director of the Institute for The Advancement of Psychotherapy. Today, I'll be speaking with Kaethe Weingarten, Ph.D., who is a psychologist and director of the Witness-To-Witness Program for migrant children's networks. Kaethe's work focuses on the development and dissemination of a witnessing model. Part of her work is on the effects of witnessing violence and trauma in the context of domestic, interethnic, racial, political, and other forms of conflict. She has published numerous articles, chapters, essays, and books, including her book, Common Shock Witnessing Violence Every Day. And she serves on the editorial boards of five professional journals. She has taught and spoken in numerous contexts in the United States and internationally as well as founded and directed the program and families, trauma and resilience at the Family Institute of Cambridge. Let's listen to the interview. Okay, well welcome. Hi Kaethe, Thanks for joining us today.
Kaethe Weingarten, Ph.D.: (01:27)
My pleasure.
Dr. Keith Sutton, Psy.D: (01:29)
So I heard a bit about your work from a mutual colleague of ours. Becky Pizer, who's over at the Wright Institute and involved with our organization, The Association of Family Therapists, Northern California, also, AFTA the American family therapy academy. And in a conversation with her, I was talking and she was saying about how her recent interests have been in kind larger systemic and social justice work. And, I was asking about maybe talking about some of this and she was saying, “actually, you know, Kaethe would be a great person to discuss this with.” And the innovative work that you're doing with your Witness-To-Witness program so I'd love to hear more about that. And particularly too, I always like to hear people's story about, you know, kind of the evolution of their career and their thinking and kind of what led up to the work that they're doing now. So, nice to meet you Kaethe, and thank you for taking the time.
Kaethe Weingarten, Ph.D.: (02:23)
Well, nice to meet you and for giving me this opportunity to situate the work that I'm doing now in essentially a life story in an autobiography and a professional biography as well. So, I do feel, and you're a family therapist as am I, that my family position set me up for both the politics of my work and the social justice aspect. But the particular content because I think more than anything, I was in fact, a witness in my family. So, I'm going to say a little bit about what I mean by a witness and, you know, I think to link it to the current moment because it's a difficult concept. The easy thing to say is that I have been working on a model of witnessing for the last 30-35 years.
Kaethe Weingarten, Ph.D.: (03:29)
I think it actually started in the early 1970s when I was a witness to my mother's cancer diagnosis and the way it was handled in our family. But I think it's easy to say that the witnessing model has to do with combining bystander theory and trauma theory which is the conceptual or theoretical foundation of the model of witnessing that I'm using. But I think that I could just give you the example that is pretty much in every mainstream media account that I have been reading this past week really working around the Derek Jovin trial. It has named the witnesses on the stand and the young woman, Darnell Fraser, as a bystander, and to me, this is absolutely the incorrect term to understand her experience. She was absolutely a witness.
Kaethe Weingarten, Ph.D.: (04:43)
And in my model, there are four positions, not one. And the position that she was in, as were so many of the other people who were there and then who took the stand. And then as well as, a global audience who either actually saw the video or heard about it. We were in the aware but disempowered position, and the effects on people, of being in an aware but disempowered position are similar to but not identical to being a victim of violence and, or violation. And the other position in the model, they're four, but just to be sure to connect it to current events, the police officers were in the most dangerous position. The fourth position, which is unaware of what they were doing, presumably or at least that was what they said, but empowered to do exactly what they did.
Kaethe Weingarten, Ph.D.: (05:50)
They were authorized by the state, but they were witnesses to somebody who was dying and they were unaware. So many people, when I initially talk about witnessing go, “well, you know, what's the difference between that and being a bystander”, but I think most people viscerally, and physically know the difference in themselves. You know we were not bystanders. We were brought into an experience that was horrific and traumatizing. As it was traumatizing for so many people in the world. And just one other example, and then I can kind of go back to the biography. But you know, the heart of what I do and what I'm talking about is witnessing. I finally, you know, after a decade submitted a book proposal which is the book Common Shock, but I submitted it on September 8th.
Kaethe Weingarten, Ph.D.: (06:56)
I submitted it to four publishers in New York City, on September 8th, 2001. And on September 10th, my agent said, “I don't really understand. It's a great proposal, and we're not getting any offers.” On September 13th there was a bidding war for the book and every single person said, “now I understand. Now I understand because September 11th had happened.” And so what had been kind of an odd usage of a term for them suddenly they actually understood viscerally also. That, yes, they were witnesses. They were not bystanders and, you know, there was a lot to understand about it. So that's just to kind of state from the beginning that all of the work that I've been doing really for the last 30-35 years has been about witnessing and primarily in two domains. So if I go back to the first thing that I said, which is about being a witness in my family, I was not a bystander.
Kaethe Weingarten, Ph.D.: (08:13)
I tell you that I was impacted by, you know, the dynamics that I observed in my family. So I guess to kind of speed forward I feel really fortunate that my clinical degree was in a program called clinical psychology and public practice. So right from the beginning, my clinical orientation was always about, and my professors were completely committed to social justice work, public practice, and how to make clinical training responsive to the larger issues of our day and of our time. And I graduated in 1974 or, I mean I got my Ph.D. from Harvard in 1974. Then as I mentioned my mother was diagnosed for the first time with cancer in 1974. And that was an era in which there were laws in New York state where somebody had to be informed of their diagnosis, it was discouraged to tell somebody their prognosis.
Kaethe Weingarten, Ph.D.: (09:39)
And the logic at the time was that it would take hope away and then, you know, they would decline. So my sister, who's older than I, but she and I were violently in disagreement with my mother's physicians and my father who went along with and respected the physicians. And so we, you know, there was a kind of an added layer for me of being aware that my mother was dying but disempowered and helpless in relation to being able to be in conversation with her about that. And there were all kinds of moments that were just excruciating because she was confused about what was happening and didn't really, you know, she didn't have a frame to understand what was happening.
Kaethe Weingarten, Ph.D.: (10:48)
So I would say that kind of, from that point in 1979, my husband and I had our second child and she was born with a very rare genetic disorder that required multiple hospitalizations and procedures. And at that time, I mean, you may remember the history of how the DSM has evolved over time. But it wasn't until in the 1990s, that if you were a parent of a child, let's say you had a child who was going through chemotherapy or some horrific operation, and you were a witness to that. There was nothing in the DSM that indicated that you might have symptoms of trauma or be traumatized by that. There was no concept for that. Well, I knew that I was completely traumatized by having a doctor tell me when my child was four hours old that she might not live.
Kaethe Weingarten, Ph.D.: (11:59)
She's now I should say a social epidemiologist tenured professor at San Jose State. She did live, but it took a long time. It took a lot of years before we knew what that trajectory was going to be. So the witnessing model kind of developed in two arenas. One was what it means to be a witness in the context of medical illness. Dying in death and then what it means to be a witness in the context of violence and violation. And in particular, I was the clinical director of a sexual abuse team in the Boston region. So I was very interested, particularly in the experience of the non-offending parent who was, you know, again in the witness position. So I was interested in these issues of violence and violation and at a kind of a domestic level, but then also kind of scaling up in post-conflict societies. I had some experience with and then did an intensive study of five different genocides, where again, it seemed to me that the concept of a witness was crucial to understanding what was happening.
Kaethe Weingarten, Ph.D.: (13:31)
In the late 1990s, I began doing work in South Africa. That was a location where it was really possible to put together the construct of witnessing both in the illness domain, which had been a really important strand of my career because that was the era of the aids pandemic when antiretroviral medications were not available in South Africa but it was also both a conflict zone sure and a post-conflict zone in terms of the apartheid era. And so the witnessing paradigm probably in South Africa, more than anywhere else, was completely understandable to everybody. It was such a strong fit for them. They got it absolutely immediately and it really permitted tri-racial conversations. Not just dialogues but, you know, conversations amongst Africans and Afrikaners and English-speaking people in a way that prior language terms hadn't been as effective, particularly the concepts of bystander or beneficiary.
Dr. Keith Sutton, Psy.D: (15:11)
Yeah.
Kaethe Weingarten, Ph.D.: (15:11)
Was often a roadblock to the kinds of working alliances that people absolutely desperately needed to have to deal with the aids pandemic. But the concept of witnessing and that it's possible that somebody would witness something and actually freeze. In other words, once you incorporate trauma theory.
Dr. Keith Sutton, Psy.D: (15:35)
Yeah.
Kaethe Weingarten, Ph.D.: (15:35)
You understood that there were multiple positions, fight, flight, freeze, FAW, and flounder that you know, could arise out of being in the witness position suddenly. Avenues of communication open that had really been closed to people or that's what I've been told. So I think that's just an answer to one question.
Dr. Keith Sutton, Psy.D: (16:04)
No, this is good. In part, I wanna just make sure that I'm comprehending the witnessing because actually when I was originally thinking of witnessing and your witness-to-witness program, I was thinking of my past narrative therapy training. And kind of the concept of witness and kind of bringing witness into, you know, either through reflecting team or into the session or somebody from the larger system. But it sounds like what you're saying is that the witness position is really kind of the variance of those who may not have necessarily been even directly experiencing the trauma themselves, but then kind of witness to it. But that witness is the experience of trauma. You know, they may not have been in the building at 9/11, but watching on TV or being in the area or being a first responder. This idea of being involved and affected by and having kinda words for that.
Kaethe Weingarten, Ph.D.: (17:05)
Yeah, exactly and I'm happy to or I'm imagining some of the people listening to the podcast are wondering how it relates to the narrative or Michael White's construct of witnessing. And that's something, you know, I worked with Michael from the early 1980s on. And he was very aware of our kind of having these two different tracks, if you will, of developing the construct of witnessing. Mine really does come from, or the point of origin is around moving bystander theory and trauma theory together, merging them. And for Michael, that's not a point of origin of the construct of witnessing, but it is about reflection, and both CT and X. I have written an article called the art of reflection and that really does, I would say, merge the narrative understanding of witnessing with the witnessing model. And I also think that in the now sort of bumping, you know, ahead to the witness-to-witness project. That the way we do the work that we do is very much influenced by narrative ideas. So there's gonna be a connection, you know, that I can make for you but that, I probably wouldn't do it right at this moment.
Dr. Keith Sutton, Psy.D: (18:54)
Okay, no problem. That's coming up and actually speaking of coming up. I'm dying to hear the other two witness positions, but maybe we'll save that for a little bit later
Kaethe Weingarten, Ph.D.: (19:05)
Yeah, I think that's probably a good idea. So, the witnessing model you can think of as having two axes so it's a little bit difficult, I think, for people to hear it and imagine it. But I think of it as there four squares and across the top, that would be the word aware and unaware. And then on the left-hand side on the top would be the word empowered and on the bottom would be disempowered.
Dr. Keith Sutton, Psy.D: (19:43)
Mm. Okay.
Kaethe Weingarten, Ph.D.: (19:45)
And if you imagined then that your top left square is the coming together of an aware and empowered position. And I call that the green square because I'm kind of thinking, trying to simplify it and there's gonna be an analogy to the, you know, a traffic light. So all of the work that I've done and the witness-to-witness program comes out of a project called the witnessing project, but it all, what we're trying to do in every instance is to help people move into the aware and empowered position. Because that's really the only place in the long term. Well, certainly, well let's just say in the long term, you can only be effective if you're in the aware and empowered position.
Dr. Keith Sutton, Psy.D: (20:43)
Sure.
Kaethe Weingarten, Ph.D.: (20:44)
The one that's below, which is aware and disempowered, where I mentioned that the witnesses, and really the global public in relation to George Floyd's murder. We were in the aware and disempowered position feeling, you know, helpless, enraged, grief-stricken, furious besides ourselves and that's the yellow square. And what happens is that people, and this is now the square that you haven't heard about.
Dr. Keith Sutton, Psy.D: (21:21)
Sure.
Kaethe Weingarten, Ph.D.: (21:22)
Kind of a short-term remedy for how awful that yellow square is feeling aware, but disempowered. People will move over into thinking, you know, I can't deal with it. So they withdraw, they isolate, they numb out, and they use alcohol. This has been happening if you think about it, just sort of in terms of what we know is happening during the pandemic. You know, we have way more opioid use, way more alcohol use, obviously way more streaming internet use. And you know, some of it is taking a break from let's say you're a healthcare worker and you don't have adequate PPE, and you are disempowered by virtue of the fact that you don't have the equipment you need. You know you're, let's say you're in India, they've run out of oxygen. So you're doing your job, but you're completely aware of what's needed. You cannot provide it. You are in that yellow square, you are disempowered by virtue of the fact that you don't have the resources, the external resources you need to do your job. If that healthcare worker goes home and says, you know, “I can't deal. I just have to move out.” You know, more power to you. You know, you're gonna go back the next day. If that's what you need to do.
Dr. Keith Sutton, Psy.D: (22:59)
A mental break.
Kaethe Weingarten, Ph.D.: (23:00)
Take a break. I mean, that's probably not the best-taking care of yourself. If what you're doing is, you know, drinking a lot, or shooting up, or whatever. You can understand it, but it's a temporary fix. And the only thing that really works is to figure out ways of moving up into that green square, not moving over, even though temporarily. Yes, we all do that. You know, if I've had a 12-hour work day, I'm fine streaming some stupid Netflix show.
Dr. Keith Sutton, Psy.D: (23:39)
Sure, sure, sure.
Dr. Keith Sutton, Psy.D: (23:43)
So maybe you move over like to move over to the unaware kind of side of things,
Kaethe Weingarten, Ph.D.: (23:46)
Right, I mean, by virtue of the fact that you're unaware, you're disempowered, right? I mean, yeah. So, you know, for the most part.
Dr. Keith Sutton, Psy.D: (23:56)
So like kind of temporarily unaware, just kinda zoning out, not having to think about it, not gonna deal because the being in that disempowered. But aware, knowing that things should be different, but having no ability to make that change is just very overwhelming.
Kaethe Weingarten, Ph.D.: (24:12)
It's overwhelming, it's exhausting. It's chronically exhausting physiologically. We know that there are health consequences and physical health consequences. As well, high measures of anxiety, depression, and PTSD symptoms tend to be developing when people are in an aware but disempowered position. Yeah, and even before the pandemic, I would say that presenting this model to service providers, healthcare providers in many, many, many different parts of the world. It's actually the yellow square, that aware and disempowered position that the majority of people say they are in, you know, temporarily people can feel aware and empowered for sure. But you know, globally healthcare workers sadly are so frequently under-resourced.
Kaethe Weingarten, Ph.D.: (25:14)
Either internally they lack the training, they would love to have access to, but don't, or they lack the external resources to provide the care that they know needs to be provided. Yeah, and that's a chronically stressful position to be in. So maybe I could fast forward and just say something about, as I did say this, but I'll just say it again because it's so important. All of the work that we do in the witness-to-witness program is about simplifying and presenting ways of moving up into the aware and empowered position. And I'll kind of jump way ahead to my I think most effective statement when I do these online seminars or the peer support groups. That your brain cannot tell the difference between whether or not you have solved the biggest problems that we have.
Kaethe Weingarten, Ph.D.: (26:24)
Like, let's say world hunger, let's say your goal is to solve world hunger. Your brain cannot tell the difference between them. And when you woke up in the morning, you said you were gonna make dinner. If at the end of the day, you've made dinner, you'll get a squirt of endorphin and you will feel better. So it turns out that setting modest goals and achieving them is actually one way of creating a steady diet of feeling aware and empowered and you just feel better. So W2W is all about kind of coming up with these ways that people can move up and not rely on, you know, moving over. But then I can also tell you about, so what is W2W?
Dr. Keith Sutton, Psy.D: (27:21)
Well, and so to just see if I'm getting this right. So, I thought of climate change popped into my head, it's like when sometimes people really think about it and think about all that's going on, and then they kind of get overwhelmed. For example, how can I have an effect? There's so much that needs to be done that sometimes then they just kind of go-to tuning it out, not thinking about it, kind of avoiding it and just like, see it in the paper and like, Ooh, that's bad. And moving on versus kind of, it sounds like what you're saying is that by kind of engaging with that but then taking kind of a small action. So when the person is like, okay, I'm doing this to help with climate change even though it's a small step. It ends up giving that same kind of some more effect of moving into that kind of aware and empowered kind of quadrant.
Kaethe Weingarten, Ph.D.: (28:06)
Yes, and I mean I'm not being a fool and thinking that if everybody contented themselves with, you know, making dinner then the world would be rosy now. Saying, you know, the perspective and the objective, if you will, of this particular program, the witness to witness program, is to work with service providers and healthcare providers, childcare workers. People who are essential workers who work with the vulnerable well, who work with people who've been made vulnerable by very specific policies, including racist ones. We are aiming to help those people feel better day by day so that they can continue to provide the absolutely critical services that they do. Our goal in W2W is actually not to solve climate change but to help assist a workforce that's under tremendous, tremendous strain. So that little kind of, you know, I don't know, it isn't really foolish. It's actually the, you know, it's neurologically accurate, your brain has the difference.
Kaethe Weingarten, Ph.D.: (29:30)
And even to, you know, being able to say that is not foolish, and here's a distinction. This is one of the ideas that is also central to the program. And I know, I need to tell you what the program is but the difference between something that's small and something that's trivial. So the distinction between solving world hunger or your brain doesn't know the difference, or, you know, set a goal, say you're gonna cook dinner or, you know, say you're gonna recycle this week. Those things are small but actually, they're not trivial. And so you couldn't fool your brain into releasing those endorphins if you were doing something that was trivial. But you can, if it's something that's small and meaningful. And in the sense that it's a proxy of the greater good you're trying to achieve.
Dr. Keith Sutton, Psy.D: (30:37)
I was just thinking about this. So some of the work that I do with clients. Sometimes there's a lot of shame and a lot of that shame comes up and then leads to avoidance, which means to them more shame because they're not actually dealing with the problem and so on. And so oftentimes the way I say the anti to shame is their integrity, like kind of taking responsibility or making contact with whatever went wrong or what the problem is. Which often creates a lot of distress and then trying to do something, learn something from that, make amends and then take the next step in the right direction. So a lot of my work, for example, is with adults, with ADHD, even though they might have screwed up yesterday, I can kind of say if we can kind of then at least get on the right track today and do those things. That when we're going in the direction of our values and taking those steps in the direction of our values, we tend to feel better.
Dr. Keith Sutton, Psy.D: (31:25)
And it sounds like this is kind of a similar thing that when you're making those small steps and in the direction, your values, you're saying neurologically, it produces that reaction to feeling better. And I remember even a talk with Russell Barkley on happiness and how one researcher kind of talked about how happiness is taking the steps in the directions of your goals and values and that, those kinds of small steps produce that neurological effect. And so kind of what you're saying is now applying this to these larger, huge kinds of global societal issues. Especially for many of these, I guess they're mostly professionals, you know, professionals, especially those trying to provide these services to an overwhelming problem. Really kind of connecting them to, you know, those steps that they're taking that is towards this goal along these values. Which can help kind of sustain them or kind of, you know, help them get that experience to kind of continue to move forward rather than vacillating between overwhelmed and shutting down or kind of self-medicating or numbing.
Kaethe Weingarten, Ph.D.: (32:37)
Right, that's exactly right. So let me tell you about the origin of the W2W program. And as I had mentioned it came out of work that I had been doing for four years kind of under the umbrella of the witnessing project. That brought me to many postconflict societies and also worked with primarily hospital systems so I was always able to write about and lecture in these two domains. Witnessing in the context of illness, dying, and death and witnessing in the context of violence and violation. So, I was at an AFTA, American family therapy academy, conference in Austin in 2018. And on the day after there was a workshop and it was a workshop on what was happening at the border and there was a woman who was on the panel.
Kaethe Weingarten, Ph.D.: (33:39)
Her name is Dell Garcia, who kind of broke a little bit from her PowerPoint and with a tremendous amount of effect talked about the impact on the clinicians, the attorneys, and the service providers who were dealing with people at various stages of the detention process. We, at that moment, weren't really aware that there were children in cages. So we weren't quiet, that was not the focus of her distress, about the distress that people she was working with were feeling. But during the Q and A, I raised my hand and said, “you know, what kind of support services are there for the people working at the border?” And she said, none. '' So I said, “well, meet me during the break, meet me in the back of the auditorium, let's talk.” And so she did, we met and we exchanged cards and I said, “you know, I've developed programs like this kind of long-distance support for service providers, clinicians, and I hadn't worked with attorneys, you know, let's talk.”
Kaethe Weingarten, Ph.D.: (34:56)
So, I contacted her shortly thereafter. This meeting was at the beginning of June and really by a month later with folks at the American Family Therapy Academy, I created the witness-to-witness program. And initially, it was a program to pair and we had eight AFTA volunteers to pair individual clinicians who have experienced trauma, clinicians or clinicians who had trauma experience with people working at the border. Whether they were clinicians, physicians, social workers, or attorneys within a year, we doubled in size in terms of the number of volunteers. And by 18 months we had quadrupled in size. So we had about 40 volunteers, some of whom were bilingual, and also the work that we did proliferated because we had the one-on-one individual conversation component. We had peer support groups.
Kaethe Weingarten, Ph.D.: (36:13)
We had online seminars, you know, that's what I call them. They are webinars and consultations with the agencies on the ground. And for the first 20 months, we were focused entirely and only on people who were working in immigration. But you know, as people who, or that is to say, you know, detainees, asylum seekers who arrive at the border don't necessarily stay at the border. They can fan out all over the country. So we had W2W volunteers in every time zone, and we were working with hundreds of people, you know, who were practicing, whether they were practicing lawyers or, practicing physicians all over the country. So after the events in El Paso, the murders happened in El Paso, which was August. On the first weekend of August 2019, the request for our services just exploded.
Kaethe Weingarten, Ph.D.: (37:42)
The shooting at Walmart in El Paso in the Walmart parking lot. At one point the day, in the days after W2W was getting six requests for service per hour. So I began working 60-70 hours a week. Now I'm only working 55 hours and it's much better, much easier. But it became clear that the program was, you know, expanding and there's one person doing the administration, doing the online seminars, doing the work. You know, we had a cadre of volunteers who were, you know, doing the one-on-one, but I really needed support. And at that point, began a process and a couple of months later of looking for an organization that would sponsor and becomes the home for the W2W program.
Kaethe Weingarten, Ph.D.: (38:57)
That happened through the migrant clinicians network and it's just been, you know, kind of the formal legal process that finished in February of 2020. And at that point, I was kind of a little satellite and now I'm completely absorbed. I'm inside the tent and it's just been phenomenal to work with them. They have a 35-year history of serving populations that have been made, you know, vulnerable by very specific policies. It's a health justice, racial justice organization. All of the social justice values that animate the work of W2W fit, completely within the values of the organization.
Dr. Keith Sutton, Psy.D: (39:56)
Okay. Wow. So it sounds like the witness-to-witness work is not necessarily only kind of applicable to the folks working with migrant folks but more that it ended up kind of becoming that was kind of the origin and kind of that ended up being the housing. Is that right? But is it also something that applies to other systems or is it mostly, just generally, within the context of people working with folks with migrant issues?
Kaethe Weingarten, Ph.D.: (40:30)
We work with and I think this phrase is important. I'm making a distinction between vulnerable populations, and populations that have been made vulnerable by specifically targeted policies. So yes, folks who are migrants, agricultural workers, and farm workers, have been made vulnerable by specific policies globally, not just in the United States. But we work with the people who work with populations that have been made vulnerable. And, you know, in this now we're just focusing on the United States, there are a lot of populations that have been made vulnerable, right? So we don't only work with let's say clinicians who are working with migrants, we work with clinicians childcare, you know, people who are providing services to populations who are made vulnerable by very specific policies.
Dr. Keith Sutton, Psy.D: (41:45)
And it sounds like this also would apply to like you were saying, even the people affected by 9/11 or like, you know, shootings that happen or, healthcare workers with COVID or these kinds of things. Kind of anybody falling, you know, the support staff or the frontline workers. I guess these situations are kind of, you know, witnessing what's happening.
Kaethe Weingarten, Ph.D.: (42:16)
Yes. That's right, but I mean, not just witnessing. I mean, we work with the people providing service.
Dr. Keith Sutton, Psy.D: (42:24)
Yeah. Do you consider them witnesses? I mean, is that the cause? They're the providers of the services in that witness position?
Kaethe Weingarten, Ph.D.: (42:35)
They absolutely are. I mean, what we know is that, and the frame that we use is that they are overexposed to stories of hardship. And that takes a toll and yes we work very, very hard to help people understand that they are witnesses and that they're, you know, exhausted. They're, I mean, we work with a lot of healthcare workers. I just finished a learning collaborative for managers or people in mid-level management positions working in federally qualified health centers. And, you know, the addition of the pandemic onto the work that they do is just, you know, they're in that sandwich position. You know, having to account to, or be accountable to the CEO level or the C level and the hierarchy, but responsive to their staff who are, I mean, they're dealing of course with client populations, but so are their staff. Yes, they are absolutely witnesses.
Dr. Keith Sutton, Psy.D: (43:54)
Yeah, so tell me a little bit about it, yeah. So what does that look like? What's, you know, what does that look like when you're supporting, I was gonna say an organization, but it sounds like you're supporting a population. Like you're saying that of people that are, you know, kind of supporting this group that's in need of lawyers or childcare or clinicians or so on. You know, what does that look like?
Kaethe Weingarten, Ph.D.: (44:25)
So what W2W provides is, you know, at the moment, there are 15 online seminars that an organization can request. And they range from, how to manage stress right now, and what can you do to feel better right now, to how to understand the impact of the pandemic on children in adolescence or grief. Not just, you know, grief kind of generally, but particular forms of grief that we think have not gotten much recognition. So what is called disenfranchised grief and the kind of grief that comes from losses that you don't feel, that you can share with other people? You know, for a variety of reasons, you mentioned shame. There's a lot of shame that people feel because they do feel grief that their cat died or they can't take a trip that they wanted to. But then they compare themselves to, you know, the people who are really suffering or the people who lost, who had a partner die.
Kaethe Weingarten, Ph.D.: (45:50)
Sure there's a lot of loss that people have experienced that they don't qualify for and don't believe is legitimate. And so, you know, that's a topic, that's something that we talk about, particularly with complex. So there are these online seminars that we do. There are peer support groups where, you know, the research literature is pretty clear that peer support is probably the most effective and in some ways the most efficient way of delivering support to service providers at this time. And, you know, one of the reasons is because healthcare workers in particular attorneys also really suffer from mental health stigma. That individual therapy might really be helpful, but people are afraid to use it. They're afraid to use their insurance to pay for it because it'll be on their records.
Kaethe Weingarten, Ph.D.: (47:01)
But peer support is something that is generally felt to be legitimate by people, you know, in an organization and the research shows that it's highly effective. So that is another aspect of what we do. And in those conversations, last week I did an entire peer support group on how to understand hope, and I made the contrast. This is also something that I've been writing about for 20 years. A contrast between what I call rainbow hope which is anticipating a future that will be better, with what I call reasonable hope and reasonable hope is a practice. It's a verb. It's something that we do and it's making sense of the present now. And so talking with people about the elements of reasonable hope of which there are six, but we in the group, we talk about four. It is really helpful to people, people get the difference between rainbow hope and reasonable hope really, really quickly. And, just the idea that, yes, it's a feeling of course, but it's something that you do with others. It's a practice, it's interpersonal and you set goals and you identify pathways toward them, and you're gonna feel better.
Dr. Keith Sutton, Psy.D: (48:43)
I would actually love to hear the reasonable hope kind of what you said there.
Dr. Keith Sutton, Psy.D: (48:50)
Did you say there were six forms of reasonable hope?
Kaethe Weingarten, Ph.D.: (48:53)
There are six characteristics of reasonable hope.
Dr. Keith Sutton, Psy.D: (48:58)
What are those?
Kaethe Weingarten, Ph.D.: (49:00)
The ones that I've just mentioned.
Kaethe Weingarten, Ph.D.: (49:05)
I'm happy to, I mean, I don't know if you ever attach handouts, but I have a short three-page handout on reasonable hope.
Dr. Keith Sutton, Psy.D: (49:12)
Yeah, I could put a link to it. I haven't heard that and I like that because oftentimes, especially working with people with depression, you know, it's hard to have hope. I think, you know, I am interested to look more into that.
Kaethe Weingarten, Ph.D.: (49:29)
One of the first places in writing was where I introduced the concept of reasonable hope. I was living in Boston at the time, and I was consulted by a woman who had metastatic breast cancer. And she came, she was very depressed and she said, “I have no hope.” And I said to her, “you know, really, it's not your responsibility at this point to feel hope, it's the responsibility of your community to do hope with you.” And, you know, that really shifted the frame for her and her goal was to live. She had young children and to see both of her children graduate from high school was her goal. I'm happy to say, even though she literally died within days of the younger child graduating, she did in fact live. And she did it with the supportive community who, without a doubt did hope with her, but reasonable hope, not rainbow.
Dr. Keith Sutton, Psy.D: (50:41)
Wow. Interesting. Very, very good, very powerful. So as we're kind of nearing the end of our time here I was wondering if you could talk about maybe for some clinicians that are hearing about this, the social justice kind of movement in therapy and particularly at AFTA. I actually haven't unfortunately been as involved in the last several years. I've got young children so I've kinda scaled back a bit. But, particularly I know in AFTA there's been a lot of movement in kind of broadening systems from just kind of a family system to really kind of looking at larger systems and particularly the integration of the social justice approach therapy. I was wondering if you could talk a little bit about what that even means.
Kaethe Weingarten, Ph.D.: (51:35)
So I do feel like there are very clear social justice implications of the W2W support programs, and I can speak to some of them for our work is explicitly political.
Dr. Keith Sutton, Psy.D: (51:52)
I was even wondering for the people who don't understand what social justice therapy means.
Kaethe Weingarten, Ph.D.: (52:00)
Well, I think I'm giving you some sense of what I mean by social.
Dr. Keith Sutton, Psy.D: (52:07)
Perfect.
Kaethe Weingarten, Ph.D.: (52:08)
So we work non hierarchically and collaboratively both internally amongst our staff and externally with our partners, and we collaborate with a range of community groups. Including community health centers, organizations that support migrants, and immigrant legal organizations. We frankly discuss institutional betrayal and systems of oppression, both recent and historical, that's part of the DNA of our conversations. We focus on wellbeing. We talk with people about what they want in their lives. We specifically address health disparities, and we do so from a human rights perspective, our work is culturally respectful and linguistically appropriate. So almost all of our resources are now translated into Spanish. There are a lot of handouts on the website. There are archived webinars or these online seminars that are in both English and Spanish.
Kaethe Weingarten, Ph.D.: (53:17)
We nest ideas about individual resilience inside models of peer support, family resilience, community resilience, historical resilience, cultural resilience, and organizational resilience. So I think all of those are ways of understanding how social justice can be enacted or instantiated in direct service work.
Dr. Keith Sutton, Psy.D: (53:51)
Wonderful. Well, it sounds like you're doing wonderful work and I really appreciate you taking the time. And, it was really helpful to kind of understand that concept of witness and how you apply that into supporting, you know, all these folks that are supporting these people that end up being disempowered by particular policies. And really kind of that aspect of the social justice work that you're doing. So I really appreciate your time and thank you so much.
Kaethe Weingarten, Ph.D.: (54:25)
Thank you for giving me the opportunity.
Dr. Keith Sutton, Psy.D: (54:28)
Great, and I look forward to getting that handout on the reasonable hope and I'll definitely link to it on the website. Well, thanks a lot. I appreciate you joining us today.
Kaethe Weingarten, Ph.D.: (54:40)
Thank you. Good Bye.
Dr. Keith Sutton, Psy.D: (54:40)
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