I have never regretted earning my master's degree in social work.  Social work has afforded me the ability to take care of myself because I've never had someone take care of me in adulthood financially (and about half of my adult life now I haven't shared that responsibility with a partner).  Now, it is a field I could excel in and enjoy and one the world needs.  The three big issues we need to consider when choosing a career.  The fact it isn't valued enough (yet) by society is a frustration, but that is not something that would make me foolishly say 'I won't major in that because I can't make enough money'.  I have more ethics than that and sadly, too many still don't.

One of the really cool ideas I learned early on in my training was that people are influenced to a greater or lesser degree, by their environments.  Unlike the fields of psychiatry and psychology, which tend to only focus on the person, social work 'gets it' that reality is more complex.  Psychiatry focuses mostly on a focused area of the physical body.  And psychologists tends to focus on a person's behavior, thoughts and feelings.  Psychiatry usually resorts to medications and therapy done by psychologists doesn't tap into environmental issues, such as the type of work environment, living environment, etc.  

Now I am generalizing.  Psychology much more now refers to the environment in helping people.  But this idea was first the province of the social workers, including those who started the infamous settlement houses to help the poor, earlier on in American history.

I used to get a kick out of knowing - when parents brought a child to my office due to their 'bad' behavior - the child in the current diagnostic system we have, was the one labeled as 'the patient', when most likely the parents needed more help than the child.  Because we know that, often, the child's behavior is a reflection of problems the parents have.  The child is the part of the system that 'speaks up' first.

I also joke with my clients that despite being made fun of by others in their lives for 'needing therapy' they may be 'the healthiest person' because they were willing to be the first to seek help. Often it's true: the one who is depressed is labeled as 'the crazy one' when, when you learn what the spouse or the rest of the family is like, it is apparent the client sitting in front of me is just a 'result' of living in that family system and is at least trusting enough to try something different.

So we need to stop getting into arguments about what something is caused by: nature OR nurture?  Because the truth is reality is more complex than that.  That is why it's true that it will be extremely difficult - possibly impossible - for a scientist to find and stamp out 'the gay gene' (thank god, let's hope this holds true) or the 'alcoholism' gene (a disappointment because wouldn't that be a cool form of prevention).

Nature and nurture, person and environment, they don't just 'influence' each other.  They are intricately woven together, probably impossible to unwind.  However, still influence-able enough to make some conditions and issues better.

This is also why it's tough to change unconscious beliefs that are now a part of us and, unknown to us but influence us.  When someone says the answer to it is simple - stop thinking what doesn't work and start thinking what does - it is possible to do some of this, but there must be other ways.  Most want to do and think what they know they should want and think, but are still unable.

And this is why - sometimes - a medical solution combined with thinking stategies - works best.  For example, weight loss surgery.  This is a perfect example.  Obesity is not just the result of will power or behavior.  It's the result of nature and nurture. Some of us DO have more fat genes than others.

There is a field at work today in science - called epigenetics - that is attempting to help others solve some of these more difficult issues.  Social work fits nicely into this paradigm.  It's all about coming up with ENVIRONMENTS that better support the medical and psychological treatments we know.

For example: if you don't ensure a healthy environment around the suicidal or early recovery addicted person you are inviting trouble.  Environment would include things like living with someone who is aware of your problem and is supportive.  In the case of the recently suicidal person, the supportive person keeps tabs on this person and they have a plan they both agree to follow to keep the person safe.

More to come...

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