End-of-Life, Neuroscience, Neuroplasticity, Neurolinguistic Programming, Social Work/Helping Profession/Mental Health

Buddhist Contemplative Care Symposium: 2014

The groundbreaking gathering encourages researchers, physicians, spiritual care providers, and patient advocates to learn from each other and grow as healers.  Participants will share contemplative best practices and experiential teachings, while collectively beginning work toward common standards of practice.

The symposium takes place in Garrison, NY from November 6th thru 9th.

Neuroscience research has demonstrated the effectiveness of meditation and mindfulness-based techniques for both patient healing and caregiver self-care. Mindfulness practices are increasingly being explored and used, particularly by palliative and end-of-life care teams.

Doctors, nurses, physician assistants, social workers, chaplains, and volunteers are encouraged to attend.

For more information view the Buddhist Contemplative Care Symposium Website.

By Victoria Brewster, MSW

Aging/Gerontology, End-of-Life, Grief/Grieving/Bereavement, Social Work/Helping Profession/Mental Health

Excerpt from: Journey’s End

Journey’s End: Death, Dying, and the End of Life 
by Victoria Brewster, MSW and Julie Saeger Nierenberg, MA Ed

This article is an excerpt from the upcoming book: Journey’s End: Death, Dying, and the End of Life, written, compiled, and edited by Victoria Brewster, MSW and Julie Saeger Nierenberg, MA Ed with an anticipated release date of Spring 2015.

Our 17-year-old daughter and only child, Casey, was the center of our universe. Adopted from a Polish orphanage at fourteen months in 1991, she grew from a weak, underdeveloped infant into a beautiful, smart, popular young lady accepted at elite Bennington College in Vermont for the fall, 2008 semester. We had our challenges with her to be sure. She tended to be high-strung, headstrong,argumentative, and almost impervious to discipline. Repeated trips to therapists brought the same advice – she’ll grow out of it; just be tougher with her.

One weekend in January 2008, my wife and I had a big fight with her. There was yelling, crying, slamming doors, saying ugly things we didn’t really mean – in other words, a typical teenage power struggle. I left her in a puddle of tears in her room cursing me, practically counting the days until she went off to Bennington. She seemed to revel in the notion that she’d be free of us, but I didn’t take it personally. Just another teen mouthing off to her parents, trying to get under our skin. We were actually really proud of her for getting into such a great school.

My wife Erika and I retired to our bedroom, exhausted from the shouting and Casey’s seemingly endless wailing. Later that evening, I went to the kitchen for a glass of wine, passing her in the living room. She sat on the burgundy leather sofa, watching America’s Next Top Model, pounding away on her iBook, probably chatting with a friend about her despicable parents. We shot each other icy glares, saying nothing.

And that was the last time I saw her.

I awoke the next morning to find her room neat as a pin, but Casey was gone. On her desk was a note: The car is parked at the Golden Gate Bridge. I’m sorry. I froze. The blood drained from my face. A frantic search by the local police, California Highway Patrol, Golden Gate Bridge Patrol, and Coast Guard revealed events beyond our worst nightmare. Casey had driven to the bridge at dawn, walked out onto the span, hopped the four-foot railing and jumped. The world we once knew, the most precious person in our lives – our only child – was lost that morning. Her body was never found. I wanted my life to end that day. I couldn’t possibly survive this.

I thought that losing my father suddenly to pancreatic cancer several years before was the worst possible thing that could happen to us. His death left a huge void in our family. But nothing prepared me for the loss of my own child, and at her own hand. Dad’s death, by comparison, was a speed bump.

When you lose your child, it’s like a firestorm that destroys the very fabric of your life. When she was your only child, it’s as if you’ve completely lost your identity as a parent – something I’d yearned for more than anything in life. You are no longer the person you once were. There is an emptiness of mind, body, and soul. Death by suicide leaves you with a gaping wound that never heals, and an unbearable guilt from your failure to protect her from herself. When there are no remains to lay to rest there is never closure. You’re not supposed to lay your child to rest before yourself; it’s all out-of-order. For over six years since her suicide, I’ve drifted through life in a fog, partially dead and partially alive.

January 29th has become our personal 9/11. Life is now divided into the before and after. Before this happened, we never had a close encounter with suicide. We were vaguely aware that people leapt from the Golden Gate Bridge, but it was just a random thought. The bridge was nothing more than the blissful high point of my daily commute. Now it’s a reminder of my unspeakable loss as I pass the hoards of oblivious, smiling tourists, photographers, cyclists and joggers who only see the bridge as their spectacular postcard icon.

Longtime friends drifted away, seemingly pretending that Casey Brooks never existed. She was never discussed and remained the elephant in the room. Other friends, well-meaning as they were, believed that they could help us “get over it and move on.” Read this book! Listen to this inspirational tape! Say this affirmation! Seek your higher power! Know that she exercised her free will to advance to a better place! Then you’ll feel better. Unfortunately, none of them had lost a child and couldn’t grasp that the grief and guilt are your constant companions. Members of our church mostly turned away. Like everyone else they didn’t know what to say, so they said nothing. My minister remarked that in a way I’d become “holy”, which he believed could be either positive or negative. Personally, I’ve found “holiness” to be a terrible and isolating burden.

With a few exceptions, co-workers were equally silent until I confronted them to say something, anything. I completely disconnected from work. Money, things, status, career meant nothing to me anymore. About a year after Casey died, I was relieved to learn that my entire department at a major bank was let go in the financial meltdown that led to the Great Recession. I haven’t bothered to look for a new job since. After all, how would I handle the part of the interview when asked, “So tell me about your family.”

My wife and I were hesitant about social situations with new people. Idle cocktail chatter would inevitably turn to the elephant in the room. “So do you have any children?” To say no would mean to deny that our Casey never existed, but to explain what happened would invite blank stares and a quick excuse to use the bathroom, refill a wine glass, anything to escape the discomfort of listening to our story.

In addition to our army of therapists and buckets of anti-depressants to simply cope with the emptiness of life, we tried grief groups. Compassionate Friends is one such group, a fine organization for parents who’ve lost children. Erika and I sat in a circle with other broken parents listening to their stories. We were the only ones in the circle who had lost our teenage daughter and only child to suicide, just another reminder of how suicide is treated differently from boating accidents or illnesses, not that the other parents’ grief was any easier than ours. We looked for suicide survivor groups in Marin County where we live, but there were none.

It wasn’t until we joined an advocacy group, The Bridgerail Foundation, dedicated to erecting a suicide barrier on the Golden Gate Bridge,  we found a community of others who’d lost children and loved ones to that bridge. But in making our story public, we became painfully aware of the lack of compassion or understanding of suicide and its victims. Meetings with Bridge Board members and state legislators were met with mostly more blank stares. The public draws a firm distinction between those who “want to die” and those whose death was unintentional. It’s a taboo subject, much like AIDS, rape, substance abuse and reckless driving. Suicide victims and their families are often blamed rather than consoled.

Ironically, while many of our own friends distanced themselves from us, Casey’s friends, to our surprise, stuck with us. They were clearly as devastated by her loss as we were, and volunteered everything they knew in an effort to understand why Casey – with so much to live for – would take her life. We swapped stories and pictures, many of which we were never supposed to see. We laughed together over their shenanigans, the same shenanigans I indulged in at their age. To this day we have an annual date – December 23rd – when we invite them to our house to be together, and each year we’re astonished to see 20 to 30 of them show up.

Everyone who has suffered a catastrophic loss of a child grieves and copes differently. Some have better coping skills than others. Many engage in activities to give meaning to their child’s life – foundations, advocacy, lobbying for new protective laws, speaking out to the public. I did much of that while writing a book. Published in February, The Girl Behind The Door is about my search for answers to Casey’s suicide. I work with a teen group in Marin County that speaks to high school and middle school students about vital mental health issues, such as depression and suicide. And the Bridgerail Foundation’s perseverance has finally paid off. After being treated slightly better than lepers for years we have succeeded in gaining approval for a barrier and funding. Sometime hopefully soon, the Golden Gate Bridge will no longer be the deadliest structure on earth for suicide.

We’ve also connected with another couple that tragically lost their daughter in the same way that we lost Casey. Gabriella was a high achieving “perfect daughter,” a senior at Redwood High School just like Casey. In August of 2013, she apparently snapped and jumped.  As heartbreaking as it has been to see her parents in so much pain, we can bring our experience to bear where others in their lives cannot. When asked how to handle suicide survivors, my advice is:


  1. Don’t try to fix them. They just want you to listen.
  2. Don’t say you know how they feel if you haven’t experienced their loss.
  3. If you know their loved one tell them that you miss them too.


While these activities have been a welcome distraction to my grief, I still find myself seeking yet more structure in a life I still find empty. Without my Casey there is still little to look forward to. So dealing with grief becomes, literally, a matter of taking one hour and one day at a time.

I’ll never have another Casey, and I look forward to the day when I can rejoin her on the other side. But make no mistake. Despite the difficulties of adopting and raising her and the pain of her loss, I feel like the luckiest guy in the world to have been Casey’s dad.

John Brooks, Father; His blog is: http://parentingandattachment.com/

A special thank you to John for allowing us to publish this excerpt.

by Victoria Brewster, MSW & Julie Saeger Nierenberg, MA Ed


Older Adults and Needed Changes

As a case manager who works with older adults, I see first hand the struggles that some seniors face.

Today, a question was posed to a group of seniors as to what they think needs to change or needs to improve to make their lives easier.

1- Special buses for older adults to go to various local destinations, i.e. shopping, appointments, events.

2- Transportation  that is affordable needs to be improved overall for older adults whether one is independent, uses auxiliary devices for mobility like a cane, walker, wheel chair, crutches, walking stick, etc.

3- The Montreal metro’s need to be renovated to increase access for all no matter their mobility level. Elevators should be installed, escalators in working/functioning order.

4- Healthcare to improve-access, wait times, shorter waiting lists, accessible general practitioners and specialists-a more Person-Centered approach.

I am sure all these issues are problematic for older adults across Canada. Advocacy is important and needed by seniors themselves, professionals and the general population. We will all be ‘older’ one day and why not pave the way now for the future generation of older adults.

By Victoria Brewster, MSW

Book Review, Social Work/Helping Profession/Mental Health

Employee-Centered Management: Book Review

When you begin reading a book and between the introduction and the first thirty pages of the book, you take 5 pages of notes, you know the information within is good. The book is: Employee-Centered Management by Larry Wenger, MSW.

The book is written by a social worker with a long work history as front line staff, management, and currently focused on training social service supervisors and managers.

The book is geared at non-profit organizations and agencies with the goal to focus on the staff; “Happy employees=happy clients.” A statistic within the book which surprised me was reading nearly 70% of current social service executives will reach retirement age by 2020. The other statistic was reading that only 30% of Americans are engaged in their work; this taken from the 2013 Gallup Engagement Survey.

So there will be lots of executive positions to be filled within the next 6 years and there are too many social service employees not engaged in their work.

Larry Wenger has written about 20 strategies that should happen in social services which will enable employees to be excited about coming to work, make it possible to brag to others about on-the-job accomplishments, make one’s workplace successful, and exciting to be at. “Employers are responsible to create a workplace environment which encourages employee growth, success, excitement, engagement, and motivation.”

Hiring of employees, appointing great supervisors, orientation of new employees, delegation of tasks both successfully and appropriately, learning to trust, respect, recognition, solving problems creatively, communication, and the need to train employees are some of the topics covered within the book.

“Employees are our most important asset,” states Wenger. “To ensure commitment, employees need to be happily engaged in their work.”

The typical social service agency or organization earmarks available resources to the individuals served. Wenger states that part of the new formula and approach is that money and resources also needs to be earmarked for positive employee – supervisor relationships.

I will mention a few of the chapters covered in the book briefly, ones that stood out the most for me and I strongly suggest you read the book yourself to obtain all the information. In reality, all the chapters are good and can be beneficial.

Know your staff and the first part of this is the hiring process. Wenger describes 3 types of employees; builders- self-motivated, the ‘go to people;’ cutters- under perform, make poor decisions; and maintainers- perform adequately, have little creativity or motivation. Also, the need to focus on attitude, passion, and skills is necessary in the interview process.

To me it goes without saying that employers should want to focus on higher staff retention, burnout prevention, development of new skills, good communication, development of trust, encouraging staff, recognition of work done/performed well, accountability, and seek creative solutions from all staff. These are skills taught to social workers in school and they are skills and elements that need to be carried over into the work environment.

The book is worth reading, has good information within, and as Wenger states early in the book; “happy employees=happy clients.”



By Victoria Brewster, MSW


Aging/Gerontology, End-of-Life, Social Work/Helping Profession/Mental Health

Assisted Dying as Controversial as Abortion?

Assisted Dying is a topic one sees all over social media, blog posts, and in the news; although other terms used are assisted suicide, euthanasia, and dying with dignity.

In June, Quebec became the first province to pass legislation which will come into effect later this year.  Although the wording is ‘respecting end of life care,’ it is a step in the right direction. For those concerned that either family members or institutions will implement euthanasia or assisted suicide without the patient’s consent; please note the wording of the bill is: “Patients themselves would have to repeatedly ask a doctor to end their lives on the basis of unbearable physical or psychological suffering. They would have to be deemed mentally sound at the time of the requests.” Quebec is the first province to vote in such legislation in Canada.”

On the other side is patient’s making choices themselves without legislation in place. A woman in the province of British Columbia recently ended her own life after living with dementia for a few years. Others who are living with a chronic illness/disease or degenerative neurological disease have chosen to go to Switzerland for Euthanasia.

Assisted Dying is a controversial topic with emotional, religious, and cultural implications for some. The topic is controversial much like abortion-should one have the right to choose? Some will say yes, some will say no, and others are unsure.

While advance care directives, living wills and the like can explicitly detail an individual’s wishes should they become cognitively incapacitated or unconscious, I have to wonder if they will be honored/followed by family and medical professionals. There are cases where they have not and a person was kept alive by force feeding. Some medical professionals disregard advance care directives as it goes against their medical training and oath to do no harm. What is the point in writing one if it will not be honored?

The other side of the debate is individuals who are in ICU or elsewhere in the hospital receiving what could be seen as futile and/or unnecessary medical procedures and/or surgeries when there is little chance of recovery or success. This costs money, uses up hospital and medical resources, and creates longer waitlists for needed and necessary medical procedures, tests, and surgeries for others where the rate of success would be higher. Could those that would have little chance of success or have written advance care directives re: futile procedures and surgeries instead be transferred to Palliative Care? This means more palliative care beds are needed both in the community and inpatient facilities should the patient and family choose this option.

Even if an individual expresses their wishes in a living will or advance care directive it does not mean when the time comes and they are conscious that they could not or would not change their mind.  In reality, none of us knows when the time comes what we will decide. To me it comes down to options and choice. This means legislation needs to be in place to allow for the option of assisted dying should one want it.

There are many states and countries that have legislation in place and more will follow. There will continue to be discussions, raised awareness, blog posts and articles to read.

What are you thoughts on this topic?

By Victoria Brewster, MSW

Social Work/Helping Profession/Mental Health

My Superpower? Seeing Inside People

By Kelly Mitchell – Guest Blogger

If you asked me what one of my strengths is, perhaps I’d choose to tell you that I see things in other people that they themselves either don’t see at all, or they are surprised because so few people see it. Many others have this skill and ability, and it’s probably why we gravitate to the helping professions; jobs and careers where much of our time is spent helping other people.

If you think I’m boasting, I’m not. What I’m doing is stating an ability that I have, which is one of my strengths. If put to the test or asked for an example, I could do it in a relatively short period of time, even when meeting someone just once and within a few moments. It’s my superpower. You yourself undoubtedly have skills and abilities that have become well-developed in your job over time, so it stands to reason that I’ve developed job-specific skills too, and this is just one of them.

I’ll give you two examples that just happened yesterday. In one situation I was speaking with a group of seven people about a number of options they might want to pursue in order to become financially independent. It was when addressing the topic of self-employment that I looked right at one man and said, “You for example may have not only one idea, but three or four businesses in mind, and your problem is you can’t focus on one and so you’ve never got started.” At that point I could have stuck an Italian sausage in his mouth as it opened in wonder that I’d identified his key stumbling block to even getting going. “Wow! How did you know that? It’s been my problem for years, but nobody knows that!”

In the second case, a woman in the same group was sitting with her legs entwined like a pretzel, her shoulders hunched, way too much foundation on her 18-year-old face, and her wide eyes and downcast head screamed that she was shy, introverted, and probably hiding acne; as a result feeling insecure. In talking with her 1:1 a short time later, I ventured that as a teenager myself, I had once had an acne problem which had affected my self-confidence, but over time it disappeared and I gained the confidence to look in the mirror and like what I see. “You and I both know that there’s a beautiful face emerging and that acne is only temporary.” I said. She shifted in an instant to a talkative young woman who had great eye contact and she said, “Really? Do you really believe that? I mean some people say that but then I think they have to. Do you really believe that?” And I do.

Now sometimes this ‘super power’ is one I keep to myself or reveal gently rather than with fanfare. There are times I’ll look at a person and tell them that I suspect they’ve been told over a number of years by someone who should have treated them the best that in fact they are worthless and will never amount to anything. And in those moments, sometimes tears start, heads drop, or heads raise and they’ll say, “Is it that obvious?” or, “How did you know that? My dad always told me I’m a loser.” They generally don’t believe me when I then go on to name several characteristics and personality traits they have that I admire and in which they might like to acknowledge.

Now on the sad side, I’ve sat listening to people tell me how successful they plan to be and drone on about their long-term employment goal or entrepreneur idea, and I’ve seen enough in a few moments to tell me that it is never going to happen. And I mean ever. While I’m not one to intentionally put an end to someone’s life-long dreams, there is often a gulf between what a person is really capable of and what they think they are capable of, even with support and advice. Sometimes it’s best to say nothing, and sometimes it’s best to tell it like I see it and then help to reconstruct a realistic plan in which someone can move forward.

And please don’t think I believe I’ve got all the answers. I’m not playing God here and telling people what they should be when they grow up or do to live their lives as I think they should. It’s only about helping them, and sometimes helping people means being honest and direct. Having an ability to anticipate how someone will likely react and delivering things they probably need to hear but don’t want to hear can actually be what they’ll thank you for later. It’s how the message is relayed more than the message itself at times; with compassion and sensitivity.

So if you are in the helping profession, do you have this super power too? I bet the more you deal with people, the better you have become at reading them; seeing the good and the potential when they can’t see it in themselves. I’m guessing you have provided a word or two of encouragement when they were so low they didn’t think anyone could like them, believe in them, and see them as valuable.

Well done Superhero’s.

*The original post can be found at: http://myjobadvice.wordpress.com/2014/07/31/my-superpower-seeing-inside-people/