The Hazards Story

Posted on December 25, 2012 by elizabethlombino

Over my years of Social Work clinical training, I’ve learned a lot of metaphors and stories to help explain some of the concepts I teach.

One such story is called the Hazards Story. It was conceived of, and taught to me by my former supervisor and colleague, Donna Ellenbogen.

Here is a brief, adapted version of the story:

A fellow professional travels the country training colleagues in the field of psychology. He is wheel-chair bound and would drive to most of his training engagements in his large van that accommodated his needs. For one engagement, he had to travel the length of the New Jersey Turnpike. For anyone who has spent any amount of time on this stretch of road knows that it is chaotic and not driver friendly. Just drive 70 in the left lane and see how many horns get blared in your general direction. This gentleman would travel in the right lane (it is a 3-lane highway in most places), going several miles below the speed limit (65). No one drives even the speed limit on the Turnpike, let alone slower than that, but he did. Needless to say, he was welcomed by an endless slew of swerving, honking cars with drivers yelling obscenities and making every obscene gesture possible.

The next day, he had to drive the route all over again. Around 55-60 MPH, in the right lane, on the NJ Turnpike. This time, he decided to put his hazard lights on. This simple change drastically changed the reactions of the travelers around him. Now, rather than an endless barrage of nasty looks and horns honking, the exact opposite happened. More cars just went around the van, without any aggression or obscene gestures. Several cars even slowed down next to him to see if he was okay. Sure, there was still the occasional outburst from a road-raging driver (this was the NJ Turnpike, after all), yet overall, the response he received by making this simple change was astonishing. By simply put on his blinking lights to alert others to his preferred method of driving, he minimized the stress of the situation. He received more compassion and less angst.

The moral of the story, and the meaning we teach, is that if you alert those around you that you are feeling stressed or behaving in a way that is out of the ordinary, you may just increase your chances of receiving more empathy and less frustration from those around you. You don’t need to tell every single detail of why you are feeling off. The details are irrelevant. The feeling is what is most important. You are conveying your feelings of stress or anxiety to those around you so that they are aware of the state of being you are in. You are taking an active role in informing those around you. This way they may lower their expectations of you, and you can minimize the negative reactions of those around you. Of course, you can’t control the reactions of everyone, and there will still be some people who continue to have the same expectations of you no matter what, (just like those road-raging drivers who are angry no matter what), yet the odds of you receiving more compassion and understanding are increased.

Information is powerful. Not full on details, but simple statements of how you are feeling can completely shift the energy of those around you. Case in point ~ Perhaps I have an important business meeting that I need to actively participate in. Perhaps at the same time, my daughter is not feeling well and I am awaiting a call from her doctor. How shall I handle this situation? I more than likely will have to answer my phone mid-meeting. I could just step out and answer it, but that may result in my other team members feeling slighted or wondering if I’m invested in the meeting. Yet, I can also choose to enter the meeting and inform the team from the start that I will have my phone on vibrate because I am expecting an important call about my daughter that I will have to answer quickly and return to the meeting. This way, from the beginning, I am informing the team of my current state of feeling and also minimizing any negative reactions when I do leave the meeting. I am putting my hazards on for my team.

Try it out! Next time you aren’t feeling your best, let people know. Simple and clear is best ~ “I am not 100% today”, “I will do my best today, yet there are some things on my mind as well” … Informing those around you allows you to take a more active role in how they may respond to you. You don’t have full control, yet you increase your chances of receiving compassion rather than obscene gestures.

To learn more about Donna Ellenbogen and the amazing work she is doing with new moms and families, check out her website ~ FamilyWellnessNYC.com

Filed under: Addiction/Substance Use, Compassion Fatigue, Harm Reduction, Health, HIV/AIDS, Hope Notes, Mental Illness, Self-Care, Social Work, Strengths Perspective, Stress Reduction | Leave a Comment »

Let’s Talk About Sex, Drugs & HIV

Posted on June 27, 2012 by elizabethlombino

This piece originally published on Spread Hope: A Therapist’s Guide to Living and Laughing with HIV on TheBody.com

These kids today …

I feel so old just writing that, yet there is no more accurate statement, at least with regard to the topic of HIV/AIDS. When I came of age in the 90s, one of the many hooks we all sang was “Let’s Talk about Sex.” (by Salt-N-Pepa, the first all girl hip hop group … they also had a reality show for a few minutes, if that’s all you youngsters can relate to). And talk about sex we did. From condoms to girl power to HIV. All these concepts were blended together to form our overall vision of healthy sexual expression. It was almost impossible to talk about sex without inserting (pun intended) the word “safer” in front.

This was also a time of medical breakthroughs in the treatment of HIV/AIDS.  New medications allowed people to live longer, healthier lives. The number of people dying from HIV/AIDS started to decrease drastically. People were making strides to be safer and the spread of HIV slowed down. The epidemic was losing momentum and America was taking a collective sigh of relief.

Fast forward to now. For a variety of reasons, the spread of HIV is seeing an upsurge. Safer sex is not as trendy as it once was. Abstinence only education has been revived. To talk about sex in any public forum is taboo again. The word “condom” is now categorized under dirty words. When did this happen? The pendulum has swung drastically in the opposite direction.

Seriously, this is very scary. Kids today are as sexually active as ever, yet the discussion of condoms does not come up as readily and simply as it once did. Are people using condoms? It’s not clear. In some cases, the answer is no. How many reality shows have had full episodes (along with the ever-dramatic cliff hanger) dedicated to a pregnancy scare? Case in point, the queen of reality TV, Snooki, is now pregnant. Clearly there was no use of safer sex practices with that sexual fluid exchange.  And really, there are whole series dedicated to teen moms. What about the STI risk? The risk of HIV? Is pregnancy the new trend? Oh, please no … Make it stop!

In my professional life, I’ve been conducting trainings on all things HIV/AIDS for years now. My main focus of the trainings I conduct is to discuss with fellow Social Workers and counselors what it means to work with a client who is living with HIV/AIDS. I do a basic overview of HIV, prevention, treatment, and also discuss the culture of living with HIV and some of the special concerns with this unique community.

Each year that goes by, I feel as if the information I am presenting becomes more and more foreign to the audience. My field is becoming full of younger counselors, which is bringing a new level of energy and vibrancy. At the same time, they seem to be more and more disconnected to the world of HIV/AIDS. Even the basic facts regarding HIV/AIDS are not so basic anymore.

I’m not exactly sure what’s up with this. Is it due to the resurgence of Abstinence Only Education in many of our country’s school systems? Is it due to HIV/AIDS becoming a chronic disease and therefore losing some of its “scary” nature? No matter the reasons why HIV has gone into the shadows of education, the time has come to bring it back into light. We all have an obligation to continue to talk about HIV/AIDS within every context. My fellow Social Workers and other helping professionals need to own this obligation even more. All of our clients are touched by HIV/AIDS in one way or another. We all need to recognize this and treat each client through this lens.

I will continue to teach the youngsters of my field of the realities of HIV/AIDS. My goal is to fill in the gaps that seem to be the result of antiquated sex education and over-exposure to reality TV. It’s a lofty goal indeed, yet I will not stop striving to reach it.

To read this article on TheBody.com, please click here.

Filed under: Addiction/Substance Use, Body.com, Gen X, Harm Reduction, Health, HIV/AIDS, Hope Notes, Mental Illness, Social Work | Leave a Comment »

TheBody.Com’s FB Cover Photo

Posted on May 8, 2012 by elizabethlombino

TheBody.com recently posted this new cover photo on their Facebook profile page. My face is buried in the top left corner. How cool is that?!

I am super proud and honored to be part of this amazing community. I have been writing a blog for them for almost 2 years. It is such a rewarding experience. Through this blog, I have connected with amazing people within the HIV/AIDS community. It allows for a new forum of support and information sharing. As large as the HIV/AIDS community is, we feel a sense of intimacy and true connection through TheBody.com.

Filed under: Addiction/Substance Use, Body.com, Health, HIV/AIDS, Hope Notes, Social Media | Leave a Comment »

Addictions Recovery and Las Vegas, Perfect Together?!

Posted on May 4, 2012 by elizabethlombino

Also published on Spread Hope: A Therapist’s Guide to Living and Laughing with HIV on TheBody.com

A revised version also published on BCCS Blog

Recently, I traveled to Las Vegas to attend the annual, national conference on the care and treatment of opioid addiction held by AATOD (American Association of the Treatment of Opioid Dependence). It was a huge gathering of some of the most important and influential addictions professionals, counselors, medical personnel, and other entities involved in the overall treatment of this population.

HIV/AIDS was woven into many of the presentations since a person is at risk of HIV infection with the use of opioids. There is the commonly known primary risk of direct HIV exposure from sharing needles with an HIV infected individual. Several national organizations presented materials on needle exchange and the overall prevention of the spread of HIV among intravenous opioid users. There are also the less understood secondary risk factors for exposure to HIV. These include any form of opioid use, additional substance and alcohol use, mental health issues, intimate partner violence, just to name a few.  AATOD hosted several workshops around Co-Occurring Disorders, which highlighted many of these challenges. Any person who uses any substances, has mental health issues, and/or is involved in a chaotic relationship is indirectly at a higher risk of exposure to HIV. Here are a few of the reasons why: such a person may be intoxicated and more likely to engage in high risk sexual behaviors; she may progress to the use of needles if she is chasing a better high; he may be experiencing a manic episode which may be fueled by higher risk sexual activities; she may not be able to negotiate condom use in her current relationship if there is a fear of abuse. In addition, those living with HIV/AIDS may be compromising the care and treatment of their disease if their opioid addiction is left untreated. All of this, and more, was discussed at this amazing and influential conference.

Okay, back to the location. Las Vegas. I know what you’re thinking… “How could you travel to Vegas and not invite me?” I know, I know. Next time.

You are probably also thinking… “Addictions conference? In Las Vegas? Really?” It’s okay, we got this response quite often. Even if a person wasn’t comfortable enough asking the question outright, I certainly could tell it is what they were thinking. The stares and pensive looks were enough. Yes, it is ironic, no doubt. To be surrounded by excess and clear addiction in many forms (substance use, gambling, shopping) while upstairs discussing these very topics was surreal indeed.

Yet, somehow it makes sense. Vegas is a vast land of extremes. Everything is exaggerated beyond all realistic representation. Gluttony and capitalism to the tenth power. Vegas represents (with casino credit, show girls, and glitter) what most people think and feel about addiction. Anyone is allowed to have a few wild nights, along with endless alcohol, drugs and sexual exploits, so long as “what happens in Vegas, stays in Vegas”. Vegas is where denial was born and now thrives. Leave your secrets in the desert. No one will know.

Our culture views addiction in this exact way. Those who have the money and ability to live it up in Vegas and then immediately return to the status quo are the only ones allowed to use drugs and alcohol. Those who can’t handle the sweet seduction of all things Vegas are “bad, sick, damaged, wrong, and sinful.” It is their problem and they deserve all the consequences that go along with using drugs. They certainly do not deserve any help in any way. They brought this on themselves.

Being in AATOD within the Sin City demonstrated the clear divide between drug use and drug treatment in our culture. We welcome the use of substances, so long as a person can keep it to themselves and not bother anyone (or even be the life of the party). The moment it becomes a problem and a person seeks treatment, now this same person is undeserving of our help. It is a sad reality since drug and alcohol addiction is a disease. If our society viewed it more as the true disease that it is, and embraced the true care and treatment of this disease, there would be far less negative consequences of use.

Keynote speaker William White articulated this phenomenon powerfully. He stated, “We know addiction is a chronic disease, yet we continue to treat it like a broken arm.” Addiction is not about having a person stop using and be done. No, there needs to be a comprehensive approach to treatment that includes family involvement, addressing mental health issues, past history of trauma, HIV risk and treatment, intimate partner violence, housing, employment, finances, and many others. In many instances, a person may turn to drugs and alcohol as a reaction to a past (and/or current) traumatic situation. Substances can be very powerful coping mechanisms – just ask anyone walking on the Vegas Strip after a night of partying! When a person takes steps to reduce or eliminate the use of substances, the memories of abuse may come flooding back. These nightmares and real memories can be debilitating and terrorizing. The fear of the memories could be a reason why people do not “get clean” or why they tend to relapse. In instances like this, we cannot blame the person for being “weak” or “immoral” or “criminal”. This person needs further care and treatment to develop healthier coping skills to deal with the fear and pain. Yet, since our culture does not view substance use in this way, this person only gets a band-aid, not the full surgery he may need.

We have a lot of work to do. Our culture devalues those with an addiction of any sort. We frown upon anyone doing anything in excess … even in Vegas.

Yes, there is hope. This conference exemplified the hope and inspiration we all have and all need to improve how our society treats those with addictions. More awareness is being raised about this disease, especially with more and more people coming out with their struggles. People are beginning to realize that denial is not enough. Denial is not working, even in Vegas. It’s not so easy to just leave our worries on The Strip and pretend they don’t exist. We all need to face this disease, show compassion to those who are living with it, and treat it comprehensively.

Next year the AATOD conference will be held in Philadelphia. Okay, it may not be the most glamorous setting, but it may just be a little more real.

To read the piece on TheBody.com, please click here. To read the piece on BCCS Blog, please click here.

Filed under: Addiction/Substance Use, Health, HIV/AIDS, Hope Notes, Mental Illness, Strengths Perspective | Leave a Comment »

The Invisible Lives of LGBTQ Homeless Youth

Posted on March 21, 2012 by elizabethlombino

Post also featured on TheBody.com ~ Spread Hope: A Therapist’s Guide to Living and Laughing with HIV

Imagine being a young person and being kicked out of your home for being “different”. Imagine finding a shred of hope in a welcoming shelter with other young people struggling with similar experiences. Then imagine feeling in danger of this hope and shelter being taken away. Imagine worrying that you will once again be thrown away, back to the streets. That some of your only means of survival is to engage in risky behaviors. To feel you have no other choice but to risk your health and safety just for a meal or a place to sleep.

Homeless youth, as a population, are some of the most disenfranchised individuals in our country. Many of these young people are also LGBTQ, which adds another level of vulnerability and stigma. The risks of these teens are countless, including drug abuse, violence, contraction of HIV and other STIs, and ultimately death. To make things worse, this subculture is often hidden and ignored. Recently there was a good piece written by the Associated Press that brought light to the many struggles of these young kids. We need to continue to raise awareness.

What is so difficult to comprehend is that many LGBTQ youth are homeless because they are rejected by those who are supposed to love them no matter what. Many of these kids were told by their caregivers that they are no longer welcome in their own home with their family. They literally are thrown out onto the streets because of who they are. In addition, there are other youth who feel they need to flee from their home in order to protect themselves. Perhaps a parent knows his child is gay and proceeds to abuse her relentlessly. She may leave home in the hope of escaping the abuse. She may feel it is safer to risk survival on the streets than to stay at home with consistent and severe abuse.

When we hear about young people living away from their home, we tend to lump them all together with the term “Runaway.” Our society is quick to judge these kids as the problem – that they ran away from home because they were disrespectful and unable to tolerate authority. Yet the reality is that most homeless youth are living on the streets because they were kicked out of their homes, or they feel so unsafe living with their caregivers who do not accept them as they are. The more accurate term for these youth is “Throwaways.”

Homeless LGBTQ youth are at a severely high risk of engaging in self-destructive behaviors as a means to survive. The practice of “survival sex” is common among them as literally a means of living to see the next day. The risk of contracting HIV is high among this group because of the risky behaviors. Condom negotiation often cannot even be factored in since a young person may be faced to choose between engaging in a sexual activity without a condom or spending the night outside. This is no choice at all. There is also a greater risk of violence and abuse, even within homeless shelters. Rape, forced drug use and other dangers increase the risk of exposure to HIV. Factor in a lack of resources and the strong instinct to survive and it’s a formula for utter hopelessness and disaster.

We need to provide support, safe housing, food and other necessities to ALL of our youth to ensure they do not have to turn to unsafe survival mechanisms that could eventually lead to further spread of HIV and other STIs.  Yet, unfortunately in recent years, funding has been cut to these supportive youth services, including in areas like New York City.

We cannot allow this to happen. Our children deserve so much better than this. They deserve a chance at a future.

To read the piece on TheBody.com, click here.

Filed under: Body.com, HIV/AIDS, Homelessness, LGBTQ | Leave a Comment »

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