These words are frequently used to identify teenage girls when discussing the various trials and tribulations they face on a daily basis. Overwhelmed by life experiences, these girls often find it difficult to open up and share their problems. They may feel as if their circumstances are so overwhelming and their pain is so deep that talking about them will not make a difference.My Girls: A Story of Survival and Togetherness in the Inner City
explores the real, emotional, and raw experience of working with at-risk African American teenage girls. The book is based on Graham Danzer's clinical study of counseling six teenage girls in a group setting at an inner-city public school. It explains what the author learned from the girls' struggles and how he was able to penetrate through cultural, gender, and racial barriers. It tells a tale of reciprocal enrichment and enlightenment.
- Provides students in clinical programs as well as practicing clinicians, policy makers, and lay people with a deeper understanding of how teenage girls relate to men and the challenges that clinicians face in working with such clients
- Helps clinicians in talking with teenage girls about their real feelings
- Offers a template for how to use one's self to build a relationship
- Provides information for clinicians in the field of cross-cultural clinical practice and awareness
About the Author
Chapter 1: Introduction
Chapter 2: Attachment Theory
Chapter 3: Trauma
Chapter 4: Week 1
Chapter 5: Week 8
Chapter 6: Week 12
Chapter 7: Week 21
Chapter 8: Week 24
Chapter 9: Week 38
Chapter 10: Graduation Day
When people are overwhelmed by life, they often need to talk about what is bothering them. This can help them experience some relief from painful emotions, which may be what they need to get through hard times. I have often heard people say that they do not want to talk about their problems because "talking won’t change anything." Their argument is that talking about their problems will not change the external circumstances.
In my experience, the external circumstances are not as much of a problem as the feeling of being overwhelmed. It is this feeling that makes external problems seem worse than they are, which results in paralysis. When people are unable to take corrective action, their problems seem all the more unsolvable. I have found that intense feelings often inhibit a person’s ability to think clearly, and this confusion can make problem solving impossible. Talking things out will usually help people calm down and experience some relief, which helps them think more clearly so that they can better decide what to do next.
I relearned this when I counseled six young teenage African American girls in a group setting at an inner-city public school where I was interning as part of my graduate training program. I will present a narrative of the more clinically significant weeks of the school year and will describe the events as they actually happened, with as little interpretation or censure as possible. In this way, readers can gain a deeper understanding and appreciation for how overwhelming the circumstances were for these girls and how talking about their problems helped them to hold themselves together.
These girls were called names, put down, threatened, and even attacked practically every day. The East Bay Community Recovery Project hosted an African American women’s panel in 2009; one of the guest speakers stated that these traumas tend to be routine experiences for African American women.1
I often felt frustrated that all I could do was to sit and listen to these girls’ stories. Long after my work with the girls ended, I realized that the group may have been one of their only experiences of feeling truly safe, listened to, understood, and cared about. S. Zemmelman (personal communication, November 16, 2009) stated that when patients feel this way about their therapy, they are most likely to achieve therapeutic outcome.2 Although the group experience could not begin to compensate for their difficult circumstances, the girls at least had one hour a week to talk and feel and relate.
Many of the girls were already friends and supported each other as much as they could. The only consistent and reliable support that they had was each other, yet each of their lives was so overwhelming that they only had so much of themselves that they could give to each other. Lum (2003) noted that one of the strengths of low-income, urban African Americans is their large extended family and social support networks; this is a surrogate form of clanship that originated in tribal Africa. Lum also noted that these support networks are often worn down by the extreme poverty that low-income, urban African Americans have endured throughout history.
The girls tried to take care of each other, but they often had to bury their feelings and remain prepared and ready to protect themselves. When they experienced feelings that made them vulnerable, adult men or people who were looking for a fight would often try to take advantage of their moments of weakness. The girls tended to protect themselves by being loud, aggressive, obnoxious, trouble-making, and hypersexualized. By listening to the girls and trying to keep an open mind about why they might be "acting out," I learned that they did not have much reliable, supportive guidance from adults, and so they ended up doing whatever they had to do to survive. The group environment provided them with a safe space to explore what this was like in the company of others who knew what they were going through. Ellensweig-Tepper (2000) noted that small groups can help trauma survivors feel safe and understood.
My involvement with this group may have given the girls their first experience of a positive, reliable, non-abusive, nonsexual relationship with a man. K Siegel (1980) and Harwood (2003) recommended that an adolescent girls’ group be facilitated by a male and a female therapist so that the girls can experience healthy male and female interactions in a way that resembles a mother-father dyad.
How Did the Group Get Going?
Once the girls were brought together, it did not take long for the group to begin running itself. Initially, the girls were anxious and excited and often tried to talk over each other. They tended to communicate this way outside of group as well. They may have developed this habit because they had learned through experience that this was the only way that people would listen to them. At one point in the group, three or four voices were going all at once until one of the girls called a virtual point of order and suggested that the 60 minutes of group time be divided up equally so that each girl could get her fair share of group time. For example, if there were five members present, each girl would get roughly 12 minutes of group time to share at length without much interruption. The rest of the girls readily agreed. Most of the time, my co-facilitator and I sat back and listened.
I learned a lot about the girls by doing everything I could to plug myself into their community. In addition to my more standard clinical duties, I spent a lot of time visiting and observing the classrooms, playing tag and kick ball with the kids before school, and talking to their teachers and other interested community members. In fact, these more casual interactions yielded a majority of the information I will present about the girls.
When it was time for the group to meet, I would go to the girls’ classrooms and escort them to the counseling office so that they would not get in trouble along the way. While my co-facilitator set chairs into a circle in preparation for group, I would let her know I was going to get "the girls" from class. Somewhere over the course of the year, I started to say that I was going to get My Girls. The name has stuck ever since.
Many clinicians might view my more casual interactions as a breach of therapeutic boundaries. My analytic training taught me that therapy should be bound by the beginning and end of the therapeutic hour and there should not be any extra dimensions to the therapeutic relationship, which would be created by collateral contact. Through my work with the girls and their community, The X (as I am pseudo-naming it), I learned that this was not necessarily the case. When I interacted with them in a less formal, getting-to-know-you way, the girls’ community began to consider that I might be part of the solution rather than the problem. This was important, because people in this community overwhelmingly looked upon white clinical staff with suspicion and distrust. The result was that the kids did not want to go to therapy, the parents were often reluctant to consent to their children being in counseling, and interested community members were reluctant to refer youths for clinical services. It was the experience of many community members that clinical staff who met with the children were secretive about what they were doing until Child Protective Services or the police suddenly showed up and started asking questions.
J. Kirk (personal communication, November 9, 2010) believes that collateral contact is absolutely vital to working effectively with highly traumatized, highly disorganized, social work clients and that the more analytic way of working exclusively with the unconscious without "interference" is more appropriate for relatively higher functioning clients.3 I instinctively knew that I needed to be collaborative and supportive, if the concerned adults in the girls’ larger community were going to refer children to me for counseling and provide me with the information I needed to be able to work more effectively with them. In effect, the girls were my clients and so were the members of their larger community. Lum (2003) noted that this more systemic method is the best practice for working with highly traumatized, low-income, urban African American clients.
I protected the girls’ confidentiality by not relaying their information to interested community members, but I did sometimes professionally self-disclose to concerned adults and receive information from them about what was going on with the girls. Interested community members often asked about my work with the girls. I let them know that my sessions with the girls had to be kept confidential; if the sessions were not confidential, the girls would not want to say anything in the group. (Clinicians often respond to inquiries about session content by explaining the legality of confidentiality, which low-income, urban African American community members experience as off-putting.) I would also let the community members know that, although I could not share information about the girls with them, they could tell me what they knew about the girls and this would help me work more effectively. These community members tended to see my point and appreciated my being open about what I was doing and why. I have protected the girls’ confidentiality in this book by disguising everything that is not directly relevant to the case.
Gender and Cultural Considerations
Duncan and Johnson (2007) found that African American female undergraduate college students expressed a strong preference for a fellow African American woman counselor. When African Americans have been paired with white counselors, their retention in treatment and their corresponding level of satisfaction has tended to be much lower (Gregory & Leslie, 1996; Sykes, 1987). I have sometimes been effective with my low-income, urban African American clients, but it has taken me considerable time to build relationships with them. Even when some trust is built over the course of a long-term relationship, these clients have still tended to tell me only part of their stories.
I have often found that highly traumatized women who are of a stronger, more dominant personality type (like the girls) will often engage more readily with male therapists. J. Kirk (personal communication, December 2, 2010) acknowledged this point but added that women may engage more with male therapists because they are "performing"; thus they may be engaging with male therapists in seductive ways that help them avoid doing the real therapeutic work that they would do with a female therapist. Harwood (2003) noted that women who have been traumatized by men may display avoidant reactions to male therapists. Women who are in therapy with female therapists may be better able to observe feminine gender role modeling and to have their experiences of being oppressed related to and understood at a deeper level (Wood & Roche, 2001). In my experience as a man working clinically with women, I often overlooked how their presenting symptoms might be the result of gender-based oppression until consulting with a female colleague. Evans, Kincade, Marbley, and Seem (2005) noted that gender-based oppression may be the root cause of many women’s mental health issues. This speaks to S. Zemmelman’s (personal communication, November 16, 2009) statement about the difference in the clinical work when the therapist has had similar experiences and can relate on a deeper, empathic level. Without having had similar experiences, it is likely that the therapist will only be able to understand the client in a more cerebral, superficial way.
It might have been better if the girls were paired with younger, licensed African American female therapists, but none were available. African American therapists are a rarity; in African American communities, one must take what resources are available and make the most out of them. It is typical for public schools in low-income, urban, predominantly African American communities to be woefully understaffed and underfunded (Kozol, 2005). I dealt with these limitations by managing a huge caseload and maximizing the yield from what resources were available. This is why the co-facilitator and I elected to see the girls in a group rather than individually: individual therapy hours were scarce, and a group setting provided a programmatically viable alternative. The girls and officials at their school witnessed my efforts to come up with solutions, and this helped me to engage with them. My high-energy approach to working with the girls also helped to get the group going. Ellensweig-Tepper (2000) noted that an assertive, active, engaging role model is often a good candidate for a group leader for adolescent girls.
Before presenting the girls’ stories, I will first describe two theories that help clarify the girls’ external circumstances in a more general way. Attachment theory emphasizes how development may be affected by trauma. A theory of trauma will point up the fact that low-income, urban, young teenage African American girls are a particularly at-risk group for experiencing trauma and developing posttraumatic symptoms (Kimmerling, Ouimette, & Wolfe, 2002). These theories helped me to conceptualize the girls’ often erratic and chaotic ways of behaving in an empathic, relational way, which helped me build relationships with them.
1 The East Bay Community Recovery Project is one of the leading co-occurring disorder-focused outpatient clinics in Northern California.
2 S. Zemmelman, PhD, is a practicing Jungian analyst and is a faculty member of the Sanville Institute, which has a doctoral program in clinical social work.
3 J. Kirk, LCSW, is the former director of a Kaiser Hospital teenage substance abuse program and is a practicing family therapist with more than 30 years of clinical experience.
Graham Danzer, ASW PPSC RASi, has over 12 years of clinical social work experience. His primary areas of expertise are working with at-risk adolescents and their families, substance abuse, and crisis. He has undertaken extensive research on cross-cultural issues in therapy and has had his work published in the following peer-reviewed journals: Journal of Aggression, Maltreatment, and Trauma and the Journal of Social Work in Public Health. He is also pursuing a PhD in clinical social work at Sanville Institute in Berkeley, CA.