Alan Levy, PhD

(Chicago, Il)

&

Tracy Vega, LCSW

(San Rafael, CA)

Sunday, February 12, 2023

The Moral Injuries of Everyday Clinical Practice

10am-1pm (CST):ZOOM

About the presentation: This program addresses the moral injury that results when clinicians’ deeply held convictions to help people who are experiencing psychological and social distress are seriously impaired by the conditions under which they practice. Clinicians often see their patients without the necessary supports to address their needs in any depth. Instead, patients often are overmedicated and trained to manage their difficulties. There is little time or opportunity to engage their patients deeply. Indeed, clinicians’ capacities to empathically recognize their patients as subjective human beings who have an inner life become constrained. Under these conditions, clinicians may become angry, disillusioned, and demoralized. Mired in the structural and economic limitations in which they function, clinics and agencies tend to define this phenomenon as clinician burnout. They often individualize what is fundamentally a systemic problem or simply treat this as an inconvenient reality to which staff must adjust. As a result, clinicians and agencies alike may embrace simplistic solutions to fundamentally perplexing, complex problems.

The difficulties in engaging their patients deeply and flexibly result in clinicians dissociating and withdrawing from the lived experience of their patients. They often lose their commitment to their patients, and they feel more like a bureaucrat than a therapist.

This program will help agency and clinic-based clinicians to identify the factors that militate against engaging their patients deeply. It presents how current conditions result in the moral injury of clinicians. We will explore the mutual dissociation that often occurs when clinicians are injured when their fundamental values of helping people who themselves are injured. It will highlight approaches to working with patients under these conditions. The presentation will underscore the fundamental role of clinician communities in combatting the effects of moral injury.

Alan J. Levy, Ph.D (he/him) is the President of the Chicago Center for Psychoanalysis and Psychotherapy.  He is a certified psychoanalyst, having trained at the National Institute for the Psychotherapies in New York. Dr. Levy was on staff in the Departments of Psychiatry of Tufts and Columbia Universities. He has held faculty positions at Columbia, the University of Southern California (USC), Loyola University Chicago, and the University of Chicago.  Dr. Levy was elected as a Distinguished Scholar and Fellow of the National Academies of Practice.  He was awarded the Distinguished Career Award from Simmons University and he received the Educator’s Award from the National Institute for the Psychotherapies.  Dr. Levy maintains a private practice in psychoanalysis and psychotherapy in Northfield, Illinois.

Tracy Vega, LCSW (they/she) is a social work doctoral candidate at the University of Southern California, addressing the prevalence of alcohol misuse and treatment disparities for youth. Tracy has been a Chicago Center for Psychoanalysis member since 2016, graduating from the three-year psychoanalytic psychotherapy certificate program. 

Tracy was born in Chicago to parents that immigrated from Mexico. Tracy witnessed their parents work hard adjusting to life in the United States through poverty, community violence, addiction, and trauma. Despite these difficult realities, Tracy takes pride in their cultural heritage and family’s strength, love, sense of community, food, and resiliency. Tracy attended Cristo Rey Jesuit High School in the heart of Pilsen, where they cherished cultural traditions, the opportunity to work at a hedge fund and learn in English and Spanish. Tracy obtained a bachelor’s degree in political science from Loyola University Chicago in 2012 as a Cristo Rey Scholar, a full-ride scholarship. During their undergraduate years, Tracy spent 14 months abroad studying foreign policy and journalism in China and Europe.

Tracy found their way to social work through their experience working at Hamdard Center in Rogers Park. They initially started as a tutor through their work-study program. They eventually became the assistant director of the youth program. Tracy enjoyed working with youth but realized the trauma they carried with them through immigration, acculturation, poverty, and exposure to poor social conditions. Tracy found themselves trying to run groups to address these issues but recognized they needed to return to school. Tracy obtained their master’s in social work at Erikson Institute in 2016 as a Harris Excellence Scholar. Their focus was child development and psychotherapy with 0-5 and middle school-aged youth. Tracy continued their community work as an Assertive Community Treatment therapist at Association House in Humboldt Park for a year. Tracy worked with adults ages 21 to 80 years old with severe co-occurring disorders (e.g., schizophrenia, bipolar disorder, personality disorders, anxiety, depression, substance use, and medical conditions).

In 2017 they moved to Marin County and has been working for the county for the past six years. Tracy was an emergency response social worker in Child Welfare for two years, tasked with investigating reports of abuse and neglect, safety planning, and removing children from unsafe situations. Tracy was also a bilingual licensed mental health practitioner for four years providing intensive case management and therapy for children, adolescents, and caregivers with severe emotional disturbances and trauma living in disenfranchised communities. For the past year and a half, Tracy were also a clinical consultant, providing individual supervision and group case consultation to associate and licensed therapists. Tracy is now the supervisor at Youth and Family Services of Marin County, providing clinical supervision to therapists and ensuring care for all children, adolescents, and caregivers of Marin County with severe mental health issues, complex trauma, and difficult social circumstances. Tracy is active in the community and currently serves as the board vice president of Multicultural Center of Marin, a nonprofit that supports the immigrant and indigenous populations in the county.

Learning Objectives

At the end of this program, participants shall:

1.Understand the application of the concept of moral injury in clinical practice.

2.Identify how moral injury leads to dissociation and withdrawal from patients.

3.Use the clinical community to combat the effects of moral injury to treat their patients.        

This is an all level presentation

Fees

CCP members: free with annual $175 membership, payable at registration.

Students:free with annual $150 membership, payable at registration.

Fellows: free with annual $150 membership, payable at registration.
Non-CCP members, single admission: $50

Continuing Education
This program is sponsored for Continuing Education Credits by the Chicago Center for Psychoanalysis. There is no commercial support for this program, nor are there any relationships between the continuing education sponsor, presenting organization, presenter, program content, research, grants or other funding that could be construed as conflicts of interest. Participants are asked to be aware of the need for privacy and confidentiality throughout the program. If the program content becomes stressful, participants are encouraged to process these feelings during discussion periods. The Chicago Center for Psychoanalysis maintains responsibility for this program and its content. CCP is licensed by the state of Illinois to sponsor continuing education credits for Licensed Clinical Social Workers, Licensed Social Workers, Licensed Clinical Professional Counselors, Licensed Professional Counselors, Licensed Marriage and Family Therapy Counselors and Licensed Clinical Psychologists (license no. 159.000941 and 268.000020 and 168.000238 Illinois Dept. of Financial and Professional Regulation).

Professionals holding the aforementioned credentials will receive 3.0 continuing education credits for attending the entire program. To receive these credits a completed evaluation form must be turned in at the end of the presentation and licensed psychologists must first complete a brief exam on the subject matter. No continuing education credit will be given for attending part of the presentation. Refunds for CE credit after the program begins will not be honored. If a participant has special needs or concerns about the program, s/he/they should contact Toula Kourliouros Kalven by February 11, 2022 at: tkalven@ccpsa.org.

References/Suggested Readings

1. Fourie, C. (2017). Who is experiencing what kind of moral distress? Distinctions for moving from a narrow to a broad definition of moral distress. AMA Journal of Ethics, 1:578-584.
2. Layton, L. (2014). Some psychic effects of neoliberalism: Narcissism, disavowal, perversion. Psychoanalysis, Culture, and Society, 19(2):161-178.
3. Shay, J. (2014). Moral injury. Psychoanalytic Psychology, 31:182-191.

Presented by

The Chicago Center for Psychoanalysis/CCP Program Committee: Carol Ganzer, PhD, Toula Kourliouros Kalven,  Alan Levy, PhD.

The Chicago Center for Psychoanalysis is an IRS 501(C)(3) charitable organization, and expenses may be tax deductible to the extent allowed by law and your personal tax situation.