But what’s the real problem?
This is a short story about and reflection on what’s needed to see and work with the whole person. In it, we’ve changed people’s names and superficial personal details to protect their anonymity, but all the documentation and events themselves happened as recorded.
What did Amalia do?
In the first two months of this year, Amalia has been late, a lot. About half the time she’s late (sometimes an hour, sometimes five), and about a quarter of the time she’s out.
Part of this is the same kind of stuff lots of people deal with: When we first met Amalia, she didn’t have a place to stay. She crashed at one of our apartments until we arranged temporary housing for her with someone in our extended community. Eventually, she found more stable housing. Despite feeling very unwelcome at home (which is why she didn’t have a place when we first met her), she often has to translate for her stepmom, who’s being cared for by a nurse, and that both often means she’s late, but also adds to her stress.
But pretty soon we started to think something else was going on: Amalia really wants to be here. She really wants to get her diploma. She’s incredibly polite. She hates asking for help. She’s pretty diligent.
At first, she just apologized. “I’m sorry. I’ll do better.” She felt like we were asking her because we were upset.
Then, she blamed transportation. “I hate using the subway.” “No way I’m going on the buses.” “I can’t afford an Uber.” “My ride flaked.” (Amalia lives six miles away, fifty minutes by public transit.)
Despite this, she did great work (when she was here, at least). Amalia was diligent, fun, funny, and had plenty of interesting ideas and hobbies and goals to pursue. She seemed really game to take advantage of what Powderhouse had to offer.
We didn’t know what to make of it all. Was she just blowing us off?
What did Powderhouse do?
At Powderhouse, we help people get dramatically better at figuring out the next most important thing to do and tackling it, focusing on three questions: Who am I? What do I care about? What am I going to do about it? In other words, at the heart of our work are people and their priorities. We help people achieve their goals, not ours.
Amalia’s goals (e.g. graduating high school, becoming an ultrasound tech, being able to join the world as a responsible working adult, etc.) were increasingly threatened by her late-ness. After a couple weeks, we started pushing a bit more: Why are you late? “Because I woke up late.” Why did you wake up late? “Because I went to bed late.” Why did you go to bed late? “I couldn’t sleep.”
As we talked more about her sleep, we found that sometimes she “sleeps” for 14–18 hours and still wake up tired.
We talked to her about depression. About anxiety. She said she was fine. But was she really? We felt out with some of her friends whether they thought she struggling with depression (or just more generally, emotionally). Nothing.
For awhile, we entertained the idea that maybe she really was just blowing us off. Amalia sometimes talked a big game about partying. Maybe she really did, and these were just the results. But she insisted she wasn’t.
We talked with her more about how it was interfering with her work, about how it was going to be a structural problem in her life. Eventually, she wants to become an ultrasound tech, and there’s no way she’d make it through college (much less keep a job) if she couldn’t show up on time and ready to work.
Finally, Amalia agreed to work closely with us to solve her sleep problem. So, we did what we often do: We turned it into a project: Fixing my sleep schedule. We wrote a pitch, we made a plan, and we got started.
We found that—true to form—she was game. Amalia really did want to solve the problem.
We agreed that first we wanted to understand the problem. We got her an Apple Watch and started tracking her sleep.
We started to realize there was a much bigger, underlying issue: Amalia really wasn’t getting quality sleep. On most days, the Apple Watch wasn’t even recognizing her time in bed as sleep!
We started talking to her about iron and vitamin D and B12 and sleep studies and exercise and diet, and when we said “anemia”, she perked up: “Oh yeah, I have that.” 🤦♂️
We got her permission to release her medical records...
...and all over her records were words like fatigue, inadequate sleep hygiene, iron deficiency, history of depressive symptoms, takes naps in the afternoons, wakes up at 3pm, ferritin.
Then finally, a note from more than four years ago:
…where among other things, we learned that she wasn’t stringing us along when she told us she hated pills. She’d been avoiding them for years. (Later, we’d learn this aversion was trauma-related.)
Together, we researched more about other possible causes of fatigue and found that hypothyroidism might be another factor in addition to anemia. To be rigorous about it all, we suggested taking a couple tests to capture where Amalia’s baseline was, using LetsGetChecked to send away for the necessary blood tests.
Then, after brainstorming and doing a bit of research, we found that there are, in fact, liquid and gummy iron and vitamin supplements. She got started on the gummies, setting up MediSafe to collaboratively track and share taking them.
We don’t know where this will go, of course, but we’re feeling pretty confident right now.
Regardless of the outcome, a few elements of the story deserve highlighting for those interested in human development, especially those coming from the world of School.
What would School do?
Imagine how flummoxed School (or a typical job) would be by Amalia. She’d be chronically absent, failing her classes…completely out-of-pocket. In fact, when you look at Amalia’s academic record, that’s exactly what you see.
If a car doesn’t start, we pop the hood. If a person is sick, we go to the hospital and get a diagnosis. If a computer program doesn’t run, we debug it. But if a person struggles in School, for the most part the system is only set up to profile, chide, label, and mark them.
A lot of structural factors contribute to this, but three of the biggest are:
- Most people don’t want to do most of what School asks of them, and so in many big and small ways, they refuse. So, when something doesn’t work, it can feel natural for adults within the system of School to assume it is a question of commitment or motivation.
- Most people within Schools aren’t given the time or authority to explore why any particular individual young person is struggling. For School, “Pushing harder” is a response which can be scaled through various structures (detention, grades, progress reports, etc.)
- Together, 1 + 2 mean that adults in Schools rarely have the time, access, or rapport with any given young person or their family to to really explore their holistic situation.
In contrast, at Powderhouse, we think it is important to be curious, not judgmental, 👇 and have systems set up to support that.
Most Schools would think that what we did for Amalia was completely impractical: “No School could afford to spend that much time on one student’s problem.” Those slightly more systems-minded might say, “No staff, social work, and administrator team would ever be tightly-knit enough to pull that off.” A young person might say, “I’d never let a teacher get up in my business like that!” (which a youth-worker might interpret as: “Most teachers would never have had the time and space needed to build the rapport required for that.”)
One of the most important things is that even when your student:teacher ratio is 20:1, a typical teacher might teach five or six classes, meaning they are seeing upwards of one-hundred people each day.
Combined with a forty-five minute period where you could only spend 120 seconds talking to each student even if you spent the entire class devoted to that, and what hope does the typical teacher have of making headway? And that’s before you even begin to touch on the questions of liability or training or procurement or institutional inertia that beleaguer those working to make change in most schools today.
There are at least two interesting things about School’s flat-footedness in this situation:
- The first is that if most adults in School confronted this problem within their own family—e.g. if Amalia were their daughter—they would have no trouble tackling it, or at least approaching it with a modicum of creativity and rigor. Meaning it’s not for lack of skill or imagination or sensitivity.
- The second is that while they would mostly frame their inability in resource terms (”We don’t have the time, money, etc.”), their failure to address the situation is far more resource intensive. The tutoring, the test results, the truancy paperwork, the parent-teacher and parent-student communications and follow-ups: All of these together are far more expensive than “just” fixing the problem: We spent maybe five staff hours, 180 on tests, and $200 on an Apple Watch (which we can reuse for other projects). Surely a traditional school would waste more than a few hours and a couple hundred dollars dealing with this kind of thing?
Taken together, this means that something happens to people when you put them in School. Even though most within these schools nominally have access to more resources and more expertise, their systemic context means they not only feel like they have less, but they act less intelligently and responsively with the resources they do have.
Three mindset shifts
Every person and every person’s situation is unique. Even if useful patterns and heuristics emerge over time, context and relationships aren’t interchangeable. There is no substitute for caring, thoughtful, just-in-time consideration of what a given person is experiencing and what they need in a particular moment.
Embracing this fact in Amalia’s case required three important shifts in mindset:
- Take responsibility for outputs, not inputs ⇒ I am Amalia’s math teacher. But I am not only Amalia’s math teacher. I am not responsible for dispensing algebra lessons. I am responsible [among other things] for Amalia learning math. This means that I am responsible for everything that contributes to or detracts from that. Taking responsibility requires responding. If something gets in the way, I am called to respond. But it’s not just me at Powderhouse: There is a team that’s called to respond. (This is, of course, theoretically possible in a school, but not in an arrangement where the recommended counselor-to-student ratio is 250:1, and the average is more than 400:1.)
- Understand a problem before solving it ⇒ If I were only Amalia’s math teacher, would I really be empowered to order a ferritin test? Taking responsibility requires understanding a problem before we can solve it. That means asking “Why?”, repeatedly. This is not only required by taking responsibility for outputs, but it is enabled by it: Most teachers don’t feel like they are allowed to understand a problem first because [in part] they feel it will be seen as a diversion from their “real” job. When you see the entire situation as your responsibility, you’re liberated to attend to the most important thing.
- See the whole person ⇒ First I see Amalia as a person, not a math student. A corollary of understanding the problem before you solve it is that you have to widen your perspective to the person’s entire context, because a person lives in their context, not in your class.
As of this writing, we still don’t know whether we’ve solved Amalia’s challenges. But this is not the first time we’ve tackled problems like this. We’ve worked with people to identify and treat anxiety disorders. We’ve solved housing and food insecurity that was keeping them from coming in. We’ve helped people address their anxiety and unfamiliarity with public transit, walking with them to a bus stop and helping them figure out how to take the bus so that they could participate in college and adult education classes. We’ve sat down to have extended conversations about perfectionism, turned it into a collaborative goal we work toward, and wrangled it.
We’re trying our best to set ourselves up to solve the real problems, and in some ways that leads to one of Powderhouse’s biggest advantages: We’ve arranged things so that we can take responsibility for things, which means failures and challenges are not diversions from the work, but rather the work itself.
///
☝️ Many people think Walt Whitman said this first. He didn’t. Neither did Ted Lasso. Given how predisposed we are to treating young people as problems, it’s interesting that the earliest recorded indication is from a 1986 advice column responding to a parent who found oral contraceptives in their daughter's bedroom:
Try to find out her concerns. Be curious, not judgmental. Did she think you didn't care? Does she want an earlier curfew to reduce the opportunity in developing relationship with a male? Is she being pressured by female peers to join in? It takes a lot of courage for a teen to stand up to peers and say "that is not for me now." If she needs to hide behind parents, then be there to shield her. Let her know you will act as that kind of shield anytime.
Youth can be a handful. Most adults are blessed (and cursed) with a different (and in some ways more competent) life perspective. When you care for a young person and you feel like your interests are aligned and still they subvert or resist or dissemble, it can feel like they’re your adversary, that they’re a problem. That often obscures the questions and understanding needed to solve the problem.