OCCUPATIONAL HAZARDS

 

I noticed right away the whiff of chemicals on his coat, but I didn’t want to embarrass or offend him, so I didn’t ask him to hang it up in the waiting room. I thought of him as shy and inward, in ways that might have had to do with poverty and tumult, and I didn’t want to drive him further down into any of that. I did mention lightly that I noticed something, and he told me it was diesel that had spilled on him. I opened the window, giving the excuse that I was warm, while keeping my sweater on. Did he catch that discrepancy of logic? If so, it wasn’t apparent. I liked him but didn’t know if I was reaching him in any helpful way. We sat in long silences together while he sorted out the tactile puzzles next to him. I asked him to name his feeling when he solved one, and encouraged him to notice sources of pride in his life. I told him he deserved to feel pride, and his eyebrows went up—his strongest reaction ever in session, I think. Not because of him, but for the sake of my breath that day, I was relieved when he left. He’d been sitting on a pillow that I knew would never air out; I would have to remove it. The day proceeded. I saw two more clients, then transferred my plants from the windowsill, where the morning sun through the glass is always too intense, to the little table where I sit with kids, and left for my evening job. The next morning when I unlocked my office, the diesel was still eye-burningly thick in the air, and my fluorescent pothos, formerly a glowing green, thick and exuberant with leaves, was at least half-dead—the wilted leaves brown and sickly slick. Pothos rate high among potted plants both for ease of growth and for their ability to clean indoor air; I felt as though this one had taken the hit for the other two plants in my office, and for me. I picked the dead parts off and discarded them, realizing only later that I should’ve photographed the whole plant first, to capture the devastation that had been wreaked, that evidence of ecosystem in action. Then I did what I had to do: I opened my window and sat at my desk to start notes. Absentmindedly I reached for my mug, forgetting that the water had sat overnight, and realized I was tasting diesel fumes that had settled there. I spit into the garbage, rinsed my mouth, washed the cup multiple times in the staff kitchen, rinsed my mouth again, drank filtered water. Every day for over a week, I came in to more dead leaves. At first dark like overripe bananas, then dwindling to jaundiced leaves with darker spots, like burn marks. The foliage sparser and sparser as I pruned and hoped for recovery. An acquaintance who heard about all this, after the fact, said, “Never sacrifice yourself that way again. Ask for the coat to come off.” Well, the boy didn’t wear the coat next time I saw him, which, given patterns of attendance in such an agency, wasn’t a mere seven days later. It got warmer. But meanwhile—just imagine—he’d been walking around like that, breathing that in.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. I’m deeply grateful for my readers, and as always, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

HAIL-MARY SWISH

There’s a basketball rim behind the agency that stands several feet below regulation. It’s supported by a plastic base that tends to fill with water, broken glass, and cigarette butts. The court is smaller than your kitchen, unless your kitchen is a galley on a boat; it’s made of brick and weeds and bordered by abandoned patio furniture. Beyond that, the miracle of grass.

It’s good for little but playing H-O-R-S-E, which I’ve done in blazing sun, swarms of gnats, and even cold, though not lately—it’s probably been twelve months or more since I’ve taken clients there. Different clients, different interests. My basketball, bought four years ago for work, sits deflating under the desk where I sit typing copious notes, community mental health’s Sisyphean task.

I don’t miss those outside sessions, which always made me feel like I was in the wrong place, wishing I were in the right one. I’m still working out to this day where exactly that place will prove to be, ultimately. I do sometimes, though, think about a middle school boy I saw early in my employment. He was my first truly mandated client and engaged in selective mutism in protest of his mother’s insistence that he attend therapy. The substance of her concern was his childish behaviors at home. I would not be of help, it soon became clear.

Our therapeutic relationship didn’t start strong. The boy complied with an expressive activity straight from a textbook, to choose an animal figure from a jar to represent each member of his family and place them in a constellation of sorts on a labeled paper; but his reasons for choosing each, he kept to himself.

It didn’t finish strong, either; our last visits, as I recall, surpassed mere silence and exceeded recalcitrance to enter territory beyond. While now I might recommend more co-parenting work, at that point on my learning curve, I was advocating to end services, expressing privately to my client’s mom that I would rather he feel supported in his preference than be turned off to therapy for the rest of his life. By then, she and I had had a few one-on-one talks, and I believe the most difficult piece about closing, from her perspective, may have been the loss of someone to hear her own challenges and frustrations with the whole family.

Formal activities work for some kids, but it didn’t take long before my focus shifted, for the duration of the middle phase, to attempting rapport by joining my client in whatever fun could be had. We played War (for the record, the most tedious card game I know) and UNO. There may have been an occasion of popping matchbox cars in a wordless contest; that’s a bit foggy now. Sometimes we went out back to the sorry court described above, clouds passing overhead. I had the idea that if I could impress him with my hoop-shooting skills, the energy of our visits overall might shift. Well, you already know that didn’t happen. But there was one glorious afternoon that lives in my memory…

His younger brother had come along that day, and the decision was made to head for the grass with a small finned foam football that was meant to have good spin, though not when thrown by my hands. My client was animated with unusual verve, in the role of leader. He talked! Mostly to his brother, but still! In a spirit of inspiration and delight, I proposed rules. Instead of just passing and catching or fumbling, whoever dropped the ball would run prescribed laps and then throw the football through the basketball hoop. If a basket was made, play could resume. If not, more laps.

He wasn’t just game, he showed gusto, and the three of us ran around the broken picnic tables until I literally, if dramatically, fell down panting. I think of that day, and the neon-green torpedo catching net, as my Hail-Mary Swish. I gave it my all, and my all was both grounded and free. If my client remembers anything from our time together—ancient history now, in kid years—I hope that’s it. We salvaged something, I think, however small. Not in that case, but in the very best cases, salvage can be salvation.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. I’m deeply grateful for my readers, and as always, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

 

 

O FLOURISHING WORD

 

He was not my client, he was my next-door neighbor’s, but I often passed him sprawled in the hall on my way to and from the waiting room and photocopy machine. Sometimes he was with another boy, but mostly he was alone, turning his yearning face up at the sound of any steps.

From my first friendly hello, he wanted to claim my attention. If he had blocks, he wanted me to build something; if he was holding a board book, he wanted help reading. His sweet appeal stopped me in my tracks despite my need to get things done, but his needs ran deeper than a few minutes’ interaction. Because I always had other things to do, over time I weaned myself from crouching for a chat to whisking by or pausing above him like any other adult on the move.

Almost unfailingly I had to ask that he clear sundry diversions from the center of the floor so that people could navigate to offices beyond. My requests always seemed to take him by surprise, as though the bit of variation I tried to work in week by week succeeded in creating brand-new experiences.

“Hi, nice to see you again!” “You look like you’re having fun!” “Wow, did you build that?” I might compliment a racetrack for marbles, or a scene composed in a plastic box of sand. Those openings were my prelude to asking the same old question, after which I made sure to express thanks.

Poor little guy—bounced from home to home, never in his own. His exile to the hall was meant to allow my colleague time to educate current caregivers on his need for love, rather than the kind of respect-based rearing still thought to raise good citizens, wherein respect equals obedience.

During one of our last such encounters, I felt a little self-conscious about asking him to sideline himself yet again. So arms akimbo, I asked, for novelty’s sake, “Now, what do I always say to you when I see you?”

“‘Good job,’” he quoted in reply.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. I’m deeply grateful for my readers, and as always, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

 

SUPERPOWERS.

 

 

For a lesson in heartbreak, ask a foster child what superpower she would choose if she could. I did, this evening, and her answer was, “Read minds.” I feel like those two sentences ought to tell a story in and of themselves, but my view may be colored by my second-hand exposure to the issues. Her parents’ long-standing neglect hit a little more consciously this week, when her mother didn’t bother to schedule a visit with her. One phone call, free transportation from the state, three hours’ commitment. Told by her foster provider that her father has been “sick” lately, kiddo said, “I know he does drugs.” Meanwhile, her foster family, whom she clearly loves with all her yearning soul, would not be able to keep her even if she hadn’t started acting out and creating divisions among them. My theory, not especially perceptive: She knows her fate won’t lie with them, and she simply cannot bear it. Because she can’t bear it, she’ll likely be moved all the sooner. But when? Where to? How will she be treated? Will she ever feel at home, ever belong? The ability to read minds would give her a map, a compass. The country itself would likely be no less hard.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me. To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. I’m deeply grateful for my readers, and as always, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage.

MISSING PIECES

 

It was a cold, rainy November day in community mental health. I was stood up for the third week in a row by a parent who nonetheless makes no move to end services, meaning that I have to send a letter that indicates concern (without getting too personal) and points up my outreach efforts (without sounding overbearing). Despite a background in writing, such communications are grueling for me.

I spent 25 minutes on the phone with a juvenile probation officer, discussing a client’s obsession with his ex and his legal situation related thereto; then hung up and promptly wondered whether I’d betrayed his confidentiality in the little bit of talking I’d done, something that will likely nag at me long after my supervisor reviews it with me. I was beset and nuzzled by a hand-puppet seeking affection-by-proxy on behalf of a child I have frequently had to remind about personal space.

Holding respectful silence, I supported a young adult in the process of contemplating how much of her sexual trauma she needs and wants to share. I stepped with a mother and daughter into the furnace of long-fueled resentments. At one point, an adult psychiatric patient crunched through the snow to look in my window before continuing next door to pound on the glass of the doc, cursing and threatening him till police were called. Come to think of it, that’s what started the day.

Two client visits were easy and joyful and kept the lights bright in my brain after too many hours spent doing paperwork and hearing disappointing news. But the part of this Monday that I’ll remember most clearly is the call from Sue, a foster mother, to tell me about a question posed by my kindergarten client on the drive to school. Removed from her biological mother for gross medical neglect as well as alleged abuse, my client asked from the backseat, “Do you think you can love a person without liking them?” Six years old.

Every clinician I know has favorite clients and heartbreak clients, often one and the same. This girl stole my heart from the moment we met, and although I behave with the same playful professionalism I would with any client her age, I wish in a very real way that I could adopt her. That I can’t is one of a short-list of aches that descend from metaphor to dwell in my core.

I’d gone in early to finish an annual review, so the day felt extra-long. When I got home, my bootlaces wouldn’t loosen fast enough. Yanking, tugging, heaving, I got the right boot off, taking my sock with it. Stuck to the bottom of the sock, and hence to the bottom of my foot, the bottom of my day, the bottom of my ache, was a small puzzle piece. The crackled glaze on the curve of the Mona Lisa’s mysterious smile.

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Out of respect for client privacy, names here are always changed or omitted, and details may be altered in fact while relevant in spirit. Text and image copyrights held by me.

To subscribe and receive future posts, please look to the upper right on your computer screen, or scroll to the bottom of the page on your mobile device. I’m deeply grateful for my readers, and as always, I’d love to reach more. If you enjoyed this piece, please consider sharing it with anyone you feel might like it, too, by linking to it in whatever way works for you. I typically post once a month, so no barrage! Thank you for your visit.