THE NUMBERS GAME, PART TWO (OR, MY SO-CALLED THERAPEUTIC LIFE)

One of the many challenging aspects of working in community mental health is that you are, de facto, expected to practice as a generalist. In Youth & Family work, this means taking any client between preschool and 21, with pretty much any kind of issue. It doesn’t matter if you have little to no training or skill with a particular developmental age or diagnostic picture. You learn as you go, or not. At least within the session itself, your clients sink or swim with you; elsewhere, other factors can and often do play the determining role in outcomes.

Of course, any profession will involve on-the-job learning. Still, upon reflection, does working without expertise or even affinity, in some highly sensitive cases, seem therapeutic? We have supervision, but not in vivo; we have training opportunities, but not often or intensively enough. As regards this lack of choice, I’m reminded of an obnoxious rhyme I heard while volunteering in a kindergarten, summoned on such occasions as the passing out of birthday lollipops: “You get what you get, and you don’t get upset.” Yes, in fact, you do get upset! And clients may get upset—rightly so, if they’re not adequately helped where such help might be possible but wasn’t in the roll of the dice. A prohibition against feelings and preferences helps exactly no one.

But back to generalist practice. Let’s say I have a caseload of 25 (again, as mentioned before, that’s on the most absurdly, luxuriously modest end of the community mental health spectrum). Let’s say the work week begins, and maybe I get lucky with an easy sort of Monday, six clients back-to-back but all doing relatively well. I may leave work feeling buoyant and thinking, optimistically, “It’s time I got around to reading more about blended families!” But then I remember that I started a book, some time back, on post-traumatic play, which is still relevant and likely ought to take priority. I decide that I should focus on that.

Tuesday, though, is rougher and brings fresh urgency to the need to research conflict resolution and nonviolent communication, to provide a distillation of resources to a weary and worried single parent who is hungry to learn how to talk to her teenage son before he slips away from her care and into a life of delinquency; she wants more than the basic guidelines I’ve already offered. I plan to assemble some things in the morning… Wednesday finds me, however, scrambling to photocopy materials on fight-flight-freeze and executive function, in order to best and most clearly explain brain processes to some guardians at their wit’s end and contemplating giving up a child, already abandoned multiple times, to the custody of the state. Her fate isn’t in my hands, but my success with the guardians feels as important as if it were.

Then Thursday? Thursday brings a mandated client who would probably rather chew glass or walk across hot coals than engage in therapy. I’m often successful building rapport in such cases, and even look forward to them, but this one’s giving me a run for my money, and my thoughts turn, yearning, to the book on motivational interviewing that I love but never have time to reread from beginning to end. Friday, my lightest day, nonetheless may remind me that if I had more expressive activities up my sleeve, I might better assist a boy in foster care who appears to lack the words for what he may feel.

I have hesitated over the subtitle, “My So-Called Therapeutic Life,” because to some extent it feels self-indulgent. First of all, yes, these are first-world problems. Second, I’ve had some truly amazing therapeutic experiences, and have been in awe of many of my clients and the challenges they overcome. I’m grateful for the chance I’ve had to start where I started and do the work that I’ve done. But I decided to include the subtitle because, as my colleagues and anyone who has ever worked in an agency all seem to agree, the pressures are such that there is little sense of grounded, focused, therapeutic practice. To summon the energy to try and create that experience for clients from hour to hour, can be exhausting and sometimes unrealistic.

I love reading. I love learning. I love doing good work. But, as it happens, I couldn’t live much better than hand-to-mouth on what I’m paid, in the part of the country where I currently live, and the stress of that is too much for me. So, when I leave my agency, it’s not to go home and read, but to race to another job, where I spend evenings and weekends. I average 65 hours a week, and it’s sometimes been up to 80. Additionally, in this milieu, we are buried in avalanches of paperwork, so I’m often working from home to try, in vain, to catch up. When I have free time, which is rare, I almost don’t know what to do with myself, despite a healthy number of outside interests. But I’ll tell you this: lately I spend most spare minutes dreaming of the day when I can leave my job(s) and start living another, more fulfilling kind of therapeutic life: one in which I can rest, nourish my spirit, and educate myself to better serve clients who are not stuck with me by lottery, but who elect to see me week by week. A life, for me and for clients, of choosing and making.

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I’m deeply grateful for my readers, and in 2018, 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.

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. Thank you, and best wishes for (finally!) Spring.

META ON METTA

 

The end of any year brings seemingly innumerable invitations to make financial pledges. This is not one such! It is a contemplation, rather, on the merits of taking the whole process of New Year’s resolutions one step further, by creating or adopting a meaningful philosophical pledge, for the coming year and beyond—a pledge that, like metta meditation, moves you to consider your own life and the life of the world through the same lens—then post it somewhere prominent where you won’t fail to see it. A dashboard could work, for those idle moments in traffic. The back of a smart-phone case, as a tactile reminder on an abstract medium. A few valuable inches on your fridge.

I do my damnedest, in this writing, to maintain a positive approach to the subject at hand; I could opine all day long, but the virtual world is full of tirades already. I also try to be simple and straightforward; there’s an overabundance of glib commentary. With the conscious effort that my approach can require, I help reorient myself toward my own higher ideals—of which I not infrequently lose sight in my day-to-day interactions. I mostly write about my therapeutic work; but I’m no plaster saint, to use an old expression. As a child, I was asked to suppress my anger, and it’s still coming out now—mostly in the form of outrage over this and that aspect of culture, all the grievous injustices of which I’m aware, but also things that hit close to home and close to the bone, failures of friendship and emotional betrayals.

So: New Year’s resolutions are all well and good—my default is “Write more; swear less”—but I also need something bigger, deeper, stronger. Something to help me face the daily challenge of living, above and beyond a singular achievement, however important. My very first client, at my first internship, helped me to realize this. Whereas I had grown up in a broken-down neighborhood in a broken-down city, she lived a semi-rural life and loved her chickens with every fiber of her beautiful being—knew their personalities and followed events in the pecking order like a telenovela. Together we worked on validating her negative feelings, so that instead of being suppressed, they might transform themselves and empower her.

Through her, I came to be aware of the 4-H pledge: “I pledge my head to clearer thinking, my heart to greater loyalty, my hands to larger service, and my health to better living, for my club, my community, my country, and my world.” I saw her living out those values in continuing to love those who had hurt her, despite looking with clear eyes at their flaws, and rising above the chaos she’d known at home. The first four assertions have spoken to me ever since, like a nondenominational statement of grace. (I have mixed feelings about that string of possessive mys, and those feelings amplify as the picture gets bigger. Whose world? Our world.) An even simpler distillation of values, which for me is supremely grounding, is posted above my desk at work, a reminder to me and my clients: Be curious.

In 2018 and thereafter, I hope that ecosystems will be protected and valued as sacred, and that workers will be fairly paid and treated. I hope the humble honeybee, with its staggering commitment to fructifying the earth, will survive colony collapse. I hope that the rights of women, and various vulnerable populations, will be recognized and upheld. I hope that buzz words like “slow food” and “slow fashion” will build up to full-on movements, and that the doomed cultures of Agribusiness and Big Pharma will fall. Food doesn’t come from factories, and answers don’t come in pills. I hope that we collectively will have the resilience to develop the patience to labor on toward real answers—many of which can be found in traditions whose caretakers are indigenous peoples. And, of course, I hope children grow up feeling safe, loved, and respected. So many visions and wishes for our planet. I’ll be doing my part as best I can. I share these thoughts today, in this quiet corner of the internet—deliberately free from the commercial intrusions of ads—as an act of loving-kindness: I wish good things for me, and I wish them for you.

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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. If you enjoyed this piece, I hope you’ll consider sharing it. 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. “The Numbers Game” (July 2017), now long delayed, will be continued in a future post, when I have more stamina for the topic. Thank you for reading!

 

PAPIER-MACHE, IN TWO PARTS

This story starts at my inner-city parochial school, where supplies were so sparse that at one point we were sharing a single box of construction paper amongst grades Pre-K through 8. I can still recall my pride upon being chosen by Mrs. Z to leave my 1st grade classroom and walk down the grand black-tiled hall to request the box from another teacher—head held high in my state of importance, I fervently hoped to be witnessed.

What my school lacked in resources, it made up for amply in spirit, thanks in no small part to the cultural influence of the Spanish-speaking families in our parish. The Sisters who ran things, all Caucasian, embraced those families and honored Our Lady of Guadalupe. Looking back from this distance, in a culturally hostile hour, I admire the welcome offered by administrators who would have first come to know the neighborhood when it was all Polish, before the sugar skulls of the Day of the Dead bedecked the shelves of the shabby nearby bakery. A local woman was brought in to teach us Spanish hymns. Most thrilling were the piñatas.

Preparing for an all-school festival, each class worked together at long tables in the basement, soaking strips of newspaper in gummy flour paste and laying them bubbled and buckling over balloons. Smoothed, dried, painted, and strung up in the school gym—a magical transformation—they bobbed as each member of each class, taking turns, got to leverage one blind-folded swing, until a spill of candy hit the floor.

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The story continues with Cybil, 14, who was hospitalized several times for suicidality before she came to the agency seeking services. I liked her instantly, which made it relatively easy to build the rapport that is crucial with any client, but perhaps especially with teens; she had a mordant wit and a sensitive heart, both of which provided points of connection. One evening early on she interrupted herself and looked up from her mandala, colored pencil poised, and asked, tremulously, “You know I’m not doing this for attention, right?” It was already clear she had heard that accusation many times before.

Thanks to Cybil’s engagement in session and commitment to her therapeutic homework, within several months, she had stopped cutting—then, later, purging. Much of our work, though, still lay ahead. Ahead, and below.

In ways beyond my ken, I’m sure the speculated hard inner core and molten outer core of the Earth make all life possible; but the hard inner core of pain and molten outer core of anger, beneath a crust of scars and mantle of “behaviors,” almost cost Cybil hers. She told me that it wasn’t so much that she didn’t want to talk about things, as that she didn’t know where to start.

Reception at the agency had a vestigial practice of printing visit slips, despite the transition to computerized record-keeping. Several clients were aware, when they turned them over to me, that I put them in a file marked “To Shred.” As she and her mother prepared to leave one night, Cybil handed me hers: “Oh, here, do you want this for your file?”

“Sure,” I replied, “unless you’d like to keep it for yours.”

“I’ll be able to wallpaper my room with them pretty soon.”

Her mother and I exchanged quick looks; she seemed to hear what I did. All that stigma, writ large in Cybil’s life. “Why wallpaper?” asked her mother. “How about papier-mâché?”

“Yes!”—I seized on that. “What about a piñata?” Cybil liked candy, and she deserved a celebration. Transformation for transformation. “You could fill it with sweet things and baubles!” I imagined—I hope we three collectively imagined—a jaunty silk scarf tied above her fine nose and wide smile.

“I like that,” she said. Her mom agreed.

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Out of respect for client privacy, names are always changed. If you enjoyed this piece, please consider sharing it. To subscribe and receive future posts, please click the “Follow” button, accompanied by a plus-sign, in the lower right corner of your computer screen.

 

 

A COUNTERVAILING MAGIC

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Last evening I was running some errands in town when the owner of a tiny used-and-antiquarian bookstore, bald in the style of a sea captain, flagged me down: he had a couple somethings I’d asked for months prior. So I went in, and settled into a narrow armchair, losing track of time until I realized that his open sign hadn’t been up, and I was likely keeping him from his tea.

He waved off my apology; he was staying late, as it happened. A young man would be bringing his girlfriend by, to guide her toward a certain book with a carved-out center containing—yes—a ring. Once said young man had proposed, the owner would clear a space for a small, well-appointed table, and a local restaurant would provide a catered meal. (I didn’t ask, but imagined a lone violinist there as well.)

Hearing that, surrounded by a warren of shelves all but obscuring the ancient blue wallpaper, with a peach-faced lovebird singing in the other room— “Alas, in a cage,” said the bookseller—was an instance of countervailing magic, the current that runs against the ills of the world. Such encounters—magic is always an encounter in some form or another—restore me to joy.

There is a great deal of pain involved in working with children. My first client, as an intern, was a little girl whose mother punched her in the nose and took an ax to her father’s car; she couldn’t concentrate in class and wept for the loss of an animal she’d loved, plus everything else, tears that shook her frame. We did a sensory inventory one day, and the wind spoke to her and told her to find her own safe place in the landscape at home; she let a pond remind her of peace, and the sun shining through a leafy trellis bring her hope. Magic: her dear, intelligent face, as we meditated at a picnic table, beneath the tall tall trees and a vibrant sky. May it carry her forth.

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STILLNESS IS THE MOVE

Dewy daisy

I met someone recently who has a feature on his phone that allows him to tap his screen and make water seem to ripple from the touched spot. He said it relaxes him, and given that he’s a newly recovering addict, I reigned in my critical impulse—I mean, I hope his phone does have a calming influence, since that would beat the hell out of his using heroin.

Even so, I have questions: Is such a device the portable tech version of the tabletop Zen sand garden, which is itself a marketable version of actual Zen gardens, careful oases of stillness and contemplation on a crowded chain of islands with a militaristic past and consumerist present? Is rippling water on a phone a translation of ancient wisdom for our times—a digital, audiovisual haiku—or a trading of engagement for instant gratification?

Mindfulness seems to be everywhere and nowhere these days, and I can understand why some Buddhists take issue with the trend—those of the opinion that meditation without precepts is an ungrounded activity. I don’t share that perspective exactly; I see lots of evidence that mindfulness, as a non-affiliated practice, can be transformational. Indeed, that has been my own experience. But “practice” is the key, and I don’t believe there are shortcuts for that. No apps, no props, not even good books on the subject can accomplish what just sitting regularly in meditation can.

For my groups at the jail, for example, I developed a ten-week curriculum on “The Skills of Mindfulness,” and I could open my notebook anytime, anywhere, and credibly explain my outlines and handouts. But the difference between theory and praxis is as great as the biblical “letter” vs. “spirit” of the law. I don’t think I’ll ever forget what I’ve already learned from mindful meditation, how it’s made me aware of myself in a new way as I interact with the world. But whatever memory for the benefits I possess, when I’m not actively practicing, I feel different—more harried, less steady, a poorer communicator. Out of touch with myself and what matters to me.

How much meditation is enough? At a minimum, I would say five dedicated minutes every day without fail are worth more than thirty now and then, and for those new to meditation, taking on too much can backfire. Bhante Gunaratana warns against this in Mindfulness in Plain English, making clear that starting modestly allows us to incorporate a practice into our actual lives (and thereby transform them), whereas an extreme commitment is usually untenable and will quickly fall to the wayside. This also resonates with Dorothea Brande’s advice to aspiring writers, worth quoting at length:

“We customarily expend enough energy in carrying out any simple action to bring about a result three times greater than the one we have in view. This is true from the simplest matters to the most complex and of physical effort as well as mental. If we climb stairs, we climb them with every muscle and organ laboring as though our soul’s salvation were to be found on the top step, and the result is that we grow resentful at the disproportionate returns we receive from our expended energy. Or, putting a great deal more energy out than we can use, we must take it up, somehow, in purposeless motion. Everyone has had the experience of pushing a door that looked closed with more vigor than was necessary and of falling into the next room as a consequence. Or we have picked up some light object which looked deceptively heavy. If you notice yourself on such an occasion, you will see that you must make a slight backward motion merely to retrieve your balance.” (from Becoming a Writer)

One way to recognize a trend (as opposed to, say, a movement) is to notice whether it’s feeding commerce more than it feeds the human spirit. However often we now hear the word “mindful” spoken in various contexts, talking the talk is ultimately meaningless if that’s all that’s happening. There is a garden within to tend; there are waters to touch and observe. To quote that excellent song by the Dirty Projectors, “stillness is the move.”

LESSONS IN CANDOR

Some years ago, I was briefly a student in France. Of innumerable conversations and encounters there, this memory stands out: being informed that “only simpletons and prostitutes smile at strangers.” He who declared the dubious adage meant to teach me how I was being perceived. My smiles were the outward manifestation of a then-rare feeling of bounty, so needless to say it wasn’t a welcome lesson.

Whether my would-be tutor was well-intentioned or mean-spirited is a mystery to me. With the willfulness that has preserved me through hard times, I continued to smile when moved so to do, or when trying to lift myself from a low place. (Science now demonstrates that engaging those facial muscles lights up the brain in positive ways—et alors, monsieur!) A seed of self-consciousness was planted, however—its coating bitter when swallowed and its fruit not infrequently, too.

Indeed, taking an inventory of my life thus far, I could publish a whole seed catalog of poison-berry tree varietals. I mean, couldn’t we all? Heirloom and GMO both. I long to call to account a professor who once disparaged me, condemning me as pretentious for describing a philosophical project and ethical inquiry of mine—the likes of which fill the history of letters and earn the lavish attention of scholars.

Why did he fault me, where he might have praised another? Was I too enthusiastic, too unguarded? Candor can be punished as naïve, and sincerity too often bears a competitive disadvantage in life. But my project here is not to contemplate his rhyme and reason; I’ve since learned other lessons. Though encouraged by ancient East and modern West to have no regrets—rien de rien—I grieve for times when I failed to reveal myself to someone who mattered to me, trying to make myself invulnerable. I didn’t start out that way; I developed the reflex for my own protection. Now I’m trying to reeducate myself, and mindfulness helps.

I think I’m learning from mindfulness that a great part of vulnerability is not being seen in my truth so much as being shaky in what that truth is. “Know thyself,” is the old Greek maxim; despite preferring it on principle to the Buddhist concept of “no-self”—I believe that the self exists and furthermore matters as such—they actually work well together. Tuning in to my actual experience (as a being among beings), versus any intellectual constructs of the same (as an ego with its isolating tensions), gives me a feeling of greater stability. When I meditate several days in a row, even for five minutes, I notice the difference. I find a steadier voice with which to speak—a voice more truly, less abashedly, my own.

THE JUDGMENT CARD, PART ONE

In the Rider-Waite tarot tradition, the twentieth card in the major arcana (the portion of the deck representing archetypal themes) stands for Judgment.

It’s a heavy word, isn’t it? Even spoken, a product of breath and vibration, those two syllables seem weightier than others. Judgment. Some of us carry it on our backs, some of us bear it in our arms. Some of us, like Sisyphus, push it perpetually uphill. The tarot card, however, represents forgiveness, renewal, rebirth. Judgment in that tradition is also penultimate to the card of integration and fulfillment, the final card in the Fool’s journey, and is meaningful as such.

While the birds were concluding their dawn chorus today, I made one of my rare visits to the town’s Episcopal church. I guessed the theme, given the day, would be resurrection, and that’s a potent word for me, as I near the end of an exceptionally long four-year process. How will I emerge? What will I find when I do? I thought the sermon might stimulate my thoughts. The salt-of-the-earth rector’s talks rarely disappoint; he brings boyish enthusiasm to the experience of awe. This morning he said that most of us live as though resurrection is a concept of the past, a subject for historical discussion, or a concept of the future, a fate that awaits. But no, he said—it is present, it is with us, it is active. “Not a spectator sport,” he said. The action of resurrection is love and forgiveness.

I thought about the ramifications of such an attitude for my personal life and in relation to the broader world. I thought about the value of co-construction.

Restorative justice is a model of judgment that incorporates the concept of renewal, and as I paused on the front walk of the building where I live, to examine the tight red buds tipping the trees, my thoughts turned to the county jail. Late last summer and into the fall, I led a ten-part “skills of mindfulness” course there, with two different groups, one of men, one of women. Roughly halfway through, I asked all participants to write two letters: one to a loved one, living or dead, explaining the concept of mindfulness; and one to me, in which they were to evaluate their progress in the class. This letter is shared with permission.

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Hi EA,

There are definite pluses and minuses to incorporating mindfulness into a convict’s daily life, as I’m discovering. On one hand I have a routine every day. It’s always the same and as such, I am able to choose a time for meditation that best fits. For me, just after lunch works. I’m awake and there’s ample time before the noon lockdown to get into the correct state of mind. And if it falls through I have time to plan and execute another.

On the other hand, interruptions are a way of life here. Just today, as I meditated, I had three visitors come in the room and twice they wanted to talk. I usually have earplugs in to lessen the effects of shouting, TV, showers, toilets, intercoms and all other such matters of distraction. I imagine it’s the same on the outside. Sometimes it works better than others.

But I’m also trying to work mindfulness into regular living, accepting that this is where I am now and how things are. I’ve been trying to be less judgmental for the past year in response to my legal situations. I realized that I needed to change for the positive, that a lifetime of being negative and bottling things up, as is expected of males in our society, did not lead to a happy, fulfilling life. And I hope mindfulness can bring some good changes. It definitely seems to relieve tension, even in this not so perfect climate. I have yet to see if mindfulness is something I will be able to continue in regular life (on the outside), but I will try.

My girlfriend actually started me on mindfulness and meditation before I was incarcerated and day to day living seemed to throw things at me that made me forget about the daily practice.

But I consider it a marathon, not a sprint, and a journey, not a destination, so hopefully it will become more integral to my life as the months and years pass.

Thank you for your part in my journey.