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.

 

WORK-LIFE RESONANCE

 

I recently sat in on my first Aikido class. Afterward, I was pleased to tell acquaintances that I now know how to throw a grown man to the ground. That was just silly bravado for my own amusement, however, and not at all reflective of the discipline. What you learn in Aikido, as the sensei put it, is how to help someone fall.

That concept speaks to my sense of the work I do.

Vulnerability tops nobody’s list of favorite mammalian sensations; certainly it doesn’t top my own. For me, the experience of vulnerability can evoke fight, flight, and freeze simultaneously, an anti-trifecta. So I empathize with those who are ambivalent about therapy, instinctively resistant to the deeper conversations.

My faith in the depths is firm; my compass points inward. But the “fall” into therapy has to be taken with great care and companionship, and one of the best ways to achieve that—in addition to active listening and the sensitive use of silence—is through reflective statements. Not a flurry of questions, chop-chop-chop like karate. Minimal use of questions, maximal use of restatement, summary, and gentle extrapolation, always open to correction.

This approach is beautifully described and detailed in Miller and Rollnick’s Motivational Interviewing, one of the most inspiring texts of my education. MI is the Aikido of therapy! It’s rewarding to work in such an intentional way, to assist the fall—and the standing back up.

I was sitting with a traumatized tween girl on the floor in my office. Her chaotic life experiences were poignantly evoked by the careful way she organized my dollhouse, visit after visit, arranging everything just so. One particular afternoon, she was highly escalated from the car ride to the appointment; she had shared information about her trauma with her mother, and her mother had gotten angry.

My dollhouse is an eco-friendly Scandinavian wooden “chalet” that can be separated into two parts. For the first time, the girl separated them and set one part off at a distance: “This needs to be its own house.” Sometimes that’s what’s needed, I said.

She described to me the conversation in the car as she worked on one house. I continued to reflect and validate what I heard her say. After a while, I asked her permission to share a thought I had. She granted it, and I proposed that her mother may have been too upset to give her the response she needed, but that we could try again to talk all three together when things were calmer.

She reached for the “other” house, saying, “I guess this actually belongs here,” and put them back together again, making a new space of the whole. And she started, for the first time, to tell me the story of her trauma, using the dolls and furniture as props to her narration. When her mother joined us, they were calm together. The work continued, and the work began.

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Monday I had my four-year anniversary with this site! 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.