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.

 

IN PRAISE OF SUNLIGHT AND ESPRESSO

 

 

The conscious practice of gratitude sometimes needs a little help. Throughout the dark and rainy weeks of mid- and late Fall, it was the promise of an en-route espresso that motivated me out of bed when nothing else did. If I could make time to stop for that, I would have five minutes, maybe ten, that I knew I could savor. You see, I’ve come to dread my job. I hate typing this here, with such finality, in a space I’d consecrated for inspiration. I care as much as ever about my clients, and feel their faces and voices and stories intertwined with my own. But before, between, and after client visits, I’m in agony to leave and be done. A bureaucratic setting is not for me; I need to work for myself. And, importantly, I need to write. I dream the plots of stories—characters and predicaments that I want to see on the page. I hate typing this, too, in a way, because it gives me such a concrete challenge, one that others might hold me accountable to. What if I don’t have what it takes? To which I answer myself—and you, if you hold similar doubts—joy, heart-throbbing joy, is always worth the risk. I hope to keep reflecting on my tenure in community mental health; there is so much to say. I rely on 2019, however, to be a year of change.

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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—and all good things in 2019!

THE SYLPH AND THE SKY

 

When I accepted a job with a mental health agency, I had to give up the luxury, formerly afforded me, of a walking commute. I’m not someone who hates driving, but an hour a day, five days a week, is much more than I’m inclined to enjoy, especially considering environmental impacts.

Even so, I continue to feel grateful because, rather than strip malls and billboards, my route is lined with trees, a mountain view in one direction, big skies in the other. What a difference that has surely made, in the last three years, to my resilience.

I was sitting not long ago with a young teen girl. She was showing me art with a fantasy theme, scrolling through an album she had made on her phone. There were mermaids, griffins, fairies, elves, centaurs, etc, rendered in exquisite detail: manes and feathers and tails and wings.

Resting my arms on the kid-sized table in my office, I leaned in to admire each picture she shared and listen to her commentary. She was telling me in an offhand way that this was her art; she said she’d been busy all week with the drawing. “This is one of my favorites.” “This one was hard to get just right.” At one point, she swiped to a kneeling angel with double wings. “Hmm,” she said to me, with what I perceived as embarrassment, “I’m not sure why I made her naked—but you can’t see anything, so…”

She was showing me art she’d found online. I knew that, but I didn’t challenge her, just murmured admiration. And I didn’t question that choice, just noticed it, and noticed that it felt right, while wondering what various colleagues would do. When the slideshow came to an end, I said, “The world needs more magic, doesn’t it? Like the magic in you.” She fiddled with her phone. Without looking at me, she said, “Probably you say that to everyone.”

“Actually, I don’t,” I said—which is true. After a beat, I added, “Yes, I’m a counselor, and part of my job is seeing the best in people. But I don’t have to lie to do that.” She was quiet. Then she expressed interest in making art with me. As she drew, she sought to maintain her deception with remarks like, “I’m feeling too lazy to fix the nose.” “I guess I’ll leave the leg like that for now.”

My drawing, meanwhile, was abstract. I began with my non-dominant hand, a handy trick I was once taught, to quiet the critical voice, and delineated an oblong shape, with some internal contouring, vaguely resembling a seed, a flying saucer, or a cross-sectioned hard-boiled egg. Then I reached for the crayons and colored pencils.

“What are you making?” she asked.

“I don’t know,” I said, “I’m just having fun.”

Soon her paper turned over, and she, too, began making a more abstract design, scallop upon scallop. She told me, when she had finished, that it was a mermaid’s tail. And a thing of beauty it was.

I thought about her on my drive home, and our time together. Her observations of the pictures she showed me were often poetic, which is a gift of hers. A sylph perching on a mountain ledge and gazing at the sky was “trying to understand the clouds.”

Lately I’ve been leaving the radio off for the day’s-end commute. I open the windows enough for fresh air, not so much that I’m buffeted. The air rushing past fills my ears in a pleasant way, and I feel any tension in my face relax.

This girl, my client, made a meaningful choice. Really, more fabrication than deception. I believe she wants to possess the skill that she admires, to have a direct connection to a world of possibilities much grander and more colorful than she perceives in her actual life. Given what I know of that life, why would I seek to take such a dream from her? Like an imaginary friend, it will fade when she has no further need of it.

Sometimes the clouds take strange shapes. That evening, it was as if an enormous, thick, soft anvil rose up from the horizon. I drove toward it, trying to understand it.

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How is it the end of August already? 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 warm regards.

 

IT’S THE LITTLE THINGS

 

 

Thank you for being my client.

 

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The month has gotten away from me, so I’ll just slip this photo in under the wire and keep writing for next month. 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.

 

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.