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.

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.

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.

 

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.

 

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.