Caught.

Yeah, yeah...6 months...I'm back...blah, blah, blah....

I have some big life stuff to sort out and I am having real trouble with it.  Maybe going back to a free form writing space will help? Couldn't hurt.
I decided in the spring, I am ready to be near my family again.  My affair with NYC is just about over and I want to leave while the break-up is still amicable. Since then, I have acquired my California Board of Behavioral Sciences registration and appliled to upwards of 60 positions.  I meditate, recite affirmations, maintain support from loved ones, and continue to apply. I construct well thought out cover letters, I follow up, I re-apply, and in moments of frustration I return to the aforementioned spiritual work. It's been six months of this. I figured this is where I have to dig deep for the inner strength to keep my spirits up and the applications flowing. I remind myself that my job is out there and I just need to exercise a new level of patience until it reveals itself. 
But then I had another thought. The one where I think less about going to LA and more about leaving my life here.  And then I think less about my life and more about my clients and my stomach turns.  I get a pit so deep I push away the thought and tell myself I don't have to worry about it yet.

I'm starting to realize that my typical make-it-happen-no-matter-what drive has been stunted.  My relationships with my clients has become of overgrown importance in my life. It is my #1 fault as a clinician (and one I could have predicted)  because of how connected and identified I am with them.  Sometimes I feel ashamed and weak about this aspect of myself professionally, but most times I take pride in having such strong therapeutic relationships.  Now, I feel part silly and a lot sick about it.  It has occurred to me that these relationships fill me up in a way akin to how family or a partnership fills me up.  My current core group of clients are all people I have been seeing long term and I have a rhythm with them.  There are ups and downs, misunderstands and reconnecting and above all...reliability, on both of our parts. 

For those that don't know, the novel Catcher in the Rye was life changing for me.  Following my first read of that book, I have wanted to be the catcher in the rye that Holden describes (for those of you unfamiliar- Holden describes a big field of rye where a bunch of kids are playing.  The field is on a cliff and he is in charge of making sure none of the kids fall off. Of course, this description doesn't due Salinger's writing any justice and if you don't know what I'm talking about, you really should read this classic for yourself).  Twenty one years later, I thought I had achieved something analogous to this dream with my social work career. But I feel so confused now that I am the one who is caught. I am not trying to further draw out this metaphor to my own situation, but "caught" is the only way I can think to describe how I feel in these relationships.  I feel like I have been disarmed in my attempt to move forward in my life after working so hard with these clients. It's the ultimate form of getting in my own way, as the disarmament was self-induced. My new clincal puzzle is to find my way out. 

I think I'm outta gas for now...

DADT

I'm really sad right now for one of my clients and can't get him out of my head.  He's 15 and I've been treating him and his family for about a year and a half.  Tommy (we'll call him) wears many hats- none as important as his dream to be in the Air Force. He has been preparing for this through his specialized high school and every move he makes he considers a mark either for or against his chances of getting in.

Tommy decided this week to deal, head on, with the reason he was initially referred to my agency.  Tommy's ticket in was sexual trauma inflicted by another student, his age. Someone he believed was his friend.  He reported the incident, pressed charges and began treatment soon after.  He has yet to discuss in therapy what happened with this boy.  Instead, three years following the incident, he chose to deal with it on his own.  He reported to me this week that he's been reflecting a great deal on what actually happened.  Tommy is going to be confirmed by his church this weekend and has therefore been doing a great deal of reflecting on a lot of things.  This contemplation led to reaching out to this boy for, what he reports, was closure. He lied to Mom to get out of the house and he met up with him. Then he shared a great deal with me, including:
-his (former) curiosity about his sexuality
-his belief that he is partially responsible for what happened to him
-the guilt he has been carrying around about pressing charges due to the aforementioned belief
-the shame he holds regarding his lack of understanding about his curiosity
-his realization about how he's been coping with all of this including "drinking more than a kid my age should" and his tendency to overeat since he was victimized. 
-his need to "convince" his mother that meeting up with him again was a means to get closure, not for further experimentation.   

Tommy is tangled in the confusion that is common for victims of sexual abuse- "Was this my fault?" He believes that due to his genuine curiosity, that he is brave enough to own, he must have asked for it. It is my belief that Tommy was taken advantage of based on an expression of curiosity.  The utter psychic chaos that results in the pairing of these two delicate matters is nothing less than a mind-fuck.
His need to protest any leftover sexual curiosity is naturally a red flag.  It also makes perfect sense. Is there a more homophobic culture than the military? I don't envy the road he has ahead of him in terms of negotiating his dedication to serving in the Air Force and his (more than likely) blossoming inquisitiveness regarding same sex relations. I do, however, look forward to the opportunity to support his continued self-awareness and maturity. 

Shattered Image

Remember Nikki? Check mid February for her background.
The part I want to highlight is my admiration and adoration for her. As lovely as she presents in our sessions, I know she can be difficult. She plays "tough girl with an attitude" throughout most of her life.  With me, one to one, she is a mush.  She is vulnerable, curious, honest and has never hesitated to show me her huge heart.  This typically comes in the package of discussing various people in her family.  Aside from the brother who has become her militant guardian, every cousin, grandparent, niece, 1/2 sister, and "titi" is spoken of with great love and devotion.  As alligned with her as I have always been, there's a bit of a heart-swelling that happens for me when she speaks about her family.  It reminds me that she really is going to be okay.

With Nikki's presentation, comes certain responsibilities of the image.  These parts of her image cost money- money that is in no way alloted for with her brother- mr. bare essentials.  Often times Grandpa gives her money and I hear about her godfather picking up some slack too.  Nikki wants sneakers, sweaters, hair doo-dads, a cell phone, and please don't forget the Proactiv! Y'no, girl stuff. She talks about her material needs incessantly and obsesses over where she is going to find the funds for her latest must-have.  She mentioned being at "The Grampies"- and how Grandma always has money laying all over the place:

"She wouldn't even notice if it was gone...do you know what I could get with that $50? But then I realized...naaah, I couldn't do that...it's Grandma."

Nikki shared this inner dialogue with me more than once and I naturally supported her ability to resist such temptations and discussed what it means to have a conscience.  But then, she couldn't resist.

She charges into my office showing off her new Sidekick (phone), claiming that she used "her own money" for it. I acknowledged this accomplishment. About 10 minutes into the session, she lost control and disclosed. With guilt on her face and an inability to look at me, she slowly spilled her guts. She took $100 from Grandma, used it to buy the phone and a few other items. She projected all of her guilt onto me, claiming I was "making her feel bad" as I sat silent, blank-faced and listened. I commented on how important these items must be to her that she made this choice and asked her to tap into how she felt about it now.
Rookie mistake.
She, naturally, defended against any feelings of regret and continued to justify her behavior. Nikki had some inner conflict about it, but evil was definitely winning this one. She began her new list of material necessities and I worked with her to strategize another way to deal with these needs. I knew she wasn't with me, but  my head was so filled with disappointment, I felt clinically lost.

The following week she raised a discussion about selling boxed candy to raise some funds.  I commented on her constructive plan to make her own money. She heard my subtext loud and clear- glaring at me momentarily and then quickly changing subjects.  This week she came to session with new sneakers in hand. She plopped down, slipped them on and strutted as if in a fashion show.  The subject of how she acquired the new sneakers came up and she dodged it.  I made her aware that I was aware of that move. She was aware that I was aware, and managed to keep her face hidden until she moved topics. 

I'm sick about this. I'm sick about her choices. I'm sick that I don't know how to guide her. I'm sick with judgment for this little girl.  Her guilt is too thick to be able to explore her motivation or feelings about these choices.  My judgment is too obvious to poke around in her guilt.  She feels entitled to this money and these goods- and I don't have a clue as to how to tease that out.

That is all, for now.

A Weird One.

I see this precocious and delicious 5 year old - she's been in treatment for about a year. I've watched her grow and change in meaningful yet unexplainable ways.  We have a great relationship and her treatment has always been relatively smooth.  The reason I have to write about her is because of the one aspect of our sessions that is unique to us.
Snacks.
Mom brings her to her appointment straight after school and picks up a snack for her on the way.  Her snack choices rarely have a repeat and they vary on the nutrition spectrum from one extreme to the other.  Examples? Yogurt covered pretzles, fruit flavored mentos, sour punch straws, a green apple, and today- Combos (the pretzel/cheese ones, if you must know).  Most of these items, are not snacks I would choose for myself. But here goes the weird part: whatever she is eating, I instantly crave.  There is something about the way this child manipulates her food, the sound of it in her mouth, or the project she creates in the process of consuming it that makes the item a must-have for me. And I don't mean in the moment that I am witnessing the consumption, I mean the experience gets in me and stays there so the next time I pass those stupid sour straws and feel absolutely compelled to buy them and eat them...all week!
Input anyone?
Ideas?

That's all for now. I have a bag of Combos to get to...

Forreal or Forfake?

One of the top reasons I love my work is the search for authenticity.  I eagerly await the 45-minutes of truth hunting that I get to do with my clients. I may not find it, or they may not want to say it...but I love the work of sniffing it out. When helping another find themselves, and witnessing their experience of truth and freedom in that place is exciting, rewarding and truly lights my fire.  I think part of this passion comes from the feeling that I walked around as a shell of myself for the 1st 20 or so years of my life (that might be beside the point, we'll see). 
The reason I bring all of this up is due to a comment made by my one and only male client.  A 36-year-old man, recently divorced and sorting out his custodial situation with his 2 biological children and 1 stepchild.  He is uneducated, but highly intelligent and works hard in therapy.  I have been seeing him for over a year and we have established a comfortable and friendly therapeutic relationship.  He tests my ability to hold my boundaries as he asks many personal questions, but does so with awareness and respect.  The repeating theme with this client is his resistance to creating a social life for himself due to his lack of faith in others and low self-esteem.  Upon my emphasis that our therapeutic relationship provides a model for the potential of other relationships, he flatly refuses the concept.  He maintains that our successful relationship is based solely on the fact that I am paid to do so.  Of course I understand where he is coming from, which is why I can continue to engage in this topic and not take it personally.
Well, at least I wasn't taking it personally.
We approached the topic again of his sense of self-worth in terms of socializing.  We make our way around to his ease in socializing with me. And then he dumps it on me:
"But this is fake."
"This is fake?"
"Well yeah, obviously"

Ouch. It stung my whole being. I mean, yes, I still get it- but I think calling me a big fat stingy kike would've felt better. Fake is my dirty word. Fake is my #1 aversion (well, there's bugs but that's something completely different).  Fake is often my enemy.  And now I'm letting his version of fake get tangled in my concept of being inauthentic and so the twists and turns of the puzzling therapeutic relationship goes.  Now I work to divide up his stuff from my stuff and respond in a clinical, therapeutic and (in a perfect world), helpful way.
Let's hope the stars align.

Okay, that's it for now.

Big Person

Natalie's family has decided to move.  This is typical of them, and I should have been emotionally prepared for it, but I wasn't.  Upon hearing the news from the uncle, I gave a real professional front.  Inside, I knew I was about to lose someone very important to me and I had a sudden urge to tantrum, as if I was her peer. Natalie and I have a very special relationship, as I have menitoned in a previous entry.  I may have provided her a safe place to be herself and understood as a confused 4 year old, but she has given so much to me.  Her spirit, humor and emotional honesty fills me up.  There is something unspoken that connects the two of us and has afforded us a number of exceptionally tender moments.  It is relationships like these that feel like an official endorsement made by the universe: "Yep, you found it. This is your calling, and thank you for answering it". 

Her final session couldn't have been scripted more beautifully, therefore, I figured it should be written. She showed up in her usual mixed up garb. This day it included a dressy, wide brimmed, spring hat - garnished with plenty of flowers, an army green bomber jacket and pink velour track suit pants.  We took the hike up the stairs (the ones she chooses every session over the elevator, while insisting she "hates" these stairs) for the last time and headed to the office.  She immediately honed in on the pink frosted cupcake and card I had waiting for her: "You really put stickers in here for me?" (spoken in a tone attempting to sound jaded). She requested to paint (something we did often in her sessions) and we went into our routine, "I det da wata and you det da TIG paypa!" And as she stated, she filled cups with water and I set up the big sheets of paper to paint on.  She commanded specific colors, naming where they should go and I followed her lead.  She then decided to paint a picture of the two of us.  Yes, it always feels good when a client wants to do this, but it was particulary intruguing in this case since Natalie has never painted anything deliberate. She typically likes to just go through the motions of scribbling paint to paper and sharing the activity with another.  Natalie started with an overly wet brush with paint on it and named the sprinkles that dripped on the paper "raindrops".  She then drew a figure that took up most of the page. She was emphatic with her movement up and down: "Dis is you. Cuz you awe a big big puwsun wid a big big head and a big big eyes and a big big nose".  She then painted a smaller figure next to the big figure's head: "Dis is me, cuz I'm a diddle puwson." At the last minute she drew one more figure at the bottom, naming it her uncle.  She finished in time before the alarm went off...
Then it sounded. Marking the end of our final session.
We both stared at each other. Neither wanting to make a move.
Neither wanted to say goodbye.
But one of us was the big person.
That put me in charge of containing her anger as she began hitting herself, dumping toys and throwing sand. Additionally, I was working to contain myself at the same time as I had the urge to join her (wouldn't it be great if we could both be "bad"?). It took surprisingly little effort to help her to deescalate.

We gathered up her things, took the elevator down and had a great big goodbye hug. Hopefully, she is left with a corrective experience. I am left with a broken heart.

A Different Side of Difficult.

I have been seeing a married couple for approximately a year. Sara and Joseph are smart, self-reflective, artistic, honest and a healthy split of emotional and rational. They lean more towards the latter and I work to dig into the former. They are raising 3 teenage girls- one of their own and 2 neices that they took full custody of early in the girls' lives. They have both shown time and again what solid parenting they bring to the table.  I have heard when they work as a team and when they lean on each other to take the lead.  The complexities of raising these girls takes a toll on their relationship and is, in part, the reason they sought therapy. 

We've had a solid therapeutic relationship- everyone in the room works hard in each session. I feel I am able to understand and reflect each of their positions in a way that they (hopefully) hear each other with more clarity.  Obviously, part of the complication of seeing a couple is staying unbiased to either side.  With this couple,  I have had little trouble remaining in that position. In the past year, things have become increasingly more difficult with one of the girls (Phoebe).  She is angry about being abandoned by her parents, but as a 14yo is not in touch with that fact. That kind of sadness and anger shows up in outward defiance, belligerence and blatant disrespect to the very people that have offered her the privileged life she has today. 

Sara seems to have a better understanding of where Phoebe's anger comes from and how to manage her behavior.  Joseph takes it as a personal affront and lashes out at her, escalating the power struggle to an uncontrollable level.  I have only recently heard the shocking report that Joseph is guilty of hitting her. Twice.  I probably don't have to state how troubling this is to me.  I believe in these clients and they are the ones I am treating.  I hear Joseph's frustrations with Phoebe and his own history of abuse, which allows me to feel empathy for him and comprehend the reason for his actions.  But first and foremost, I am a social worker and a child advocate.  I have not heard remorse on his part and he has been unable to "promise" it wouldn't happen again.  I have been sitting with how to address his actions for the past few weeks.  There have been talks about seeking individual treatment, and threats from Sara about asking him to leave the home if it were to happen again. 

It came to a head in our last session. He addressed the fact that Sara's trust for him with Phoebe has diminished. He expressed hurt and anger over this.  Sara did not back down and maintained that "the family could not afford to have this happen again".  His defense slid into a justification of his actions and a request for her to acknowledge all the times he had not hit her.  My heart rate kicked up and I knew it was time.  The moment that I dread in this profession.  I had to risk a rupture in our relationship.  I had to speak up against my client in an attempt to educate him, but in a moment that he was already very hurt and angry and he would most likely not hear the message immediately.  I told Joseph that not being hit is a basic right for children and that there is no reward for not hitting.  I reminded him how traumatic it is to be hit as a child (as he directly knows) and that the dynamic between him and Phoebe is dangerous for both of them. 

Several minutes passed and he didn't say anything.
He appeared incredibly injured. 
I offered the opportunity to express any feelings he had towards what I had said.

He didn't do that.
With his toxic, seething anger still in full force - he turned on himself.
It killed me to see the shift into self-deprecation, but I was pretty sure what I had said made a direct hit.
Maybe not a move forward, but movement nonetheless. 

Now we let the session marinade.
And I need a drink.