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.
Tuesday, April 20, 2010
Friday, April 2, 2010
Big Person
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.
Sunday, February 28, 2010
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.
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.
Tuesday, February 23, 2010
sex.sex.sex.
"Y'no it's normal for kids my age to be doing it"
"I told him I was a virgin and he asked me if I at least go down low"
"well, obviously he would wear a condom..."
"Is anal sex worse than regular sex?"
"I'm going to an all girls school next year, maybe this is the last chance I'll get in middle school"
"We went to the movies and he asked me to jerk him. I was like NO WAY"
"No, it's different if you have sex with your boyfriend..."
"If I've had oral sex, I'm not a virgin?!"
"Yeah, she talked to me about sex. She told me 'don't do anything stupid'."
"He said he wanted to teach me- not just anyone. We been knowin each other mad long."
"You mean, like put the condom on the banana type thing? No, they don't do that in Catholic school."
Just a few snipets of various sessions today.
Spring must be near...
"I told him I was a virgin and he asked me if I at least go down low"
"well, obviously he would wear a condom..."
"Is anal sex worse than regular sex?"
"I'm going to an all girls school next year, maybe this is the last chance I'll get in middle school"
"We went to the movies and he asked me to jerk him. I was like NO WAY"
"No, it's different if you have sex with your boyfriend..."
"If I've had oral sex, I'm not a virgin?!"
"Yeah, she talked to me about sex. She told me 'don't do anything stupid'."
"He said he wanted to teach me- not just anyone. We been knowin each other mad long."
"You mean, like put the condom on the banana type thing? No, they don't do that in Catholic school."
Just a few snipets of various sessions today.
Spring must be near...
Monday, February 22, 2010
Balancing the blessing
She listens. She laughs. She provides feedback and levity. She is not a client- she is my friend. As a fellow social worker she understands my work in a way that others friends do not. As a similar sensitive soul, our work can be the very thing that creates static between us.
Caretaking.
It's what good friends do for each other. It's what I like to provide for others and have endless gratitude when my friends do so for me. There comes a time when you put yourself first -your caretaking has to be about yourself. It's a lesson for everyone, but outwardly defined in the education of a social worker. It's an important message that gets played repeatedly as we are trained to take care of others as our full time job: self-care. So, what happens if two friends are in an emotional place where they have to put themselves first?
It gets sticky, and things fall apart.
What happens if these two have the emotional knowledge and stability to see what's bigger than the immediate situation that has becomes sticky?
Things get put back together.
My gratitude for this relationship runs deep- in times of conflict or the best of times. It seems that it is the moments of imbalance that stand out and make me appreciate her all over again.
Caretaking.
It's what good friends do for each other. It's what I like to provide for others and have endless gratitude when my friends do so for me. There comes a time when you put yourself first -your caretaking has to be about yourself. It's a lesson for everyone, but outwardly defined in the education of a social worker. It's an important message that gets played repeatedly as we are trained to take care of others as our full time job: self-care. So, what happens if two friends are in an emotional place where they have to put themselves first?
It gets sticky, and things fall apart.
What happens if these two have the emotional knowledge and stability to see what's bigger than the immediate situation that has becomes sticky?
Things get put back together.
My gratitude for this relationship runs deep- in times of conflict or the best of times. It seems that it is the moments of imbalance that stand out and make me appreciate her all over again.
Friday, February 12, 2010
Exhaling (NOT inhaling)
There is an amazing 13yo girl that I have been seeing and has been bringing joy to my life since I met her in October of '08. Smart, funny, animated, emotional, sensitive, tough, sassy and a sense of herself that is so solid, it defies logic. Our bond was instantaneous- (possibly from another life?) and her session can sometimes feel like "the girls" hanging out. I have to catch myself from slipping from therapist to friend...it's that natural. You should know some things about Nikki (we'll call her)- she watched her mother die from alcohol related illness at age 9 and was left in her father's custody. About 3 years later, her father had a psychotic break and one night lost his sense of boundaries, becoming physically inappropriate with her. The morning following this incident, Nikki told her camp director, authorities were notified and she was removed from the home. Just like that.
She has landed in the full time care of her 30-something, recovering addict, completely narcissistic half brother. Ill-equipped to parent a teen, especially a teen with this much trauma in her past- their relationship is volatile, to say the least. Nikki vents her frustrations about her living situation on a regular basis. She looks for a way out, she brainstorms solutions, she has even considered foster care for herself. She is starting to accept that this is how her life will be until it isn't anymore.
Nikki is socially pretty savvy. Her social status is very important, and if it means faking her friendship with the untrustworthy popular girl, she'll do it. The difference with Nikki and your typical 13 yo, is that she is aware of such choices. She discusses her social life in great detail on a regular basis. I have been comforted by her appropriate (or what I would deem appropriate) interests as a girl in middle school. She loves fashion and hair and music and dancing....the biggest snag Nikki has shown in her behavior is fighting. As I understand it, as a Latina, this is par for the course. In our last session: (dum-da-dum-dum)...smoking.
No, not cigarettes.
Weed.
She has several friends that do it and she verbalized her interest. Shit.Shit.Shit.
I explored what piqued her interest, who has it, what level of interest we were talking about. We discussed safety and effects and side effects. I steered so clear of that judgmental voice in order to keep this important opening we have between us- I started to panic at the end of the session. ("wait, did i forget to mention the part about this really isn't a good idea? did i become so permissive that i have encouraged this behavior?") I threw in a really clumsy reminder about my not supporting this choice and wanting to supply info to her. "Yeah, yeah...I know", I get in return.
This session has been taking up a lot of space in my brain and my heart. As a girl with addiction in her family, did I present as too lax? Did I supply the right info? Should I have provided a heavier hand to divert this behavior? My true aim was to continue to provide that nonjudgmental, empathic place where our relationship has been firmly grounded. That way, if she chooses to engage...we can continue dialoguing about it. Man, I hope that's what I did....
K. That's it for now.
She has landed in the full time care of her 30-something, recovering addict, completely narcissistic half brother. Ill-equipped to parent a teen, especially a teen with this much trauma in her past- their relationship is volatile, to say the least. Nikki vents her frustrations about her living situation on a regular basis. She looks for a way out, she brainstorms solutions, she has even considered foster care for herself. She is starting to accept that this is how her life will be until it isn't anymore.
Nikki is socially pretty savvy. Her social status is very important, and if it means faking her friendship with the untrustworthy popular girl, she'll do it. The difference with Nikki and your typical 13 yo, is that she is aware of such choices. She discusses her social life in great detail on a regular basis. I have been comforted by her appropriate (or what I would deem appropriate) interests as a girl in middle school. She loves fashion and hair and music and dancing....the biggest snag Nikki has shown in her behavior is fighting. As I understand it, as a Latina, this is par for the course. In our last session: (dum-da-dum-dum)...smoking.
No, not cigarettes.
Weed.
She has several friends that do it and she verbalized her interest. Shit.Shit.Shit.
I explored what piqued her interest, who has it, what level of interest we were talking about. We discussed safety and effects and side effects. I steered so clear of that judgmental voice in order to keep this important opening we have between us- I started to panic at the end of the session. ("wait, did i forget to mention the part about this really isn't a good idea? did i become so permissive that i have encouraged this behavior?") I threw in a really clumsy reminder about my not supporting this choice and wanting to supply info to her. "Yeah, yeah...I know", I get in return.
This session has been taking up a lot of space in my brain and my heart. As a girl with addiction in her family, did I present as too lax? Did I supply the right info? Should I have provided a heavier hand to divert this behavior? My true aim was to continue to provide that nonjudgmental, empathic place where our relationship has been firmly grounded. That way, if she chooses to engage...we can continue dialoguing about it. Man, I hope that's what I did....
K. That's it for now.
Saturday, February 6, 2010
Freedom
A 25 year old client I see on Saturdays is dealing with a number of issues- today it was about her kids. On the one hand they are the most important humans on earth, on the other- they are the bain of her existence. They are the symbol of her entrapment in this life. She told me she is a "doer" and she needs to be spontaneous and adventursome and her young children hold her back from this. She didn't wait, like the rest of her friends. She started her family early and there is no changing that now. There is only making the best of her not-so-planned-life, which gives her the feeling of being in shackles. Because of her genuine love for her kids, this sort of honesty does not come easy for her. Today she was flowing with resentment, confusion and sadness.
I looked into her tearful eyes as she spoke about the "order" in which things have happened for her and the irony was almost too much to bear. I sat there, as a 36 yo woman who has lived a free life- let the wind determine my direction for years and now feeling trapped by those decisions. Same issue, opposite direction. I have traveled the world, got an education, moved across the country and tried out several careers. I didn't take the time to settle down and start a family, like the rest of my friends. My imprisonment is the one associated with biology and while my client has to wait 14 years (as she has calculated) before she is "free", I wonder if my window of opportunity will be closed by the time I get there.
I think that's it. For now.
I looked into her tearful eyes as she spoke about the "order" in which things have happened for her and the irony was almost too much to bear. I sat there, as a 36 yo woman who has lived a free life- let the wind determine my direction for years and now feeling trapped by those decisions. Same issue, opposite direction. I have traveled the world, got an education, moved across the country and tried out several careers. I didn't take the time to settle down and start a family, like the rest of my friends. My imprisonment is the one associated with biology and while my client has to wait 14 years (as she has calculated) before she is "free", I wonder if my window of opportunity will be closed by the time I get there.
I think that's it. For now.
Subscribe to:
Posts (Atom)