Today I just feel like writing a story. Not a fancy one, and not a new one. This is an old story, and my offering to you.
Once upon a time, there was a novice monk who lived in the monastery. He was a young man, and as such was still learning about relationships between people.
One afternoon, he went for a walk through the woods with his teacher. The teacher had been a monk for many years, and was well known for his wisedom and compassion. It was a lovely day, and they were having a pleasant conversation about this and that. The trail they were walking on ran next to a stream. It was a lovely stream, maybe a foot or so deep.
Well, eventually they happened upon a young woman who was standing on the other side of the stream. Dressed for a party and in her best shoes and stockings, she could not cross the stream without ruining her clothing. Without crossing the stream, she could not attend the party. She was in a dilemma.
The novice stood looking, unsure of what to do. But the teacher crossed the river. Then without a word, he gently lifted the woman in his arms, carried her across the stream, sat her down and continued on his walk. He picked up the discussion with the novice where he had left off.
The novice was puzzled and a little disconcerted. He listened to his teacher, but his mind kept on returning to the scene of his his teacher carrying the woman. How could the teacher do such an intimate act and then return to the conversation as if without a pause. They walked on for a good bit of time. Finally the novice could contain himself no more. He asked his teacher "how can you just carry a young woman over the stream and then continue as if it were nothing?"
"Ah", the teacher answered. "It was definitely something. The thing is, I set her down an hour ago. Why are you still carrying her?"
Touching without grasping. Letting go when the time of connection is past. Such a thing is hard for such a novice as I to learn. Yet within the story lies unspeakable beauty.
Wednesday, May 19, 2010
Sunday, May 16, 2010
Alameda County Suicide (or How Not to Save a Life)
All right, back to Alameda County. I finally get to talk to the supervisor of the suicide prevention training Monday. She asks to talk with me. Of course I'm going to talk with her. The conversation - it's been six days, I'm having a hard time remembering it now. But it was essentially and above all else a half hour blood bath. My sense was that the presence of suicidal ideation had put me off of their training list from the beginning and that they were somehow taking a perverse interest in jerking me around.
She briefly goes over the contact I had with the volunteer coordinator earlier, then says she would like to discuss things. She asks about:
Why do I want to work suicide prevention - I enjoy it, I'm good at it, it provides me with a peer group who likes the same type of work I do.
My suicidal ideations - under control and my responsibility
My therapy - under control and my responsibility
My ability to deal with stress - under my control and my responsibility.
What does my therapist think about my ability to work suicide prevention - she supports it.
Now it gets even more fun. I have worked suicide prevention before. I know what I'm doing and what I am asking for here. Also, let me make this clear - I understand that disclosure of suicidal ideation on a volunteer job application is a calculated risk. I tell her right from the start that I do not lie, and that I am not going to lie to her. If I have nothing else, I do have integrity.
She asks why I left Marin. I told her first off that I knew a number of the callers, which is absolutely true. She pushed the issue a bit more, and that was always a curious phenomenon but not really why I left. I told her that I also felt that they pushed me to take shifts alone on holidays which I felt, as a volunteer, was not in my best interest.
She then moved on to the tone of my voice. When I am stressed, my diaphragm kind of spasms or something and I sound weird. I know this. By this point, I am stressed. She asks about my voice so explain that it is a stress reaction, that this is stressful, but that this was never an issue in the year and a half that I worked suicide prevention. She asks how I could possibly deal with a stressful situation when I couldn't even deal with what she was asking me. Nothing I said worked. There was no reasoning, no compromising. No matter what I said, I was judged and found lacking.
I do not like dealing with the issue of my voice. This did come up occasionally with callers, at which point I would reassure them that while my voice may sound odd, I am perfectly okay and then go on with the call. It was never a problem. Also, regular callers never had a problem with my voice - they just accepted it as my voice as do most people who know me. At this point, I am so frustrated I have lost control over my involuntary muscles (hence the word "involuntary"). She tells me that regular callers don't count and that, unlike Marin County, they really do have suicidal callers. (Huh? And Marin doesn't? I don't even know where that comes from.) Then she tells me that if she were suicidal she would find my voice distressing. I mean, c'mon, there is a point where you have hit below the belt. This is way beyond reasonable.
Oh, another fun question - "If you are suicidal, why would you want to do work where you are thinking about death?" Okay. Maybe I am a slow witted child, but the operative word here seems to be PREVENTION. It is about life. Death is always with us. So is birth. But suicide prevention is about DEATH? I don't get it. I tell her that the whole idea is to help people live. She goes back to how hard it would be for me to go through a training where they talk about death.
And ultimately, the answer was no before I picked up the phone. I know that. This was just a blood bath for some reason that I do not understand. Then she tells me, by the way, I am welcome to try again for the next training in August but that the class already started anyway. Why would a person who's job it is to protect the dignity and well being of clients subject a person to such degradation and humiliation? What did she get out of it. And how can I take back my power?
She briefly goes over the contact I had with the volunteer coordinator earlier, then says she would like to discuss things. She asks about:
Why do I want to work suicide prevention - I enjoy it, I'm good at it, it provides me with a peer group who likes the same type of work I do.
My suicidal ideations - under control and my responsibility
My therapy - under control and my responsibility
My ability to deal with stress - under my control and my responsibility.
What does my therapist think about my ability to work suicide prevention - she supports it.
Now it gets even more fun. I have worked suicide prevention before. I know what I'm doing and what I am asking for here. Also, let me make this clear - I understand that disclosure of suicidal ideation on a volunteer job application is a calculated risk. I tell her right from the start that I do not lie, and that I am not going to lie to her. If I have nothing else, I do have integrity.
She asks why I left Marin. I told her first off that I knew a number of the callers, which is absolutely true. She pushed the issue a bit more, and that was always a curious phenomenon but not really why I left. I told her that I also felt that they pushed me to take shifts alone on holidays which I felt, as a volunteer, was not in my best interest.
She then moved on to the tone of my voice. When I am stressed, my diaphragm kind of spasms or something and I sound weird. I know this. By this point, I am stressed. She asks about my voice so explain that it is a stress reaction, that this is stressful, but that this was never an issue in the year and a half that I worked suicide prevention. She asks how I could possibly deal with a stressful situation when I couldn't even deal with what she was asking me. Nothing I said worked. There was no reasoning, no compromising. No matter what I said, I was judged and found lacking.
I do not like dealing with the issue of my voice. This did come up occasionally with callers, at which point I would reassure them that while my voice may sound odd, I am perfectly okay and then go on with the call. It was never a problem. Also, regular callers never had a problem with my voice - they just accepted it as my voice as do most people who know me. At this point, I am so frustrated I have lost control over my involuntary muscles (hence the word "involuntary"). She tells me that regular callers don't count and that, unlike Marin County, they really do have suicidal callers. (Huh? And Marin doesn't? I don't even know where that comes from.) Then she tells me that if she were suicidal she would find my voice distressing. I mean, c'mon, there is a point where you have hit below the belt. This is way beyond reasonable.
Oh, another fun question - "If you are suicidal, why would you want to do work where you are thinking about death?" Okay. Maybe I am a slow witted child, but the operative word here seems to be PREVENTION. It is about life. Death is always with us. So is birth. But suicide prevention is about DEATH? I don't get it. I tell her that the whole idea is to help people live. She goes back to how hard it would be for me to go through a training where they talk about death.
And ultimately, the answer was no before I picked up the phone. I know that. This was just a blood bath for some reason that I do not understand. Then she tells me, by the way, I am welcome to try again for the next training in August but that the class already started anyway. Why would a person who's job it is to protect the dignity and well being of clients subject a person to such degradation and humiliation? What did she get out of it. And how can I take back my power?
Saturday, May 15, 2010
The new psychiatrist, of course.
Okay, I will own up to this one right off the bat. I moved over to Kaiser Psychiatry from Community Mental Health somewhere around a year ago. It has been, for the most part, a very good albeit somewhat bumpy transition. (Most of the landing gear was down before the plane hit the tarmac, anyway.)
I started out in San Rafael seeing Dr. Glass, who I think is a bobo. Boy is sweeter than he is bright, which is why all the other patients at Kaiser want to see him. He has bedside manner down to a fine art. However, he did write all my prescriptions at the wrong dosages, thus proving me right. (One was already in the computer - how can you possibly screw that up.) Then I had a guy who had the personality of a turnip. (I tested this theory by speaking with a turnip at the produce store. Yup - definitely same sense of bland disinterest.) didn't know you could use Benedryl for extrapyramidal symptoms, and didn't return an urgent e-mail sent on a Thursday evening until Monday morning. Like, hey...I made a point to let you know the symptoms before the weekend SO I DIDN'T HAVE TO BITE THE BULLET FOR 4 DAYS. It was like the scene in the first Harry Potter movie where he is trying out his first wand. Ollivander hands him a wand, Harry waves it, and draws fall out and stacks tumble over all over the place. Then Ollivander says "no, no. Definitely not!" Yuppers - that was a definitely not.
So I call and request a new psychiatrist. Now, it is sometimes hard for me to ask for what I want. But dang it - we're talking about a psychiatrist here - you might as well step on up and let them know what works. So I tell them I work really well with young women doctors. So the guy I'm talking to says "oh, we can do that. I know just where to put you". Oh my gosh, this psychiatrist looks likes shes 25. She is so cute. And bright. I like working with here. She asks intelligent questions, does thorough assessments, and goes over treatments. She assesses for suicidality on each visit (which is a task that frequently turns even the most seasoned professionals green). Yeah! Interpersonally, it is a good fit. But also, watching her from an objective point of view, her way of assessing and presenting treatment options is simply beautiful to watch. There is nothing more wonderful than a mental health professional who knows how to establish, assess, and treat while making it seem effortless. Oh, the heartbreaking beauty of it surpasses any other artistry I have ever witnessed.
I started out in San Rafael seeing Dr. Glass, who I think is a bobo. Boy is sweeter than he is bright, which is why all the other patients at Kaiser want to see him. He has bedside manner down to a fine art. However, he did write all my prescriptions at the wrong dosages, thus proving me right. (One was already in the computer - how can you possibly screw that up.) Then I had a guy who had the personality of a turnip. (I tested this theory by speaking with a turnip at the produce store. Yup - definitely same sense of bland disinterest.) didn't know you could use Benedryl for extrapyramidal symptoms, and didn't return an urgent e-mail sent on a Thursday evening until Monday morning. Like, hey...I made a point to let you know the symptoms before the weekend SO I DIDN'T HAVE TO BITE THE BULLET FOR 4 DAYS. It was like the scene in the first Harry Potter movie where he is trying out his first wand. Ollivander hands him a wand, Harry waves it, and draws fall out and stacks tumble over all over the place. Then Ollivander says "no, no. Definitely not!" Yuppers - that was a definitely not.
So I call and request a new psychiatrist. Now, it is sometimes hard for me to ask for what I want. But dang it - we're talking about a psychiatrist here - you might as well step on up and let them know what works. So I tell them I work really well with young women doctors. So the guy I'm talking to says "oh, we can do that. I know just where to put you". Oh my gosh, this psychiatrist looks likes shes 25. She is so cute. And bright. I like working with here. She asks intelligent questions, does thorough assessments, and goes over treatments. She assesses for suicidality on each visit (which is a task that frequently turns even the most seasoned professionals green). Yeah! Interpersonally, it is a good fit. But also, watching her from an objective point of view, her way of assessing and presenting treatment options is simply beautiful to watch. There is nothing more wonderful than a mental health professional who knows how to establish, assess, and treat while making it seem effortless. Oh, the heartbreaking beauty of it surpasses any other artistry I have ever witnessed.
Friday, May 14, 2010
Why I left Suicide Prevention Marin - Part 2
So now, I have a chronically angry shift partner (he never got over my smacking him upside the head). I am struggling to get past the pain of watching my old classmates move on while I am left with no way of continuing my education. And then, Thanksgiving came. I work Fridays. Every Friday unless I'm on vacation or sick. And I try very hard not to be sick.
I show up for work. The trainee working the shift before me informs me that she had talked to my partner the day before and he was in L.A. But as he had not called it nobody was absolutely sure whether I had a partner for the day. The staff had gone home since it was me on and of course I could handle it alone. I was so angry. Then, the calls starting coming in. 10 in two hours. Nobody left me a note telling me who my backup staff was, and anyway I wouldn't have had time to call for help. IT SO BIT. It's a holiday, I'm alone, and the number of calls is overwhelming. (I really don't mind working shifts alone - I do so frequently. But I do mind being left without the staff checking in. I also hated it when the director would ask me if I was okay handling the phones. If I was having a difficult day and said no, she would laugh, assume I was kidding, and walk away.) I get the callers through of course, and go home.
Next week, I talk to the volunteer coordinator, who is a kind and reasonable woman. I tell her I do not want to work a holiday alone again. She gets it and assures me she will make sure it does not happen again.
Next week, director and sucky shift partner are there. I am still a little bent out of shape about Thanksgiving and my partner not letting me know he would be gone. Then, his classmate who works the shift before is stays and they discuss whether he is in the right field. (The answer is no. He is unprofessional and doesn't really care about the callers.) He sits with his back to me. I am in the room, but it is clear that I am not to speak.
Later, he says notices I am upset and asks why. So I tell him he left me hanging on a holiday without giving any notice and that I was excluded from a conversation, on my shift, by people sitting right next to me. He apologizes for not giving notice of missing a shift, then pouts for two hours. I finally ask what's wrong. Dude stands over me and yells for two hours about how he doesn't appreciate my expecting to be included in a private(?) conversation between to experienced students who actually have real life experience. (In other words, I am to be seen and not heard.) The guy is really angry. He has officially been promoted to asshole in my book.
The next week, the conversation between him and the other hotline worker continue. They are talking about Kaiser Santa Rosa's post-doctoral program for psychologists. She has a friend who knows somebody who trained there. I know I am unwelcome to talk, so I refrain from telling them that my therapist runs that program and that the only thing she knows about my shift partner is that he is officially and unequivocally an asshole. Somehow I take a bit of satisfaction in this little bit of private knowledge, but feint sickness and go home rather than sit through an hour of being treated like an uneducated child by an arrogant boy half my age.
But then again, this is still not why I left. I left because of the director.
She comes to me, and asks me to work the Christmas day shift alone. I want to keep my regular schedule as I do better with consistency, but do not want to work alone. She bats her eyebrows and says, but you would save us money. (I am contributing my time, working shifts alone, and very generous in what I will give them. I expect no compensation in return other than respect.) I ask if she knows that I told the volunteer coordinator that I did not want to work holidays alone. She told me that she did know of this conversation but that "I didn't understand it". Huh? What part of I am an unpaid worker who won't work a holiday alone is unclear? Game playing!!!! So then, she's like "then we'll need to pay somebody to do the shift. So we really don't need you. Why don't you just take Christmas day off?"
This is shaming to me. I don't take it off because it is a holiday, which means spending those four hours alone kinda sucks. I'd rather be with someone else helping other people. I just do better. I actually look forward to working holidays as long as I'm not alone.
Now mind you, this conversation was not between her and I, but took place in the hotline room with other people present - hell no. Pressure to do things that aren't good for me and belittlement when I won't do it in a public forum? Combine this with the lack of respect from peers who think that a non-trainee is persona non grata, well then... there is only one thing wrong with this picture. Me, being there.
I am sorry, but it is time to leave.
That was half a year ago. Leaving the prejudice and humiliation was like angels lifting unbearably heavy weights off of my heart, which was being crushed like a bug. I miss the volunteer coordinator. I miss the people who were there that did treat me with dignity and respect, and there were those who recognized and appreciated me. And most of all - I miss the work. Deeply.
I show up for work. The trainee working the shift before me informs me that she had talked to my partner the day before and he was in L.A. But as he had not called it nobody was absolutely sure whether I had a partner for the day. The staff had gone home since it was me on and of course I could handle it alone. I was so angry. Then, the calls starting coming in. 10 in two hours. Nobody left me a note telling me who my backup staff was, and anyway I wouldn't have had time to call for help. IT SO BIT. It's a holiday, I'm alone, and the number of calls is overwhelming. (I really don't mind working shifts alone - I do so frequently. But I do mind being left without the staff checking in. I also hated it when the director would ask me if I was okay handling the phones. If I was having a difficult day and said no, she would laugh, assume I was kidding, and walk away.) I get the callers through of course, and go home.
Next week, I talk to the volunteer coordinator, who is a kind and reasonable woman. I tell her I do not want to work a holiday alone again. She gets it and assures me she will make sure it does not happen again.
Next week, director and sucky shift partner are there. I am still a little bent out of shape about Thanksgiving and my partner not letting me know he would be gone. Then, his classmate who works the shift before is stays and they discuss whether he is in the right field. (The answer is no. He is unprofessional and doesn't really care about the callers.) He sits with his back to me. I am in the room, but it is clear that I am not to speak.
Later, he says notices I am upset and asks why. So I tell him he left me hanging on a holiday without giving any notice and that I was excluded from a conversation, on my shift, by people sitting right next to me. He apologizes for not giving notice of missing a shift, then pouts for two hours. I finally ask what's wrong. Dude stands over me and yells for two hours about how he doesn't appreciate my expecting to be included in a private(?) conversation between to experienced students who actually have real life experience. (In other words, I am to be seen and not heard.) The guy is really angry. He has officially been promoted to asshole in my book.
The next week, the conversation between him and the other hotline worker continue. They are talking about Kaiser Santa Rosa's post-doctoral program for psychologists. She has a friend who knows somebody who trained there. I know I am unwelcome to talk, so I refrain from telling them that my therapist runs that program and that the only thing she knows about my shift partner is that he is officially and unequivocally an asshole. Somehow I take a bit of satisfaction in this little bit of private knowledge, but feint sickness and go home rather than sit through an hour of being treated like an uneducated child by an arrogant boy half my age.
But then again, this is still not why I left. I left because of the director.
She comes to me, and asks me to work the Christmas day shift alone. I want to keep my regular schedule as I do better with consistency, but do not want to work alone. She bats her eyebrows and says, but you would save us money. (I am contributing my time, working shifts alone, and very generous in what I will give them. I expect no compensation in return other than respect.) I ask if she knows that I told the volunteer coordinator that I did not want to work holidays alone. She told me that she did know of this conversation but that "I didn't understand it". Huh? What part of I am an unpaid worker who won't work a holiday alone is unclear? Game playing!!!! So then, she's like "then we'll need to pay somebody to do the shift. So we really don't need you. Why don't you just take Christmas day off?"
This is shaming to me. I don't take it off because it is a holiday, which means spending those four hours alone kinda sucks. I'd rather be with someone else helping other people. I just do better. I actually look forward to working holidays as long as I'm not alone.
Now mind you, this conversation was not between her and I, but took place in the hotline room with other people present - hell no. Pressure to do things that aren't good for me and belittlement when I won't do it in a public forum? Combine this with the lack of respect from peers who think that a non-trainee is persona non grata, well then... there is only one thing wrong with this picture. Me, being there.
I am sorry, but it is time to leave.
That was half a year ago. Leaving the prejudice and humiliation was like angels lifting unbearably heavy weights off of my heart, which was being crushed like a bug. I miss the volunteer coordinator. I miss the people who were there that did treat me with dignity and respect, and there were those who recognized and appreciated me. And most of all - I miss the work. Deeply.
Thursday, May 13, 2010
The Kitchen
It's Thursday morning. I woke up alone before dawn, then laid around in bed for a bit. Then I got dressed, went for a walk, and went to the kitchen for breakfast. They were a little late opening. I stood outside at 6:30 and watched the natives get restless. The guy in the alley standing next to me was shivering something fierce. He was new to being out and had neither a sleeping bag or a jacket - just a blanket and a sweatshirt. I told him to go to Ritter House - They will give him both a bag and a warm jacket. Martin was going on again about how everybody stereotypes Indians. The man was not raised right and likes to be the victim. I found myself biting back the obnoxious urge to ask him when he immigrated from India. (It would not have gone well.) They opened the door.
Ray came up to me and gave me the morning hug, checked in to see how I'm doing. There was some food that was donated from a party yesterday. I had a tuna sandwich. Jeb was there. I hadn't seen him in a few days - he said he ran out of money so he had to walk and he usually catches the bus. Spoons was in his usual mood. We shared the table and talked. I finished my sandwich, talked to a few people, and went to see if there was any food I wanted to take home for later. There wasn't.I talked to one or two other people, stood around in the alley a bit, and walked home. It was a pleasant morning. I wasn't alone.
When I have been to sick to go get food, the kitchen fed me. When I was so depressed that I didn't want to live and nothing at the store looked appetizing, a warm plate of food served before me was a blessing. When there was no money, there was a bounty of beautiful things to eat. When I was lonely, I was not left alone. When I was sad, nobody thought less of me for crying through breakfast. I am checked on, looked after, and above all else respected.
If there is one thing I've learned, it is this. When interviewing for a potential job, when asked about what kind of support system you have, do NOT cite a soup kitchen as a place you go for human contact. Do not tell the middle class social ersatz elite mental health workers you eat with what amounts to the least of their clients. That it is a home base and social support. That these are people you need. Slapping food on a homeless guy's plate is ennobling. Sitting at the table for comfort and support is degrading. Then, degradation it is. Isolation is as bad as it sounds, and the kitchen teaches an equanimity one cannot learn anywhere else.
I saw some guy on t.v. - can't remember who. Wait, I think it was actually Nigel on So You Think You Can Dance. (Love love love that show!) And Thanksgiving week, he said something to the effect of don't spend the holiday alone. It doesn't matter who you're with - go someplace where there a people. If you are in need of people, go anywhere. And everybody at the kitchen, diners and staff alike, refer to it as home and family. I get to go home and be with my family, every day of the year.
Ray came up to me and gave me the morning hug, checked in to see how I'm doing. There was some food that was donated from a party yesterday. I had a tuna sandwich. Jeb was there. I hadn't seen him in a few days - he said he ran out of money so he had to walk and he usually catches the bus. Spoons was in his usual mood. We shared the table and talked. I finished my sandwich, talked to a few people, and went to see if there was any food I wanted to take home for later. There wasn't.I talked to one or two other people, stood around in the alley a bit, and walked home. It was a pleasant morning. I wasn't alone.
When I have been to sick to go get food, the kitchen fed me. When I was so depressed that I didn't want to live and nothing at the store looked appetizing, a warm plate of food served before me was a blessing. When there was no money, there was a bounty of beautiful things to eat. When I was lonely, I was not left alone. When I was sad, nobody thought less of me for crying through breakfast. I am checked on, looked after, and above all else respected.
If there is one thing I've learned, it is this. When interviewing for a potential job, when asked about what kind of support system you have, do NOT cite a soup kitchen as a place you go for human contact. Do not tell the middle class social ersatz elite mental health workers you eat with what amounts to the least of their clients. That it is a home base and social support. That these are people you need. Slapping food on a homeless guy's plate is ennobling. Sitting at the table for comfort and support is degrading. Then, degradation it is. Isolation is as bad as it sounds, and the kitchen teaches an equanimity one cannot learn anywhere else.
I saw some guy on t.v. - can't remember who. Wait, I think it was actually Nigel on So You Think You Can Dance. (Love love love that show!) And Thanksgiving week, he said something to the effect of don't spend the holiday alone. It doesn't matter who you're with - go someplace where there a people. If you are in need of people, go anywhere. And everybody at the kitchen, diners and staff alike, refer to it as home and family. I get to go home and be with my family, every day of the year.
Tuesday, May 11, 2010
Why I left Suicide Prevention in Marin
There is always a long story and there is always a final straw to the story. Or at least that is how it seems. Here is a small piece in the long story:
I need a field placement before I can go any further in my schooling. Just the way it is. So when I couldn't get a placement, I started doing volunteer work in hopes that someone would recognize my absolute brilliance and take me on. Good plan. (Didn't work, but that does not mean it wasn't a good plan.) I did a year at a place called Community Violence Solutions. (Does this name say "sexual assault advocacy and counseling" to you? Because it sure doesn't translate that way to me. Seems like nobody else could figure it out, either. I reckon that's why in the year I worked every Friday night I only got two phone calls.)
All right, that one isn't working so hot, but we still have the plan. Let's try finding a different volunteer job. How about Suicide Prevention at Family Service Agency. FSA had turned me down for a placement earlier that year, but they didn't know me. (Also, my car died 3 times on the way to the interview, I was stressed to the max, and the valium wasn't cutting the akathesia after that so I was turning whirlies in my chair. That may be part of the reason why it did not go well.)About 20 places have turned me down. They don't know me. I don't interview well. Okay.
I take the training. I pass the training. I start the hotline. Lot's of stuff going on, but certainly within my capabilities. I like the work, and I am good at it.
But lets face it. I wanted something in return. When it came time for them to interview for trainees, I applied, put on a clean shirt, and brought myself to the table. After half a year of doing two shifts a week, I was the second most experienced person on the hotline applying for the job. Priority is given to people who have already trained for working the hotline.
When I was turned down, it hurt. They sent the director of the hotline, who is not licensed to train new therapists, to tell me how sorry they were but I should be in social work, I wasn't ready to work a 20 hour week, blah blah blah. So shes like, you'll find another placement. And I said no, it's not happening. So she asked me what I was going to do, and I said I would do what I have always done - find a minimum wage job and work like a dog. So, she went to her supervisor, talked to the school, and offered me a traineeship that would count towards a general master's in counseling psychology but would not count for licensure hours. In order to take the deal, I would forfeit the option of ever using the 42 units I had already completed towards my degree towards licensure. Basically, the day I signed up to take the deal, I would never be able to become a licensed therapist using the schooling I had already obtained. I turned it down. It was not a fair offer.
But, I did not leave the hotline for another eight months. Staying was incredibly difficult. So was leaving. I worked with the students who got the position I was turned down for. They were less experienced than I was. They were less trained than I was. For the most part, a good bunch of them were less committed than I was. And I worked with them, many as they started their first shifts. Ouch!
My shift partner got a placement (which was very deserved) in another FSA department, and as summer approached she got ready to leave the hotline. It is always a pleasure working with a partner who is a good match. And I will own up to this right now - I can have a hard time getting along with co-workers. Especially if they do not get my boundaries or are less experienced but do not take feedback well. Or if they breath wrong.
Okay - I didn't finish this post yesterday, so I've kind of lost my train of thought. Let's see - where was I? Oh, at suicide prevention, didn't get field placement (pain), liked my shift partner, on and on. So, I end up with this narcissistic little drip of a trainee who is basically put off by the whole notion that he should actually be expected to show up. Now I kind of expect for a trainee every week, on time, except in an emergency or scheduled vacation. Not happening. And he is a trainee and thinks he's cute. Once, when he had missed two weeks in a row, (one week was actually legit), he showed up late and instead of checking in on the line wanted to know, and I quote "Did you miss me? How much did you miss me? Did you miss me a lot?" Okay, here goes. I am going to own up to my part of the problem. After about 10 minutes of this, I roll up a magazine and smack the boy upside the back of the head. Hey, made sense to me.
I need a field placement before I can go any further in my schooling. Just the way it is. So when I couldn't get a placement, I started doing volunteer work in hopes that someone would recognize my absolute brilliance and take me on. Good plan. (Didn't work, but that does not mean it wasn't a good plan.) I did a year at a place called Community Violence Solutions. (Does this name say "sexual assault advocacy and counseling" to you? Because it sure doesn't translate that way to me. Seems like nobody else could figure it out, either. I reckon that's why in the year I worked every Friday night I only got two phone calls.)
All right, that one isn't working so hot, but we still have the plan. Let's try finding a different volunteer job. How about Suicide Prevention at Family Service Agency. FSA had turned me down for a placement earlier that year, but they didn't know me. (Also, my car died 3 times on the way to the interview, I was stressed to the max, and the valium wasn't cutting the akathesia after that so I was turning whirlies in my chair. That may be part of the reason why it did not go well.)About 20 places have turned me down. They don't know me. I don't interview well. Okay.
I take the training. I pass the training. I start the hotline. Lot's of stuff going on, but certainly within my capabilities. I like the work, and I am good at it.
But lets face it. I wanted something in return. When it came time for them to interview for trainees, I applied, put on a clean shirt, and brought myself to the table. After half a year of doing two shifts a week, I was the second most experienced person on the hotline applying for the job. Priority is given to people who have already trained for working the hotline.
When I was turned down, it hurt. They sent the director of the hotline, who is not licensed to train new therapists, to tell me how sorry they were but I should be in social work, I wasn't ready to work a 20 hour week, blah blah blah. So shes like, you'll find another placement. And I said no, it's not happening. So she asked me what I was going to do, and I said I would do what I have always done - find a minimum wage job and work like a dog. So, she went to her supervisor, talked to the school, and offered me a traineeship that would count towards a general master's in counseling psychology but would not count for licensure hours. In order to take the deal, I would forfeit the option of ever using the 42 units I had already completed towards my degree towards licensure. Basically, the day I signed up to take the deal, I would never be able to become a licensed therapist using the schooling I had already obtained. I turned it down. It was not a fair offer.
But, I did not leave the hotline for another eight months. Staying was incredibly difficult. So was leaving. I worked with the students who got the position I was turned down for. They were less experienced than I was. They were less trained than I was. For the most part, a good bunch of them were less committed than I was. And I worked with them, many as they started their first shifts. Ouch!
My shift partner got a placement (which was very deserved) in another FSA department, and as summer approached she got ready to leave the hotline. It is always a pleasure working with a partner who is a good match. And I will own up to this right now - I can have a hard time getting along with co-workers. Especially if they do not get my boundaries or are less experienced but do not take feedback well. Or if they breath wrong.
Okay - I didn't finish this post yesterday, so I've kind of lost my train of thought. Let's see - where was I? Oh, at suicide prevention, didn't get field placement (pain), liked my shift partner, on and on. So, I end up with this narcissistic little drip of a trainee who is basically put off by the whole notion that he should actually be expected to show up. Now I kind of expect for a trainee every week, on time, except in an emergency or scheduled vacation. Not happening. And he is a trainee and thinks he's cute. Once, when he had missed two weeks in a row, (one week was actually legit), he showed up late and instead of checking in on the line wanted to know, and I quote "Did you miss me? How much did you miss me? Did you miss me a lot?" Okay, here goes. I am going to own up to my part of the problem. After about 10 minutes of this, I roll up a magazine and smack the boy upside the back of the head. Hey, made sense to me.
Saturday, May 8, 2010
transference and countertransference
I attach hard to therapists. Seriously, suction cup me to your breast hard. Okay, bad choice of words maybe. Or maybe not - attachments are primal. Any therapist I've ever seen is probably cringing at this point. My sincere apologies. When I was younger and was in therapy every week, for years this was my lifeline, the only raft in the sea of suffering. When I was 19, I had some poor therapist I called every day, sometimes more than once. That is the down side for her. I reckon the good side is that my level of self expression at that point was limited to saying "I don't feel good", maybe several times, and then hanging up. My pain when I was a young woman was simply beyond words, and therapy consisted of going to the office, saying hello, talking for 5 minutes, and then sitting in silence for the rest of the hour. I wish I could say that I had reached a zen-like state of wisdom that was beyond words but the truth is I just hurt. And, to any therapist who ever wondered if sitting there with somebody who isn't even talking does any good, you have my undying love and gratitude. Thank you for sitting with me. Thank you for not leaving me alone. Thank you for putting up with self doubt and boredom and all the other things you went through to pull me out of the pit.
It took me years to develop an emotional language. One where I could describe what had happened to me, how it felt, and what I needed.
Now, about what, over 10 years ago now I saw a therapist at Kaiser in Santa Rosa. Really quite fond of the woman. (And now that I live in San Rafael, I have discovered that it does matter which Kaiser you get your psychiatric care from. Huge difference - drive the 50 miles.) Okay, so a year ago I go through a restructure of my Medi-Cal benefits due to having earned income in addition to SSDI. (C'mon people - I'm working eight hours a week at $12.00/hour. C'mon now.) So I get a huge share of cost on my Medi-Cal, go ask Patrick what I should do, and he advised I get Kaiser to handle my Medi-Care, which means switching my psychiatric care from the County Community Mental Health to Kaiser. And I'm "I dunno. Kaiser sucks at urgent psychiatric care". Which he knows - "You use the E.R." Not a good sign when everyone in Marin knows this, but I trust his judgement so I go ahead and make the switch.
Actually, it was a very good move, and improved my access to psychotherapy. I remember telling my private therapist at the time that I was going to move my psychiatric care up to Santa Rosa, and she reminded me that I had said that same thing when I had Kaiser 5 years before. It was time to move.
So, I called up my old psychologist. I still adore the woman - she is stabilizing in a crisis and unfailingly kind. I am happy to be back seeing her, and my impression is the emotion is clearly mutual.
Here is the basic scenario. In between my switching my mental health insurance and the insurance kicking in (a matter of weeks), my life falls apart. Opps. I get turned down for a traineeship at Suicide Prevention, where I have been volunteering for a year. Not only do I get turned down, but I am still working with the people who were offered the position. I'm there every week looking at people, most with less experience and not as far along in coursework, doing something I am not able to do. This is my second year looking for a placement. I am hurt bad. Seriously like artery bleeding, kick to the groin, finger in the blender bad.
Now, I like kung fu movies. There is always a point in the movie where the hero is almost beat beyond the ability to stand, gets up, pulls up one last ounce of strength, and wins the fight. This ain't no kung fu movie. And, I am fighting like hell but just taking a hell of a beating. There is a point in every fight where the kindest a fighter can do for herself is to stay on the floor and let it be over. This may sound like weakness, or resignation, but it is actually incredibly difficult.
So, I walk in after being away for over ten years. I am beat. I am working on accepting that, for now, it is time for me to stay down. I stand up I get hit and I can't seem to cover my head. I'd too frail to take another blow. This is where I am.
And I end up with a very good therapist who happens to be the head of training for the post doc psychology program for Kaiser. She wants to go over what happened, what went wrong, how programs should have run. It is her issue now - it isn't right that I got turned down from some of these places.
Is she right - yup, it's not fair. Right now, there is nothing I can do about the unfairness. The issue for me is letting go and moving on. But, as somebody who recognizes my potential and who likes me, she wants to see me finish my school. We discuss what should have happened, how her program runs, and it is all well and pleasant. But these are her issues.
School is over for me now. I will never be a licensed therapist. My face is on the mat, and I am staying down. And I am on the floor alone...she just can't get down there with me.
This is the sad part. The problem is one of care - she loves me and wants me to be happy. And this has left me holding more pain than I can possibly hold.
This is the minor problem. Now, here is the crux of the matter. She responds very well when I leave a message where I sound clearly distressed. Sometimes I could catch her if I talk to reception when I needed to be out on a Friday afternoon. She is, as I said, unfailingly kind and when she is there she is totally present. But it became apparent fairly early on that she is having the beginnings of cognitive deficits. She forgets. So, in order to get over her threshold, pleas for help need to be extreme.
I first noticed the cognitive deficits when I began and she kept on insisting during the first several sessions that we needed to do the formal intake even though we had done it the first meeting. This happened about three times. Then once she told me that if she didn't call me back to call again to remind her. Finally, in one session I mentioned that she had a poor memory which she summarily denied. So I gave her my "come on now, it's just me here" look. People will tell me anything - swear to god. So she says "you know, you're right. If I talk to someone in the hall and I have to remember to do something they ask I have to go right back to my office immediately so that I don't forget. I have a really hard time like that".
So sad. Then, when I call, if I really sound bad and if she is in that day, she calls back. But, if I sound reasonably stable, I don't get a call back. The woman can prioritize.
But now, about one out of every three calls, the waiting time for a call back is about 50 hours. (Nope, not a typo. Not 5 hours - 50 hours.) The receptionists, when I check to see if she's in, tell me the policy for a call back from a therapist who is in the office is within 48 hours. Do these people not understand a therapeutic relationship? She will frequently call after 8:00 p.m. on Tuesday if I call earlier in the week, or else later on Thursday evenings if I remember right. But, if I feel like I need the contact, I will stay home.
The last time I called her, I left one message on Monday and one on Tuesday. When I checked on Monday reception told me she was in the office. She did call me back Wednesday about noon. Here is the way these interactions in general and this one in particular effect me. I will wait, and not be too worried if she doesn't call back on Monday. There's a freebie there. If I need to talk, I will call again Tuesday. In her regular schedule she is off on Wednesdays. So I will wait all day Tuesday for a call back, knowing that if I miss her it will be Thursday before I get to talk with her.
By this time I have spent most of Monday and Tuesday wanting to be make contact and receive reassurance. I don't remember now what the incident that prompted the call was, but if I called two days in a row it was pretty significant. (At least at the moment.)
I once saw an interview with a surfer talking about trying to go over a 40 foot wave at Mavericks. He talked about how you paddle as hard as you can, trying to get over the crest before the wave breaks. And you're sure you've made it over. Then you feel the ocean pulling you backwards, and you have no control and know that you are going to take a beating. About nine on Tuesday night, I know there is nobody there. The department is closed, she has gone home and is due out tomorrow. I am paddling as fast as I can, and now it's later night and I am being pulled over backwards. There is nothing I can do. The pit of my stomach sinks and I know I am absolutely alone.
Now, when there is an issue, I weigh the gravity of the issue against the thirty percent possibility that I will be pulled over backward by the wave. Unless it is to change an appointment or some other administrative task, I do not call.
I love her and am attached. Knowing that I am cared about fills a huge need. And I have confidence in this woman's ability to handle a suicidal crisis. No question about it. I also know that as far as the day-to-day interactions that make therapy production this is not a good situation. But the heart is there.
As for her, she loves me and wants me to do well. She is also in charge of a program that trains therapists, and sees in me the skills necessary to do this work. She can't just let me go, even though that is what I need to do.
A transference/countertransference dilemma if ever I saw one. Oh the bonds of love and human frailty.
It took me years to develop an emotional language. One where I could describe what had happened to me, how it felt, and what I needed.
Now, about what, over 10 years ago now I saw a therapist at Kaiser in Santa Rosa. Really quite fond of the woman. (And now that I live in San Rafael, I have discovered that it does matter which Kaiser you get your psychiatric care from. Huge difference - drive the 50 miles.) Okay, so a year ago I go through a restructure of my Medi-Cal benefits due to having earned income in addition to SSDI. (C'mon people - I'm working eight hours a week at $12.00/hour. C'mon now.) So I get a huge share of cost on my Medi-Cal, go ask Patrick what I should do, and he advised I get Kaiser to handle my Medi-Care, which means switching my psychiatric care from the County Community Mental Health to Kaiser. And I'm "I dunno. Kaiser sucks at urgent psychiatric care". Which he knows - "You use the E.R." Not a good sign when everyone in Marin knows this, but I trust his judgement so I go ahead and make the switch.
Actually, it was a very good move, and improved my access to psychotherapy. I remember telling my private therapist at the time that I was going to move my psychiatric care up to Santa Rosa, and she reminded me that I had said that same thing when I had Kaiser 5 years before. It was time to move.
So, I called up my old psychologist. I still adore the woman - she is stabilizing in a crisis and unfailingly kind. I am happy to be back seeing her, and my impression is the emotion is clearly mutual.
Here is the basic scenario. In between my switching my mental health insurance and the insurance kicking in (a matter of weeks), my life falls apart. Opps. I get turned down for a traineeship at Suicide Prevention, where I have been volunteering for a year. Not only do I get turned down, but I am still working with the people who were offered the position. I'm there every week looking at people, most with less experience and not as far along in coursework, doing something I am not able to do. This is my second year looking for a placement. I am hurt bad. Seriously like artery bleeding, kick to the groin, finger in the blender bad.
Now, I like kung fu movies. There is always a point in the movie where the hero is almost beat beyond the ability to stand, gets up, pulls up one last ounce of strength, and wins the fight. This ain't no kung fu movie. And, I am fighting like hell but just taking a hell of a beating. There is a point in every fight where the kindest a fighter can do for herself is to stay on the floor and let it be over. This may sound like weakness, or resignation, but it is actually incredibly difficult.
So, I walk in after being away for over ten years. I am beat. I am working on accepting that, for now, it is time for me to stay down. I stand up I get hit and I can't seem to cover my head. I'd too frail to take another blow. This is where I am.
And I end up with a very good therapist who happens to be the head of training for the post doc psychology program for Kaiser. She wants to go over what happened, what went wrong, how programs should have run. It is her issue now - it isn't right that I got turned down from some of these places.
Is she right - yup, it's not fair. Right now, there is nothing I can do about the unfairness. The issue for me is letting go and moving on. But, as somebody who recognizes my potential and who likes me, she wants to see me finish my school. We discuss what should have happened, how her program runs, and it is all well and pleasant. But these are her issues.
School is over for me now. I will never be a licensed therapist. My face is on the mat, and I am staying down. And I am on the floor alone...she just can't get down there with me.
This is the sad part. The problem is one of care - she loves me and wants me to be happy. And this has left me holding more pain than I can possibly hold.
This is the minor problem. Now, here is the crux of the matter. She responds very well when I leave a message where I sound clearly distressed. Sometimes I could catch her if I talk to reception when I needed to be out on a Friday afternoon. She is, as I said, unfailingly kind and when she is there she is totally present. But it became apparent fairly early on that she is having the beginnings of cognitive deficits. She forgets. So, in order to get over her threshold, pleas for help need to be extreme.
I first noticed the cognitive deficits when I began and she kept on insisting during the first several sessions that we needed to do the formal intake even though we had done it the first meeting. This happened about three times. Then once she told me that if she didn't call me back to call again to remind her. Finally, in one session I mentioned that she had a poor memory which she summarily denied. So I gave her my "come on now, it's just me here" look. People will tell me anything - swear to god. So she says "you know, you're right. If I talk to someone in the hall and I have to remember to do something they ask I have to go right back to my office immediately so that I don't forget. I have a really hard time like that".
So sad. Then, when I call, if I really sound bad and if she is in that day, she calls back. But, if I sound reasonably stable, I don't get a call back. The woman can prioritize.
But now, about one out of every three calls, the waiting time for a call back is about 50 hours. (Nope, not a typo. Not 5 hours - 50 hours.) The receptionists, when I check to see if she's in, tell me the policy for a call back from a therapist who is in the office is within 48 hours. Do these people not understand a therapeutic relationship? She will frequently call after 8:00 p.m. on Tuesday if I call earlier in the week, or else later on Thursday evenings if I remember right. But, if I feel like I need the contact, I will stay home.
The last time I called her, I left one message on Monday and one on Tuesday. When I checked on Monday reception told me she was in the office. She did call me back Wednesday about noon. Here is the way these interactions in general and this one in particular effect me. I will wait, and not be too worried if she doesn't call back on Monday. There's a freebie there. If I need to talk, I will call again Tuesday. In her regular schedule she is off on Wednesdays. So I will wait all day Tuesday for a call back, knowing that if I miss her it will be Thursday before I get to talk with her.
By this time I have spent most of Monday and Tuesday wanting to be make contact and receive reassurance. I don't remember now what the incident that prompted the call was, but if I called two days in a row it was pretty significant. (At least at the moment.)
I once saw an interview with a surfer talking about trying to go over a 40 foot wave at Mavericks. He talked about how you paddle as hard as you can, trying to get over the crest before the wave breaks. And you're sure you've made it over. Then you feel the ocean pulling you backwards, and you have no control and know that you are going to take a beating. About nine on Tuesday night, I know there is nobody there. The department is closed, she has gone home and is due out tomorrow. I am paddling as fast as I can, and now it's later night and I am being pulled over backwards. There is nothing I can do. The pit of my stomach sinks and I know I am absolutely alone.
Now, when there is an issue, I weigh the gravity of the issue against the thirty percent possibility that I will be pulled over backward by the wave. Unless it is to change an appointment or some other administrative task, I do not call.
I love her and am attached. Knowing that I am cared about fills a huge need. And I have confidence in this woman's ability to handle a suicidal crisis. No question about it. I also know that as far as the day-to-day interactions that make therapy production this is not a good situation. But the heart is there.
As for her, she loves me and wants me to do well. She is also in charge of a program that trains therapists, and sees in me the skills necessary to do this work. She can't just let me go, even though that is what I need to do.
A transference/countertransference dilemma if ever I saw one. Oh the bonds of love and human frailty.
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