Monday, December 30, 2013
Saturday, December 28, 2013
Friday, December 27, 2013
Monday, December 23, 2013
Sunday, December 22, 2013
Patient Suicide: Part Eight--On Scarves and Lessons Learned
This is part of an ongoing story about a patient suicide. Click here for Patient Suicide Part One: The Phone Call, here for Patient Suicide Part Two: 30 Minutes to Think, here for Patient Suicide Part Three: Fully Present, here for Patient Suicide Part Four: What's a Life Worth, here for Patient Suicide Part Five: Treat People Like They Matter, here for Patient Suicide Part Six--Leftovers, here for Patient Suicide: Part Seven--Training Monkeys/Herding Cats, and here for Patient Suicide: Part Eight--On Scarves and Lessons Learned
I've been wearing the scarf my dead patient knitted for me the last few weeks. The scarf is made from yarn of yellow and green and blue. Soft to the touch and just a bit too short, it isn't really a scarf that I'd pick for myself. Nevertheless, I've liked having it near me, on me, and around me. I am, in fact, wearing it now while I write this entry. I'm aware of no specific reason why. I suppose the most true thing I can say is that I've been feeling particularly close to my memories of her these last few weeks.
I'm sure an analyst somewhere would have all sorts of interpretations.
Some of them might even be right.
I haven't always wanted to wear the scarf. There are times when I haven't even wanted to see it.
''And I've become more humbled by how little one can do, ultimately, to keep someone alive.'' -- Joan Wheelis, MD
I've been wearing the scarf my dead patient knitted for me the last few weeks. The scarf is made from yarn of yellow and green and blue. Soft to the touch and just a bit too short, it isn't really a scarf that I'd pick for myself. Nevertheless, I've liked having it near me, on me, and around me. I am, in fact, wearing it now while I write this entry. I'm aware of no specific reason why. I suppose the most true thing I can say is that I've been feeling particularly close to my memories of her these last few weeks.
I'm sure an analyst somewhere would have all sorts of interpretations.
Some of them might even be right.
I haven't always wanted to wear the scarf. There are times when I haven't even wanted to see it.
She gave it to me for Christmas--four months before she died. She was knitting scarves and hats as a form of distress tolerance. Some went to cancer patients being treated at a local hospital. Some went to babies who were born prematurely. One of them went to me. I kept the scarf in the closet for months. I considered giving it away. I considered throwing it away. I didn't want to see it.
I hated it.
I hated her.
The scarf made me feel guilty. I felt guilty for hating her. I felt guilty for my anger toward her. I felt like a failure because she was dead. I hated that she was dead and I hated that I felt like a failure. I hated that I hated.
I wanted all my feelings about my dead patient to go away.
I couldn't make them go away. The best I could muster was to stuff those feelings into my closet and repress them. Store them away. Bring them out later for inspection.
I didn't save her.
I couldn't save her.
She didn't want to be saved.
I hated it.
I hated her.
The scarf made me feel guilty. I felt guilty for hating her. I felt guilty for my anger toward her. I felt like a failure because she was dead. I hated that she was dead and I hated that I felt like a failure. I hated that I hated.
I wanted all my feelings about my dead patient to go away.
I couldn't make them go away. The best I could muster was to stuff those feelings into my closet and repress them. Store them away. Bring them out later for inspection.
I didn't save her.
I couldn't save her.
She didn't want to be saved.
She couldn't be saved.
I didn't want to learn these lessons. I didn't want to learn that I cannot rescue those who cannot be rescued. I didn't want to learn that some people don't want to be saved. I didn't want to learn that no matter how hard I try, Humpty can't always be put back together.
These are some of the lessons I learned.
I didn't want to learn these lessons. I didn't want to learn that I cannot rescue those who cannot be rescued. I didn't want to learn that some people don't want to be saved. I didn't want to learn that no matter how hard I try, Humpty can't always be put back together.
These are some of the lessons I learned.
I'd rather have not learned them. I'd rather my patient still be alive.
We don't always get what we want.
I'm not angry anymore. I don't feel guilty. I don't blame myself. I miss my dead patient. Sometimes a little, sometimes more intensely.
We don't always get what we want.
I'm not angry anymore. I don't feel guilty. I don't blame myself. I miss my dead patient. Sometimes a little, sometimes more intensely.
Another lesson has been bubbling up. Perhaps this is the reason why I've worn the scarf nearly every day since it's gotten cold this year.
In the wake of my patient's suicide I've become strong. I've become strong in ways that I never anticipated. I feel calmer--not just around issues of suicide, but around everything else that happens in my office. I'm learning the difference between the things I have power to influence and things that are outside my power as a psychologist.
Suicide no longer frightens me as a clinician.
In the wake of my patient's suicide I've become strong. I've become strong in ways that I never anticipated. I feel calmer--not just around issues of suicide, but around everything else that happens in my office. I'm learning the difference between the things I have power to influence and things that are outside my power as a psychologist.
Suicide no longer frightens me as a clinician.
I hope it doesn't happen, and yet I don't fear it.
There are days when I feel a little hysterical at the thought of going through this all over again. Those feelings don't last too long. I hope I'm always just a little hysterical at the thought of someone dying.
Mostly, I welcome suicide into my office. Every day it becomes a little easier to talk about.
I wish she didn't have to die, and yet in her death, she made suicide something that is mentionable for me--something really mentionable. Rather than frightening and silencing my patients with threats of hospitalizations and retribution, I've become more skillful and inviting suicide into the room. It's become a thing that can be spoken. A thing that can be known. A thing that is mentionable and therefore more manageable.
“Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone.” -- Fred Rogers
Saturday, December 21, 2013
Dear Young Therapist: Consider Your De Rigueur Requirements | The Post-Doctoral Tie Incident
image credit: Nicholas Ruiz. Bow Tie #10. Assembled November 2011. Acetaminophen pills, multiple adhesives, plastic knife. Forest Hills, Queens, New York. |
"Do you mind if I eat? Not that you really have a choice. I'm doing the interview and have the power in this situation."He continued to masticate and fill his office up with the seasonally incongruent smell of Thanksgiving. This was going to be a fun filled interview.
"I'd like to ask you why you aren't wearing a tie today for your interview. Before you answer, I want you to know that as a psychologist I think everything has a meaning. I hope you have thought about the meaning of why you didn't wear a tie. If you haven't, then you aren't what we are looking for in a post-doctoral fellow. We'll end the interview here and I'll wish you good day."
I had a variety of inside-thoughts that I considered sharing. They included:
- Asshole.
- Drop dead.
- Who the hell do you think you are? I just had fucking brain surgery, a post-operative infection, and joint damage from an adverse reaction to the antibiotics that treated my infection.
- Your turkey sandwich is making me want to throw up.
- I'm scared because I can't find a job.
- Do you know who the fuck I am?
- Am I going to fail as a psychologist?
Friday, December 20, 2013
The ShrinkThinks Validation Machine
....we here at the Irreverent Laboratories have cooked up a little validation machine. To learn more about Martha Crawford visit her blog, What a Shrink Thinks.
Saturday, December 14, 2013
Edgewater: Fishing for Light
This past autumn I took a quick trip back to Cleveland. Before driving the rest of the way to my parent's house, I made a stop at Edgewater Beach. If you are planning your visit, remember that the Cleveland Metroparks have some helpful rules to make your visit pleasant including no:
- Spitting, spouting of water, urination, nose blowing or defecation in the water
- Access to the water for any person with open sores or wounds
Thursday, December 12, 2013
Monday, December 9, 2013
Friday, December 6, 2013
Time-Lapse Map of Nuclear Tests
Isao Hashimoto created a 14 minute film depicting each of the 2,053 nuclear bomb tests that have occurred around the world.
Such sad folly, thinking these weapons of mass destruction might somehow keep us safe. What a world we live in, poisoned by our own weapons.
Can you make yourself vulnerable enough to find yourself in the other rather than using violence (or the threat of violence) to wipe the other off the map?
Such sad folly, thinking these weapons of mass destruction might somehow keep us safe. What a world we live in, poisoned by our own weapons.
Can you make yourself vulnerable enough to find yourself in the other rather than using violence (or the threat of violence) to wipe the other off the map?
I'm a Wellesley Woman
The other day I made an early morning trip to the gym. Crawling up to the top of the cardio deck for my Sunday morning date with the dreadmill, I observed the crowd below. It occurred to me that I was the only white-appearing person in the room. This isn't an entirely unexpected occurrence as the area near my gym has the second largest Cambodian population in America. The region as a whole is in the top 1% of diverse areas in the state of Massachusetts.
Still, it's not a very common experience for me to find myself the only white man in a room. For a variety of complicated reasons--demographic, social, economic, preference, structural and institutionalized racism--white people most commonly have the experience of looking around and seeing only similar looking people. The implications of this are enormous. When we only see people like ourselves reflected back at us, we tend to think the world is like us. We lose touch the the diversity of knowledges, experiences, and viewpoints that are present in our world.
We are stronger when we find ways to come together. Finding unity in our diversity isn't an easy enterprise. Pushed to far, the notion of unity can erase individual and group level differences that brings the world the riches of ethic and cultural diversity. Done poorly, the move toward seeing unity in diversity can fragment a population that fails to find a common goal. Done incompletely, the notion of unity can lead toward mere tolerance of differences. Done correctly, finding a unity in our diversity can build a common connection that enriches us through our differences.
Perhaps the founders of the United States were thinking of this when on July 4, 1776, it was suggested to the Continental Congress that on the seal for the United States of America appear the phrase E pluribus unum -- out of many, one.
What on Earth does any of this have to do with me being a Wellesley woman? I'm glad you were wondering. In the winter of 2000 I was searching for a practicum for the following academic year. My nose was still out of joint from the practicum search for the 2000-2001 academic year. Having never been turned down for a job that I applied for, I had been turned down for every practicum that I applied for.
Not wanting to go through that horrific experience again, I interviewed for placements in New Hampshire, Maine, and Massachusetts. All said, I had about 15 interviews. One of them was at Wellesley College. I was discouraged from interviewing there. "We've not had a student there in a long time," one faculty member said. "Why would you want to be at an all girls school?" asked a classmate. I was even unsure myself--I was living in Manchester New Hampshire and would have to drive sixty miles in each direction.
I did the interview.
I got the job.
I was the first male psychology trainee ever brought on for practicum training. Figuring they didn't want me to be alone, they also brought on Stephen Bradley, who was the first every male social work trainee. Of course, if Stephen was writing this he very well might write:
Stephen and I spent a lot of time together navigating what it was like to be two men an a women's college. All of our clients were women. All of our coworkers were women. While there are other male faculty and staff members at Wellesley, during my year as a practicum student I didn't encounter any of them.
We were alone in a sea of women. Our every move as men was amplified and noticed. We were, for the first time in our lives, minorities. This is of course not to say our experience was comparable to that which people of color experience. My maleness and whiteness carry an enormous amount of unearned privilege no matter where I go (see here and here for more thoughts on white privilege). The uniqueness of this experience is that the environment around me highlighted and magnified that privilege. The things that I never had to notice--or never could notice--became evident in an environment where we were the only white dudes.
What stands out the most? The bathrooms. There aren't a lot of men's rooms at Wellesley and none at all at the Stone Center. We had a bathroom with a sign on it that said men/women. The women always forgot to slide the sign (why would they remember, they never had to think about it before) so I was always walking in on someone. They were always walking in on me. Given a few more years experience, I think we'd have gotten to the point were we peacefully coexisted in the restroom at the same time doing our business.
I remember the day Ann and I finally gave up on navigating the uncomfortableness of the shared bathroom experience, smiled at each other, and talked about our weekends while we washed our hands.
To make my experience even more rich, my supervisors were an African American woman and an Indian woman. I got to examine everything. It was a gift that I never anticipated and one that I still benefit from. The moments where we collectively discovered how my whiteness or maleness bumped up against the system, intruded upon the viewpoint or another, or was shown deference, were held and explored and thought about carefully.
Years later I'm still thinking about it.
Several years later, after I was licensed as a psychology, the Stone Center Counseling Service at Wellesley College came calling again and hired me as an interim staff psychologist. I got to explore the experience again as the only male and the first ever male psychologist.
So I thought about this while I was on the treadmill at the gym this morning surrounded by a sea of people who had skin tones that were different than mine. I was surrounded by a sea of humanity that each had a different set of experiences, values, morals, and outlooks that are dictated in part by cultural and racial experience.
I wish more white people could have this experience.
I wish more white people would be open to experiencing this when it happens.
I wish more white people could be open to knowing there are different ways to know the world, and our way isn't the only valid way.
Not wanting to go through that horrific experience again, I interviewed for placements in New Hampshire, Maine, and Massachusetts. All said, I had about 15 interviews. One of them was at Wellesley College. I was discouraged from interviewing there. "We've not had a student there in a long time," one faculty member said. "Why would you want to be at an all girls school?" asked a classmate. I was even unsure myself--I was living in Manchester New Hampshire and would have to drive sixty miles in each direction.
I did the interview.
I got the job.
I was the first male psychology trainee ever brought on for practicum training. Figuring they didn't want me to be alone, they also brought on Stephen Bradley, who was the first every male social work trainee. Of course, if Stephen was writing this he very well might write:
I was the first male social work trainee ever brought on for practicum training. Figuring they didn't want me to be alone, they also brought on Jason Mihalko, who was was the first ever male psychology trainee. Of course, if Jason was writing this he very well might write:Interesting how much perspective matters. Anyway.
Stephen and I spent a lot of time together navigating what it was like to be two men an a women's college. All of our clients were women. All of our coworkers were women. While there are other male faculty and staff members at Wellesley, during my year as a practicum student I didn't encounter any of them.
We were alone in a sea of women. Our every move as men was amplified and noticed. We were, for the first time in our lives, minorities. This is of course not to say our experience was comparable to that which people of color experience. My maleness and whiteness carry an enormous amount of unearned privilege no matter where I go (see here and here for more thoughts on white privilege). The uniqueness of this experience is that the environment around me highlighted and magnified that privilege. The things that I never had to notice--or never could notice--became evident in an environment where we were the only white dudes.
What stands out the most? The bathrooms. There aren't a lot of men's rooms at Wellesley and none at all at the Stone Center. We had a bathroom with a sign on it that said men/women. The women always forgot to slide the sign (why would they remember, they never had to think about it before) so I was always walking in on someone. They were always walking in on me. Given a few more years experience, I think we'd have gotten to the point were we peacefully coexisted in the restroom at the same time doing our business.
I remember the day Ann and I finally gave up on navigating the uncomfortableness of the shared bathroom experience, smiled at each other, and talked about our weekends while we washed our hands.
To make my experience even more rich, my supervisors were an African American woman and an Indian woman. I got to examine everything. It was a gift that I never anticipated and one that I still benefit from. The moments where we collectively discovered how my whiteness or maleness bumped up against the system, intruded upon the viewpoint or another, or was shown deference, were held and explored and thought about carefully.
Years later I'm still thinking about it.
Several years later, after I was licensed as a psychology, the Stone Center Counseling Service at Wellesley College came calling again and hired me as an interim staff psychologist. I got to explore the experience again as the only male and the first ever male psychologist.
So I thought about this while I was on the treadmill at the gym this morning surrounded by a sea of people who had skin tones that were different than mine. I was surrounded by a sea of humanity that each had a different set of experiences, values, morals, and outlooks that are dictated in part by cultural and racial experience.
I wish more white people could have this experience.
I wish more white people would be open to experiencing this when it happens.
I wish more white people could be open to knowing there are different ways to know the world, and our way isn't the only valid way.
Sunday, December 1, 2013
World AIDS Day 2013
I've been thinking a lot today about my first job as a psychotherapist at the Free Medical Clinic of Greater Cleveland. Nearly all of my clients were gay and nearly all of those clients were HIV positive. Some were recently diagnosed while others were ill before AIDS even had a name. A whole generation of gay men were blighted by this disease. Many still are.
I remember the dead today. So many lives lost. So many stories that can never be told. So many dreams that will never be realized. So many gifts that will never be brought into this world.
Remember the generation of gay men who had to leave because of this disease.
The original image I used was captured by the photographer William Gedney at the June 26, 1983 gay pride parade in New York City. You can see the original here at the Duke University Libraries.
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