Friday, September 21, 2012

Keep Calm and Carry On


Self care when you’re a therapist is important, nay, critical to being successful in a career where you take on the burdens of others throughout the week and shoulder the weight of their woes. In graduate school, there are several brief mentions on discovering your own methods and devices for preserving your strength, emotional well-being, and sanity, but as I’m coming to find in my career, it was hardly enough.

As my career has progressed and I have skipped from one population to the next, I am finding that self-care is not just a recommendation passed down by clinical supervisors and professors, it is a necessity that needs to be fulfilled. And where I work, the severity of the cases we deal with, I believe, supercede what most clinicians will encounter in their lifetime. Most of our children find themselves on the cusp of lock down, either teetering towards being hospitalized or incarcerated, or freshly released from such facilities and attempting to re-integrate back into the general population. They have experienced severe neglect and abuse, are emotionally and psychologically disturbed, some are psychotic, others are delinquents, and a handful are human trafficking victims. They come to you as a therapist and divulge their deepest darkest secrets, detail their experiences of abuse, rage against the world, and look to you for guidance, support, and sometimes even safety and security.

Such a responsibility has been a load I’ve struggled to maintain. Never one to cope with large amounts of stress appropriately, I’ve slipped down the dark road of infinite bitchiness, biting the heads off of my loved ones and prompting my mother to inform me I was “no fun to be around anymore”. I spent nights crying, stressed to the max, just trying to breathe my way through it. But breathing doesn’t suffice when faced with such catastrophes. One incident that drove me to the very brink found a client committing an unmentionable act against another human being, triggering not only an overwhelming amount of anger and grief as I attempted in vain to manage my counter-transference, but touching on my personal experiences and eliciting a cold apathetic response I never wanted to have for any client. My prescription for self-care? A bottle of wine and three tear-filled hours as my stomach churned and tied itself in knots. Later, I tried music, exercising, writing, and more crying, to no avail. A more recent incident had me set in an office, listening to explicit details of sexual abuse as a client recounted her childhood trauma, an experience no one had tried to protect her from and no one tried to stop, though they undoubtedly knew it was occurring. And I left the session devastated.

Some people enlist family and friends for a support system, an ear one can ramble to, a shoulder one can cry on, someone to hold until the nerves quiet. I have found these are short in supply. I don’t discuss my job with my parents too much, given that my father didn’t want me to take this job and my mother can only take so much of my stories. Most people listen to my work days and cringe with a pained look on their face that simply tells me “their stomach is too weak for this”, and I silence myself. Many friends are therapists, however when socializing on a relaxing weekend, one runs the risk of becoming Debbie Downer if they arrive to simply vent and cry about work. Many co-workers, though incredibly supportive, have their own trysts to face and can hardly manage the burden of my grief along with theirs. I finally got myself a therapist, and worked through many struggles, and she also gave me amazing advice I have been trying desperately to implement. It is okay to say no.

Given the difficulties of my job, spending several hours a day with incredibly difficult people, I need my weekends. I need time to recharge my batteries and time to quiet my own nerves. Generally I can manage with one day off, and leave the other for chores, errands, and social events. Other times I need both days depending on how my week has gone, otherwise I know I will be utterly useless for the next week, finding myself on the verge of a breakdown or a panic attack. Adding to my anxiety-ridden, stress-plagued emotional state is my full-fledged status as an introvert. Shying away from too many people, too much noise, and too much activity, I require quiet time to myself with minimal stimuli where I can escape into the recesses of my mind, be alone with my thoughts, wherever they will take me, and avoid the trials and tribulations of the real world. This much needed solitude affords me the calm I seek in order to recuperate. Hence, when people plot and plan various activities and parties on the weekends, as much as I want to be there, sometimes I just can’t. Loud music, hustling bustling crowds of people, and putting on a facade to socialize takes more energy than I can give. And really, sometimes it is a facade. To put on a smile, greet friends, family, and strangers with laughter and a hug is occasionally nothing more than a mask you don, because the reality is you’ve spent the week listening to children talk about being beaten and raped, being neglected and unloved, having their bodies sold for money and drugs, watching friends and family be killed in the hood, or slowly realizing that the odds in their lives are stacked against them. And somehow, you’re expected to put that away, bury it in the paperwork and leave it on the progress notes, go out on the weekends and celebrate as though everything is right in the universe. At times, it simply can’t be done.

However, when I get that invitation in the mail for this and that, I feel an obligation to agree. Maybe it will be fun, I tell myself, or maybe that week won’t be so bad at work and I can enjoy myself. Maybe wine will be provided and I’ll sip a glass in the corner, count that as making an appearance, and sneak out early. If I don’t go, I’ll feel guilty, I don’t want them to be mad at me, I don’t want to neglect the relationships in my life, I don’t want to isolate myself. So, at times I’ve agreed to attend events, and find myself cracking, breaking, even shattering later because that crucial battery charging time was never given. My therapist pushed me to exercise my right to say no. Will the world end if you don’t attend? she would ask, and of course, it would continue on as it always had. Will people be angry if you don’t go? And of course, the answer was yes, and I would face the criticism of those who simply could not understand the struggle of the profession I have chosen, adding to my guilt for refusing the invitation. But does it matter? It’s a work in progress but I am slowly realizing in the end, I need to be okay, at whatever costs.

I love my job, I have always wanted to leave a positive impact in the world and help people. That doesn’t mean that such a journey is a walk in the park. It is an expedition with pitfalls, mountains to climb, storms to brave, and treacherous paths to trek. The job of a therapist is such an important one, the job of a therapist to emotionally and psychologically disturbed children and teens is tantamount to securing the future, an attempt to heal festering wounds and rebuild the crumbling ruins of tomorrow’s society (yeah it’s that important, so can we get a freakin’ raise?). As much as I struggle, I can’t see myself retreating from the front lines just yet, I can’t leave my kids, the fallen soldiers, to die in the battlefield. As big of a pain in the ass some of these kids can be, I care about them, I just need my Me time on the weekends. Likewise, we all need to find what works for us in order to provide the best quality care we can to our clients. Maybe a crazy party is just what you need. Not me, but to each his own.

Répondez, s'il vous plaît? Sorry, my kids went cray-cray this week, see you next time. Apologies, with regret, much love, best wishes. And if you can’t handle that, pucker up and kiss it. Your approval is neither desired nor required.