For the birds

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When he called, he had already been expressing some thoughts of wanting to harm himself. The night before, he had been involved in a dramatic domestic abuse incident, and those thoughts lingered with him still.

“I am having thoughts of harming myself,” he told my coworker, who, by random luck, was the one to pick up his call.

“OK, sir- where are you right now?” she asked, attempting to gather more information.

“I’m at work,” OK this was good as he was probably not alone. “I’m currently up in a tree lift,” OK, maybe not so good.

The man was making his desperate call for solace from the raised bucket of his tree trimming truck, and he was contemplating how easy it might be for him to just jump out.

As we assisted her in what ways we could, my coworker managed to talk the man into lowering his bucket back down to earth. As she relayed me the details of his current situation (actively suicidal with plans and means, domestic issues, etc.), I arranged everything to provide that man with a smooth admission into our adult hospital for crisis stabilization.

And then he refused to go. 

Not because he did not think he needed help. Not because he did not want to go into an inpatient setting. No, he refused because he believed he needed to finish up his workday: high up in the air, cutting down tree limbs… while actively suicidal.

Often times, I think just the act of calling a help line is enough for some people to realize that they are not alone in whatever they are currently facing.  On the other end of the phone is a stranger that now carries some of that burden for them. And for some, the act of sharing is enough, in their minds, to get them out of their immediate crisis.  What they forget is that while they did go and make the effort to call a crisis line, they still need to follow-through with the recommendation made by the professional on the other end.  If the person knew how to change their situation already, they would not be calling a crisis line in the first place. One call is not going to solve all their problems, but it can help set in motion the next steps that will assist towards that goal.

So back to our guy: It took a lot of reality-based confrontation and multiple calls back and forth before he agreed to get help beyond just a phone call. Sometimes all a person needs is to hear their own words said back to them before they realize how they sound to the rest of the world. In this case, it worked (as did explaining to him how a fall from that height would probably not have the desired effect, and would more likely result in a stay in a medical hospital and extensive physiotherapy for whatever limbs he could still move.)

You have really pretty hair

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“You have really pretty hair.”

This was not the statement that my friend expected to hear at that moment. Not from her therapist. Especially not in the middle of a rather emotional counseling session.

Sometimes it can be very difficult to know how to respond to a consumer (client, patient- they are all the same, but for my purposes I will be referring to them as consumers or cons throughout) during a particularly emotional session. But as counselors, therapists, and social workers, we have been trained on how to be empathetic to our consumers’ needs; even if that response is just a non-verbal one. We strive to help our consumers feel as if they are in a safe environment, where they can open up and be heard. And while there are some situations where a consumer might try to take advantage of that empathy (some cons with borderline personality disorder come directly to mind), as professionals we seek to respond to these situations in a manner that will hopefully allow the cons to become more open and honest with him or herself. This alteration allowing the cons to process the root of their issues, rather than just the issues they continue to create.

So while it is often human nature to freeze-up or become verbally inept when confronted with emotional or confrontational situations, it is important for us to remember that there is another human on the other side of that exchange.

So when this professional therapist interrupted my friend and her emotional disclosure to give an out-of-context compliment of her hair, it lead my friend to wonder if that therapist even knew what empathy meant. With one little phrase, that session, and any future sessions with that therapist, was effectively over.

Sometimes you just have to start from the side

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I’ve been working in the mental health field for over four years. Prior to that I worked backstage in a professional theatre. There were many times that I had difficulty distinguishing between the two. The Drama Queen might be the one on stage or the one you are helping to admit on an inpatient unit. The difference between the creative dreamer and the man talking to the invisible cow could just be a matter of medication levels. In both environments, a sense of humor became very important, as did a sense of teamwork and comradery.

With this blog I set out to put down some of the things I remember, a few of the things I learned, and perhaps just ramble on here and there. You are welcome to join me.