It's been a while since I've last posted...a long while. It's not as if I haven't been writing - to the contrary, actually. My whole existence these days is based on writing. I am an assessor. When a person comes to my agency seeking help I am the one who conducts an interview to determine the person's needs and links her with the appropriate services. There's financial paperwork to complete, releases to sign, and all of that other fun stuff that gives one the impression she is signing her life away; then, there's completing the treatment plan, asking for information ranging from one's childhood through what mental health symptoms/signs of drug abuse one is experiencing, and then scheduling appointments to meet with the psychiatrist, case manager, and/or substance abuse treatment counselor. It amazes me how people are usually trusting enough to share their most intimate details with someone they have just met. I feel honored at the amount of times people have said to me, "I've never told anyone this before" or "I feel very comfortable with you." It validates my role as a caring professional. It makes me feel good about myself; however, the work can be overwhelming. The easy part is the interview. The difficult part is writing the bio-psycho-social narrative that will accompany that person's chart at this agency and beyond. I am always cognizant that the mental health diagnosis I give a person who has never sought mental health services before will follow her forever.
I have often wondered how I would appear on paper if I was on the other side of the desk and coming to my agency for an assessment. Since I write about other peoples' lives for a living, I thought I'd write one for myself on this blog.
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Presenting Problem:
Client is a 34 year-old married bi-racial female who is seeking to engage in mental health services due to a history of depression. She reports that she has been dealing with depression since childhood and has engaged in multiple mental health treatment programs. She expresses her desire to engage in pharmacologic management, behavioral health counseling, and anger management. She states that her goal for this assessment is “to learn to effectively manage my depression in order to lead a happy and productive life.”
Biomedical conditions:
Client reports that she has medical insurance and receives her medical care through University Hospitals and has a primary care physician and a chronic pain management physician. She reports that she has fibromyalgia, an ulcer, and hypoglycemia. She reports that she has had 2 surgical procedures - a dilation and evacuation procedure to remove a polyp in her uterus in 2008 and an excision to remove a 3rd degree chemical burn from her left buttock in 1996 (an aside, I accidentally sat in 6M HCl in O-chem lab as a sophomore in college). She denies ever sustaining head trauma. She denies having any advanced directives. She reports that she is taking the following medications - over-the-counter Prilosec (dosage unknown, qd) for an ulcer; Lyrica (60mg, bid) for fibromyalgia; and Zanaflex (6mg, hs) for fibromyalgia. She reports that she is also taking Loesterin 24 for birth control. She reports that she is allergic to Morphine and Compazine. She describes her appetite as "fair" and her sleep as "good."
Recovery Environment:
Client reports that she has been living in her own home with her husband for the past 7 years. She denies having access to firearms.
Client reports that she was born in Akron, OH, and raised in various cities in Ohio and in Belle Plaine, Iowa, by her mother, who is a retired nurse, and her father, who is a retired physician. She reports that the relationship with her mother is strained, and the relationship with her father is "okay - only because I don't get to speak with him often. If I talk with my dad I have to talk with my mom." She reports that she has 2 siblings - a younger sister, who lives in California, and a younger brother, who lives in the area. She states that she has an "excellent" relationship with her siblings. She describes her childhood as “dysfunctional.” She reports that, for the most part, her basic needs were met. She denies having any children. She denies ever serving in the military.
Client reports that she became sexually active at the age of 18. She identifies herself as heterosexual. She reports that when she has engaged in sexual activity, she has sometimes used condoms. She reports currently engaging in a sexual relationship. She reports that she was tested for HIV a year ago, and the results were negative.
Client reports that the highest level of education she has completed was obtaining a Masters degree in social work. She reports that she is currently employed part-time as an assessor at a local mental health/substance abuse treatment agency. She reports that she has income.
Client denies a history of legal involvement.
Client reports that her family, her friends, and God are her support system. She reports that she believes in a Higher Power and identifies herself as Roman Catholic.
Intoxication/Withdrawal:
Client reports that she has used alcohol in her lifetime. She reports that she first drank at the age of 21 and regards herself as a casual drinker. She denies endorsing criteria for abuse or dependence. She reports that she last drank in 10/09. She denies ever engaging in a substance abuse treatment program. She denies ever attending 12-step meetings. She reports a history of gambling, sheepishly admitted to gambling away her Christmas bazaar money by losing at chess in the 4th grade. She reports a familial history of substance abuse that includes her mother and her maternal aunt, who have been addicted to opioids.
Emotional Health:
Client reports a history of mental health treatment that began at the age of 8 when she first engaged in counseling at school for family issues. She reports that she first engaged in pharmacologic management at the age of 12. She reports that she was diagnosed with depression and given "happy pills" as neither her psychiatrist nor her parents informed her the name of the medication. She reports that the medication did not help as it did not improve her mood, and it made her mouth very dry. She reports that she re-engaged in counseling as an undergraduate at Case Western Reserve University and also briefly engaged in counseling 10 years ago when she was living in Dayton, OH. She reports that she has most recently been engaged in counseling for the past 5 years through University Hospitals. She reports that she briefly received pharmacological management services 10 years ago while living in Dayton, OH, and had been taking Effexor XR, Prozac, and Paxil. She reports that the Prozac was helpful but the Paxil gave her nightmares and the Effexor made her very aggressive, stating "I was looking for fights." She reports that she lost her medical insurance and did not resume pharmacologic management services until 5 years ago when she got married and was put on her husband's medical insurance. She reports that she was receiving services at University Hospital; however, her psychiatrist has taken a fellowship and she is in need of obtaining a new psychiatrist. She reports that she is currently taking Wellbutrin XR (450mg qd) and Lamictal (qd) 300mg for depression. She reports that the medications are helping but feels that their efficacy has been steadily decreasing and is not averse to trying something new.
Client denies a history of hospitalizations for mental health reasons. She reports a history of suicidal ideation and 2 past suicide attempts. She reports the first time was when she was 8 years old when she almost stabbed herself in the chest with a butcher knife; however, she reports that one of her paternal aunts caught her before she could harm herself. She reports that shortly before the age of 10 she attempted suicide by overdosing on Valium, but only succeeded in taking 2 pills before stopping, stating "God gave me a sign to stop." She reports the attempt at the age of 10 was the last time she experienced any suicidal ideation. She denies a history of homicidal ideation.
Client reports that she first experienced depression when she was 6 years old. She reports that her mother was constantly ill when she was young, and the pressure of having to take care of her younger siblings, her mother, and herself was too much to handle sometimes. She reports experiencing at least 4 distinct periods of depression that have lasted at least 6 months each. She reports that the last time she experienced depression lasting for 2 weeks or longer was a month ago. She reports endorsing the following criteria for major depressive disorder: sadness; feelings of worthlessness and hopelessness; lack of appetite; excessive sleep; racing thoughts; excessive worry; increased irritability; impaired concentration; and lack of energy. She reports that her longest period of depression lasted almost consistently for 9 years - from 1996, that was triggered by the break-up from her first boyfriend, through 2005, when she re-engaged in mental health treatment. As she did not meet full criteria for major depressive disorder consistently for 9 years but admits to being depressed, she does endorse criteria for dysthymic disorder.
Client denies ever experiencing symptoms indicative of (hypo)mania; therefore, she does not endorse criteria for bipolar disorder. She denies experiencing anxiety or panic disorder. She denies experiencing hallucinations that were not medication-induced. She denies experiencing any delusions. She does experience periods of paranoia in which she feels that catastrophic events will occur and harm her or her family. She reports that she will get upset with her husband for not locking the car doors or back door for fear that someone will open the door and harm them. Although she denies experiencing suicidal ideation, she reports that a year ago she was experiencing terrible thoughts of turning the steering wheel sharply while speeding down I-71 and wondering what would happen.
Client reports experiencing periods of anger that negatively impact her relationship with family and friends, and she is also reports problems with "road rage." She expresses her interest in anger management.
Client reports an extensive familial history of mental illness as her sister and father have depression. She expresses her belief that her mother, maternal grandmother, and one of her maternal great-grandmothers may have (had) borderline personality disorder. She reports that her mother has a history of anxiety disorder. She reports that a maternal cousing also suffered from depression and committed suicide 11 years ago.
Client denies a history of physical abuse; however, she reports a history of sexual abuse as she reports that she was repeatedly molested by a neighbor between the ages of 7 and 8 and date-raped by her first boyfriend. She reports that she was also emotionally abused by her first boyfriend. She reports that this behavior continues to affect her today.
Mental Status Evaluation:
Client presented for the assessment appearing well-groomed and displayed euthymic mood with full range of affect. She was alert and oriented x3, and her thought process was tangential. She was able to provide an organized history, and her speech was normal in tone, volume, and content. Her psychomotor activity was within normal limits. Her fund of knowledge was appropriate for her age and education level. No internal stimulation was noticed. She denied any suicidal/homicidal ideation.
DIAGNOSIS
Axis I: 300.04, Dysthymic disorder, full remission; R/O 296.32, Major depressive disorder, recurrent, moderate
Axis II: 799.9, Diagnosis deferred
Axis III: Fibromyalgia; hypoglycemia
Axis IV: none reported by client
Axis V: 70
The rest basically consists of a summary and the treatment recommendations. In my case, I would refer myself for behavioral health counseling, pharmacologic management, and anger management.
This exercise has given me a much greater appreciation for the trust bestown upon me by my clients. I don't think I could share so much to a person I just met for an hour. I feel vulnerable sharing all of this; however, I feel that it was also a cathartic experience to see how my life is similar to those I meet everyday. Some are worse off than I am, and others are more well-adjusted - that or they are minimizing their disclosure. It also helps me to see that while I have issues, I have come a long way. I have a good, even wonderful, life. I am sitting in my house with my baby kitty sitting next to me. My best friend and husband are playing Mario Galaxy. U2's "Discotheque" is playing on my iPod. Life is good. :)
Saturday, July 31, 2010
Sunday, January 10, 2010
Confession
Hello, my name is Persephone, and I'm a food addict and an emotional eater. It has taken me a long time to admit this and now I can begin my journey towards understanding my addiction and being able to manage it.
Step 1: "We have admitted we were powerless over food - that our lives had become unmanageable." (Overeaters Anonymous)
I'd like to change that slightly to - I have admitted I AM powerless over food - that my life HAS become unmanageable. It seems more appropriate to phrase it in the present tense as an addiction is something one has to manage for life. The way OA presents it seems like it's a past thing and it's over with.
I am trying to remember when I first became addicted to food. It's been a long time. I remember being little and not having access to food. I don't remember if I had eaten at meal times and would sneak downstairs in the middle of the night looking for food because I was still hungry, or if I hadn't been fed and I was looking for something to eat. I came from a rather dysfunctional family and it wouldn't surprise me if the reason was the latter. We didn't really have healthy food in the house either. I remember sneaking frozen coconut bon bons from the freezer and stepping on the lowered door of the dishwasher to reach into the cabinet where my mother hid her stash of Hostess treats, e.g. Ho-Ho's, Twinkies, fruit pies, and ding-dongs.
I was never thin, either. I remember going from having baby fat to just being fat. I think, if I really want to analyze this, even at a very young age, i.e. 5 years old, I was already seeking comfort in food when I could not get the affection of my parents. I remember being overweight as early as 8 when my pediatrician put me on a diet. I remember being placed on diet pills when I was 9 and all they made me feel was sick, dizzy, and shaky. They didn't seem to work and my weight continued to rise at a dangerous pace until I reached a plateau at the age of 15. By then I weighed 235lbs and had already been dealing with hypertension and hypoglycemia, a precursor to diabetes.
I remember a talk my mother had with me around that time, as I was a freshman in high school, that it was important for me to lose weight or else no one would want to date me and I would have no one with whom to go to prom. Sure, those words stung, and they worked for by the time I had graduated high school I had lost 35lbs. The notorious "freshman 15" in college did not apply to me as I lost an additional 10lbs. Despite the drastic weight loss, it was not done in a healthy way. I became anorexic for a while. I fasted and ate very little, if at all, when I was in high school. In college, I was too busy with classes and activities to eat. My reward was occasionally passing out. I remember walking home one night from Physics lab and passing out somewhere near Thwing on Euclid Ave. I had no idea how long I was lying there as no one helped me.
My second semester of my freshman year in college I fell in love - hard. My boyfriend instilled such confidence in me that I stopped losing weight and slowly began to gain the weight back. When he broke up with me nearly 2 years later all of that confidence left me again but I didn't lose the weight, I compensated for my sadness by eating. In a matter of months, not only had I gained all of the weight I had lost since high school but I gained an additional 15lbs. I yo-yo'd back and forth until I reached my freshman high school weight minus 5lbs by the time I graduated from college.
I feel emotional eating definitely played a role throughout the years from childhood until adulthood but my food addiction did not truly manifest itself until a few months after graduation. It started innocuously enough with a small bag of Hershey Kisses. I had been working a temp job, taking a year off before I went to grad school, and kept the candy handy when I would get hypoglycemic from lack of eating as I often worked straight through lunch. I did not touch that bag of Kisses for 2 months until I did get really hypoglycemic and I didn't have access to orange juice or something more substantial. I ate 1 Kiss, which turned into 2, which turned into 3. I took the bag home with me and continued to eat them until all of the Kisses were gone. I bought another bag the next day and ate them all by the end of the day. This pattern continued for a few days until I realized it was bad and I stopped; however, my craving became instatiable and soon I found myself going out to Krogers during my lunch break and buying a dozen cinnamon rolls to compensate. Sometimes I would go to Aldi's to buy a bag of chocolate chip cookies. No matter what I bought, by the end of the day it was gone. When I got paid at the end of the week I would go to a Hallmark store that was out of my way from my usual route home and would buy 4lbs of fudge that would be gone in a matter of 2 days. In a matter of 5 months I had gained nearly 70lbs. I could not walk long distances without my back and/or knees hurting. The chocolate, especially, wreaked havoc on my gastrointestinal system. My craving for sweets had spiralled out of control. I tried to quit cold turkey but I would feel shaky and get migraines. I'd have to eat something sweet to make me feel better. It was a very horrible time for me. I had also been feeling depressed. I felt trapped by living at home and working at a job that bored me. I felt like a failure as my dream of going to med school didn't materialize. I felt like the world had passed me by and I compensated by eating.
Shortly after my temp job ended I weighed 300lbs and slowly started to lose the weight. Once again I yo-yo'd - lose 20lbs and gain 10lbs; lose 10lbs and gain 5lbs. This cycle continued for 5 years until I stopped yo-yo'ing and steadily lost the weight. During this time my depression worsened and I was diagnosed with fibromyalgia. Once again I have reached a plateau and have hovered around the same weight +/- 10lbs for 3 years. I gave up chocolate entirely for a little while and eat it sparingly now. I greatly reduced my intake of sweets and cut pop from my diet. I have continued to diet but I seem to be stuck.
I had heard the term "emotional eating" for a long time but never once thought that applied to me. I thought to myself, "I don't eat when I'm happy or sad. That's ridiculous." I have realized now that I am indeed an emotional eater. Sometimes when I have a bad day I'll think to myself, "screw it, I want something bad," e.g. a piece of cake or fast food. I also noticed I did the same thing when I was happy, "I had a good day and I'm going to reward myself with a piece of cake or a nice large meal from a restaurant." The bad types of food, however, are not only triggered by emotions but also by cravings. I will crave a Whopper or a Big Mac (which I had not eaten since the age of 8) or a piece of tiramasu from Zagara's. I will reason to myself, "I really want a quarter pounder with cheese and large french fries but I'll get a double cheeseburger and small fries instead." It's still satisfying to addiction.
I never made the connection between my use of food to satisfy cravings and to make me feel better with drug addiction. I work in the chemical dependency field and had no problem trying to convince my clients to abstain from their drug use. How can I convince them to be sober when I can't even manage my own addiction? I feel like a hypocrite. The difference between my addiction and theirs is my clients are required to abstain from all mood-/mind-altering drugs and alcohol (excluding psych meds) but I can't abstain from food. One can make the argument that I can stay away from bad food - and one would be right; however, I have also tried that and always seem to overcompensate with something else. I don't think it's a matter of eating right so much as addressing the reasons for my addiction. I have already provided a few reasons but there is one more.
It is amazing how one's self-esteem can take years and years to build, only to be taken to nothing in a matter of days/months. I feel that when I get to the point of making progress, re: my addiction, I relapse - I sabotage myself. Certain events that have occurred in my life have caused my inability to move forward. It does not even matter that I have a husband who worships the ground I walk. When I see myself to start improving in a physical sense, something holds me back.
I have seriously contemplated having gastric bypass, much to the protestations of my sister and husband. They have faith in me; I do not. Morever, if I even have the surgery done it still does not address the addiction. Alcoholics who are dying from a liver disease or are suffering from pancreatitis still drink despite the intense pain. Having gastric bypass is no guarantee that the weight will stay completely off. There have been people already who have gained all of it back. The stomach is like a rubber band and can expand with time and the addition of more and more food. If I want to get better, I have to address my addiction and emotions behind my eating. I have decided to join Overeaters Anonymous. I am grateful that there is an organization that addresses the addiction of food. Perhaps with some soul-searching, learning new tools, and working the steps I can move on with my life.
Step 1: "We have admitted we were powerless over food - that our lives had become unmanageable." (Overeaters Anonymous)
I'd like to change that slightly to - I have admitted I AM powerless over food - that my life HAS become unmanageable. It seems more appropriate to phrase it in the present tense as an addiction is something one has to manage for life. The way OA presents it seems like it's a past thing and it's over with.
I am trying to remember when I first became addicted to food. It's been a long time. I remember being little and not having access to food. I don't remember if I had eaten at meal times and would sneak downstairs in the middle of the night looking for food because I was still hungry, or if I hadn't been fed and I was looking for something to eat. I came from a rather dysfunctional family and it wouldn't surprise me if the reason was the latter. We didn't really have healthy food in the house either. I remember sneaking frozen coconut bon bons from the freezer and stepping on the lowered door of the dishwasher to reach into the cabinet where my mother hid her stash of Hostess treats, e.g. Ho-Ho's, Twinkies, fruit pies, and ding-dongs.
I was never thin, either. I remember going from having baby fat to just being fat. I think, if I really want to analyze this, even at a very young age, i.e. 5 years old, I was already seeking comfort in food when I could not get the affection of my parents. I remember being overweight as early as 8 when my pediatrician put me on a diet. I remember being placed on diet pills when I was 9 and all they made me feel was sick, dizzy, and shaky. They didn't seem to work and my weight continued to rise at a dangerous pace until I reached a plateau at the age of 15. By then I weighed 235lbs and had already been dealing with hypertension and hypoglycemia, a precursor to diabetes.
I remember a talk my mother had with me around that time, as I was a freshman in high school, that it was important for me to lose weight or else no one would want to date me and I would have no one with whom to go to prom. Sure, those words stung, and they worked for by the time I had graduated high school I had lost 35lbs. The notorious "freshman 15" in college did not apply to me as I lost an additional 10lbs. Despite the drastic weight loss, it was not done in a healthy way. I became anorexic for a while. I fasted and ate very little, if at all, when I was in high school. In college, I was too busy with classes and activities to eat. My reward was occasionally passing out. I remember walking home one night from Physics lab and passing out somewhere near Thwing on Euclid Ave. I had no idea how long I was lying there as no one helped me.
My second semester of my freshman year in college I fell in love - hard. My boyfriend instilled such confidence in me that I stopped losing weight and slowly began to gain the weight back. When he broke up with me nearly 2 years later all of that confidence left me again but I didn't lose the weight, I compensated for my sadness by eating. In a matter of months, not only had I gained all of the weight I had lost since high school but I gained an additional 15lbs. I yo-yo'd back and forth until I reached my freshman high school weight minus 5lbs by the time I graduated from college.
I feel emotional eating definitely played a role throughout the years from childhood until adulthood but my food addiction did not truly manifest itself until a few months after graduation. It started innocuously enough with a small bag of Hershey Kisses. I had been working a temp job, taking a year off before I went to grad school, and kept the candy handy when I would get hypoglycemic from lack of eating as I often worked straight through lunch. I did not touch that bag of Kisses for 2 months until I did get really hypoglycemic and I didn't have access to orange juice or something more substantial. I ate 1 Kiss, which turned into 2, which turned into 3. I took the bag home with me and continued to eat them until all of the Kisses were gone. I bought another bag the next day and ate them all by the end of the day. This pattern continued for a few days until I realized it was bad and I stopped; however, my craving became instatiable and soon I found myself going out to Krogers during my lunch break and buying a dozen cinnamon rolls to compensate. Sometimes I would go to Aldi's to buy a bag of chocolate chip cookies. No matter what I bought, by the end of the day it was gone. When I got paid at the end of the week I would go to a Hallmark store that was out of my way from my usual route home and would buy 4lbs of fudge that would be gone in a matter of 2 days. In a matter of 5 months I had gained nearly 70lbs. I could not walk long distances without my back and/or knees hurting. The chocolate, especially, wreaked havoc on my gastrointestinal system. My craving for sweets had spiralled out of control. I tried to quit cold turkey but I would feel shaky and get migraines. I'd have to eat something sweet to make me feel better. It was a very horrible time for me. I had also been feeling depressed. I felt trapped by living at home and working at a job that bored me. I felt like a failure as my dream of going to med school didn't materialize. I felt like the world had passed me by and I compensated by eating.
Shortly after my temp job ended I weighed 300lbs and slowly started to lose the weight. Once again I yo-yo'd - lose 20lbs and gain 10lbs; lose 10lbs and gain 5lbs. This cycle continued for 5 years until I stopped yo-yo'ing and steadily lost the weight. During this time my depression worsened and I was diagnosed with fibromyalgia. Once again I have reached a plateau and have hovered around the same weight +/- 10lbs for 3 years. I gave up chocolate entirely for a little while and eat it sparingly now. I greatly reduced my intake of sweets and cut pop from my diet. I have continued to diet but I seem to be stuck.
I had heard the term "emotional eating" for a long time but never once thought that applied to me. I thought to myself, "I don't eat when I'm happy or sad. That's ridiculous." I have realized now that I am indeed an emotional eater. Sometimes when I have a bad day I'll think to myself, "screw it, I want something bad," e.g. a piece of cake or fast food. I also noticed I did the same thing when I was happy, "I had a good day and I'm going to reward myself with a piece of cake or a nice large meal from a restaurant." The bad types of food, however, are not only triggered by emotions but also by cravings. I will crave a Whopper or a Big Mac (which I had not eaten since the age of 8) or a piece of tiramasu from Zagara's. I will reason to myself, "I really want a quarter pounder with cheese and large french fries but I'll get a double cheeseburger and small fries instead." It's still satisfying to addiction.
I never made the connection between my use of food to satisfy cravings and to make me feel better with drug addiction. I work in the chemical dependency field and had no problem trying to convince my clients to abstain from their drug use. How can I convince them to be sober when I can't even manage my own addiction? I feel like a hypocrite. The difference between my addiction and theirs is my clients are required to abstain from all mood-/mind-altering drugs and alcohol (excluding psych meds) but I can't abstain from food. One can make the argument that I can stay away from bad food - and one would be right; however, I have also tried that and always seem to overcompensate with something else. I don't think it's a matter of eating right so much as addressing the reasons for my addiction. I have already provided a few reasons but there is one more.
It is amazing how one's self-esteem can take years and years to build, only to be taken to nothing in a matter of days/months. I feel that when I get to the point of making progress, re: my addiction, I relapse - I sabotage myself. Certain events that have occurred in my life have caused my inability to move forward. It does not even matter that I have a husband who worships the ground I walk. When I see myself to start improving in a physical sense, something holds me back.
I have seriously contemplated having gastric bypass, much to the protestations of my sister and husband. They have faith in me; I do not. Morever, if I even have the surgery done it still does not address the addiction. Alcoholics who are dying from a liver disease or are suffering from pancreatitis still drink despite the intense pain. Having gastric bypass is no guarantee that the weight will stay completely off. There have been people already who have gained all of it back. The stomach is like a rubber band and can expand with time and the addition of more and more food. If I want to get better, I have to address my addiction and emotions behind my eating. I have decided to join Overeaters Anonymous. I am grateful that there is an organization that addresses the addiction of food. Perhaps with some soul-searching, learning new tools, and working the steps I can move on with my life.
Thursday, November 12, 2009
Anger
I know I haven't posted in a while. I'd think of something that I'd want to write about but when I had the chance to do so either the thought escaped me or I had no motivation to write about anything. In this case, I feel I have to write something; otherwise, it will continue to tear me up inside. Those of you who know me know that I'm a sensitive person, almost to a fault. So when something occurs that would seriously disturb someone else, I'm almost besides myself.
I'm talking about the murders on Imperial Ave. I know it's world news but in case you don't know about them here's a very brief synopsis: after serving a search warrant on charges of aggravated rape and attempted murder (I'm not sure if those are the correct charges and I really don't want to look them up) to a man, Anthony Sowell, in Cleveland, Ohio, it was discovered that there were dead bodies located throughout the house and in the backyard - 11 as of this writing. All of the bodies recovered so far have been African-American women. Most of them had been strangled. This is a horrific crime on all levels but when I would see something like this in the past I would feel absolutely horrible but at the same time feel detached because I know it didn't involve anyone I knew...until now.
I was watching the news one morning as I was getting ready for work and as the reporter was discussing the murders I saw the picture and name of someone I knew. I didn't want to believe it at first so I watched when the news was rebriefed at the bottom of the hour. Sadly, it was true and the horrible reality slowly began to sink in: one of the women recovered was a client.
I remember seeing her last sitting in my office saying "I'm not feeling it today." Her usual sunny self was replaced by a woman who was desperately trying to fight her demons...and she was losing. I did everything I could to help her with what she needed. Before she left, she smiled, thanked me, gave me a big hug and told me she would call when she got to her destination to let me know she had made it there okay. To be honest, I was shocked. No client until then was diligent enough to say she would call me. She kept her word as she called later that day to let me know she had made it to her sponsor and she was safe. I greatly appreciated the consideration she gave me in notifying me. She said she would be back that night. I was not sure if she returned but that was the last time I saw or heard from her.
You have to understand something. In my job, people are transient. They come and go as often as the breeze. I hate to say this, but sometimes when someone is gone she doesn't want to be found. Typically she would have relapsed and felt ashamed about what she had done. We've had women who would, seemingly, disappear off of the face of the world, only to return months, or even years later. My client had fit into that category. She had been there a few years before I started working there and had returned for a while, then disappeared, then reappeared. She had been in our program in the past and, unfortunately, per our grant, she was not eligible to re-engage with our program; however, my coworker and I never turned anyone away when she needed help and she and I treated her just as if she was our client.
What I remember about her is her smile and her beauty. She was a truly beautiful woman both inside and out. Her energy was infectious and when she was happy, everyone knew it. She was very friendly and would stop by and say "hi' even if she didn't need anything. One day she came bounding into my office to tell me she had pictures with her youngest child and she wanted me to have one. I was honored that she gave me a picture. It made me feel like I was an important part of her life. And just like that, she's gone.
We had a meeting yesterday to discuss how we all felt about her death. There were sad points, especially when someone said that she felt bad because she died alone, then someone countered that and said that she hadn't died alone but that God was with her. It should have been comforting to me, especially since I believe in God, but it wasn't. It made me cry even more. Then there was laughing when we all had stories to share about how she touched our lives. Some talked about how she would walk around in an "old lady" duster even though she was young.
I want to say all of this because I want you to know that she is not just 1 of 11 bodies recovered, but she was a person, a beautiful person - full of hopes and dreams for both her and her children. However, it also makes me very upset to think that, as one co-worker put it, "she never got a fair shake...whenever she was able to take one step forward she was pushed two steps back." She struggled with her addiction. She was involved in a very abusive relationship. She had lost custody of her children. She was homeless. Despite all of her disadvantages, though, she was a fighter. I honestly cannot say I would have the same spirit she had if I was in her position.
I have to also admit that when I found out my client was murdered I felt a lot of guilt. The last time I saw her was about the time she was last seen. In my strange thinking I felt I was one of the last people to see her alive and therefore I could have saved her. This is completely irrational and in reviewing my actions there was nothing I could have done. If faced with the same situation, I would have done the exact same thing. It has made me think differently about the way I work with clients, though. I will never put myself in a situation that is both dangerous to my client and/or me. I will never again pick up a client from a crack house and drive her to 2 other crack houses so she could obtain her belongings. Unless I know the people at the destination where my client would like to be dropped off, I will not transport her. I will never transport clients to the house of a cousin or friend, only to be told at the last minute, "oh just drop me off here and I'll walk the rest of the way."
My heart cries for every single woman found in that house, as well as for those who are still missing. I do not blame the police for this because there's only so much that they can do. Like any profession, there are people who really care about what they do and those that only view it as a paycheck. I know one woman's family felt that the police did not do enough to find her. One of my co-workers said that a police officer came every month for a year looking for her. There are police officers constantly coming to our workplace asking if missing women are there.
I gave the job to Paul to stop me from watching anything else about these murders. It's too much. As I think about my client and get upset sometimes I can almost hear a voice telling me, "you need to stop this. I'm happy now. I'm at peace." I sincerely hope she's at peace. I sincerely hope they are all finally at peace.
I'm talking about the murders on Imperial Ave. I know it's world news but in case you don't know about them here's a very brief synopsis: after serving a search warrant on charges of aggravated rape and attempted murder (I'm not sure if those are the correct charges and I really don't want to look them up) to a man, Anthony Sowell, in Cleveland, Ohio, it was discovered that there were dead bodies located throughout the house and in the backyard - 11 as of this writing. All of the bodies recovered so far have been African-American women. Most of them had been strangled. This is a horrific crime on all levels but when I would see something like this in the past I would feel absolutely horrible but at the same time feel detached because I know it didn't involve anyone I knew...until now.
I was watching the news one morning as I was getting ready for work and as the reporter was discussing the murders I saw the picture and name of someone I knew. I didn't want to believe it at first so I watched when the news was rebriefed at the bottom of the hour. Sadly, it was true and the horrible reality slowly began to sink in: one of the women recovered was a client.
I remember seeing her last sitting in my office saying "I'm not feeling it today." Her usual sunny self was replaced by a woman who was desperately trying to fight her demons...and she was losing. I did everything I could to help her with what she needed. Before she left, she smiled, thanked me, gave me a big hug and told me she would call when she got to her destination to let me know she had made it there okay. To be honest, I was shocked. No client until then was diligent enough to say she would call me. She kept her word as she called later that day to let me know she had made it to her sponsor and she was safe. I greatly appreciated the consideration she gave me in notifying me. She said she would be back that night. I was not sure if she returned but that was the last time I saw or heard from her.
You have to understand something. In my job, people are transient. They come and go as often as the breeze. I hate to say this, but sometimes when someone is gone she doesn't want to be found. Typically she would have relapsed and felt ashamed about what she had done. We've had women who would, seemingly, disappear off of the face of the world, only to return months, or even years later. My client had fit into that category. She had been there a few years before I started working there and had returned for a while, then disappeared, then reappeared. She had been in our program in the past and, unfortunately, per our grant, she was not eligible to re-engage with our program; however, my coworker and I never turned anyone away when she needed help and she and I treated her just as if she was our client.
What I remember about her is her smile and her beauty. She was a truly beautiful woman both inside and out. Her energy was infectious and when she was happy, everyone knew it. She was very friendly and would stop by and say "hi' even if she didn't need anything. One day she came bounding into my office to tell me she had pictures with her youngest child and she wanted me to have one. I was honored that she gave me a picture. It made me feel like I was an important part of her life. And just like that, she's gone.
We had a meeting yesterday to discuss how we all felt about her death. There were sad points, especially when someone said that she felt bad because she died alone, then someone countered that and said that she hadn't died alone but that God was with her. It should have been comforting to me, especially since I believe in God, but it wasn't. It made me cry even more. Then there was laughing when we all had stories to share about how she touched our lives. Some talked about how she would walk around in an "old lady" duster even though she was young.
I want to say all of this because I want you to know that she is not just 1 of 11 bodies recovered, but she was a person, a beautiful person - full of hopes and dreams for both her and her children. However, it also makes me very upset to think that, as one co-worker put it, "she never got a fair shake...whenever she was able to take one step forward she was pushed two steps back." She struggled with her addiction. She was involved in a very abusive relationship. She had lost custody of her children. She was homeless. Despite all of her disadvantages, though, she was a fighter. I honestly cannot say I would have the same spirit she had if I was in her position.
I have to also admit that when I found out my client was murdered I felt a lot of guilt. The last time I saw her was about the time she was last seen. In my strange thinking I felt I was one of the last people to see her alive and therefore I could have saved her. This is completely irrational and in reviewing my actions there was nothing I could have done. If faced with the same situation, I would have done the exact same thing. It has made me think differently about the way I work with clients, though. I will never put myself in a situation that is both dangerous to my client and/or me. I will never again pick up a client from a crack house and drive her to 2 other crack houses so she could obtain her belongings. Unless I know the people at the destination where my client would like to be dropped off, I will not transport her. I will never transport clients to the house of a cousin or friend, only to be told at the last minute, "oh just drop me off here and I'll walk the rest of the way."
My heart cries for every single woman found in that house, as well as for those who are still missing. I do not blame the police for this because there's only so much that they can do. Like any profession, there are people who really care about what they do and those that only view it as a paycheck. I know one woman's family felt that the police did not do enough to find her. One of my co-workers said that a police officer came every month for a year looking for her. There are police officers constantly coming to our workplace asking if missing women are there.
I gave the job to Paul to stop me from watching anything else about these murders. It's too much. As I think about my client and get upset sometimes I can almost hear a voice telling me, "you need to stop this. I'm happy now. I'm at peace." I sincerely hope she's at peace. I sincerely hope they are all finally at peace.
Saturday, April 25, 2009
Doubt
It seems ever since I left graduate school I have been filled with doubt: I don't know if I will be a good social worker. I don't know if I will make a difference. I don't think I'll do a good job. I realize when I think these things I'm a hypocrite. At work we are required to use strength-based approaches towards our clients. Some people are so quick to look at their faults and find it difficult to find and build upon their strengths. This is especially true among the population with whom I work. I help my clients find that tiny spark of positivity within themselves and yet I am so quick to look at everything that's wrong with me.
Sometimes I feel that I am a bad social worker and co-worker. Sometimes I feel I do not do enough. My one co-worker is so good at what she does and because she is so outgoing everyone loves her. I help my clients but I need to be more engaging with the rest of the residents. I get frustrated when I cannot contact someone, e.g. making a doctor's appointment for a client. Why do people in the psychiatric department at Metro Health never answer their phone? Why won't anyone at Social Security return my phone calls?
I know, I am just complaining. I get upset when things don't go my way and don't really make the effort, in my opinion, to change things. I need to take things in stride. I should not become frightened when a resident tries to intimidate me. I need to rationalize that this is a defense mechanism for her. I try to be strong but I'm still a vulnerable person. I need to be more strict with my boundaries and know when someone is trying to manipulate me. It's not therapeutic to enable clients for fear if I don't something bad will happen to them. For example, a client of mine who was in a residential treatment facility for drugs decided to leave after being there only a week and a half. She asked me to come get her. I told her "no." She was upset and begging me to pick her up. I had things to do that day and couldn't take the time to get her. I felt picking her up would mean it was okay for her to do whatever she wanted without having to deal with the consequences. She has the right to leave treatment but I have the right as a case manager not to get her, I think. She ends up finding her way home and then goes out the next day to get high and breaks her leg. I actually felt bad! I thought if I had picked her up things would have been different; however, I realize that I have no control what my clients do nor can I control them.
I know all professionals have moments of doubt when they start a career and I should not be an exception. It's still painful when it happens though. I need to learn to care for myself and not be so wrapped up in my clients' doings. I should not press what I want for them but rather be empathic and there for them no matter what they choose. To quote William Ernest Henley, "I am the master of my fate. I am the captain of my soul."
I hope it gets better.
Wednesday, April 22, 2009
My Return to the Blogosphere
Yes! I have returned. It took me a long time to discern whether writing regularly to a blog would be beneficial or even feasible. However, since I've told many people that I already use journaling as a means to decompress and care for myself, I figured it's time to either put up or shut up. I had written a blog in the past and it was quite interesting to see how much I had evolved as a person from my very first entry in June of 2001 through my last one in July of 2007. Various things prevented me from writing again, e.g. returning to school, not having enough time, and, quite honestly, apathy. I felt I had nothing interesting about which to write. After all, who wants to read about what I had, or did not have, for breakfast? Unless you're a scientist researching cereal trends or are incredibly voyeusteric, no one would care.
So why am I writing again? I need an outlet to voice my frustrations and share my thoughts. I am a social worker who works for a non-profit AODA/MH treatment agency. I work with an extremely challenging population and many times I take my work home with me. I'm sure my husband and sister are tired of seeing me mope or listen to me complain. I will try and not make this a bitch blog, but rather, share my journey in which I am evolving in my profession and as a person. I would enjoy feedback or commiseration, if that's even a word. I hope, above all, that writing this blog will be extremely therapeutic for me. If I am able to help myself then I will be a better clinician to my clients - at least I hope so.
So why am I writing again? I need an outlet to voice my frustrations and share my thoughts. I am a social worker who works for a non-profit AODA/MH treatment agency. I work with an extremely challenging population and many times I take my work home with me. I'm sure my husband and sister are tired of seeing me mope or listen to me complain. I will try and not make this a bitch blog, but rather, share my journey in which I am evolving in my profession and as a person. I would enjoy feedback or commiseration, if that's even a word. I hope, above all, that writing this blog will be extremely therapeutic for me. If I am able to help myself then I will be a better clinician to my clients - at least I hope so.
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