Just because you’re paranoid doesn’t mean they’re not out to get you

At least that’s what Dr Meister used to tell us in our philosophy classes. I posted earlier about my uneasiness with casual diagnoses from nontherapists like my coworkers, but I’ve had a few “aha!” moments at work that are making me change my mind.

Today, I was meeting with one of my clients that I dearly love, and I couldn’t figure out why she was repeating her life’s ambitions to me for the hundredth time. And then it hit me: there’s something different about her. She’s thinking differently. She compulsively tells stories, and often it’s the same stories. Now, a fixation with telling stories is not only healthy but desirable in our culture. But, I think after meeting for an hour with this woman every week for months on end, you’d think that she would stop telling us that she’s a self proclaimed “damn good writer.”

I was in a similar session with a man who I see about once a month, and in the middle of the session I realized that he continually tells stories which must be exaggerated. And then it hit me: he always does this! When I first started meeting with him, he would exhaust me because I had to “fight” with him to get anything done.

These people aren’t crazy. They aren’t violent or mean spirited or stupid, and I doubt that they need medication. And, for the record, I like their stories!

However, they (and many of my other clients) seem to have things happening in their brains that got in the way of them staying housed and made their lives really difficult for them to cope with. Now that I’m nearing the end of my time at St Joseph Center, I’m starting to believe that there’s something to this whole mental health thing after all.

Introducing My Life as the Terminator

What do giving your cellphone number to clients, delaying the inevitable, and freaking out have in common? They're all bad strategies for terminating my clients. No, I'm not going to hire the governor to execute my clients. Termination in social work refers to stopping one's work with a client.

We had a meeting with all of the case managers on Wednesday in which we discussed our strategies and anxieties about terminating clients. It's unfortunate for our clients that several of us interns are terminating because our internship is over, not because our work is really finished. I trust that the next interns will be equally good, if not better.

I know I won't miss my clients in 6 months, but it's still a little agonizing to think about leaving my endearing senior clients and single mothers behind. I won't be able to savor the latest tales from my middle aged nudist client, or wage war on my crafty Philippino's most recent money scheme, or soak in the activist story from an elderly woman I know only by phone. Who will bring me more lyrical poetry and confuse their lives with their novel? I'm afraid to leave them more than they're afraid to leave me.

Today, I told one of the frail looking ladies whom I meet with that my last day is in August. Rather than reacting emotionally as I dreaded, she continued on in her fixation to find the perfect Section 8 apartment near the beach. She didn't even miss a beat! I had to suppress a laugh at my own neediness as a case manager.

I hope that future interns will hear the motto we talked about on Wednesday: termination begins on day one. I think that this process (which has thus far been only painful for me) could be even smoother if the clients are told up front that their beloved case manager will be leaving in one year.

I'm going to end with a happy story. I told one of my most capable clients that I'll be leaving soon. She said, Aww! I'm miss you, Bryce, and then she shared her story of going through detox and rehabilitation for drug abuse, learning parenting skills and holding down a job, getting a beautiful apartment near the beach, and saving up for a car. I wanted to cry happy tears. Sometimes endings aren't sad after all.

On the Streets Again

After setting two of my alarms and one of PJ's, I jumped out of bed this morning with a start, brewed a cup of tea, sneaked in some early morning reading, and drove in to work at 2:07am. Nothing was going to keep me from completing the last day of surveying the homeless in Venice.

Eddie (whose job is to know and serve the homeless daily), Sean, officer Jerry and I hit the streets for the final time this week. After a few minutes, we found Pat (not the real name) who was washing clothes in a drinking fountain and agreed to talk with us. Pat was happy and tangential, and explained that when the marriage became violent, Pat came out of the closet and has been on the streets for the last 7 years. I wish I could show you the picture of Pat and I beaming at the camera.

Eddie woke up Kylie (again the name has been changed) who was asleep in a car and managed to get Kylie to complete a survey. I genuinely felt bad for Kylie who was reluctant to be photographed when the first five flash photos were blurry.

Last story—earlier in the night we pulled into another parking lot with probably 15 homeless people camping out there. I hovered over one sleeping bag, calling out Wakey! Wakey! and other such enticing phrases for several minutes before an angry woman sat straight up. Didn't you hear my uncle say leave us alone?? she hissed. There was no else around, and no one had said anything.

Living on the streets for years at a time changes people's minds. I think this lady had already snapped and may even have become violent if I kept harassing her. Notice that I didn't say the streets make you crazy. I'm not convinced that these people are crazy. I think that they think differently than I do, but I'm not sure that makes them crazy. Is it wrong to have a mind that works differently? Sure this lady may hallucinate (and that's a problem), but is it wrong to not want to participate in society? On the other hand, everyone should have the help they need to move back into housing and get a job, etc. if they want to.

Well, I'll be back in the office tomorrow, but first Sean and I are off to watch Star Trek!