Thursday Re-View: “I Wasn’t Enough…”

Hubble Telescope

Hubble Telescope

I wasn’t enough.

When she came for her first counseling session, everything about her screamed a hard life. You could see it in her slumped shoulders, how she shuffled her feet, the weary sigh when she collapsed in the chair, the emptiness in her eyes. Her deeply lined face with its weathered features belied her chronological age of 37. If that wasn’t enough, it was confirmed in the ankle bracelet that peeked out from the ragged cuff of her jeans.

“Tell me why you’re here today.”
“My parole officer sent me.”

“How can I help you?”
“I don’t know if you can.”

She was under house arrest, her license had been suspended, and she’d been through this before.

That’s how our therapeutic relationship started. Trust was going to be difficult. I asked for her patience while I got through an initial history, since she hadn’t been through this before with me. Polite but distant, she waited for whatever was to come. She’d get through it; she’d been through a lot worse.

Family history is important; we are the sum of our experiences. A therapeutic tool known as a genogram is something I perform with every client/patient – it is a family tree that shows marriages, divorces, step-children, siblings, relationships, suicides, substance abuse, imprisonment, mental illness – all important ways to know where the person is coming from, in order to determine where they need to go, and how to get there.

Hers was a very common story for the general population our county mental health clinic served – never knew her father, had an alcoholic mother and several half-siblings, had been sexually abused by an uncle and physically abused by a stepfather, dropped out of high school, had her own child when she was 15, battled alcohol and prescription drugs off and on for the past 20 + years, and was married to an alcoholic. She had several arrests for DUI and shoplifting. Her teen-aged daughter was pregnant and living with an abusive boyfriend.

Oh – and she always wanted to be an artist.

She was depressed. No surprise there. Whether she got depressed when her life fell apart, or her life fell apart causing her depression…her use of alcohol and other drugs only complicated matters. It’s hard to know which came first, but depression and addiction go hand in hand far too often. And they were tough to beat…

Textbook – depressed mood, hopeless, helpless, emotional withdrawal, difficulty falling asleep, but sleeping excessively, weight gain, trouble concentrating, not interested in any social activities. The fact that she had been clean and sober for almost a month was wonderful, but terrible at the same time – these feelings were raw and painful; unwanted and unfamiliar; after all, for most of her life, her feelings had been numb from the drugs.

“I’d like to make a deal with you,” I said to the eyes that grew more wary. “How about if I hold onto your hope until you find it again yourself?”

“Okay,” came out softly, along with a slight sense that perhaps I was the one who needed help, rather than her.

Her parole officer wanted her to talk with someone about how to deal with her husband, who wouldn’t stop drinking with his buddies at their house several nights a week. It was too much of a temptation for her; she craved the alcohol even though her husband put a combination lock on their keg; she desperately wanted the Oxycontins and Vicodins and Percosets that her daughter offered her, but still found the strength to refuse. But she was losing ground…

Where to even start? Here, it was one day at a time, one hour at a time. By the end of the fourth session, she had managed to get her husband’s beer nights moved out to the garage, along with the keg, and to tell her daughter to not bring any of the meds when she came to visit. They were giving her some grief about it, but she stood firm.

Baby steps? No. In actuality, they were huge. She took control of those two things in her environment, and her sense of empowerment brought a smile to her face and a slight squaring of her shoulders.

“I’m so proud of you!!!”

She covered her face with her hands, sobbing. “No one ever said that to me before.”

“Well, they should have. You are a strong, courageous woman; a survivor. Right now, as is, you are enough…”

Her blue eyes, glistening with tears but clearer without the effects of the drugs, met my gaze with something different, something lost that was slowing being found.

With hope.

For an instant, I saw the beautiful young girl she would have been had all of the terrible things not dragged her down and worn her out and bruised her soul. Innocent, expectant, full of hope for the future. It was staggering. It was humbling.

Sacred ground. She felt it too.

Palette of Memories Josephine Wall

Palette of Memories
Josephine Wall

She missed her next appointment, but when I called to reschedule, I could tell she was excited about something. She had just gotten off the phone with her parole officer; he arranged an interview for her at a local family run convenience store that took part in a county program for ex-offenders. It was part-time, but a start. Plus, it was in walking distance from her house. The interview was next week.

Hope. There it was again, tinged with a girlish excitement.

We spoke briefly about what she might expect from the interview, and what she planned to wear. I congratulated her again, wished her luck, and assured her she would be fine. She signed off with a breathy, “See you next week.”

And that was the last time I ever heard her voice.

When I came in to work on Monday, my supervisor showed me her obituary in the local newspaper. Dead, at 37 years old.

Why? What happened? I was in shock as I relayed our last conversation in full.

I called her husband, looking to offer my condolences, and hopefully, for some answers.

They had some friends over for a party to celebrate her job interview. She cooked lots of food and seemed happy and excited. He remembered drinking too much and falling asleep on the couch. His daughter woke him up and asked if he’d seen her mother; she was nowhere in the house, and the keys to the truck were gone. At first, he didn’t understand.

When they found her, she was already dead. By her own hand.

A. Successful. Suicide.

I couldn’t speak.

He mentioned how much his wife had liked coming to her appointments at the counseling center, and that she seemed to be doing better.

I asked him if I could help in any way; he said no, but thanked me for calling, and for helping her.

I hung up. Helping Her? Hardly.

Suicide meant that at that moment, for a reason that we would probably neither know nor understand, she had been in such emotional pain that she just wanted to stop hurting; she just needed to escape. She hadn’t been thinking clearly enough to realize that the feelings of hopelessness and helplessness would pass; that they were only temporary; that she would get through it and survive, just as she always had.

Survive and thrive. Clean and sober. Perhaps at a new job. Or so we had hoped… Or so I had hoped…

The tenents of good practice dictate that involved staff and supervisors hold a “psychological autopsy” for any patients who suicide. We sat around a conference table on speaker phone with administration at our other office. I presented her history, from start to finish, along with treatment plan, progress, appointment schedule, recommendations, contact with her parole officer and family, patient compliance. Every detail.

Why? What happened? What could we have done differently?

Nothing. But she committed suicide. Everything? No, I knew that wasn’t true. Delayed it, perhaps. But change takes time, and there hadn’t been enough of it…

After about 25 minutes of this, I started to cry. In front of 2 supervisors, and over the speaker phone “in front of” the CEO of the county mental health offices and two attending psychiatrists.

“She has a name; she’s not just a case.” I struggled on. “And for just a brief time in her 37 years, she felt good about herself. It wasn’t long, and it obviously wasn’t enough, but it was something.” Silence in two rooms filled with people. “And she was important…”

I couldn’t sit there with it being so impersonal. We health care professionals do that so often by necessity; we need to retain distance and objectivity in order to do our job well. It’s not about us, but rather always about the patient.

But I had to remind them, and myself, that she lived and loved and hoped and dreamed and fought as long and as hard as possible. And I admired her for that. And I loved her for that. And I would remember her for that.

Be well, lovely lady. You touched my heart. I know that you are free of any of the torment that weighed so heavily upon you, and that your eyes and thoughts are clear. And that you have hope again…

Paint with bright colors, with abandon, with your heart…and paint outside the lines, without limits or restraint.

My time with you was too short, but it was my privilege.

And remember – right now, as is….you are, and always will be, enough.

Eternal rest, grant her, O Lord, and perpetual light shine upon her.
May the souls of the faithful departed through the mercy of God rest in peace. Amen.

spotonlists

spotonlists

__________________________________________________________________________

I Wasn’t Enough…

Hubble Telescope

Hubble Telescope

I wasn’t enough.

When she came for her first counseling session, everything about her screamed a hard life. You could see it in her slumped shoulders, how she shuffled her feet, the weary sigh when she collapsed in the chair, the emptiness in her eyes. Her deeply lined face with its weathered features belied her chronological age of 37. If that wasn’t enough, it was confirmed in the ankle bracelet that peeked out from the ragged cuff of her jeans.

“Tell me why you’re here today.”
“My parole officer sent me.”

“How can I help you?”
“I don’t know if you can.”

She was under house arrest, her license had been suspended, and she’d been through this before.

That’s how our therapeutic relationship started. Trust was going to be difficult. I asked for her patience while I got through an initial history, since she hadn’t been through this before with me. Polite but distant, she waited for whatever was to come. She’d get through it; she’d been through a lot worse.

Family history is important; we are the sum of our experiences. A therapeutic tool known as a genogram is something I perform with every client/patient – it is a family tree that shows marriages, divorces, step-children, siblings, relationships, suicides, substance abuse, imprisonment, mental illness – all important ways to know where the person is coming from, in order to determine where they need to go, and how to get there.

Hers was a very common story for the general population our county mental health clinic served – never knew her father, had an alcoholic mother and several half-siblings, had been sexually abused by an uncle and physically abused by a stepfather, dropped out of high school, had her own child when she was 15, battled alcohol and prescription drugs off and on for the past 20 + years, and was married to an alcoholic. She had several arrests for DUI and shoplifting. Her teen-aged daughter was pregnant and living with an abusive boyfriend.

Oh – and she always wanted to be an artist.

She was depressed. No surprise there. Whether she got depressed when her life fell apart, or her life fell apart causing her depression…her use of alcohol and other drugs only complicated matters. It’s hard to know which came first, but depression and addiction go hand in hand far too often. And they were tough to beat…

Textbook – depressed mood, hopeless, helpless, emotional withdrawal, difficulty falling asleep, but sleeping excessively, weight gain, trouble concentrating, not interested in any social activities. The fact that she had been clean and sober for almost a month was wonderful, but terrible at the same time – these feelings were raw and painful; unwanted and unfamiliar; after all, for most of her life, her feelings had been numb from the drugs.

“I’d like to make a deal with you,” I said to the eyes that grew more wary. “How about if I hold onto your hope until you find it again yourself?”

“Okay,” came out softly, along with a slight sense that perhaps I was the one who needed help, rather than her.

Her parole officer wanted her to talk with someone about how to deal with her husband, who wouldn’t stop drinking with his buddies at their house several nights a week. It was too much of a temptation for her; she craved the alcohol even though her husband put a combination lock on their keg; she desperately wanted the Oxycontins and Vicodins and Percosets that her daughter offered her, but still found the strength to refuse. But she was losing ground…

Where to even start? Here, it was one day at a time, one hour at a time. By the end of the fourth session, she had managed to get her husband’s beer nights moved out to the garage, along with the keg, and to tell her daughter to not bring any of the meds when she came to visit. They were giving her some grief about it, but she stood firm.

Baby steps? No. In actuality, they were huge. She took control of those two things in her environment, and her sense of empowerment brought a smile to her face and a slight squaring of her shoulders.

“I’m so proud of you!!!”

She covered her face with her hands, sobbing. “No one ever said that to me before.”

“Well, they should have. You are a strong, courageous woman; a survivor. Right now, as is, you are enough…”

Her blue eyes, glistening with tears but clearer without the effects of the drugs, met my gaze with something different, something lost that was slowing being found.

With hope.

For an instant, I saw the beautiful young girl she would have been had all of the terrible things not dragged her down and worn her out and bruised her soul. Innocent, expectant, full of hope for the future. It was staggering. It was humbling.

Sacred ground. She felt it too.

Palette of Memories Josephine Wall

Palette of Memories
Josephine Wall

She missed her next appointment, but when I called to reschedule, I could tell she was excited about something. She had just gotten off the phone with her parole officer; he arranged an interview for her at a local family run convenience store that took part in a county program for ex-offenders. It was part-time, but a start. Plus, it was in walking distance from her house. The interview was next week.

Hope. There it was again, tinged with a girlish excitement.

We spoke briefly about what she might expect from the interview, and what she planned to wear. I congratulated her again, wished her luck, and assured her she would be fine. She signed off with a breathy, “See you next week.”

And that was the last time I ever heard her voice.

When I came in to work on Monday, my supervisor showed me her obituary in the local newspaper. Dead, at 37 years old.

Why? What happened? I was in shock as I relayed our last conversation in full.

I called her husband, looking to offer my condolences, and hopefully, for some answers.

They had some friends over for a party to celebrate her job interview. She cooked lots of food and seemed happy and excited. He remembered drinking too much and falling asleep on the couch. His daughter woke him up and asked if he’d seen her mother; she was nowhere in the house, and the keys to the truck were gone. At first, he didn’t understand.

When they found her, she was already dead. By her own hand.

A. Successful. Suicide.

I couldn’t speak.

He mentioned how much his wife had liked coming to her appointments at the counseling center, and that she seemed to be doing better.

I asked him if I could help in any way; he said no, but thanked me for calling, and for helping her.

I hung up. Helping Her? Hardly.

Suicide meant that at that moment, for a reason that we would probably neither know nor understand, she had been in such emotional pain that she just wanted to stop hurting; she just needed to escape. She hadn’t been thinking clearly enough to realize that the feelings of hopelessness and helplessness would pass; that they were only temporary; that she would get through it and survive, just as she always had.

Survive and thrive. Clean and sober. Perhaps at a new job. Or so we had hoped… Or so I had hoped…

The tenents of good practice dictate that involved staff and supervisors hold a “psychological autopsy” for any patients who suicide. We sat around a conference table on speaker phone with administration at our other office. I presented her history, from start to finish, along with treatment plan, progress, appointment schedule, recommendations, contact with her parole officer and family, patient compliance. Every detail.

Why? What happened? What could we have done differently?

Nothing. But she committed suicide. Everything? No, I knew that wasn’t true. Delayed it, perhaps. But change takes time, and there hadn’t been enough of it…

After about 25 minutes of this, I started to cry. In front of 2 supervisors, and over the speaker phone “in front of” the CEO of the county mental health offices and two attending psychiatrists.

“She has a name; she’s not just a case.” I struggled on. “And for just a brief time in her 37 years, she felt good about herself. It wasn’t long, and it obviously wasn’t enough, but it was something.” Silence in two rooms filled with people. “And she was important…”

I couldn’t sit there with it being so impersonal. We health care professionals do that so often by necessity; we need to retain distance and objectivity in order to do our job well. It’s not about us, but rather always about the patient.

But I had to remind them, and myself, that she lived and loved and hoped and dreamed and fought as long and as hard as possible. And I admired her for that. And I loved her for that. And I would remember her for that.

Be well, lovely lady. You touched my heart. I know that you are free of any of the torment that weighed so heavily upon you, and that your eyes and thoughts are clear. And that you have hope again…

Paint with bright colors, with abandon, with your heart…and paint outside the lines, without limits or restraint.

My time with you was too short, but it was my privilege.

And remember – right now, as is….you are, and always will be, enough.

Eternal rest, grant her, O Lord, and perpetual light shine upon her.
May the souls of the faithful departed through the mercy of God rest in peace. Amen.

spotonlists

spotonlists

__________________________________________________________________________

Katrina’s Circles of Grace

Katrina

Cast of Characters:

Katrina: hurricane that hit the Gulf Coast on August 29, 2005 causing more than $100 million in damage and taking almost 2,000 lives
Luc: evacuee at Houma Terrebonne Civic Center, Houma, Louisiana
Theresa: Luc’s deceased Godmother
Teresa: volunteer social worker
St. Therese: “Little Flower”
Theresa: me

On September 11, 2005, I flew into Baton Rouge, Louisiana for my first Red Cross volunteer deployment as a mental health professional. Those of us who offered to go were given 48 hours notice prior to our departure and were warned that this location would present “hardships” to the volunteers. After having watched the television coverage of Katrina and what looked like a third world country, I was certain that no hardship I experienced could touch that of the people in the ravaged Gulf Coast.

I was assigned to the Houma Terrebonne Civic Center in Houma, Louisiana (slightly south-west of New Orleans), where 3 mental health volunteers (a social worker, a marriage & family therapist, and I) provided services to the fluctuating 800-1,200 Katrina victims who were housed there. We three were also responsible for the mental health of all the Red Cross workers in the staff shelter where we stayed (160 of us), along with the National Guard unit stationed at the Civic Center.

The evacuees at the Civic Center were primarily from the Lower 9th Ward of New Orleans, those folks who didn’t have the money or transportation needed to evacuate. Many of them somehow got through the water that flooded the Lower 9th Ward when the levies broke, got onto the overpass, waited in the Superdome, then were brought to Houma. These were the poorest of the poor. They ranged in age from 1 month old to around 95 years old, with perhaps 20 Caucasian, 6 Asian, the rest African-American.

The Houma Terrebonne Civic Center, normally home to cultural and athletic events, graduations, trade shows, and concerts, now housed the evacuees
in an area of 37,000 square feet of open floor space (Hall A & Hall B, below right). It was a sea of cots, blankets, pillows, clothing and people with very little room to move around. Houma Terrebonne Civic Center

Although hard to imagine, when volunteering for two weeks for this many evacuees as one of three mental health professionals, you got to know the names of a lot of the people who were staying there.  I circulated around Halls A & B all day, talking with people, getting them clothing, answering questions, hearing their stories and doing my best to keep them calm.  It was common to hear “Miss Theresa” as I walked through, always polite, always scared. The hours spent and the subsequent emotional rollercoaster took their toll on even the most seasoned of volunteers.

One day, one of the women from the Southern Baptist Convention responsible for meals took me by the arm and brought me to the loading dock, put a heaping plate of food on top of the cases of canned corn and said firmly, “You need to eat something, and take a rest.” I sat on another pile of canned goods and thankfully ate, my mind blank. It wasn’t long before I heard a quiet “Miss Theresa.” I turned to see one of the evacuees standing near-by.

“There’s a man who sleeps next to me that I’m worried about. He cries an awful lot and last night was mumbling about not having a reason to live.”

I stood up. “Where is he? Take me to him.”

We walked through the arena to the far right corner, where a man was seated on the floor, looking down. I thanked the young man and introduced myself to Luc and asked if I could join him. His dark eyes met mine, intelligent and filled with pain, as he nodded his assent.

“Tell me how I can help.”

With that, Luc’s words poured out. In the mass exodus from New Orleans, Luc had been separated from his two brothers. He spent a few days in the Superdome, where the situation had steadily deteriorated with no electricity, suffocating heat, gangs running around in packs, women giving birth on the floor. Tears ran down Luc’s face as he described the primitive conditions, which he finally escaped by leaving.

From a list kept on a legal pad by an unknown official, he was told his brothers had gone to Texas. Luc took one of the same busses outside the Superdome that took Louisiana evacuees to Texas, only to be told that his brothers had been seen in the Houma Terrebonne Civic Center. So, he turned around and came back to Louisiana. The Civic Center, struggling to keep track of the comings and goings of all people who streamed through, had no record of his brothers having been here. Exhausted (only sleeping a few hours in the past few days), having failed to find his brothers – the only family he had left – and having lost all of his belongings, Luc was ready to give up. He was not only thinking about suicide, he already had a plan and the means to carry it out. It was simply a matter of doing it.

Concerned about Luc’s safety, I asked if he would consider spending the night in our “medical wing,” which was actually a narrow hallway outside the arena event area. It housed 2 rows of beds with people who were being monitored by volunteer medical people who staffed our makeshift infirmary and pharmacy. He agreed.

As we walked out, I noticed how tall and muscled Luc was, his gait almost panther-like. A handsome face, even with his two front teeth missing. A boxer? Construction worker? Tracker? Prisoner? I had no idea, only that he was a man in deep emotional pain who was all out of hope.

Luc was assigned to a bed at the far end of the hall and given something to help him sleep. As he settled in for the night, having promised that he would not take any action of self-harm, Luc looked up at me, his eyelids already drooping from the medication.

“My Godmother’s name was Theresa. I think she must be looking out for me, by sending you here.” I smiled. “Will you be here in the morning when I wake up?” he asked quietly, so fragile a feeling in so strong a body.

“Yes, Luc, I promise,” already trying to figure out the logistics in my head.

Early the next morning found me seated on a stool next to Luc’s bed in the medical hallway, its 10 beds slowly coming to life. I heard a woman’s soft Southern drawl from behind me.

“Look up, Miss Theresa. You look so sad. Always remember to look up; God is there.” Tamika, staying with her father-in-law whose high blood pressure was almost under control, smiled and pointed up. Support from someone I was supposed to help, coming from the most unlikely of places. I smiled and nodded at her reminder that all would be well with Luc, if I only had faith.

Later that day, I told Brother Seraphim, one of the Franciscans who provided pastoral care at the Civic Center, about Luc’s despair and hopelessness and asked him for his prayers. Hands joined with Luc and me, Brother Seraphim prayed that St. Therese, the Little Flower, help Luc to find his brothers. Head bowed, thinking of St. Therese, Luc’s godmother Theresa and myself, I couldn’t help but feel goosebumps – or “God bumps,” as I call them, trusting in the knowledge that our prayers would be answered.

Throughout that day and evening, Luc’s mood improved as he interacted with others in the medical hall. He even found a ride to a near-by Wal Mart that re-opened. Sleep, prayer, support and good food all brought him comfort and hope.

When saying my good-nights, the medical hall was always last in my routine before I left for the evening. When I came to Luc, he was smiling, one hand behind his back. “I have something for you,” he said shyly. In his hand, he held a small box labeled, New: Red Velvet Mini Cake. “You can’t come to Louisiana and not try our Red Velvet Cake. My Godmother always made it for me; it’s my favorite.”

I smiled as I accepted Luc’s gift, unable to speak for the tears in my eyes. This man, with nothing but the clothes on his back, in the midst of his despair and loneliness, thought of someone else and found a way to say thank you. He touched my heart with a gift straight from his heart.

A man with nothing, yet who had everything.

The next morning, I was met at the back entrance by a volunteer social worker from Illinois named Teresa (what else?), jumping up and down with excitement. Having heard about Luc yesterday, she contacted some friends at a central office with computer capability and asked them to track down any information on Lucs’ brothers. Overnight, they located them in another shelter. Lucs’ brothers were alive and well in Alabama!

Teresa and I waited impatiently outside the men’s shower room for Luc to finish. Word spread rapidly through the small staff, and we couldn’t wait to tell Luc the good news. When he came out, we were smiling ear-to-ear as we told him we had a surprise. We walked into the infirmary, which was one of only three places in the entire building that had a semi-private phone. In the last few days, phone service had improved, and the medical staff was able to call in medication orders, supplies, etc. That line to the outside world was a lifesaver.

Teresa led Luc to the phone and told him to call the number written on the paper and identify himself. Dazed, Luc sat down and followed her directions. The entire infirmary staff – doctor, nurse, pharmacist, techs, Brother Seraphim, Teresa, the other 2 mental health volunteers and myself -stood silent and unobtrusive as we watched Luc speak softly into the phone. We couldn’t hear him, but his expressions told the story. Dazed – polite – patient – confused – a hesitant smile – a big smile – disbelief – sobs that shook his big shoulders – and at last, tears of joy. Luc sat, head in his hand, phone pressed against his ear, crying and talking to each of his brothers.

The only other sound in the infirmary was the rest of us quietly crying and blowing our noses.

In the midst of widespread death, destruction and crime, in the midst of hopelessness, helplessness and loss, came love and community and joy. Strangers who became extended family, interconnected in that moment in a way that could neither have been imagined nor predicted nor explained.

Katrina, Luc, Brother Seraphim, St. Therese, Godmother Theresa, Teresa and another Theresa; from Pennsylvania and Illinois to Texas, Alabama and Louisiana.

Circles of Grace.

Thank you, God, for this privilege. Thank you, Luc, for the gifts of you and my Red Velvet Cake; I still have the box that it came in.

I wish you blessings, good health, happiness, love and family all the days of your life. I hope one day – somewhere, somehow – to meet again.

Sacred Ground. Holiness and Angels Unaware.

My blessings to all who were effected by Hurricane Katrina.