Thursday Re-View — The “Greatest Therapist Award”

The handwriting is looping, the capitalization non-existent, the ragged piece of paper torn on one edge, but with a faint flower at the top. It looks like the effort put into the note is considerable, the pressure of the words seen through the paper from the other side.

It is childlike. It is simple. It is a priceless treasure given to me upon my departure from Community Mental Health that I keep under glass on my desk.

No, it wasn’t written by a child. It was written by a 31-year old woman – a patient for 2 years. A woman-child. A woman whose emotional maturity was paralyzed in early adolescence, when she had several children as a result of sexual abuse by her father…abuse that her mother never stopped. A woman who never finished junior high and who ran away to get away from the monster at home, only to meet more of them on the streets and under the bridge where she slept. Where she did what she could to eat and to take care of her children until Child Protective Services removed them and placed them in Foster Care.

No protection for her, but at least there was for her children. And for the children with different fathers from severed relationships who came after that.

Rape. Childbirth. Physical abuse. Homelessness. Death of one of her children and institutionalization of another. Arrests and incarceration. Drugs and alcohol. Prostitution. Multiple suicide attempts and hospitalizations. Emotional abuse.

Self-esteem: zero. Worthlessness: 100%. In her mind, that is. And in the mind of the bruiser of a man whose son she raised as her own, who beat her up regularly, even though she took any and all that he threw at her.

But she never left. Why?

Where could she go?

She had no job – who would hire her? She had no high school diploma, with her jail time checked honestly on every application. Applications where the handwriting would look like it looked in the note above.

But she loved the squirrels outside her window, and had names for each one of them, and when her boyfriend killed one with a BB gun when he was drunk, she carefully dug a hole and buried it while he slept off the rage and the drink.

Until the next time.

Non-compliance with therapy appointments and medications until she realized that I saw past her bravado and resistance to the little girl underneath.

She was hard to like, but her survival instinct was easy to admire.

For several months, she never missed an appointment. I looked over her shoulder while she filled out applications with an agency that was willing to hire people with an arrest record. We picked out an outfit together for her interview, her boyfriend there to have the final approval on what she wore.

She didn’t get the job.

But she finally got a driver’s license so if another opportunity presented itself, she would be ready. She started to study for her GRE but didn’t have the money to sit for the exams. A fairy godmother took care of the fee at the local office that registered people for the review classes that she got thrown out of for being disruptive.

She always had difficulty with anger management, but she was also sleep deprived, since everyone around her did whatever they could to prevent her from studying. She passed all but one part of the exam for her GRE anyway, and got a tutor for the higher math.

Her father got a cancer diagnosis, and she struggled mightily with whether to go see him to tell him that she still loved him as a daughter, or to go see him to kill him for the despicable horrors that he visited upon her as a little girl. Normal feelings for what she had been through, and I daresay far above anything her father would have felt.

Then, seemingly out of nowhere, for me, a chance at another job, this one in higher education. One with a secretary to answer the phone and a computer to make appointments, with time off and supplemental help. Nothing like the limited resources of Community Mental Health that wore people out.

For someone who was exhausted with compassion fatigue, it was a relatively easy choice.

But it was so terribly hard to leave the patients in my case load. And she was one of them. Right when she seemed to be making some headway, another person who she had slowly, hesitantly learned to trust was abandoning her.

Who to save? It had to be me. Because I cannot “save” anyone but myself, and I needed to give some of the compassion that I so easily poured into others, to myself.

So everyone was transitioned to new psychotherapists whom I thought would be a ‘good fit,’ and I had enough advance notice to properly ‘terminate’ my clients.

I wish I could tell you that she passed the final portion of her GRE, left what would hopefully be her last abusive relationship and found a full-time job.

But I can’t.

I don’t know what happened to her…not even if she kept her appointments with the new therapist. Not every story has a happy ending, or at least an ending that we are a part of or even privy to.

But I do have the tiny stuffed green frog she gave me on the last day, one she got from a McDonald’s Happy Meal. And I have the “Greatest Therapist Award” next to me on my desk.

Not to remind me of my award, but to remind me of the special woman-child I was so privileged to work with for 2 years.

To remind me of what a survivor looked like…a woman so tough that she was still standing, a woman so gentle that she named each of the squirrels in her back yard.

Thank you for gifting me with a glimpse into your life and sharing things that no one else knew. For keeping a small shred of hope alive even when the voices all around you ridiculed and berated.

I wish you happiness and warmth and smiles; sunshine and rainbows and sweetness.

But most of all, I wish you love.

Pure love. Of yourself and from someone good and decent and kind.

You deserve nothing less.

The privilege was mine, lovely lady. Be well.

You are in my thoughts and in my heart…go out and shine!

____________________________________________

Thursday Re-View: “I Wasn’t Enough…”

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

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

__________________________________________________________________________

The “Greatest Therapist Award”

The handwriting is looping, the capitalization non-existent, the ragged piece of paper torn on one edge, but with a faint flower at the top. It looks like the effort put into the note is considerable, the pressure of the words seen through the paper from the other side.

It is childlike. It is simple. It is a priceless treasure given to me upon my departure from Community Mental Health that I keep under glass on my desk.

No, it wasn’t written by a child. It was written by a 31-year old woman – a patient for 2 years. A woman-child. A woman whose emotional maturity was paralyzed in early adolescence, when she had several children as a result of sexual abuse by her father…abuse that her mother never stopped. A woman who never finished junior high and who ran away to get away from the monster at home, only to meet more of them on the streets and under the bridge where she slept. Where she did what she could to eat and to take care of her children until Child Protective Services removed them and placed them in Foster Care.

No protection for her, but at least there was for her children. And for the children with different fathers from severed relationships who came after that.

Rape. Childbirth. Physical abuse. Homelessness. Death of one of her children and institutionalization of another. Arrests and incarceration. Drugs and alcohol. Prostitution. Multiple suicide attempts and hospitalizations. Emotional abuse.

Self-esteem: zero. Worthlessness: 100%. In her mind, that is. And in the mind of the bruiser of a man whose son she raised as her own, who beat her up regularly, even though she took any and all that he threw at her.

But she never left. Why?

Where could she go?

She had no job – who would hire her? She had no high school diploma, with her jail time checked honestly on every application. Applications where the handwriting would look like it looked in the note above.

But she loved the squirrels outside her window, and had names for each one of them, and when her boyfriend killed one with a BB gun when he was drunk, she carefully dug a hole and buried it while he slept off the rage and the drink.

Until the next time.

Non-compliance with therapy appointments and medications until she realized that I saw past her bravado and resistance to the little girl underneath.

She was hard to like, but her survival instinct was easy to admire.

For several months, she never missed an appointment. I looked over her shoulder while she filled out applications with an agency that was willing to hire people with an arrest record. We picked out an outfit together for her interview, her boyfriend there to have the final approval on what she wore.

She didn’t get the job.

But she finally got a driver’s license so if another opportunity presented itself, she would be ready. She started to study for her GRE but didn’t have the money to sit for the exams. A fairy godmother took care of the fee at the local office that registered people for the review classes that she got thrown out of for being disruptive.

She always had difficulty with anger management, but she was also sleep deprived, since everyone around her did whatever they could to prevent her from studying. She passed all but one part of the exam for her GRE anyway, and got a tutor for the higher math.

Her father got a cancer diagnosis, and she struggled mightily with whether to go see him to tell him that she still loved him as a daughter, or to go see him to kill him for the despicable horrors that he visited upon her as a little girl. Normal feelings for what she had been through, and I daresay far above anything her father would have felt.

Then, seemingly out of nowhere, for me, a chance at another job, this one in higher education. One with a secretary to answer the phone and a computer to make appointments, with time off and supplemental help. Nothing like the limited resources of Community Mental Health that wore people out.

For someone who was exhausted with compassion fatigue, it was a relatively easy choice.

But it was so terribly hard to leave the patients in my case load. And she was one of them. Right when she seemed to be making some headway, another person who she had slowly, hesitantly learned to trust was abandoning her.

Who to save? It had to be me. Because I cannot “save” anyone but myself, and I needed to give some of the compassion that I so easily poured into others, to myself.

So everyone was transitioned to new psychotherapists whom I thought would be a ‘good fit,’ and I had enough advance notice to properly ‘terminate’ my clients.

I wish I could tell you that she passed the final portion of her GRE, left what would hopefully be her last abusive relationship and found a full-time job.

But I can’t.

I don’t know what happened to her…not even if she kept her appointments with the new therapist. Not every story has a happy ending, or at least an ending that we are a part of or even privy to.

But I do have the tiny stuffed green frog she gave me on the last day, one she got from a McDonald’s Happy Meal. And I have the “Greatest Therapist Award” next to me on my desk.

Not to remind me of my award, but to remind me of the special woman-child I was so privileged to work with for 2 years.

To remind me of what a survivor looked like…a woman so tough that she was still standing, a woman so gentle that she named each of the squirrels in her back yard.

Thank you for gifting me with a glimpse into your life and sharing things that no one else knew. For keeping a small shred of hope alive even when the voices all around you ridiculed and berated.

I wish you happiness and warmth and smiles; sunshine and rainbows and sweetness.

But most of all, I wish you love.

Pure love. Of yourself and from someone good and decent and kind.

You deserve nothing less.

The privilege was mine, lovely lady. Be well.

You are in my thoughts and in my heart…go out and shine!

____________________________________________

Thursday Re-View — “The Welcome Angel”

bhmpics

I met Dannie when her social worker discharge team brought her to my office after more than a year in a residential mental health facility. Probably in her mid-thirties, but looking much older, she was petite, wiry – all coiled muscle – with high cheekbones that validated her ethnic background. Her long hair was held back by a headband across her forehead. Her shoulders were slumped, her skin a pasty gray, with a shuffle in her reluctant steps. Her voice was deep and scratchy, the type that country music would describe as “whiskey and smoke.”

We had nothing in common.

She remained standing after I invited her to be seated, looked up for the first time, met my eyes with a spark in hers and informed me: “You have 5 minutes, and then I’m walking out of here.” Under the spark in her gaze was pain, made all the more marked by the deep circles under her eyes.

I was wrong; we had quite a bit in common.

As I worked with Dannie, I came to know of her struggles with addiction – to alcohol, to prescription drugs, to family conflict and to abusive men. Her present boyfriend was soon to be released from prison, and the rescuer in her struggled with letting him back into her life. I reminded her that if that was her decision, she risked losing the progress she had made with staying sober, not having another suicide attempt (she had two prior to our meeting) and remembering that she, as a human being, had value and worth.

I so hated to see this strong woman – the one who told me that this boyfriend was better than some of her others because “he always made sure to hit me where no one could see it” – lose ground in her healing and recovery. But I believe in the autonomy of my clients – and Dannie needed to feel in control of something, even though I believed that taking control in this instance would be to refuse his coming back to live with her.

Life, like therapy, is never without setbacks, and a new concern was a health issue that flared up, with a prognosis that offered only maintaining her present health and not letting it decline, rather than any type of cure. Coping with that, along with the depression, addiction and everything else, became a daily task.

One day, in Dannie’s latest update on her continuing family conflicts, she asked my opinion about something. Apparently when Dannie went to her mother’s grave site, she saw a wrought iron angel lawn ornament stuck next to the headstone, the word “Welcome” in big letters. Dannie was horrified and appalled, especially since she found out later that it was her very own sister who had put bought this for their mother, when her sister had a few too many beers. Dannie removed it and threw it away, only to return a week later to find another one in its place.

Wasn’t that terrible?

She looked at me, at once aghast, angry, yet expecting no less from her family. Then, I saw it – the faintest gleam in her dark eyes, that fiery spark that only Dannie had after a life filled with 10 kinds of despair. The edges of her mouth curved up a bit, and she looked down at the floor. But I could see her shoulders start to shake. I couldn’t help it – this therapist started to laugh, struggling to keep it private, since Dannie wasn’t looking at me.

Her eyes met mine and we both burst out laughing at the same time; a rollicking, easy, raucous laughter that, I found out later, had quite a few of the other offices in the hall wondering what in the world was happening in Theresa’s office. Dannie and I were bent over, laughing, until tears ran down our faces. An angel in a cemetery – okay; but a welcome angel?

The absurdity of it caught us both, and in that moment, for Dannie and me, there was nothing else but our sharing joyously in something macabre, yet somehow, in some way, making sense in the larger scheme of things. It felt good and it felt right; it was beautiful. We collected ourselves, then were able to segue perfectly into her own fears about dying, a topic which she had always skirted in the past.

Unexpectedly, I left that job to take another position that I felt called to, and with a month until my departure, I said my goodbyes to Dannie. I felt certain she would be in good hands with the therapist assigned to take over her case. Our 5 minutes that turned into a few years was done, and I was proud of her progress and transformation. When she thanked me for saving her life, saying that she’d never forget me, I answered that she did the work, and that it was a privilege for me to have been part of even a small portion of her life journey. I also mentioned that whenever I saw a wrought iron welcome angel, I would think of her and the laughter we shared.

Not long after, I heard that Dannie had passed away. “Oh no…” My sadness was immediate.

I was afraid to ask, but I had to ask, how she died. A suicide? No. An overdose? No. As a result of physical abuse? No. The answer – “of natural causes” related to the condition we knew about. Her body shut down; it was time.

I breathed a sigh of relief. At the time of her death, Dannie was sober and still living on her own, having refused to take back the abusive boyfriend. It was unfortunate, but it was a good death. Yes – a good death.

Now, whenever I see an angel lawn ornament, I smile, think of Dannie and send her a prayer. Sometimes, I can almost hear her laughter, but then I realize it was only the wind. (Maybe. Then again, maybe not…)

Thank you, Dannie, for the gift of your generous and strong spirit. You mattered. You made a difference. You shine in my heart, and in my memory.

Someday, find a way to let me know if you were met on the other side by a Welcome Angel…

Somehow, I think the answer to that is yes.

______________________________________________

The In-Between Time

It’s in the in-between
that the real magic happens.
The seeds are planted,
the roots take hold…
and we blossom into who
we were meant to be.

~ Kristen Jongen

I’m not good at this in-between time. That’s where I am at the moment. Since a health scare prompted me to take a “time out” from working as Director of a Counseling Center in a small, private college in late December, I’ve been on hold as far as contributing to the Gross National Product.

And since patience never was one of my strong suits, I’m none too happy with not getting up at 6:30 every morning, coming home at 6:30 at night, having done my part to save the world.

Some of you who follow me know that I expected big things from my health care professional retreat to Assisi, Italy this month (“My Pilgrimage to ????”).

While there, I expected nothing less in the town of St. Francis’ birth than for the heavens to open and rain wisdom down upon my thirsty soul, giving me detailed instructions on where/what/when/how I would be doing for the rest of my life. Give me my Divine Missive and I will obediently carry it out to the letter, and beyond.

I want a lightning bolt to strike the ground directly in front of me with the answer to my impatient question of, “Now what?????”

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My therapist has respectfully suggested that perhaps my imagery of a lightning bolt striking directly in front of me might need to be modified.

Let me explain.

Since my husband’s illness prevented us from going on retreat, my pilgrimage was one of hospitals and doctor’s offices and bedside vigils. Now that he is slowly recovering…I’m ready for the lightning bolt.

Now what???

I can still hear my therapist, Dr. G, saying, “Theresa, I don’t like that image – the lightning bolt.” He’s trying to be polite and professional. That works for awhile. “That’s too much like a defibrillator!!! You need to use something more calming for the imagery – like a sunset, or a sunrise.”

My feet came off the floor as I burst out laughing. He and I have been through a lot together (…bless him…), ever since I first met him and, barely having sat down, informed him, “You have 6 months for me to get through this ‘whatever.'”

He tried to be polite and professional back then as well. “Theresa, perhaps putting a time limit on the therapy might add more stressors to your life?”

Don’t you just hate it when people are right???

Perhaps putting a time limit on my in-between time will also add more stressors to my life. And stressors are what sidelined me in the first place.

So now I have to let go of one of my all-time favorite symbols – my lightning bolt – and attach myself to something (unlike the defibrillator paddles) more soothing, more peaceful, less shocking, less startling.

Something without a sense of urgency or that won’t be seen as an intrusion; something that will simply allow answers and inspiration to come forward slowly, in their own time, bringing me to a “new and stronger Theresa.”

[Whew! Is this the kind of stuff I tell my patients/clients/students?]

So naturally, I start thinking.

[That’s another thing my therapist has observed; when he presents an idea, I “run with it like a German Shepherd, dragging my owner behind me.” I’m not sure if that was praise or censure, but I’m still going to run with it.]

And in thinking, I recall my time working in the trauma bays of a near-by hospital (“Of Hospitals, Loss and Love” and “Wounded Hearts” ), when a man was brought in with extensive burns from electrocution. The palm of one of his hands was the exit point of the bolt of electricity, and it had blown open a hole where you could see blackened skin, tendons, muscle and blood.

Burned. Charred. Unrecognizable.

This is what I was praying for? Asking for? A lightning bolt?

Maybe not such a good idea.

So here I am in the in-between time, impatiently waiting for a lightning bolt beautiful sunset to remind me that all good things come to those who wait. To have patient trust in whatever has been written for me, even before I was born.

“For I know the plans I have for you,” declares the LORD,
“plans to prosper you and not to harm you,
plans to give you hope and a future.”
Jeremiah 29:11

Do I go back to Hospice, working with people as they make the “graceful passage” from this life to the next (“You Are My Sunshine” and “The Last Good-bye?”)?

Do I return to Community Mental Health, where people are in desperate need of just about everything (“The Welcome Angel” and “I Wasn’t Enough...”)?

Do I return to a college campus, where students struggle to carve out an identity (“An Adolescent’s Christmas with the Infant of Prague“)?

Do I open a private psychotherapy practice?

Do I volunteer in an international setting?

Do I venture forth as a motivational speaker?

Do I continue my blog?

Do I finally write the book I’ve always wanted to, something to uplift and inspire and offer hope?

Or do I simply continue as is, taking care of my family and myself, working my way through the grief of the vast losses that took hold of my life in the past 14 months (“Remembrance II” and “Who Will Remember?”)?

What is enough? What is too much? Where do I belong?

I’m not good at the in-between time.

The time between who I was and who I am yet to be.

The time between chapters…between birth and rebirth…between death and resurrection…

But above all, I am a listener. A co-journeyer.

The seeds have been planted, the roots have taken hold, and I have only to blossom in another setting, with another offering of my self.

I will wait in the quiet. I will listen for the whispers. I will keep watch for the soft glow of the banked embers that is the fire in my soul.

I will open and stretch to the golds and oranges of the welcoming sunrises. I will rest, bathed in the muted purples and pinks of the sunsets.

I will be still and know that I am.

And that will be enough.

For now….

Come. Who will journey with me?

____________________________________________________

Kristen Jongen

I Wasn’t Enough…

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

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

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Thursday Re-View — “Mouse Therapy Expert”

Occasionally, I will post “Thursday Re-View,” a post from when I first started my blog that you may have missed. Enjoy!

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Mouse Therapy Expert

I was born to be a psychotherapist. No, that’s not being egotistical or arrogant; at a “certain age,” you come to know your strengths as well as your limitations. You have to – there’s probably not much time left to live each day with intention.

Like I said – I was born to be a psychotherapst. But little did I know that I would gain even more credentials while working in Community Mental Health. Thanks to my colleague Katherine and my patient Ben, I was awarded the M.T.E., or Mouse Therapy Expert, specializing in a Rodent Recovery Program. Drop-ins welcome. Group rates available. Perhaps I’d best explain.

Working in Community Mental Health is not for the faint of heart. Resources are almost non-existent, schedules are jammed and the clients/patients are desperately in need of good mental health services. For some reason, my supervisor determined that as a counselor, I worked well with “chronic” patients: those who were in and out of the system, with long mental illness histories and a poor prognosis. It was common for the patients and therapists to give up, with little progress made through no one’s fault.

Ben was fairly typical of his diagnosis and personality: middle-aged, never married, still living with his mother, poor social skills, no friendships, unemployable, but a genuinely nice man. Somewhat rotund, Ben would shuffle into my office, his round face anxious but with a bit of a smile, his regular outfit of jeans and a plaid shirt freshly washed and ironed (by his mother). He always sat at the edge of his seat for the entire session, as if he would bolt out of the door at any moment. As usual, he would start his first sentence with, “Theresa…” and launch in to his latest anxieties about his family, his finances, his nightmares and his smoking habit.

In Ben’s case, therapy was often nothing more than reassurance for his many worries, making certain that he was taking his medications correctly, and setting his mind at ease that he would never be homeless in his present situation; that there was enough funding available, as well as local resources, to help him survive.

My office was one of many in the Adult Outpatient section on the first floor of a 3-story brick building that used to be a hospital (verified by the morgue refrigerator corpse drawers in the basement now used for plain old storage), but now used to provide mental health services to the county. It was an old building with drafts everywhere, marble floors and dropped ceilings. I was lucky enough to have 2 windows, which either brought the succulent aroma of a delicious carbohydrate lunch from next door’s KFC or the seemingly twice-a-day whirr of the Medivac helicopter as it landed in the landing zone of the general hospital next door. For visualization purposes, when in my office, the patient sits with his or her back to the windows while I face them, seated at my desk, my back to the door. (Note: always keep yourself closer to the door.)

It was just another day as I jotted a few things in his record, Ben and I discussing his goals for next week. I heard a bit of a thump, but extraneous noise was common in the building – shredders, telephones, voices, drawers slamming, people walking down the hall, etc. – so I didn’t think anything of it. As I listened to Ben, my eyes drifted to the window behind him, and there on the ledge was the cutest, tiniest mouse that I had ever seen. He sat there on his hind legs, calmly looking at me. Then, (was that a smirk on that adorable face?) he leaped to a near-by electric cord and started to make his way down towards the floor. Which would put him by the back leg of Ben’s chair. Which was far too close to Ben’s feet. All this time, I’ve got a poker face, but my mind is racing a mile a minute. Ben – a bit of a paranoid schizophrenic, with auditory hallucinations and fears of just about anything – far too close to a mouse.

A brief aside – I am not really afraid of mice, but I prefer rats. Ever since I worked with rats as a biology major in undergrad, I found them to be friendlier and not as quick to nip at your fingers. (Lab rats, at least. I can’t account for sewer rats the size of dogs.) I genuinely was concerned about not setting Ben off emotionally with a cute little mouse crawling up his leg.

Animal Crossing Wiki

What’s pounded into our head from Day 1 at my place of employment? If there’s a problem, consult with your supervisor. So I punched in my supervisor’s extension. Thankfully, he answered. “Mike, I have a problem.. Could you please come to my office?”

“What’s the problem, Theresa?”

Darn it. He’s going to make me say it in front of Ben. I put Mike on hold while I break the news to Ben. “Now I want you to stay calm, Ben, but I have to tell you something. It’ll be okay.” His eyes are like saucers. “There is a tiny little mouse – he’s so cute – (I hope that will soften the blow) on the windowsill (a little white lie, also to soften the blow) behind you.”

Ben turned around, saw the mouse dangling on the cord, and in one swift movement, vaulted behind me in my chair. He was trembling. I took my supervisor off hold. “Mike, there’s a mouse in my office. He must have dropped from the ceiling tiles. Can you come down here?”

No answer – just disjointed breathing. Then I hear a faint voice. “A mouse, like M-I-C-K-E-Y – that kind of mouse?”

Disney at a time like this. “Yes.” I feel Ben restless behind me.

Mike squeaks at the other end of the phone. “Theresa, I’m scared of mice.”

Well, you’re not supposed to hang up on people, especially your supervisor, but I was running out of time here. I dialed my colleague in the next office. She could handle it; she was an independent, capable, take charge kind of woman. “Katherine – I need you to come over here.”

“I can’t. I’m with a client.”

“Katherine – I need you over here now.”

In a few seconds (it must have been something about my voice…), my door opens and Ben races out while Katherine walks in. I point to the mouse, who’s still having fun on the electric cord. “It’s a mouse.”

Katherine – my heroine – takes one look at Matt (that’s what I named the mouse) – and puts both hands up while she backs out of my office. “I don’t do mice.” So much for colleagues coming to the rescue. At that point, Matt scurries back up onto the window sill. I hear someone behind me, and there’s a very confident-looking man (not my supervisor) walking up to the mouse. Katherine explains from the doorway, “My client is a hunter; he said he’ll take care of it.” Without any hesitation, the man grabs the mouse. With Matt cupped in his hand, Katherine’s client walks down the hall to release him into the wild (the bushes outside our building, which probably means the mouse will be back inside in 30 seconds flat).

I see Ben cowering against the wall, inching his way toward the waiting room. “I’m going to leave now, Theresa. Is that okay?” I assured him it was, so he tore out of the building and raced down the steps. (I was hoping the mouse wouldn’t leap out of the bushes; we’d have to carry Ben through the parking lot to the hospital.). We calmly asked all of those waiting to disperse from the hallway and told them everything was okay.

All in a day’s work. I made a mental note to call Ben the next day in order to check on him, since I knew he had trouble sleeping. I hoped this mouse incident wouldn’t cause a nightmare. The next morning, promptly at 8:30 am, Ben called me before I could call him.

“Ben, how are you after yesterday’s excitement?”

“Theresa, I’m sorry I left, but I don’t like mice. I just don’t like mice. They scare me.”

“That’s no problem, Ben. It seems a lot of people don’t like mice.” Once I knew he was fine, we made another appointment for next week.

“Theresa, will there be another mouse there?”

I explained that I didn’t know, but I was sure maintenance and housekeeping would be on the look out from now on.

I could hear Ben’s sigh of relief. “Okay. Thanks, Theresa.” He hesitated and I could hear the wheels turning. He spoke again, ever the gentleman. “It’s a good thing there weren’t any ladies there; they would have been scared…”

I kept the shock from my voice and answered with Ben’s same sincerity. “You’re right, Ben – it’s a good thing there were no ladies there.” We said good-bye and I hung up, shaking my head in amazement.

At least I was doing something right – Ben obviously viewed me as his therapist, and not as a female. But my Mom, who would accept nothing less from her daughters than for them to be “ladies” – would be appalled and disappointed about my new status.

After all, there were no ladies present.

Thanks, Ben. I’ll never forget you. I wish you healing and peace of mind and people who love you. And no more mice…

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You are a blessing.

Mouse Therapy Expert

I was born to be a psychotherapist. No, that’s not being egotistical or arrogant; at a “certain age,” you come to know your strengths as well as your limitations. You have to – there’s probably not much time left to live each day with intention.

Like I said – I was born to be a psychotherapst. But little did I know that I would gain even more credentials while working in Community Mental Health. Thanks to my colleague Katherine and my patient Ben, I was awarded the M.T.E., or Mouse Therapy Expert, specializing in a Rodent Recovery Program. Drop-ins welcome. Group rates available. Perhaps I’d best explain.

Working in Community Mental Health is not for the faint of heart. Resources are almost non-existent, schedules are jammed and the clients/patients are desperately in need of good mental health services. For some reason, my supervisor determined that as a counselor, I worked well with “chronic” patients: those who were in and out of the system, with long mental illness histories and a poor prognosis. It was common for the patients and therapists to give up, with little progress made through no one’s fault.

Ben was fairly typical of his diagnosis and personality: middle-aged, never married, still living with his mother, poor social skills, no friendships, unemployable, but a genuinely nice man. Somewhat rotund, Ben would shuffle into my office, his round face anxious but with a bit of a smile, his regular outfit of jeans and a plaid shirt freshly washed and ironed (by his mother). He always sat at the edge of his seat for the entire session, as if he would bolt out of the door at any moment. As usual, he would start his first sentence with, “Theresa…” and launch in to his latest anxieties about his family, his finances, his nightmares and his smoking habit.

In Ben’s case, therapy was often nothing more than reassurance for his many worries, making certain that he was taking his medications correctly, and setting his mind at ease that he would never be homeless in his present situation; that there was enough funding available, as well as local resources, to help him survive.

My office was one of many in the Adult Outpatient section on the first floor of a 3-story brick building that used to be a hospital (verified by the morgue refrigerator corpse drawers in the basement now used for plain old storage), but now used to provide mental health services to the county. It was an old building with drafts everywhere, marble floors and dropped ceilings. I was lucky enough to have 2 windows, which either brought the succulent aroma of a delicious carbohydrate lunch from next door’s KFC or the seemingly twice-a-day whirr of the Medivac helicopter as it landed in the landing zone of the general hospital next door. For visualization purposes, when in my office, the patient sits with his or her back to the windows while I face them, seated at my desk, my back to the door. (Note: always keep yourself closer to the door.)

It was just another day as I jotted a few things in his record, Ben and I discussing his goals for next week. I heard a bit of a thump, but extraneous noise was common in the building – shredders, telephones, voices, drawers slamming, people walking down the hall, etc. – so I didn’t think anything of it. As I listened to Ben, my eyes drifted to the window behind him, and there on the ledge was the cutest, tiniest mouse that I had ever seen. He sat there on his hind legs, calmly looking at me. Then, (was that a smirk on that adorable face?) he leaped to a near-by electric cord and started to make his way down towards the floor. Which would put him by the back leg of Ben’s chair. Which was far too close to Ben’s feet. All this time, I’ve got a poker face, but my mind is racing a mile a minute. Ben – a bit of a paranoid schizophrenic, with auditory hallucinations and fears of just about anything – far too close to a mouse.

A brief aside – I am not really afraid of mice, but I prefer rats. Ever since I worked with rats as a biology major in undergrad, I found them to be friendlier and not as quick to nip at your fingers. (Lab rats, at least. I can’t account for sewer rats the size of dogs.) I genuinely was concerned about not setting Ben off emotionally with a cute little mouse crawling up his leg.

What’s pounded into our head from Day 1 at my place of employment? If there’s a problem, consult with your supervisor. So I punched in my supervisor’s extension. Thankfully, he answered. “Mike, I have a problem.. Could you please come to my office?”

“What’s the problem, Theresa?”

Darn it. He’s going to make me say it in front of Ben. I put Mike on hold while I break the news to Ben. “Now I want you to stay calm, Ben, but I have to tell you something. It’ll be okay.” His eyes are like saucers. “There is a tiny little mouse – he’s so cute – (I hope that will soften the blow) on the windowsill (a little white lie, also to soften the blow) behind you.”

Ben turned around, saw the mouse dangling on the cord, and in one swift movement, vaulted behind me in my chair. He was trembling. I took my supervisor off hold. “Mike, there’s a mouse in my office. He must have dropped from the ceiling tiles. Can you come down here?”

No answer – just disjointed breathing. Then I hear a faint voice. “A mouse, like M-I-C-K-E-Y – that kind of mouse?”

Disney at a time like this. “Yes.” I feel Ben restless behind me.

Mike squeaks at the other end of the phone. “Theresa, I’m scared of mice.”

Well, you’re not supposed to hang up on people, especially your supervisor, but I was running out of time here. I dialed my colleague in the next office. She could handle it; she was an independent, capable, take charge kind of woman. “Katherine – I need you to come over here.”

“I can’t. I’m with a client.”

“Katherine – I need you over here now.”

In a few seconds (it must have been something about my voice…), my door opens and Ben races out while Deb walks in. I point to the mouse, who’s still having fun on the electric cord. “It’s a mouse.”

Katherine – my heroine – takes one look at Matt (that’s what I named the mouse) – and puts both hands up while she backs out of my office. “I don’t do mice.” So much for colleagues coming to the rescue. At that point, Matt scurries back up onto the window sill. I hear someone behind me, and there’s a very confident-looking man (not my supervisor) walking up to the mouse. Katherine explains from the doorway, “My client is a hunter; he said he’ll take care of it.” Without any hesitation, the man grabs the mouse. With Matt cupped in his hand, Katherine’s client walks down the hall to release him into the wild (the bushes outside our building, which probably means the mouse will be back inside in 30 seconds flat).

I see Ben cowering against the wall, inching his way toward the waiting room. “I’m going to leave now, Theresa. Is that okay?” I assured him it was, so he tore out of the building and raced down the steps. (I was hoping the mouse wouldn’t leap out of the bushes; we’d have to carry Ben through the parking lot to the hospital.). We calmly asked all of those waiting to disperse from the hallway and told them everything was okay.

All in a day’s work. I made a mental note to call Ben the next day in order to check on him, since I knew he had trouble sleeping. I hoped this mouse incident wouldn’t cause a nightmare. The next morning, promptly at 8:30 am, Ben called me before I could call him.

“Ben, how are you after yesterday’s excitement?”

“Theresa, I’m sorry I left, but I don’t like mice. I just don’t like mice. They scare me.”

“That’s no problem, Ben. It seems a lot of people don’t like mice.” Once I knew he was fine, we made another appointment for next week.

“Theresa, will there be another mouse there?”

I explained that I didn’t know, but I was sure maintenance and housekeeping would be on the look out from now on.

I could hear Ben’s sigh of relief. “Okay. Thanks, Theresa.” He hesitated and I could hear the wheels turning. He spoke again, ever the gentleman. “It’s a good thing there weren’t any ladies there; they would have been scared…”

I kept the shock from my voice and answered with Ben’s same sincerity. “You’re right, Ben – it’s a good thing there were no ladies there.” We said good-bye and I hung up, shaking my head in amazement.

At least I was doing something right – Ben obviously viewed me as his therapist, and not as a female. But my Mom, who would accept nothing less from her daughters than for them to be “ladies” – would be appalled and disappointed about my new status.

After all, there were no ladies present.

Thanks, Ben. I’ll never forget you. I wish you healing and peace of mind and people who love you. And no more mice…

You are a blessing.

An Adolescent’s Christmas with the Infant of Prague

Working with college students is great.

Before anyone gets into that type of work, however, it would be wise to warn you about the college student brain. Studies have shown that “late adolescence” may actually extend until 25 years old. The scientist in me wants to explain that until then, the neural networks that regulate behavior don’t reach full maturity, making the person subject to sensation-seeking and increased risk-taking, as well as more vulnerable to impulses, emotions, and the effects of alcohol and other drugs.

Still want to work with college students??? (You should. It’s energizing!)

When I explain that to the students themselves, in trying to help them understand the developmental changes during their college years, their reactions – after the shock – divide into two different camps. The first group sits up straighter, usually with an affronted look on their face – “Hey, just one minute! We’re adults, not adolescents!” The other group slouches a bit, eyes glazed, wheels turning, and you can hear them thinking, “Sweet! When I get drunk tomorrow night, I’ll have a great excuse. I couldn’t help it; my brain made me do it…”

My point being that it’s hard to transition from high school to college, and a common problem is the “emotional disconnect” that so many young people seem to have with their parents. Communication is not their strong point (one only has to look at the texts and twitter feeds to see that; while I’m on that topic – Rule #1: Never break up by texting or on Facebook! Man-up or woman-up and do it in person.).

Which brings me to Kristy… Together, she and I worked through a nasty break-up with her boyfriend, a charge of plagiarism by a professor, changing her major, feeling left out as a commuter, drinking too much on weekends, and the struggle with going to college and working a part-time job at the same time. All in an average day in the life of an adolescent. (One good thing – students who commute are spared the drama of roommate issues that flare up with alarming frequency).

But – and there’s always a but – no matter how hard she tried, no matter how much role-playing we did together, Kristy could not seem to reach an uneasy peace – or even a truce – with her mother. There was no father in the picture; only Kristy and her Mom. Finances were, of course, a huge issue, and Kristy’s only ticket to a better life was to keep her grades up in order to keep her scholarships and find some middle ground with her mother. Most times, they didn’t even speak to/with each other.

One day right before Christmas break, Kristy came in with shoulders slumped, looking dejected. (Uh oh – probably another incident with Mom.) I asked her what was wrong. Kristy grabbed a tissue (uh oh, uh oh – Kristy never cries) and started to explain what happened the night before.

She and her Mom were in a particularly tight spot with money, and were behind on rent and other bills. It was bleak enough that they couldn’t even afford to put up a Christmas tree. Last week, we had already discussed that not having money for a gift for her Mom didn’t matter; we Moms love a hug or a hand-made card – nothing else needed. But Kristy felt strongly that if she could only get her Mom something wonderful, their relationship, in this season of joy, would suddenly be terrific – wonderful – like everyone else’s (if Kristy only knew…). So what happened, with a child wanting nothing more than to please her hard-working, single mother?

Kristy had noticed in the past that her Mom cherished a statue she kept all alone on a coffee table in their apartment. Kristy wasn’t supposed to touch it, in case it broke. Sometimes, after coming home from her 2nd job, Kristy would see her Mom take off her sneakers, put her feet up and just stare at the statue, lost in thought.

“That has to be so very special to your Mom; what/who is the statue?”

Kristy struggled with this. “Well, it’s a small boy – looks kind of weird with something like a crown on his head, and his hand is held up like he’s agreeing with Mom – stay away.” She sighed. “Oh, and sometimes she dresses it up in clothes that she made herself, when she still had her sewing machine; you know, kind of like I used to do with my Barbie.”

Okay. The picture in my head is taking shape.

“The statue – was there something like a globe in the little boy’s left hand?”

“Yeah – how did you know?”

“My Mom had the same statue. But what happened?”

Kristy explained that the 2 things her Mom loved most were costume jewelry and this statue. So, thinking of surprising her Mom with something even better than an expensive Christmas tree, Kristy got some of Mom’s favorite, chunky jewelry out of her bedroom and draped the statue with it, Mardi-Gras style. “Lots of bling, you know?” When the statue looked blinged out enough, Kristy draped a string of lights around the statue, too, so it blinked in color and blinged at the same time. “I thought it looked good.”

Now I am trying to keep my “listening intently” look, and not show my concern about where this might lead. “What did your Mom do when she saw it?”

Kristy looked down for a long moment. “She didn’t say a word. She just kept looking at the statue, then at me, then the statue…and she started to cry. So I just went up to my room. Why didn’t she like it?”

Okay. So – how to explain. “Well, I know you meant well, and I’m proud of you for wanting to make your Mom happy with her 2 special things, but that statue… that’s the Infant of Prague – the Child Jesus – and the hand He holds up, like He wants you to stay away so you won’t break Him – that’s the Child Jesus blessing you.”

Kristy’s eyes had that “deer in the headlight” look, horrified and scared at the same time.

“Some might think what you did was sacri – (no – skip that word) disrespectful.”

Her eyes got even bigger. But then she got a twinkle in her eye and covered her mouth with her hands. Remember the high emotion and mood swings in the adolescent make-up? We were there. For only the second time in my work as a therapist, I lost it (for the only other time, see my post “The Welcome Angel.”).

Kristy started to laugh, then I started to laugh. She choked out, “I put bling on Jesus? And Christmas lights???” She alternated between being horrified at what she had done and being proud of herself for rendering her Mom speechless. I laughed right along with her, as I pictured the Infant of Prague decked out for the 21st century.

I tried to explain when I quieted. “You know how you don’t know how to feel right now – upset, but a bit of you thinks it’s funny? That’s probably what happened with your Mom; she was upset with having something other than “proper” clothing on the statue, but happy that you tried so very hard to give her something that would mean so much to her, and maybe even put a smile on her face. It’s okay, Kristy; it will all be okay. Your heart was in the right place.”

What do you think? Was the new appearance appropriate? It sure was! Was the Child Jesus angry with Kristy? Absolutely not. In fact, I think He must have smiled while He watched her face, so intent on dressing Him in something special for her Mom; so intent on pleasing her, so intent on trying to show her that deep down, there was love.

Kristy’s intention was pure; her adolescent love – fickle but piercing in its strength – was on display, her heart vulnerable. And what better time than at Christmas, with the birth of Jesus and a Mother’s love. Who knew that something so innocent could be so wondrous?

You did good, Kristy. You saw with the eyes of your heart, and Jesus smiled with love and understanding; He offered His blessings to you and your Mom.

Indeed – you are a blessing to me as well.

There’s a lot to be said for that adolescent brain, isn’t there? And the heart – don’t forget the heart.

The Welcome Angel

I met Dannie when her social worker discharge team brought her to my office after more than a year in a residential mental health facility. Probably in her mid-thirties, but looking much older, she was petite, wiry – all coiled muscle – with high cheekbones that validated her ethnic background. Her long hair was held back by a headband across her forehead. Her shoulders were slumped, her skin a pasty gray, with a shuffle in her reluctant steps. Her voice was deep and scratchy, the type that country music would describe as “whiskey and smoke.”

We had nothing in common.

She remained standing after I invited her to be seated, looked up for the first time, met my eyes with a spark in hers and informed me: “You have 5 minutes, and then I’m walking out of here.” Under the spark in her gaze was pain, made all the more marked by the deep circles under her eyes.

I was wrong; we had quite a bit in common.

As I worked with Dannie, I came to know of her struggles with addiction – to alcohol, to prescription drugs, to family conflict and to abusive men. Her present boyfriend was soon to be released from prison, and the rescuer in her struggled with letting him back into her life. I reminded her that if that was her decision, she risked losing the progress she had made with staying sober, not having another suicide attempt (she had two prior to our meeting) and remembering that she, as a human being, had value and worth.

I so hated to see this strong woman – the one who told me that this boyfriend was better than some of her others because “he always made sure to hit me where no one could see it” – lose ground in her healing and recovery. But I believe in the autonomy of my clients – and Dannie needed to feel in control of something, even though I believed that taking control in this instance would be to refuse his coming back to live with her.

Life, like therapy, is never without setbacks, and a new concern was a health issue that flared up, with a prognosis that offered only maintaining her present health and not letting it decline, rather than any type of cure. Coping with that, along with the depression, addiction and everything else, became a daily task.

One day, in Dannie’s latest update on her continuing family conflicts, she asked my opinion about something. Apparently when Dannie went to her mother’s grave site, she saw a wrought iron angel lawn ornament stuck next to the tombstone, the word “Welcome” in big letters. Dannie was horrified and appalled, especially since she found out later that it was her very own sister who had put bought this for their mother, when her sister had a few too many beers. Dannie removed it and threw it away, only to return a week later to find another one in its place. Wasn’t that terrible?

She looked at me, at once aghast, angry, yet expecting no less from her family. Then, I saw it – the faintest gleam in her dark eyes, that fiery spark that only Dannie had after a life filled with 10 kinds of despair. The edges of her mouth curved up a bit, and she looked down at the floor. But I could see her shoulders start to shake. I couldn’t help it – this therapist started to laugh, struggling to keep it private, since Dannie wasn’t looking at me.

Her eyes met mine and we both burst out laughing at the same time; a rollicking, easy, raucous laughter that, I found out later, had quite a few of the other offices in the hall wondering what in the world was happening in Theresa’s office. Dannie and I were bent over, laughing, until tears ran down our faces. An angel in a cemetery – okay, but a welcome angel?

The absurdity of it caught us both, and in that moment, for Dannie and me, there was nothing else but our sharing joyously in something macabre, yet somehow, in some way, making sense in the larger scheme of things. It felt good and it felt right; it was beautiful. We collected ourselves, then were able to segue perfectly into her own fears about dying, a topic which she had always skirted in the past.

Unexpectedly, I left that job to take another position that I felt called to, and with a month until my departure, I said my goodbyes to Dannie. I felt certain she would be in good hands with the therapist assigned to take over her case. Our 5 minutes that turned into a few years was done, and I was proud of her progress and transformation. When she thanked me for saving her life, saying that she’d never forget me, I answered that she did the work, and that it was a privilege for me to have been part of even a small portion of her life journey. I also mentioned that whenever I saw a wrought iron welcome angel, I would think of her and the laughter we shared.

Not long after, I heard that Dannie had passed away. “Oh no…” My sadness was immediate. I was afraid to ask, but I had to ask, how she died. A suicide? No. An overdose? No. As a result of physical abuse? No. The answer – “of natural causes” related to the condition we knew about. Her body shut down; it was time.

I breathed a sigh of relief. At the time of her death, Dannie was sober and still living on her own, having refused to take back the abusive boyfriend. It was unfortunate, but it was a good death. Yes – a good death.

Now, whenever I see an angel lawn ornament, I smile, think of Dannie and send her a prayer.  Sometimes, I can almost hear her laughter, but then I realize it was only the wind. (Maybe. Then again, maybe not…)

Thank you, Dannie, for the gift of your generous and strong spirit. You mattered.  You made a difference.  You shine in my heart, and in my memory. I am so blessed.