Friday, April 30, 2010
Hungry, Hungry HIPAA (in which I exaggerate for effect)
brrring brrrring*
Person: Well, hello. I am the person you have made up to recreate your iconically frustrating conversation.
Me: Oh hey thanks for that.
Person: No prob. Shall we get on with this?
Me: Sure, yeah. So aright: my name is Franklin Smearcase and I'm calling from The Society for the Righting of As Many Wrongs as Possible. I'm working with the attorney for Paradigmatic Client.
Person: [this is actually more or less what she said] Wait wait wait I have to stop you. I can't even talk about this person, who I may or may not have seen, unless you have a signed...
Me: YeahyeahyeahIknowIknow. Just...I know you can't even acknowledge that you might know the name, but I also have progress notes you wrote about him so...
Person: [Silence. Perhaps she is sharing an emphatic shrug with me, a shrug of "I fucking give up" over the way that worthy ideals get legislated into straightjackety impossibilities in the interest of Nothing Ever Going Wrong Again. Perhaps she is wanting to shake me. Perhaps she is juggling. On the phone, nobody knows you're juggling.]
Me: How about we try this: Just give me a fax number and I'll send you a HIPAA-compliant release for this guy who, oh, just to indulge a random fantasy, for all we know might one time have been seen for ongoing substance abuse treatment by someone who is you. I mean, it's a small world.
Person: Peach of a world. A true little corker.
[And then she gives me the number with which I can fail to fax her the release for Ostensible Erstwhile Client (né Paradigmatic Client) when some other shit distracts me.]
click
*I wonder if The Youth get all WTF about reference to telephones making bell-like sounds and if maybe in not all that long when we are miming the beginning of a phone conversation we will have to sing the awful little Verizon song or something.
Thursday, April 29, 2010
I mean...
Me vs. the Tea Party vs. Me again
Here's this though, because it's been bothering me. I just saw that a friend had joined a group on facebook called "I am American and I would rather live with Immigrants than Racist Assholes." Well, me too, obvs. But...this tone of discourse. It's gotta go.
I mean, listen, I get it. A friend from high school added me on facebook and turned out to be a teabagger and I was really hostile and made it clear I think his political party is a ship of fairly dangerous fools.
But here's the thing. Unless the next step in your plan involves violence, it doesn't make any sense to reduce your adversary to a monolith of wrongness and leave it at that. No matter how much you hate what they are saying, you have to consider it motivated irrationality and try to get your head around it a little.
I watch this happen everywhere, and I frequently participate. From the New Yorker* and its cringe-inducing condescension toward/baiting of Red State anything to meaningless internet wank like RaceFail to plenty of other ways and places people butt heads, I just don't think this is a good idea.
It feels good to call someone stupid if they have offended you. For a few months after Prop 8 in California, I had a few venomous sentences in my head that I day-dreamed about rattling off to the next pair of Mormon missionaries I saw in my neighborhood. It feels good because it's a tiny speck of revenge, and it feels good because it establishes your solidarity with the other folks on your side.
It just probably isn't worth it. My single new year's resolution for this year was "1) Be less of an asshole about religion." It's hard sometimes because I think religion is incredibly destructive. But I realized I was starting to sound like a crazy person. Well, or to sound like the people who provoke my (tiny, futile) rage.
I think we're not this bad. I think the fear we have is of unilateral disarmament. Stop attacking the tea party and maybe they'll win and we'll all have to celebrate Ayn Rand's birthday by laughing at a poor person. This is maybe our semi-conscious suspicion, our worst case scenario.
But the thing is, what we're doing now isn't working either.
*The New Yorker is basically my religion, but.
Tuesday, April 27, 2010
RIP Alice Miller
Further adventures of FPS in Fuckaway
Beyond the massive supervision fail, there were a dozen reasons to hate being out there, and the only reason to stay (at the time, better job market) was that it seemed like my path to being a therapist. But, yeah, much to dislike. Coworkers who found the place utterly normal and my evident distress about it a little bit crazy, that was one thing that should have told me to get out. You can go around saying "isn't this place terrible?" but between the possible objective reality that the place isn't terrible and you are just Doing It Wrong and the possible objective reality that they are all nuts who can't see the disasters around them, well, there ain't much twain.
I should say more about why it felt like a madhouse (ok, stupid choice of words considering it was in some sense functionally a madhouse.) I should say more about why it felt like everything there was profoundly bad. Because the truth is, clinics like that might well feel a bit like an emergency room. The populations that have to rely on interns and people straight out of grad school for their mental health care because that's what Medicaid will pay for are not easy to take care of.
Often the baseline of "things going wrong vs. things going ok" is already pretty low, and in Rockaway in particular, well, the people who came through that door were very rarely there to discuss how nervous they were about their retirement funds. In all but the most floridly psychotic clients (and maybe there, too) there was content that you could dig into--and I mean this less to reduce clients to their interestingness-level to a pretentious young therapist, I hope, than to talk about the difficulties and possible inefficacies of talk therapy across some serious barriers to understanding, many of which could be navigated with good superivison but see above. Or below. Stupid blog format vs. referential conventions.
But wait, this is actually the point. I had a lot of clients I didn't know what the fuck to do with, and nobody was giving me the least suggestion of what the fuck to do with them. This could have been because they assumed I was better prepared for this work than I was. This could have been because they had little idea more than I did, were all inured to How Things Are and just saw the people, let them sit there in their offices while they wrote billable notes, and called it a day. There could be other explanations.
I'll never know. I do know I had serious misgivings about asking for help, not just because Murgatroid seemed, and I won't try to paint myself as less than judgmental here, just not to be very smart. Also because of how things were discussed higher up.
Aunt Slappy did something I read as very supportive early on, and then came to have enormous misgivings about. So, let's take for example the kid clients I had.
Backing up, to the point of incoherence, I had always hoped not to work with kids because I'm awful with them, but in a community mental health setting, you get a ton of kid clients no matter what. It's a socoieconomic thing I probably don't have the perspective to dissect, but to me it always looked like people with kids they didn't particularly like, but also kids who lived in a terrible environment and were hard to manage by any standard, bringing them in and saying "fix him. Or just take him off my hands for an hour."
I was hopeless with these kids. I can't imagine I did a damn thing for them. I talked to them in the useless, annoying tone of a person who doesn't know how to talk to kids. In some cases, I spent the hour just trying to keep them from hurting themselves on sharp desk edges because they were so hyperactive, or saying "no you can't have that" when they picked up thing after thing and said "I can have this?"
It's tiring having that kind of privation bounced off you and thinking about where need that ceaseless comes from. It's tiring and distressing trying to make some tiny connection with someone you have no idea how to connect with. Sometimes you take these frustrations out by getting mad at the parents, who in many cases really do seem like walking horrors.**
I was too busy talking to Murgatroid about my charts to ask about any of this (which is its own story) but sometimes I'd talk to Slappy, and she would be, as I started to say, apparently supportive. She'd take my side anyway. She'd fume at the parents. And then eventually it occurred to me that I was standing in the office of my clinic supervisor listening to her say about some kid's mother "I know that woman from way back. She's a piece of shit."
Someone once said to me "Oh, I've had my analysis. I don't have countertransferences anymore." I didn't bother to express my skepticism because it was a friend and someone who indeed reacts fairly to many things and seems to have benefited from analysis. TPSAII*: all people's training and all their advancement within the field sometimes means very little or nothing about how they react to Things That Happen. I was working in a place mean to help people, ruled with a tanned leather talon by someone who referred to these people or their families, frequently, without any encouragement to stop and think about this stuff, as garbage.
This was not a place I needed to be.
Right, yeah, I'm going to keep going....
*The point, such as it is. I have decided this is probably something I should just abbreviate.
**Hey, sorry. The last entry was funnier, right?
Monday, April 26, 2010
The Deep End
because this is obviously going to run long so maybe it's best to chop it up. By the way, yeah, I'm kind of feeling out what the hell to write about because currently not many people read this, so I can play around. That may remain true, of course. I had a piece of luck at my old blog, a link from someone with a metrick fuckton of readers. This may turn out to be more of a Marsha Brady writing in her diary type of situation. And if that's true, I have all the time in the world to futz around with content.
With that out of the way...
I was thinking earlier about my first job out of school, and I've told people about it about a billion times but never really written out the story. So if that sounds at all interesting, stick around. It is, oh, pretty much a tale of woe in which things go not so very well. Read on if you are a Schadenfreudian. This is Schadenfreude with consent.
2004. I had completed my degree in a town that was not the town I wanted to live and work in. Clampett-like, I loaded up the truck and moved not so much to Beverly but to Manhattan with a sublet and no job. Somehow this did not strike me as especially foolish.
Went on a few interviews for jobs that would have been the death of me. I was in over my head one way or another, never did a stitch of social work before starting my MSW program and had no idea what I was doing. In some ways this has not changed, but I fake it a lot better. One interview was in Far Rockaway, working in the dilapidated high rises by the beach that are full of elderly Russians and people from the former republics, the ones who are not doing nearly well enough to live in Sheepshead Bay, I suppose. I would have had an enormous caseload and really my Russian was in lousy shape by then. I think the woman interviewing me took one look and knew I'd be a disaster.
Weeks pass. I'm wondering if I'm going to have to leave New York. I get another call out to Far Rockaway, and I go out for the interview, and it's immediately clear that it's a good match, even though of course this turns out to be untrue on a scale that is tragicomic, possibly epic. But I do have experience as a therapist in community mental health. I speak Russian (though they determine this by having me exchange exactly two sentences with a native speaker.) They are openly very enthusiastic about me, and....they seem surprised that I want to work there. Which is never a good sign.
If you want to picture them, the two people interviewing me are in their late 40's, tanned to a crisp, blonde in a way that nature may or may not have intended but Ashkenazic DNA pretty much forecloses, and have intense Long Island accents. The director, who I'll call Aunt Slappy if I have occasion to speak of her again, will later pronounce "poignant" as it looks in some conversation about Billy Crystal's doubtless utterly poighnant Broadway show*, and being a word snob, I'll say to myself "I really should have known about this one."
They introduce me to my supervisor who I'm going to call Murgatroid. She has a look of blank, stative panic in her eyes. "Working with Murgatroid," I am told by Aunt Slappy, "is a great clinical opportunity."
I get my first client. I couldn't tell you her name or her story if I wanted to. We'll briefly call her Hellacia because she's not in this story long, and if you're noting a dread of my clients in this name that doesn't speak well of my ability to treat them, you're noting right. Let's all sit around the fire and read "Hate & the Countertransference" (sort of like "Sex & the City" but no, not really) aloud, the fire composed of drafts of the conference paper I was going to write on difficult clients and what helps us do something for them. Not on that list: supervisors like Murgatroid. I had 11th grade English. That's called "foreshadowing."
What I remember about Hellacia is that I was told right away she was infamous at the clinic, had been there for years, had a chart you could use to boost a small child at the dinner table and Borderline Personality Disorder, which is a salient diagnosis but also something a clinician hangs around the neck of anyone that pushes his/her buttons.
The session is totally fine. She makes some overquick cathexes, tells me I remind her of her brother or something, and we're done. Except five minutes later Murgatroid comes in and says my client has completely decompensated in the waiting room and is screaming at the receptionist.
I've been a professional for one hour. I have no pride to swallow. I skip any hedging and say to Murgatroid, my supervisor, my holding environment, my safety net, "what should I say to her?" Murgatroid looks at me with the same blank panic I saw during my interview and will see for the next nine months of my life and says "I don't know what to say to her!" and basically walks off.
The universe takes pity and by the time I get out there, the client has not only calmed down but left. Just the same, I'm a dead man. I am suddenly aware that I am fucked. Murgatroid will turn out to be only one of my problems, but my basic impression is correct. The person who has been charged with managing my transition from student to professional is an addled, not particularly bright person who appears to have been shattered by years at this clinic. We will have a total of maybe 45 minutes discussing anything about my clients over my 10 months at the clinic**. The rest will be about their charts, because that kind of clinic exists not for the sake of clients, but for that of charts.
About the clinic itself, I should mention that the general air of the place was something between an emergency room and central booking. It's the nature of the neighborhood, in part--socioeconomically at the bottom of the barrel, and also through some accident or "accident" of the deinstitutionalization process, it's where a ton of group homes ended up so they wouldn't have to look at them in patchily wealthier western Nassau County.
A lot of people who want to be therapists have the same naive fantasy I had going in: working with the "worried well," on their depression/anxiety/other manageable problem. That's what happens on a tv show, maybe. This was what actually happens, in concentrated form. Clients who don't show. Clients who have to be hospitalized. Clients who are there for their meds and can't possibly fill ten minutes, not to speak of an hour, with introspection or even perhaps conversation...
Um this is not really a cliffhanger here but to be continued...
*Uh, this is maybe so far off-topic as to be of no interest, but the Billy Crystal thing is what we would call diagnostic in the biz. The people I worked with live in Nassau County and treat New York City with a kind of Victorian dread. It seems to me this is not exactly healthy for social workers. They express alarm that I'm taking the A train home, not because I have to catch it at the Far Rockaway station which genuinely was worrisome at the time, but because I'll be going through Bedford Stuyvesant. In truth I 1) am going under it, and 2) looked at an apartment I couldn't afford there, so. Anyway, I find myself wondering why they don't move to another part of the country, but I guess the dread is a giant, overwhelming garnish to a tiny sundae of delight, because all of them maybe once a year will go in and see a Broadway show or something. I think of them when Carmela takes Meadow to the Plaza for tea on The Sopranos. It's something I'll never understand, as someone who worked pretty hard to live in this urban hell. I can understand getting tired of it, but I can't understand never being a little in love with it, at least.
**I eventually start referring to Far Rockaway as Far the Fuckaway and the clinic as the Fuckaway Center for the Farblondjet or something like that. I'll just stick with that.
Friday, April 23, 2010
Vorshtein
There are a few things hanging out in my brain that I want to talk about, but otherwise it may be wise just to write about the things that happen day to day here. I'm not exactly writing this to get out my own frustrations or to edify anyone. I guess I like the potential sense of community that blogs offer, even if it's a fragile sort of community.
Today was slow, and that's a topic in itself, though I'm not sure how to go at it. What I'm interested in is that I have a lot of down time, and I need a lot of downtime, and I've always assumed everyone does. And in the job I started to type about, for instance, there was this immense effort at putting on a pageant of everyone being busy every moment. How anyone could survive that I don't know, or why they'd want to.
Look the value of work is that it gets something done that needs done. Somehow this has been turned on its side in American culture. Think about this in the most basic way: Suppose you were completely done with what you have to do today, and you said to your boss "I'd like to go home now." Your boss would of course assume you were speaking hypothetically, and would say "sweet fancy Moses, so would I!" You would not go home.
The particular social work side of this is how it's been institutionalized, or this is my hunch as I sit here and type with my ass. I mean not literally. That's like "talking out your ass," an expression I sometimes use and then think I'm making it up and think I sound vulgar/crazy and remind myself next time to say "talking out my sleeve" which I'm not sure exists either but at least it doesn't give people nightmares.
Where was I? Well, think about audits, the things that define work in a clinic. One could only believe these occur for the benefit of clients* if one were being paid to believe this. They are there to make sure that social workers are not playing FreeCell or writing blogs or napping under the desk (what, you don't?) during the last fifteen minutes of sessions. They are there to make sure not only are you doing something that can make for a convincing progress note for most of the session, but that you are using the end of that session to write that convincing progress note. I really do think this is true.
Like all other exercises of authority, what they mostly do is inspire methods of subversion. I don't even know if they still do this, but quarterly progress reports--themselves an abomination--used to call for, what was it called, a performance review or some piece of meaningless jargon like that, might as well just call it a vorshtein, and they had to have this long sentence at the end of them that was a kind of formulaic language beyond all reason, and so eventually we all just learned what was supposed to be there, got very adept at writing vorshteins quickly and writing one individualizing detail at the end, and getting an LCSW to sign off, which they did without reading because nobody had any illusion that there was a point to this.
Things like this, if you squint at them right, they are important roots of societal problems. Because they mean that the people who will stay in those jobs are people who are okay with writing vorshteins rather than doing anything meaningful. I'd rather have someone lazy in a job than someone who could spend ten years writing vorshteins. Hell, maybe those people like them. Maybe they write them for fun, or do cross-stitch vorshteins.
This is how the unfortunately aggregated and decentralized villain that is, I guess, the imaginary will of heartless capitalism makes sure people who don't deserve anything never get a shot at having it. That sentence is terrible, but maybe you know what I mean? I'll try this again: the structure of our working life suggests that someone out there doesn't want us to do any good. It's like the argument of intelligent design, inverted: things could not have gone this wrong without a decision that they should be so. And yet, probably not a constructive thing to imagine.
Probably this is all simplistic and muddled to people with a bigger mind for big systemic grokking of things than I have, but it feels worth bumbling my way through.
*or consumers or customers or cupcakes or whatever term we are now supposed to use; again, not an issue of importance to the cupcakes themselves.
Thursday, April 22, 2010
Why, yes...
This may be just a whisp of a post, though, more of a cambric post really. About something whose relevance I can't vouch for, because it's just sort of a disgusting curled up notional caterpillar until I type it out.
I went to get my haircut, because it was right at the midpoint between "that looks ok" and "he probably is a hipster and intends it to be seen as a vague sort of commentary." In college I got the cheapest haircuts possible, then for a decade I clippered my own damn head, and then there's been some time of sartorial reckoning. I decided I was going to get an expensive haircut, because my boyfriend had gotten one at this place on the Lower East Side, and skeptic though I am about many things high-end, it was undeniably a good haircut. Once in my life, I thought, I will give this a shot. If it's great, I'm in a bind. If it's just like my last haircut, I've blown $25 extra bucks and am the wiser.
This place, it's hard to figure exactly. The Lower East Side is part Chinatown, part Williamsburg, some weird little remnant of Jewish New York with the little shops where you can buy a tiny Torah for I guess confirmation classes...I dunno what else; it's not really my part of town. So I don't know exactly who goes to this place. I imagined maybe a preponderance of gay hipsters.
The guys cutting the hair, though, unless my 'dar is broken or these guys are super ultra mega stealth models*, are incredibly straight. Like I am hardly a Van Dyke style homo separatist--Some Of My Best Friends Are Straight as the saying goes--but it was like I was listening in on a secret society. I'd like to try to recreate some of the conversation, because it was like I was hearing West Frisian: familiar-sounding, but not quite comprehensible. "Whoever Puffy puts on, it's Puffy that eats. You remember Puffy put Total on--where is he now?" That was one paragraph I couldn't do much with.
So of course my coiffeur asks how I heard of the place and this is the miniscule point to this posting. "My boyfriend got his hair cut here," says I. Coiffeur basically doesn't respond. It's New York and I doubt he was either shocked or offended, but I had that twinge of nervousness, bred in the middle of the country where I grew up, for just a second that I'd gotten on the wrong side of the law somehow.
Compulsory assumption of heterosexuality is not the biggest problem in the world. It's a historical thing. It'll be gone in fifty years. Often when it pops up now, it's quickly amended. This guy, for all I know, wasn't even doing it. It's something that's been maintained by both sides until one side stopped and certain members of the other side got it.
This is so unimportant but it reminds me of important things. I started coming out in about 1989, in Kentucky. It was a nerve-wracking process that never went seriously wrong. The best coming out scene I've seen in pop culture lately was on Glee, where the kid obviously has a moment of courage, takes a blind leap, and it goes surprisingly well, with reservations. I cried. Anyway.
Coming out stories--I remember when they were the first thing one went over on a date or coffee-interview-for-date. It was tedious. But it had to happen, because coming out is the essential political act. I have complained a lot, a lot to my friends lately about the thing that happened in the last year while gay marriage to my eternal astonishment started to happen in the U.S.: going to protests, standing in a cordoned area, chanting heinously banal things to nobody but ourselves. Two, Four, Six, Eight, We'd be really grateful if you'd maybe in the next eighty years not discrimn...ate. So much. If that's ok.
It really does sound that feeble to me now. I started getting furious and said to the lesbian standing beside me "why are we not throwing things through other things?" She smiled at me as you smile at a rabid dog. And I was no more right than she was. Stonewall was a moment, not necessarily a model for what should happen now. The fantasy of violent protest is a satisfying one, but, like the fantasies of an obsessive, healthy to acknowledge rather than to act on, or so that you can keep from acting on it.
The real political act is, yeah, coming out. I have always thought so, and so I am out in as many contexts as I can be, sometimes even when it's awkward or not 100% appropriate to the situation. It's the only thing that works. So this old habit reared its head in a city where the chant we might hear back is "You're here, you're queer, we're used to you already." And in a context where the worst possible consequence might have been an unwanted flat-top. There was no reason to lie, so I didn't.
*my gaydar: it is really good
Today there were donuts
First of all there's obvious financial stuff. Wait, hang on though. This is not going to be a complaint blog. I am determined that it is not. I mean 98% of blogs are, to some extent, whineblogs, but I don't want this to be overwhelmingly that. So let me take a few steps back and mention that my workplace, donuts aside, is a humane one. I don't dread coming to work in the morning, and on the days that I do dread coming to work in the morning, I stay home, because I have a good amount of time off and a boss who doesn't view his role (as many bosses do) as that of punishing superego*, and if I tell him I need a mental health day, he asks no questions.
Right then, back to the kvetching. First of all social work is something the increasingly right-center political center of gravity in these here United States appears to want to will out of existence. Srsly, if you think about it, you can judge the worth of things in the public estimation by how they're positioned in the free market, otherwise known as The Measure of All Things. So then look at the incentives:
1) To practice on a professional level, you're going to have to go to a two year program and lay out maybe $20-50K because these programs give very little grant aid.
2) Loan repayment for social work seems to be complicated, hard to find out about, incomplete. In New York State there's a program that pays a lot but it's (of course it is) a lottery. I've entered three years in a row. My understanding of the federal system is I might have 3 years paid off at the end of my TWENTY YEAR REPAYMENT PLAN. I'm sure I'll really enjoy that financial freedom. IN MY FIFTIES.
3) The goddamn salaries. I don't mean to get technical but: oh my fucking god.
4) I imagine if I were an economist I'd have a more precise way of talking about time off as a form of pay, but suffice it to say, this is not a selling point of social work. I compare social work and teaching a lot because a lot of people I know are in both, and teachers work a lot harder than I do but they also get a lot of time off. **
5) You are going to work in a setting where there are rarely donuts because who has money for donuts?! Maybe once in a while you'll get what we used to just call Drug Lunch when some fresh-faced 24-year-old who makes three times what you do brings some lasagna and a wilted salad from the place on the corner so everyone will gather in the conference room, eat a few bites, smile while young Vermont or whatever state they're naming kids these days gives his elevator spiel about the new study that says Paxil treats anxiety about the decline in quality of Wes Anderson's scripts.
Oh, and so on. Anyway the point is why would anyone go into this? Good intentions, sure, but that's not what I would like to be the lone strength of your average social worker. I think we're kind of all doomed if the people who are supposed to fix a lot of these messes are people who have good intentions and not much else in the toolbox. Smart people, for better or worse, eventually want things, and if someone is smart and schmaltzy about saving the world, it's often a matter of time until that balance gets resolved. Good intentions burn out faster than wants/needs, right?
*Let me tell you sometime about my last boss, who we will call Bad Breast. (Hat tip: Melanie Klein, for the most amusing imagery in the history of man's inquiries into the mind.)
**Even compared to me at my cushy job with lots of time off. Honestly, I've set a timeline for myself where two years is about the longest I'm going to stay here, but I live in dread of some job where you get two weeks off a year.
Tuesday, April 20, 2010
Part II: Possible TL;DR
I feel like kind of a Rikers Island maven of sorts. I know which facilities you will always wait at least 45 minutes at (RNDC, the former ARDC. It's the adolescent facility and I don't know why it always sucks to go there, but it does. There was a lawsuit and now they are legally required to produce people for counsel visits in I think half an hour, but they always give you some kind of reason for the delay whereof you have no way of testing the veracity. I hate that place.) and which one is usually a painless transaction (GMDC. I was there today, in and out.) I have a reasonably tuned instinct for how to get them to let you walk to RNDC, if you have to go there, instead of taking the bus. Yeah all of this is really pretty superficial but it gives me a shallow sort of expertise to feel fancy about. I ask the bus drivers if they're going to "Rosie" if I need to go to Rose M. Singer, the women's facility, because that's what people who work there call it. Are you impressed yet? Oh well.
Anyway today I interviewed two people in a row, which is...well ideally you'd want a few minutes to take some deep breaths and visualize a basket full of kittens or whatever gets you through. But it also meant getting back off the Island faster, so I can't really complain. Why I bring any of this up is to talk about the difference between why this work is sometimes really taxing and why people think it is.
The comment I said I always get? The one that gives this blog its title? It usually continues like this: "Oh, wow. That must be hard. Doesn't it get you down hearing people's stories all day, all that terrible stuff about abuse and whatnot?*" And depending on my mood, I either say "oh it's not that bad" and wait for the topic of conversation to change, or I get into it, if the person seems interested.
Client #1 was archetypal in his way. Childhood in a tough neighborhood (which is a category worth questioning but suffice it to say if they say it sucked without my prompting, the label probably has little to do with my bourgeois alienation from working class life), constant physical abuse and then, no great shock, he became a drug addict. If you know how the drug war works, you know that he's screwed but good. The law, being an ass, supposes that addiction and its consequences respond to treatment more quickly and permanently than they do, so he's likely to end up in and out of jail. But this guy, even if he got out, it was hard to know what he was going to do to pull it together. No GED, a few jobs for a few months, emotional problems, probably not the world's best support network.
Client #2 was 50, looked 35, articulate, affable, had a drug problem that didn't seem to really tear his life apart (some addicts are higher functioning than others) except when he got caught, has some serious drama with his kid's mother** but otherwise has some shot at holding it together. Except that he's probably going to use again and he's probably going to get caught again and after a while they stop giving you breaks, if they give them to you at all. So really both of these guys stand a good chance of things not working out, in a big way.
Experientially, the cases were the same in a way. I wasn't more beaten down after one or the other. They shared a characteristic that I am always grateful for, which is that both guys, when you asked them a question, gave you a detailed answer.
A thing that happens a lot that is draining and hard to work with is that plenty of clients (adolescents worst of all) answer a question like "what was it like growing up there?" with an almost monosyllabic slur of "it was aight." This happens for plenty of good reasons, I'm sure. Guessing at a few 1) not everyone has thought a lot about what their neighborhood is like in contrast to, oh, anywhere else. 2) it is not that fun being interviewed by a social worker and being asked questions one has heard before. 3) it is kind of a stupid question. Sometimes I get a look that seems to say "the South Bronx? It was like a champagne picnic on the beach every day, you asshole."
You can get past this sometimes. You can say "I know, dumb question, but I need to be able to talk about what's going on with you to people who may not automatically get it, and some of that is about where you're from" or words to that effect. Or you can ask it another way. Or you can come back to it. Frankly, what I end up doing most of the time, if it's an adolescent, is talking to the parents, who will immediately come out with "a crack addict lives outside our front door" and other stuff I can use. Anyway, I was glad not to have to do any of it.
The point, insofar as there was one, is that the traumatic context of people's stories, well...either that stuff kills you or it doesn't, and if hearing about someone getting beaten is likely to make you cry and ruin your day, you're likely not in this field. There's a kind of compartmentalization I'm not sure can be learned, though it is conventional wisdom that being in your own therapy if you're constantly subject to "secondary trauma" is not a bad idea. Me, I'm not tough about many things in life, so I claim it as my kind of rarefied toughness that I care about the things I hear but they don't sink their teeth into me.
What does leave tiremarks all over me is the systemic stuff. That is what's hard. You take a guy who has been rendered incapable of ordinary kinds of coping by his past and is likely to do time because society doesn't know what the fuck to do with him, and then take a guy who does this insane trick of navigating some serious socioeconomic hurdles, cobbling together an ok life, and sometimes has things derailed by a drug problem that ranges from manageable to not that manageable. Take these two guys and think about the fact that they're both somewhat likely to get fed to the drug war and the prison industry. This is the shit that wears a fellow down.
Enough for now. Currently nobody is reading this, in any case. Except B. Howdy B.
**I am somewhat hesitant about the term "baby mama" simply because it's not native to my dialect and I really hate hearing it used in a mocking way. It addresses the lack of a basic kinship term in what I suppose is class-determined Syntax, so really there's nothing funny about it but when people who wouldn't ordinarily say it say it, they're usually throwing some shade.
That Must Be Hard
So anyway it was gone as far as the earth and its inhabitants are concerned, and I thought: maybe this is not the right place to write about work anyway. Maybe I should see if there is a place out there in the big, wide blogosphere for talking about social work. Yes, it'll be slightly tricky because it's basically an act of exhibitionism constrained by an ethical concern for anonymity I do put stock in. And no, it isn't a sure bet, because in my experience, there's not a huge overlap between the kind of people who go into social work and the kind of people who blog and read blogs.
But...it's what I'm gonna do. And if nobody reads it, may it be enjoyed or tolerated, as it merits, on that same star where they will have been so keen on Orson Welles and, 72 years hence, will have been wondering what else humanity is up to.
Oh, but the title. "That must be hard." Part of me wants to assume this needs no explanation to any social worker who may end up reading this. In moments of frustration with my career choices**, I've told people I want to be in a profession where, when someone at a party asks what you do, their response upon learning the answer is to slip you a key and say "I'm in Room 917" instead of "oh, wow. That must be hard."
So tomorrow, or maybe just later after I publish this introductory post and maybe do a promotional tour with my agent since I'm all published and shit, I am going to try to reconstruct the lost account of my day at Rikers Island and the way it illustrates something I consider vaguely interesting about this line of work, namely: what people think is hard about social work vs. what is actually hard about it. My friends have already heard this one, so I thought I'd bore the internet.
*Publish! "Publish." Get a load of us. The internet has made us all published authors. This is among the top 1200 rotten things it has done.
**"career path" I started to type, and then it seemed a touch romantic. Path, indeed. All paved with stars.