Hate and the Public Defender

...was possibly going to be the title of my paper, once-before-referenced. It is on my mind today because I'm feeling fed up with certain clients, which is a problem.

It was about Winnicott, see. He wrote this essay which perhaps you have read or perhaps you have not, called "Hate and the Countertransference" or very possibly "Hate IN the Countertransference." I make that mistake about "Sex & the City" sometimes, too. My memory: it is not specific even about things I like and revisit often. One could google. One is not in the mood.

HATC (I am now amusing myself by thinking of it as akin to SATC. There should be a movie version with Kim Catrall. I can see her making some not-very-well-written double-entendre on "good enough mother" in the preview, and sort of putting it over anyway because in point of fact, her delivery is often very funny) is, in a nutshell, about how we ignore/suppress the feelings of rage our psychotic clients produce in us at our own peril. It's one of these things that seems pretty intuitive but it's well said and, in fact, lots of us do need to be told or reminded, whether that's because we've never thought about it or we have a first-year-of-MSW save-the-world thing we never got over.

I should reread it before talking about it in any even slightly public way. I loved it when I read it...Winnicott is big where I did my MSW, and was presented to us by a professor with a kind of infectious enthusiasm, but also it's so different in tone from a lot of analytic writing. Whimsical, almost, at times. And I think of that essay and a couple of other ones we read when I have to think clinically, which in this job isn't that often. I did a seminar for the interns, actually, essentially about clinical thinking for non-clinical workers, and talked about Winnicott. But I'm afraid I pass it on as a street evangelist, more zealous than well-versed.

The thing about it is that it isn't just good advice for dealing with psychotic* clients. I'm trying unsuccessfully to remember specifically why he focuses on psychotic clients, whether it's a matter of scale, or more a yes/no thing, where it's only psychotics due to some kind of, eh, I want to throw around words like projective and pre-Oedipal but anyway something about them that triggers intense, unhelpful transferential reactions in people charged with their care.

I had a client whose story, poorly as it reflects on me, I always end up telling. Mirandolina wanted an electric wheelchair. Needed it like the axe needs the turkey, if you'll forgive a gratuitous Barbara Stanwyck reference. Her doctor, who I worked with, told her she absolutely did not need one; indeed, did not need a wheelchair at all. I got to try and wrestle one out of Medicaid, which was like the setup for a Yakov Smirnoff routine**. To make it all more delightful, Mirandolina was either mildly personality disordered, or just kind of an asshole, depending on how you care to look at it.

One day when it was clear the wheelchair wasn't going to materilize as quickly as if one had ordered it from Zappo's, Mirandolina glared at me and asked me what were my damn qualifications anyway. I just answered her question as if she had asked out of curiosity, failed to engage/escalate, and it was ok. But as I was wheeling her out to her bus...

Well, I should pause to say that I understand obsessives really well, though I don't consider myself one of them. I think if I feared that I had to act on my thoughts, I'd never leave the house, because terrible impulses and images enter my consciousness quite a lot, as if my id had been installed a little too close to the light of day. I wonder sometimes how unusual this is.

But as I was wheeling Mirandolina to her bus, I imagined pushing her into the street. And then felt weird enough about it, the above paragraph notwithstanding, that I told my supervisor, who said basically you have to dig in and enjoy these fantasies because otherwise, in small, passive ways, you'll act out. A very wise piece of advice, this. We laughed about it and I promised that even though I spent two years and a ton of money becoming one of the good guys--social workers: we're like incredibly half-assed, incompetent superheros! who can't fly and stuff!!--I would let my mind murder my client.

This is all with me today because I think I must not be doing the thing I speak of lately. The reactions I have to my clients is off, at times, in a way that concerns me. When someone calls you and makes some hardly-even-trying excuse about not having called back a program for her daughter (such that her daughter may be a young, new-minted felon soon. Felonne? There should be a feminine form, preferably dainty just to make everything worse) you need to be able to contextualize. You need to get that she's fucking up for a reason.

If you don't, you do what I'm doing lately, which is wanting to sass back at people. The iconic statement I am always aware I could end up using at someone if I were really having the worst day is "Well here's an idea: why don't you stop breaking into cars?" It's a joke--I'd never say it, but it's the abstraction of possible fuckups.

The mother mentioned above did at one point react to my palpable irritability by saying "you don't care about us" at which point I had to do some silent, inner version of a few deep breaths. She had taken my tone or something I said as skepticism about her parenting or her concern for her daughter. It seems almost certain that this was a combination of her projected doubts and my improperly managed frustration. One person or the other is so rarely fully to blame.

What to do? Maybe it's about self-care and sleeping more. Maybe I should be back in supervision so I could have a partner in introspection and keep everything in perspective. Frankly, blogging helps a little, but I can't talk in much detail. And, not to beat this drum again, it's possible I need to do something else for a while.

*God forfend I should start talking about what psychotic means, though it's not the worst idea in this conversation. We'd be here well into the night. And by "we" I mean me because you'd be like "it's been grand but I'm going to go read something coherent now."

**I dunno what the punchline was. Me I guess.