More Postcards from the Drug War

When I took this job we had an orientation or maybe it was just an early training I went to where we discussed our worst fears about our work and our clients. In retrospect, this was both a profoundly considerate impulse on the part of management and maybe something that should have been done in a different context.

What I mean about context is this, I guess: I have said to interns over and over "you're not a therapist to your clients. You'll meet them a few times. You have to find a good balance between giving them space to really open up so you can make a good case on their behalf and not opening up a can of worms you're not going to be there to [oh god, all I mean is "deal with" but I've started an analogy here and I'm not sure what it is one does with worms, least of all canned ones.]"

As usual, not the point. We did indeed discuss our fears about our clients, and I think most people said suicide, which is a reasonable thing to top your list with. Perhaps trying to be different in resistance to go-around-the-room exercises, I skipped right over suicide and said "I don't want my clients to be sent to a facility where they're just kind of there so someone can say they're being treated, but nothing worthwhile is really happening." Or words to that effect.

My uber-supervisor is someone I have a somewhat vexed relationship with, but she clearly and immediately understood my Worst Fear and gave me a nice piece of shorthand for it. "You don't want to feel your client has been warehoused," said she, perfectly. I've thought of the term a hundred times since then, succinct and also evocative of just the right despair.

My generation does a lot of job-hopping. I don't know, we get bored easily? On alternate days when my near-ideal work environment no longer makes up for the deadening tedium of having done the same thing for almost four years, I wonder about working in residential substance abuse.

This will never happen, mind you. A dear friend from grad school visited me two weeks ago and, sitting in a kitschy ice cream parlour on the Upper East Side, we talked about the fact that social work kills the impulse toward the broadening of horizons--neither of us, we agreed, would be capable of the financial hit we'd have to take to be more of a generalist in the field. I think I'd lose 20% of my salary if I took an entry-level clinical job now. Never, ever gonna happen.

But it's a shame. My old officemate spent years working in substance abuse treatment and loved a lot about it, I think specifically the fact that progress is observable, a detail that taunts those who have worked in ordinary counseling where change takes forever and may or may not be a result of the treatment itself.

Beyond that, I refer people to drug treatment constantly. It's a strange, blind process since I've never seen the inside of a drug program. I've gone on program visits, but that's about it. I make my judgments on where to refer people based on 1) who has been responsive and easy to deal with in the past, 2) conventional wisdom around the office, and 3) my conviction that it probably doesn't matter. 3 is obviously something of a problem.

Eh, I don't know. I have someone coming in later today who completed his program and then fucked up in some small way and is in hot water. I wonder what they're going to do to him. Send him upstate? Tell him to do another program? It's perplexing to watch, but prosecutors really do seem to have this idea either that treatment is a kind of punishment, incarceration-lite (which maybe it is) or that--as in newspaper scandals, if anything goes wrong, you go into rehab and that fixes your addiction/habit of sleeping with young girls/habit of sleeping with a gender your constituency would prefer you didn't sleep with/problem Not Otherwise Specified.