Mixed Feelings, Inc.

Doubts

2011-01-10T14:56:00.000-08:00

You know what I hate more than anything else in working life? Reading a 2000-page stack of ACS records is what I hate more than anything else in working life. And they always seem to come in 2000-page stacks.

Nothing good can come of any endeavour that generates this kind of paper trail.

That day will come.

2011-01-06T13:19:00.000-08:00

I imagine this to be the perfect lyric expression of my client's experience.

To this we've come,
That men withhold the world from men
No ship, no shore for him who drowns at sea,
No home nor grave for him who dies on land.
To this we've come,
That man be born a stranger upon god's Earth
That he be chosen without a chance for choice;
That he be hunted without the hope of refuge.
To this we've come. To this we've come.
And you, you too shall weep
If to men not to god we now must pray
Tell me secretary tell me, who are these men?
If to them not to god we now must pray
Tell me, secretary, tell me:
Who are these dark archangels?
Will they be conquered?
Will they be doomed?
Is there one, anyone behind those doors
To whom the heart can still be explained
Is there one anyone who still may care?
...
Oh, the day will come I know
When our heart's a flame
Will burn your paper chains
Warn the consul, secretary, warn him
That day neither ink nor seal
Shall cage our souls
That day will come.
That day will come.

[Patricia Neway performs Magda Sorel's aria "To This We've Come" from the Giancarlo Menotti's The Consul. It is a melodramatic reading but I can't find much fault in it. It ends around 7:50 but the poster has included more of the piece.]

Today I met with two of those clients who remind me that my purpose is little more than to answer the question: can this person find a place in society? It's about capitalism as much as it's about anything. The fellow this morning is caught between his inutility the cost of containing him. He's cognitively barely there and reads as likely having no impulse control, not things you can do a lot about at age twenty. He's fucked. His day will not come.

The one this afternoon is pretty likely to die in prison if the ADA is having a bad day. It never really comes down to risk of recidivism--I'd be a fool to make many pronouncements on people's future--but this guy looks too frail to do much now. He's here because, I don't even remember fully, some kind of squabble with someone else the ADA and the aggregate vulnerable public would doubtless recoil from. The fear is not what they'll do to each other, but whether their bullets will go astray. We punish them mostly to exorcise the fear, because unless you're going to throw almost everybody in jail, it's going to happen anyway. And I think you kind of have to leave 51% of us unincarcerated or things get tricky.

This squeak of anguish brought to you by my day. Perhaps I'll try and blog a little more here again.

This space not quite abandoned

2010-09-20T10:02:00.001-07:00

There's work stuff that is asking to be blug, and the nonSW blog seems like the wrong place so if this mic is still on...

I'm always a little curious if other social workers get, oh what is it called, Impostor Syndrome? I was talking about this phenom with someone who recently began law school at a Very Prestigious University and apparently people get there and feel all This Is A Giant Mistake and probably have dreams where they show up to class without their head or whatever. It's dumb to think of this happening in social work because, for reasons that are another post, it's a complicated field populated by a fairly high percentage of people who aren't what you'd call brilliant (is this a terrible thing to say?) so why would you feel like an impostor?

Hang on while I redeem myself for a sec. I'm not saying I'm brilliant. I'm probably, in some way I should possibly be frowned at for, saying at times I feel more intellectual than a lot of people who do this work. And maybe that's fine, because what's more useless than an intellectual? It's possible everyone I'm talking about would, if told this, shrug and say: your point?

Anyway it's probably a good corrective when I have a day where I am confronted with the great usefulness meter that constituted by unexpected situations and one's readiness to deal with them, and the needle on the usefulness meter swings from sewing machine to houseplant as I step on the scale.

I think of myself as being on the front line sometimes, because I deal directly with clients and their families and the verkakte systems they have to deal with. But. I have carved out a niche for myself wherein I see a small swath of the systems part, and when I'm outside that niche, I can sometimes be rather helpless.

We have a calendar of who handles "ER" cases here when our supervisor isn't around, i.e. cases where the attorney needs a social worker right away rather than long-term. Today was my lucky day, and they called me over to the courthouse for an ER. I go into the court part and talk to the attorney for a second who says the thing I least like to hear, which is some form of "just talk to him for a minute and see what's going on with him." Answer in head: ok, I talked to him. He thinks the writing on Friday Night Lights has gotten a little slack but that Connie Britton's ability to inhabit her character and her improved accent as well as the ever elusive possibility that Matt and Landry might one day do it have become reason enough to lament its cancelation. Would you like to try again, and be a little more specific?

I got her to clarify that the guy seems to want to be hospitalized and that they might not set bail if we can make that happen. I talked to him in back hall after being sort of insistent with a court officer. "I'd like to be able to talk to him without whispering, ok?" He presented like your average falling-apart, probably mentally ill person. Not quite able to engage, in what feels like non-performed distress, and what I was once encouraged to include in progress notes under the relatively polite terminology "malodorous."

What next? Well, I had to call a colleague. Because the last time I was the person who had to have someone hospitalized was five years ago, and I simply didn't know how to go about it. The answer was: if they'll let him go, bring him back to the office, call 911 like you would any old time you want to hospitalize anyone, and wait. But I was all "does it need to be at a particular hospital? Do I escort the guy to an ER?" etc etc the answer to all of which, from the universe if not my colleague, was "no, and get a grip."

This is a basic thing. People are hospitalized all the time. Maybe there's some resistance in this, in that I think of hospitalization as running the risk of "warehousing" and also of putting a bandaid on the more systemic factors that mean people have to go to hospitals when they're not fitting nicely into the economy. But shut up, me. Doesn't matter. Being a social worker and not knowing some of these basic ins and outs is really not good. It's one of several things that should be reminding me that it's time to figure out whether I'm in or out, profession-wise.

So, that happened.

Oh hey so

2010-09-04T08:23:00.000-07:00

Out of the depths of the interwaffle I have conjured or I suppose I should say begun conjuring a group blog on no particular topic. I haven't exactly given up on social work blogging but I think I am for the moment likelier to blog over there than here. I may actually blog about similar topics, but without the restriction of only writing about work-related things. Check it out if you're looking for new reading material. My friends, they are really smart and know many things. Let me show you them, or however that meme goes.

The Mustard Bath

2010-08-31T12:51:00.000-07:00

I haven't posted anything in two weeks and I'm having my doubts about whether I'm going to keep doing this. It seemed like a great idea when I started it and for a while thereafter, but right now I can't imagine what I ought to write about.

Some of this, too, is spillover doubt about my place in this field, I'd imagine. There are days when I think I'm not accomplishing a damn thing, and on those days, I look around at other jobs a little, and they all sound unappealing.

Do you have days where you'd rather do something else completely? It's tough because I'm still on board with the idea that jobs that chip away at the upfuckedness of the world, even impercetibly, are better than jobs that contribute to it or do nothing. But then I also daydream of work that pays me enough to wipe out my debt.

Maybe inspiration will strike. We'll see.

More about breasts than you were maybe expecting

2010-08-16T14:08:00.000-07:00

I talked to a worker at another agency about a client of mine. Often revealing. She said of the client's mother, calling her "Mom" the whole time which I find is a thing you either do or find extremely grating, "she's doing a lot of splitting," which is, o god, o Montreal, so true.

It's one thing to be on the business end of splitting when you're a therapist...well ok and since not every one of the vast hordes who read me is all "and then you won't believe what Melanie Klein said to little Richard*," I will pause to mention that by splitting I mean the habit of people who are for whatever reason of stress or personality disorder regressed beyond the ability to tolerate much ambiguity to cast the people they're interacting with as either all good or all bad, on my side or against me. If it's not something you've thought about it, I am betting you will next time you're around it.

Because who among us goes through the day without dealing with Axis II disorders? Who indeed?

Right so anyway when it happens to you as a therapist, it's fine or even good because 1) you're sort of in the right stance not to be knocked over by such things and 2) it's useful, at least if you put any stock in these things. (Say, did anyone read the thingy in Harper's about psychoanalysis? Me neither! I mean I didn't finish it. I've been talking to my shrink about my failure to follow through on things, though, so I'll get back to you.)

When you are subject to splitting as a non-therapist, it's just disconcerting. If you're the good guy*, you can feel a little skeeved by the twenty-foot wave of positive transference, unless you're any of us in their second year placement and you get to briefly enjoy the sensation of "oh wow, I don't know what I did, but I'm the best therapist EVAR" until the other shoe drops. And when the other shoe drops (and, again, in the current paragraph, you are not a therapist. Keep up!) it just feels like the client is being an asshole you are not paid enough to put up with.

Client's Mom was sort of a good person to deal with on our first meeting, from my explicitly limited perspective where good=gives good copy for a two-hanky Pre Plea report. Two thumbs way up for eloquent mitigation! Better than Cats! And I was the good breast and she was forthcoming, focused, and appreciate of my help. Who can ask for more?

What always happens here is that you turn into the bad breast because public defenders are hard to reach--lots of cases, in court most of the day--and as this crazy but interesting prof I had once said "sometimes the breast has to answer the door." And in this increasingly strained metaphor, which is a danger of psychoanalytic thinking actually, the breast is actually the entire organization so when the lawyer is bad, I am bad.

What can one do but make a valiant attempt to understand why it's happening? And have a milkshake, maybe, because self-care is important? Ekh, sorry to bring up milk, probably not the best idea after all that. I mean right, what one can do is try to make sure that Client's Mom*** is in therapy herself, and hope that the therapist is good, and hope that therapy really can do something about the gestalt that conditions overmuch splitting such that Client's Mom does not come off as a raging asshole to too many people, and keep it in perspective that there are bigger problems than the possibility that none of this will happen.

I once watched a woman I worked with at a library win what could have been a yelling match with an angry patron (q: who could be angry at a library? a: lots of people!) by just nodding and agreeing and "Oh gosh I that does sound frustrating"ing until the person calmed down enough just to be a category 1 pain in the ass. It is good to keep in mind that the social worker's task is, in some situations, not to fix anything just because it's presenting, but rather to do whatever works to keep everyone more or less friendly while the bigger picture stuff gets worked out.

[For anyone who is all "why are you blogging about social work but not saying anything about the actual goddamn cases?" I would say, 1) watch your language, but also 2) I keep wondering the same thing. I think maybe it's because I'm obviously not going to share actual details because, duh, gigantor ethical fuckup, but I've noticed that when I anonymize things, they sound fakey. So, we'll see what happens with that...]

*note capitalization. Not Little Richard. Though Mahler had a session with Freud once, so I guess there's no reason Little Richard shouldn't have talked to Melanie Klein except that he almost certainly did not.
**or to be Kleinian in the way my shallow knowledge of MK allows, the good breast. I reserve for another time tales of my imaginary FreudCore band Bad Breast.
***to the tune of "Stacy's Mom"

Sometimes we win

2010-08-04T13:57:00.000-07:00

Friends is an easy show to mock and lament, but one joke I always liked was when Ross was going to China and Phoebe said to him "You're going to have some great Chinese food! Only there they just call it 'food.'" I think it's time to drop the phrase "gay marriage" from our lexicon and just talk about marriage. Ours is the same as yours, fuckers. Anyway, whatever. We have it again in the large, populous state of California until we don't again. I always have to spend 15 minutes with the office door closed when these things happen because no matter the ups and downs of my life as a gay man in the late 20th and early 21st century and the ambivalences that have resulted, it makes me cry when we win.

(It is also always in these moments that I wish I believed in heaven so it could have a special room made of cake or something for the straight people who want us to win. Without them, we'd be toast. Sorry about all the metaphorical carbs. On a diet.)

Blog. Roll.

2010-07-30T08:48:00.000-07:00

Added some folks to the blogroll. Maybe I'll put some more non SW stuff on there.

The weird thing is that I was clicking around, following links, and there was one with links like the Cato Institute. Um, libertarian social worker? There isn't even a joke there...

Actual thing happening in the world

2010-07-27T07:00:00.000-07:00

So, there's some kind of news on the New York LCSW front, but it's a bit hard to decode.

The history, through the veil of my own muddle: in the last ten years New York created a tiered licensure system like most states now have instead of everyone just being CSW. Ostensibly this would benefit um...clients? Maybe insurance companies?

In fact this would benefit people lucky enough to get grandfathered in as LCSW or those with the foresight to get it quickly, because suddenly a huge class of people were shut out from getting the credential that would enable them to bill insurance companies for private practice, but also to apply for a good number of upper level jobs.

The other beneficiary, it should absolutely be noted, is the licensing board in Albany and ASWB, both of whom could make a lot of new money off the licensing process. Win/win, although more accurately win/win/lose. If you graduated around 2004, you were in the lose, because unless you immediately got a job in what would turn out, several years later, to be one of the approved settings, you were out of luck. Pretty much permanently, because a lot of those approved jobs are clinic work that pays so little nobody in his/her right mind would go back to it after 4-5 years clawing a path up the shallow incline of the social work payscale.

A lot of people got screwed but good. There was an active listserv about it, which was hard to make a lot of sense of but satisfying for bitching, and in any case seems to have disappeared. A lot happened behind the scenes, apparently, though it's been hard to follow because it isn't exactly big news, well-covered. Some debt of gratitude is apparently owed to the NASW for advocating for the broadening of what is an acceptable setting, and this is the news that broke recently.

Me, I spent thousands of dollars and a lot of my time on private supervision. It was a gamble. My work isn't therapy, but for a while the rules were vague and everyone knew it and what you did was hire a private supervisor who saw what you did as clinically substantial enough that you should enter the elect class of those able to increase their earning potential and maybe someday pay off their debt. Everyone knew this. But, of course it could go wrong if someone decided that things were going to be more by-the-book, and it did.

The question here is what it means to create these divides and whether anyone actually benefits from them. It'll never be reformed, because things don't tend to go backward that way, especially when someone is profiting from it not doing so. But in a profession that already has a kind of beggars-can't-be-choosers thing going on in terms of who signs up, it is a wilfull act of worsening to tell a number of the smart ones who sign up anyway to go fuck themselves.

I have the letter somewhere in which I am told to go fuck myself. I wrote back and forth a number of times and was none too pleasant myself. But if I can find the letter, I'm posting the guy's name here and anywhere else I can think of as a tiny protest and a tiny publicization of one of the people who made this field weaker. I'm sure I'm not the only person who has thought of leaving rather than saying in my meek little social worker voice "oh well! Fucked again!"

Ah, here's some actual information. Which I will now read. Except, eh, part of me has given up on it.

Define "irony."

2010-07-26T10:21:00.000-07:00

"(does Smearcase enjoy social work?… being a social worker?… hard to tell, at times)"

This from a gracious link coupled with a gentle critique yonder at Asocial Work.

I'm afraid this is going to prompt more me-blogging for the moment, but I can't resist the question, once asked.

It seems to me I may have had some idiosyncratic reasons for going into Social Work. I mean, it wasn't wholly divorced from the vague "tikkun olam"* impulse that drives a bunch of other people in, which by itself is a roller-coaster to burnout, but without which, why would you bother?

Well wait. Why do people go into social work? If I were to generalize from people I knew in grad school, I'd say "because they have an undergraduate degree in psychology and are 21 and aren't brimming with good ideas." If I were to turn an equally awful eye on the people I've met since graduating, I might say "because they really like kids and think that's enough."

Whatever my other mistakes, I was creeping up on 30 when I applied to my MSW program and, though I was on my way out of a PhD program I was hopeless at, and needed something new PDQ, I had put a reasonable amount of thought into the whole question. I had sort of jumped the fence because of the 2000 election from "vaguely lefty because Mom & Dad are democrats" to "passionately though still often ill-informedly lefty" and I think this had something to do with it as well.

Mostly, though, I had had some jobs and met some other people with other jobs and decided that the main thing I wanted was a job that didn't make the world any worse, but also didn't make me want to run screaming into the sea. (I was in Chicago at the time. Long run.) And here is where I made the world's most laughably naive mistake, which I will confess for your Schadenfreudian delectation.

Boiling this down to the form in which it makes me look most idiotic (as the card in Slacker says: take the most embarrassing detail and amplify it) I became a social worker because I didn't want to do paperwork.

How this bit of epistemological slapstick occured is that I dreamed of jobs where the substantial part of your work was also the valued part, where you didn't have to corporately market the spending of your minutes, and the job that most matched up in my head with this was psychotherapist. This had to do with going to therapists and not knowing what bullshit they had to do later to get paid by the insurance company, and by watching for instance The Sopranos where they never show Dr. Melfi screaming "THERE WAS NO OBSERVABLE BEHAVIORAL GOAL THIS SESSION IT IS FUCKING THERAPY NOT PUTTING TOGETHER A FUCKING IKEA TABLE" as she writes a progress note full of colorful Italian-American expressions and unrecognizable Sicilian pronunciations of lunch meats.

But for real. I thought: therapy is a job where you don't have to meet some standardized metric. You listen, you talk, you proffer Kleenex, and the session ends. Self-contained, non-commodified, perhaps non-commodifiable helpfulness. At worst, not that helpful. At best, fairly helpful!

And then the last eight years happened and I realized that if you get really lucky, you get a job where you do a little good instead of being a full-time bureaucrat with a quaint little hobby of talking to people when not tending to the papers. Granted, this is the low end, the "trenches" as we sometimes say. Higher up it may be different but I haven't smelled the air up there.

I mean therapy and casework can be really helpful, but you have to fight for it to be, and I have never relished fighting for what should be given. So I have not enjoyed a lot of it. I feel good about what I do, which I'm sometimes nervous just means I enjoy having some built in moral superiority, but it has been only intermittently satisfying.

Do I enjoy it? Eh, define "enjoy." As work goes, it seems relatively non-soul-crushing. I enjoy my coworkers. I enjoy the good cases I get here during the interview and some of the writing process when I'm in good voice so to speak, but not the collateral interviews with overly concrete parents, not the phone tag with programs, not the primitive ritual you participate in to get records. I enjoy getting my perfectly ok paycheck. I enjoy it as much as one can expect to enjoy a job, I think? I'm not sure it means much whether I enjoy it. I get more or less what I expect out of it.

There is once in a while the tingling sensation in the top of the head to be had from the feeling of having done something well. "I really helped him with behavioral interventions for anxiety" sez Me The Imaginary Therapist or "I really got what his story is about in a way the D.A. would have to be an Ayn-Rand-reading reptile not to be moved by" sez Actual Me. It's infrequent. When I find something likely to produce it more often, maybe I'll jump on it.

So that's the direct statement of my unsurprisingly discursive answer. Whether that makes the navelly directed gazing of the other entries more digestible, I do not know.

*Hebrew for "to heal the world." Why I feel compelled to include it in this form is anyone's guess. My lovely gentleman companion recently noted that Jews blame our worst characteristics on Judaism which--just between you, me, and my overly assertive Ashkenazic eyebrows--may be true. The thing is, we also ascribe all our best to it.

Things I have done lately

2010-07-21T10:44:00.000-07:00

1) Explained the blogosphere to my therapist

2) Made a cufflink out of a paperclip so I could fake looking presentable in front of a judge

3) Penned a long entry for this thing about unions and my predictably mixed feelings about them but deleted it because it seemed incoherent even by my standards

4) Took two benadryl at work because I thought they didn't particularly have any effect on me like for instance, say, making me have to say to my officemate "close the door. I need to go to sleep on the floor" and then sleeping for an hour under my desk.

Sheep

2010-07-19T13:29:00.000-07:00

Feeling sheepish about having whined for comments. Real entry later I think.

Extreme Sports

2010-07-15T08:04:00.001-07:00

This is not about social work so much as work in general. It's on my mind right now because, well, the cat kept waking me from about what I'd guess was 5 a.m. to feed her, only it was 5 a.m. so I couldn't figure out what she might want and kept just pushing her aside, muttering obscenities you wouldn't usually say to a cat, and going shallowly back to sleep for three minutes until she redoubled her efforts. No, I promise this isn't going to be catblogging. We are not on Livejournal here. It's just that I am especially unable to perform ordinary mental tasks this morning, because I do not function at all well on sleep deficit.

The first thing to go is my ability to multi-task. I'm not good at it to begin with. I'm better at mono-tasking, which I believe in ancient times was called "working." Actually you know what this makes me think of is the time I interviewed to work at Large HIV Organization of Anonymity and I was totally digging the interviewer until she said to me "how are you under pressure? Because at Large HIV Organization, we don't multi-task, we hyper-task!" Or maybe it was mega-task. Something really self-dramatizing and redolent of corporatization and a professional ethos that makes me insane, about which I am using this entry to kvetch.

Well wait. This does turn out to be specifically about social work. Because I'm afraid there's an unpsoken, eh, thing* where we assume our jobs are going to suck the life out of us and accept it, so organizations don't make much of an effort to prevent this.

Here's another bad interview story. This time, substance abuse treatment, and at some point in the interview for the job (which I don't really want, which I'm not good at hiding) I stumble on the answer to a question and say "I don't really know how to answer that," to which my interviewer extremely sourly responds "well, this is a job interview." Later in the interview she'll ask if I have any questions and I'll say "sure, is this a good place to work?" and she'll say "I don't know how to answer that question" and I will spend the rest of my life regretting that I didn't say "well, this is a job interview." Sometimes late at night I consider trying really hard to remember her name, googling her extension at the agency, and leaving her a voicemail consisting of me screaming WELL THIS _IS_ A JOB INTERVIEW.

All I'm really talking about is the idea we have that we are going to be have enormous caseloads, have to mega-task, get minimal support, get Dangerfieldian levels of respect, and of course make too little to comfortably pay back our loans. This is of course the fault of agencies, and of a society uncomfortable with the idea that anyone might need help and so, to some degree, with the idea that anyone might get paid ("my hard-earned tax-payer money") to provide it. But I think we're complicit in it. We identify with our misery, make it part of our professional culture. Those sad fucks in Far the Fuckaway, they neither expected nor seemed to want better, you know? It's no way to live.

I don't know where one begins to address this. I'm just running it up the flagpole to see who salutes.

*Vocabulary is the second thing to go.

In which two clients misbehave very slightly

2010-07-13T13:05:00.000-07:00

Yesterday was a Rikers day. I posted on facebook that those are like little holidays gilded with despair and burnout, but the fact of the matter is I can get up at 10 if I need to, or really even later, on a Rikers day. It takes a fucking long time to get there but...I'm getting ahead of myself. I did need to get up at ten. Twelve hours earlier I was in the Atlantic in my underwear, no kidding, and then you have to figure in slow service at Volna and two medium-length subway rides and it all adds up to, well yeah, fun, but also a stack of unwise choices for a Sunday night.

I had two clients to interview on Rikers, but the great news was that they were both at the same facility which, all told, cuts about an hour off a two-client day, I'll wager. Just check in at mission control or whatever the hell they call it, get on the 4 bus which happened to be right there, interview, interview, back on the 4, Bob's your incarcerated uncle, and you're done.

Both were good interviews, which means the same thing it meant last time I was yammering about this: able to describe what went wrong in some detail. More generally: able to participate actively in their own defense by doing things like providing the names for a bunch of people who will say "he can do better." One was kind of a fast-talking, I'd have to say charming young guy who breaks into cars for drug money. I'd anonymize that except it's quite anonymous already. The other was a middle aged addict who wants to leave New York but meanwhile breaks into cars for drug money. See?

The funny thing is that each one, in the course of a good, ready-to-use interview said something a client has never said to me. In each case it put me mildly on the defensive. Maybe both are worth thinking about for a sec?

Client A had refused my request to be produced at the courthouse because he works at night and wouldn't have gotten any sleep. Client A was really pissed at his attorney but didn't take it out on me, which plenty of them do. People with public defenders often assume that the things that suck about their situation are because of having a public defender, primarily the difficulty they have getting in touch with their attorney.

And some of this is probably fair, though they'd do better to blame the state for things involving funding and therefore caseloads.* Client A said "she's had my case six months and I've never met her." I kind of doubt this, as the attorney in question is diligent and organized, but I also don't know why he'd make it up altogether, though exaggeration seems likely. Exaggerating is just part of complaining. Ask me. I know.

Client A gets a bunch of credit for self-control or something like, since I actually started the interview by saying "listen, we're not in great shape because you refused my request and I have to have something done by your court date on Thursday." Had the roles been reversed, I would have been defensive and petulant, but the kvetching about his attorney actually didn't come up until the end. And suddenly I realize none of this has much to do with what he said to me but whatever, you may be used to this by now.

So his surprising statement happens this way. I ask him a question that is useful what feels like exactly 50% of the time, and I phrase it this way: "aright, this is kind of a dumb question but I always ask it because sometimes people have interesting answers. What do you get out of getting high? What does it do for you?" He doesn't have much of an answer [Client B does, by the way. 50/50.] but when I sense that from his fumbling around in no particular direction and reiterate--for reasons of my own need to feel like I'm not asking dumb questions--"ok, well, no big deal, sometimes it's not the best question," he says in a completely non-confronatational way "I've heard all these questions before, you know. A lot of times."

Of course I know. But, presumably because saying so does contain some baseline degree of frustration--not just with me, but with the way people with problems are treated when those problems are inconvenient for society--people never, ever say to me "ah right. Next you're going to ask about high school. Could we mix it up a little?" So I'm able to pretend that my interview is searching, original, a veritable cocktail party, a veritable appearance on Larry King. I said "I know you have" and left it at that because usually I'm pretty good at not making clients take care of me.

Client B said something less revealing but, to me, kind of funny. Basically started by thanking me for coming out to Rikers--all but a very few clients hate being produced, because they get them up at 4:30 a.m. or something. I have heard this so many times that I started saying to clients I did have produced "I'll try really hard not to have you produced again. I know they get you guys up in the middle of the night." Once in a while someone says "are you kidding? It beats the hell out of being at Rikers" but not as often as you'd expect.

So he starts out by thanking me sort of effusively for not putting him through that particular ordeal. But then he says "anyway it works out for both of us. I know when you guys come out here, you don't have to go in to the office for the day." I actually got kind of flustered and started to say how it's a schlepp to Rikers but trailed off with this because yes, it is in fact a tiny holiday gilded with despair and burnout.

It was just funny how discomfiting it was to have that acknowledged. We want gratitude, of course, and there is a sadistic element to this wish, especially when it's frustrated. In a worse mood, let's say if I had ended up going to Rikers in the rain (newsflash: not fun!) I might have gotten frustrated with him, maybe given him a shorter interview though I think/hope not. But, his luck: he had already charmed me a little. So I just took it home to think about and maybe blog about, which I have now done.

*By which I just mean that's where the blame is properly lain. If you can't get in touch with your attorney when your court date is coming up, of course you're not going to write to your senator.

On a stupider note

2010-07-08T09:09:00.001-07:00

The Red Dress

I always saw, I always said
If I were grown and free,
I'd have a gown of reddest red
As fine as you could see,

To wear out walking, sleek and slow,
Upon a Summer day,
And there'd be one to see me so
And flip the world away.

And he would be a gallant one,
With stars behind his eyes,
And hair like metal in the sun,
And lips too warm for lies.

I always saw us, gay and good,
High honored in the town.
Now I am grown to womanhood….
I have the silly gown.

--Dorothy Parker

Some little boys dream of machine guns and some little girls dream of tiaras and then for fun, sometimes it's reversed. Fortunately there are other options in between.

I'm not making this up: since I was a kid, I wanted an office. My parents were professors and my dad in particular had an office with lots of interesting-looking books and a bulletin board with pictures and lefty political buttons and a desk drawer full of cup-o-noodleses. We sometimes walked over there from our university-adjacent lab school and waited to be driven home to what you could just barely call the suburbs, and one time Dad was late and in feigned terror/seekrit delight we plotted how we would make it through a harrowing night marooned at an office not far from the mean streets of East Jesus.

There's nothing of clinical or otherwise professional interest to say in conjunction with this, just I have the silly office now* and secretly, when my officemate isn't here and the day is over and I'm not even pretending to get things done anymore, I love the place. I have a bulletin board with pictures and (now rather rueful) buttons from Inauguration '08 and a trillion tchotchkes work friends and I started buying for each other on trips. I sometimes stop in here on a hot day because it's like a tiny pied-a-terre, perhaps an orteil-a-terre, a quiet place to duck out of the city.

There's a shelf whose contents ought to be somehow diagnostic, lots of clinical books I don't touch, a stack of opera CDS, a lint brush, various digestive remedies that don't work, four kinds of tea, and two small empty tequila bottles (Russian more amusingly says "two small bottles out-from-under tequila") that I drained surreptitiously at critical moments. On the wall, my broken Risperdal clock which may be right only twice a day but you'll pry it from my cold dead fingers. My license. A map of the world from Doctors without Borders, because in aforementioned critical moments, I like to pick a place I've never been and pretend I'm there despite my dread of travel.

I've actually spent a few minutes this morning making the place look less, er, symptomatic, because I'm not unconvinced of the perhaps behaviorist notion that the physical gesture of smiling can and sometimes must precede actual happiness so perhaps the office of a functional professional will encourage things like motivation and efficiency, though I have my doubts. I guess the next step is to take the grocery bag full of shirts to the dry cleaner but they exist in the gap between my newfound sartorial aspirations and my income. (Dry cleaning: not cheap.)

(((Very most tangentially, I have stolen twice in my entire life, both times out of spite rather than need. I just looked up at the books on the shelf and realized that I absconded from the Fuckaway Center of entries past with a book called The Adult Psychotherapy Progress notes Planner, which I have not once opened. Also up there: a bunch of analytic writings I wonder if I'd understand anymore, reference materials for a few languages the most interesting of which is a grammar for Haitian Creole that was really hard to find, and a few books that have nothing to do with anything but got exiled from my home for reasons of space. On days when I'm not really present in this job anymore, I think apprehensively about the moving on process and lugging all these books away to my next office.)))

*though not a university office, alas. The world was spared the misguided misprofessorialization of me, the would-be Dr. Smearcase when I dropped out of my PhD program.

Mama said, mama said...

2010-06-23T08:55:00.000-07:00

Well alright it isn't quite that kind of day. I'm hesitating here for a minute about embedding a video that makes light of suicide on a social work blog except...I actually sometimes wish suicide could be taken out of its box of "things that can't be discussed without reaching for the batphone" because (huh this is so not at all where this entry was going to go) I believe the idea of having an escape and being fully in control of whether to go through with This Whole Thing can be a consoling thought for people who are truly unhappy.

The fact that we have to start immediately thinking about hospitalization if someone even mentions it is...understandable, because something un-undoable might be about to happen when it's mentioned. But it's a shame not to be able to let someone talk about it. I'm pretty sure some of the time something real would be gained. I'm certainly glad of my ability with certain friends in times of real misery to vent, albeit in a flippant, joking-about-going-for-the-window way, about the galling, burdensome nature of people's expectations that we will necessarily go on being.

But again, I have just perfected the art of the self-directed thread hijack. I was just going to post about it being one of those days where the idea of doing my job is really galling, I think because I was just reading at A Basement about the whole notion of not wanting to work. I've been having a lot of days lately where the only thing in my head is escape fantasies, to the point where I hardly get a thing done all day.

When I was in private supervision we would talk about this and my supervisor would say, and I always thought this was a good mix of funny and perceptive, "should we be talking about the fact that you want to be fired?" It was only helpful to an extent, of course, because I quickly acknowledged that dragging my feet at work was a self-sabotaging habit based in the...let's for now say unconscious desire not to have to work.

Unconscious is an odd concept because really I was very much aware of it, but it existed in that inconvenient space between awareness and the ability to do anything about it. I have never known exactly what bridges that gap, though the orthodox answer in analytic terms would be, I expect, "working through." And maybe this is so. Maybe if I could lie on the couch and really look at the factors present (compassion fatigue, half-assed conviction about what I do, etc) and past (oh, you know...family of origin bullshit about care->ego-strength->a lesser tendency toward repetition compulsion or something) I could do what most people seem to do, which is make a to-do list and then do it. But then maybe I idealize Most People and lots of people go through this song and dance.

For fun, I'll tell you my worst escape fantasy, worst in that it betrays a lot of consciously rejected hostility-by-way-of-fallacy toward the people I am supposed to be helping. So please do take it with a grain of salt: fantasy meaning "thing that pops into my head no matter my moral and intellectual objections."* It goes like this:

I stop doing my work. I am fired. In the fantasy this doesn't take the endless aeons it would take in my union job. I have a decadent month and then run out of money. My parents do not come to the rescue which, in real life, they would if I fell apart. I lose my house. (Fantasies do not have to be wholly about things you would ever want to happen.) I get SSI unless I mean SSDI for mental health and I move into public housing. (Ok the fantasy stays enough in the realm of the desirable that I don't have to go through the shelters and the rest of that nightmare.)

The rest is hazier as it must be. In any real detail it ceases to function as a fantasy, even with caveats ("yeah but never having to set an alarm again might outweigh not getting to spend money on the fun things I enjoy now.") But in its liminal form, with my conscious objections shelved in the corner, it gets me through a thing or two, sometimes.

Now let's see if that's enough working-through to get me through one report that's taunting me.

*Because really, I think I have a little more the filter for these things that an obsessive person has than, again, my imaginary normal happy person. I have unbidden thoughts very frequently, some of them really objectionable. I recognize them as detritus, the consequence of having the mind Freud tells me I have, which I believe I do. If I thought I had to act on my thoughts, as I understand people with crippling obsessions do, I'd be paralyzed.

(Fan)

2010-06-16T10:00:00.000-07:00

Actually whatever. I'm in a writey mood.

So I did write once here about supervision and how much it is or isn't like therapy. I'm pretty sure we all make a few assumptions about this, in order to maintain the holding environment that we'd all like in supervision. One of these is that it's (in some loose sense) confidential. If you were to say to your supervisor that you were having trouble with a coworker, it would be reasonable to assume that your supervisor would not go straight to the coworker and say so.

Murgatroid went, I think the same day, to Director Slappy and told her apparently verbatim about my Medicaid mill comment. Slappy apparently regarded "Medicaid mill" as the worst thing you could say about a place, about her place. I think we can file this under "reaction formation" because in retrospect, the label was absolutely appropriate. Slappy and Murgatroid went into action and reviewed my chart and saw that Jake had no notes for weeks and weeks, probably the same story for Pierrot. There was a letter on my desk the next morning saying that if my charts weren't up to date in two weeks, we would need to review my employment at Fuckaway.

I went and met with Slappy. She couched everything in concern for my well being, except when she brought of the fatal phrase, le Moulin Medicaidaire. At that point she wasn't doing much to mask her anger. She explained that a Medicaid mill is a place that bills for services not provided. And then she started talking about how I should think about what might be a better work environment.

Well, I wrote the notes. It was pure fabrication, but it would have been anyway. I threw in the right phrases. Once in a while I would try to remember some actual content in the interest of some obscure correctness. It was unpleasant, not least because now I was doing it under threat of losing my job, but I finished it all up, and Murg and Slaps reviewed my charts, and that was that.

Slappy stopped talking to me. She would sit beside me in the lunch room and not look at me. I should say that for some time, she had been really collegial with me, seemed happy of my clinical interests, talked to me about Linehan and Kernberg and shit. But from the instant of l'affaire moulin until I gave my notice a few months later, I was dead to her.

Shit, meet fan.

2010-06-16T09:39:00.000-07:00

Here is the part where my fuckup meets a fucked up system and all is fucked.

So it's maybe January and I'm losing it. I have two clients out of 25 with whom I'm doing what I thought of, coming in, as therapy. I'm actually supposed to see 25 or maybe it was 30 people a week, but it's another impossible clinic situation: you'd have to be double-booked at times to compensate for the fact that low-functioning clients don't come in when it's raining or when they're tired or when it's Tuesday, sometimes. On top of which I'm not getting assigned that many new clients.

I continue to live badly there. I feel nothing for the majority of my clients. I resent the fact that my coworkers (as mentioned, I think) are so terrified of cities that they make, and I mean they won't take no for an answer, they make me spend my own money to take LIRR home when I'm there after dark because the subway goes through Bed-Stuy and that is just terrifying. I'm too shell-shocked to do much but go to work and come home, certainly not in much of a state to make positive changes like bringing lunch to work, so I'm also spending my punchline of a salary on unhealthy food every day from one of the two places by work.

(One day I walked to the beach and picked up a bunch of sea rocks I still have. It took up more than my lunch hour, because the beach isn't right by work, but as an analog to my one friendly conversation with a coworker, it was the only time my surroundings in the place I worked felt anything but hostile.)

I continue to see Jake and a few similar kids and not now what to do with them and not see anything change for them. There was another kid named oh let's say Pierrot who is different, not nearly so hyper, but not very verbal, not sure why he's there in a way I'm never able to help with, and clearly pretty miserable. I play games with him because 1) this is considered a form of therapy in a way I guess is valid if you know way more what you're doing than I did. I was just playing games. 2) it passes the time and does not require me to pelt a kid with questions I am having trouble coming up with anyway and watch him look at me like (possible projection alert) "is this doing anything for either of us?" He's another one where the whole family is in treatment, by the way.

One day I get miserable enough that I talk to Murgatroid about it. If Murgatroid wrote treatment notes for supervision session, I guess she could write that I "ventilated affect" in this session, which is vaguely billable, I think. I don't remember feeling all that much better but I did one thing that got a result. I remembered hearing Slappy speak of other clinics as "Medicaid mills" and instinctively, in my session with Murgatroid, I use this phrase. "I don't feel like I'm doing anything here," I say. "I see these kids, we play a few games. I see the SPMI people for fifteen minutes because that's all they can tolerate and I bill a session. Sometimes it feels like I'm working in a Medicaid mill."

Affect ventilated, I guess.

That is the shit. Next: the fan.

And then! (Along came Jones, but not.)

2010-06-15T07:21:00.000-07:00

That was sort of a stupid place to leave off with that story but oh well. It's a blog. The stakes are low.

So at this clinic, as I may have talked about in a roundabout way, there were families wherein the whole bunch of them came to therapy. As I got jaded about the place my conclusion came to be that the kids were there for free babysitting and the parents were there because that was the rule. It's a good rule, actually. I'm not saying kids never have their own problems, but I still think fondly of Dr. Russian Woman* for sometimes saying "what this kid needs is a parentectomy."

Things get done a certain way when you're in an environment of fast-paced despair. I had this kid whose real name I wish I could share because it was really funny, but I'll just call him Jake, and then one day, because Jake's brother's therapist went on maternity leave, I got to see them together for what got called "family therapy" when in fact it was pure logistics.

Attempting therapy with Jake was, of all the professional experiences in my life, the one I have been least prepared for. A therapist later would point me to an article by I think Neil Altman (who wrote The Analyst in the Inner City) called "Hyperactive Ghetto Child." Provocative title, but I remember the article as a good one though the content now is gone from my head. Anyway it was basically about Jake and his kind: uncontainable, seemingly uknowable little balls of id that bounce around your office. Jake would try to play with my computer, hide under my desk (leading to me freaking the fuck out that he was going to hit his head and my career would be over) and ask me, with respect to every object in my office "I can have this?"

I had no idea in the world how to connect with him on any level. I tried being blandly nice. I tried being blandly firm. The time he got under my desk I actually yelled at him because I had lost any sense of what to do. Analytic sorts might look at this as him producing in me the kind of reaction he was used to from others. I tentatively buy that.

Despite the fact that Murgatroid had shown no interest in discussing anything but paperwork, I broke down and asked her: what the hell do I do? She said: why don't you take him out of the office, try a different environment. There was this incredibly sad room full of cheap, mostly broken toys, and I took Jake there. It's hard to know whether this was terrible advice in terms of eliminating what little holding environment we had established, or just didn't work out. But it was a disaster. The Chamber of Derelict Toys had some kind of pipes in the middle, and not long into our session, Jake was climbing these. Again, visions of injury, lawsuit, careerdammerung.

I don't want to whitewash my role in the next part of the story. I got seriously, but seriously behind in Jake's notes. I had no idea what to write. For a while, at first, I tried writing really detailed notes, as analytic as I could make them. Murgatroid would say in an exasperated tone "these are really interesting, but" and then she'd tell me how they had to sound for Medicaid.

It's another thing I've kind of suppressed, but there was some pretty specific language that had to be in there that demonstrated perceptible behavioral change in each session. This is a lovely idea but it is not how therapy works. I will make that absolute statement and not hedge.

Writing my attempted riffs on Klein or Winnicott or whoever wasn't working time-wise anyway, but now it seemed like the two options were do that and cause myself a lot of stress or write formulaic lies, absolutely divorced from the actual experience, making both sides of the equation false: 1) I had no idea what I was doing with Jake and nobody seemed about to throw me a clue. 2) I had to discard what little content I could scrape out of telling Jake for the thousandth time that he couldn't have the plastic clock on my desk and imagine some change we had made in his life.

This imaginary change would somehow improve his life with his foster parents, who didn't seem to have any particular feelings about him, good or bad. This imaginary change would somehow improve his life in a rough, neglected school in a neighborhood of no political importance. This imaginary change would somehow mitigate the disconnect between his career goals (I am fairly sure I never saw a male child out there who didn't think he was goign to be a professional basketball player) and his numbingly bleak options.

You can imagine how writing this kind of galling fiction did not engage me. What you may not be able to imagine, if you are a functional person who goes through the day doing what needs to be done, is that I just stopped writing his notes. This is called acting out. I knew perfectly well you can't do this, because audits happen, and the auditors are no friend to anyone**, and a blank chart can be a real disaster for a clinic.

The next chapter is about the shit hitting the fan.

*There were two people who fit this description, and then Dr. Russian Man who was a bit blustery and not of great interest to me. I was kind of fond of both Drs. Russian Woman though the social heirarchy of the workplace meant neither was someone I really connected with. Also they were older, married people. But I'd have liked to have lunch some day with Dr. Russian Woman II because she was smart and sane and didn't seem to be a part of the air of disfunction that pervaded the Fuckaway Center.

**I guess if you're teabaggy you could say they're a friend to the taxpayer. To think this, though, you pretty much have to start from a position of paranoia about social services as a plot to steal everyone's money.

S'more

2010-06-14T14:43:00.000-07:00

For reasons not worth going into, I just had to call good old Murgatroid, so that story is on the top of the mental stack again. I should say she was rather sweet, for what it's worth.

What I thought of immediately when I was talking to her was the one moment of connection I can remember having with anyone at that place. It was totally superficial, but it stuck out because basically I was either collaboratively complaining with the other people who hated the place (which doesn't nourish the soul) or just failing utterly to connect with anyone. Like there was this woman who had just had a kid named I think MiKayla or whatever the approved name that year was, and she would do things like write thank you notes to the office in sort of proto LOLcat baby-speak, first-person for baby gifts, and we just looked at each other like "are you nuts?" a lot.

Anyway the one moment of connection involves a confession: I have enjoyed certain novels of Dan Brown. Worst prose stylist in history, but good with the suspense! Shamefully, I have read most of what I guess I will go ahead and call his oeuvre. Oh, so wait, though. Uninteresting back story: there was this guy who worked as a clinician and supervisor at the Clinic at Fuckaway, and his mother worked in some accounting position or something like. We'll call them George and Estelle because Estelle had the accent and more or less the exact demeanor* of Estelle from Seinfeld and George was accordingly a pretty miserable guy like his televisionary counterpart.
Sad/diagnostic fact: it took a lot of effort to remember their actual names, and the last name isn't coming.

This story is getting really "and then I found five dollars" really fast so I'll end it as quickly as possible and get on with what I meant to write about. So I'm in the lunch room and people are talking about Dan Brown and George and I are the only ones who have read, uh, which one is it...all same book...Angels and Demons? And we're trying to talk about the ending and people are freaking out at us on grounds of "no spoilers!" and we end up doing this rather elaborate intepretive dance to express which part we just found beyond the pale in terms of willing suspension of disbelief and we laughed together and it was maybe the single instance of friend-like interaction I experienced on the Fuckaway Peninsula.

The other thing about the lunch room is that people discussed clients there. In front of support staff, who jumped into the conversation. In front of anyone who was around. I was stunned, because my second year placement had been a setting where people were stright about those boundaries. And Aunt Slappy, if you have been following this story, would jump right in a lot and say "oh I know her for years now. That one is real trash, a real piece of garbage." This was the tone of things.

I mention this because I think it's one of the things that led up to my real shellshock experience there. Which I guess I'll make another entry, because this is already a snack and it probably need not be a meal.

*You brought 'er...

We Have Met the Enemy and you know the rest

2010-06-09T12:15:00.001-07:00

Our union rep was here today. Offhand I would say she has a mild personality disorder and some cognitive weirdness. Technically speaking. Loose association, pressured speech, and just that ineffable quality that makes me turn around and walk in the other direction if the situation allows. Wonderful.

Expectations, Raised and Lowered

2010-06-02T13:51:00.000-07:00

Today I had to tell a client "it's going to take me slightly longer to find you a program, because you don't have Medicaid." The problem wasn't that he had no insurance. The problem was that he had private insurance, otherwise known as the thing most of my clients would love to have but may or may not ever. It occurred to me that in the isolated instances where I had to refer someone with private insurance for treatment, the Medicaid clinics kind of shrugged at me. Picture a clinic shrugging. Or don't.

This was part of a larger interaction that gave me pause. I got this case as an "ER"--this is to say, the attorney wanted something to happen without the delay of referring the case. They're allowed to do this, obvs. It's a pain in the ass but only the way paying taxes is--it's a drag but you have to do it. It was an especial pain in the ass today because I have some slightly-more-vicious-than-usual twenty-four-to-please-baby-jesus-forty-eight-hour malaise. I feel, as they say in certain parts of the south, as if I'd been shot at and missed, shit at and hit.

So, nothing special except he needs to start treatment post haste so the judge will say "what a sweet angel--he's suffered enough already" instead of "why should I give a middle class white guy a break?" I don't know if judges start from there, but it wouldn't be unreasonable to. Look at prison demographics and get back to me when you're done repeatedly shooting yourself. Now of course they should get the same baseline of consideration anyone else gets, but it's hard not to notice they've had a head start already. If you buy a bunch of cocaine and have a lot of advantages including your skin color, you are counting on these advantages. It's understandable, but it might factor in to the sympathy you get.

The thing that went on that I wanted to sit with for a minute is this: I talked to this guy very differently than my other clients. I made assumptions about what he knows and what he is able to do without my prodding or assistance. I took a different tone, some of which is just because the stance I take with someone clearly from a very different background from mine is to remove a certain assumption of rapport. I do this with kids, too, which makes me feel a little less like it is my class bullshit. But it can be a number of things at once.

It's one of the real fears you have in school, or I did anyway. How is anyone going to take me seriously when, by my clothes and my job and probably my snooty way of pronouncing things*, it is probably clear I have not had things too bad. I will never truly get the stories that are told to me, and I know it, and the people telling them know it. What you figure out is that most people get past this because there's not much to be gained by dwelling on it. Anyway.

What I can't shake is that it felt like I was flipping a switch between "talk down to" and "don't talk down to." My explanation of what I do was different, something of a mess both because I feel like doom and because I was recalibrating as I talked. I think this is the crux of it, actually. There is a fairly standard spiel I give, and it is very possibly a bit condescending in a way that I don't notice when I'm talking to a 15-year-old or someone who made it to 9th grade. There is native-language stuff in there too, and from there, race stuff, which is the thing that makes for least comfortable introspection. I should notice. This is a little bit of a resolution.

Maybe I'll talk more about my spiel and its assumptions later on, if it seems like there's much to say.

*Truish story: when I was growing up in Southlandia, my friend M and I went stomping around someone's farm in the delightfully dewy very tall grass. Some cops were not into this (charge: trespassing? unauthorized grass stomping?) and questioned us a little and after I had said just a few words one of them said to me "where are you from, anyway? Liverpool?"

What is "to toddle" please anyway?

2010-05-23T18:25:00.001-07:00

In Chicago, birthplace of my master's degree and my seasonal affective extravaganza.

Today a few things happened that had something to do with something. One was that I ate at Harold's, which is not really worth talking about here but it's pretty much reason enough to love Chicago. Even if I sort of, ok, don't. Longer story.

One was that I had lunch with my old supervisor and talked about a thing about supervision we both find kind of interesting, to wit: the fact that it tends to have elements both of therapy and plain old administration, and nobody really talks about this balance much as it's happening.

I had two really me-centered internships in grad school. I wasn't asked to do tasks my supervisor wanted to get rid of. I was treated as someone who was there to learn, and whose training was a priority. I'm very grateful for this. One placement was at a residential HIV facility and the other at a community mental health center, famous at my school for being a great place to intern if you were really interested in psychodynamic therapy. (Yes, it's a long way from what I set out to do to my current tenure at the Lemonade Society, which I have just decided to call my current job. I suppose plenty of us don't do what we thought we were going to do.)

My supervision at the first place was a little like therapy, in that it was a regular hour a week where I could say whatever was on my mind, and was encouraged to. I think I was probably sort of overwhelming, because I had no idea about anything. I remember launching into some monolog about what I called "therapeutic affect" which was just my way of asking basically "should I try to talk like a shrink?" (Answer, courtesy of the next few years: no; you will simply end up doing it.)

Supervisor J had a terrifically helpful calm and certainty, which made for an excellent "holding environment" as they say in the biz. Some of it was just how he is. I know this now because we've been friends for years. Some of it was him seeing his role as, in part, that of the therapist. I feel certain this is true. The analytic therapist, I should say, as there was a lot of that kind of reflectiveness that, depending on how you feel about that kind of thing, gives you enough rope to hang yourself or teaches you negative capability in a really important way. Obviously I lean toward the latter view.

So then second year rolls around and I go to the community mental health center and am a therapist, hilariously. I don't think I was awful but I was certainly not a pro. I quickly learned that supervision can only do so much--in the actual therapy hour, you are in there on your own.

I'm not a kid person, by the way. I don't have an easy rapport with kids. It's something I accept and occasionally take a perverse pride in just because it's fun not to be on the same page as everyone once in a while. A woman in the seminar I had to take to supervise interns two years ago said something to me like "oh it's just all worth it when you get to work with the little ones, isn't it?" and I can't deny I kind of enjoyed saying "oh I try not to work with them, if at all possible."

So I really didn't want to work with kids, but the thing is good fucking luck with that if you're at a community mental health center. Supervisor S was pretty sensitive to my nervousness about it, but there was only so much she could do, and of course she rightly thought it would be important in a lot of ways to go ahead and work with them anyway. I ended up just having two all-year kid cases, and I think back on them fondly and wonder what the hell they're doing, but in the moment, a lot of it was terror. And it gets worse, because parents who put their kids in therapy are terrified too, and accordingly can be hard to deal with.

Wait, what was the point of this...

Well, S was pretty orthodox about some basic analytic stuff, sometimes in ways that drove me mad. Talking to her in supervision about kids in particular, I would say, oh, something like "what the hell do I do when she talks about cutting herself?" and S would tilt her head and say "huh...what comes to mind? what do you think?" And I get this technique, of course, but I also was not at a stage where I could use it. I knew nothing. I wanted some goddamn input.

Another thing she did that was really hard for me to deal with was the psycho-a tic of turning everything around. "[Client] seemed really angry with me," I would say, and again the head tilt, and "it sounds like someone was angry with someone, anyway." One time we sort of brought it into the room in a way neither of us knew what to do with. She told me it sounded like I had some hostility toward the parents of a child and I said "I'm wondering if you have some hostility toward them" and she seemed really thrown by this.

Suddenly I'm talking more about doubts I have about analytic stuff than supervision and whether it should be like a therapy hour, and I guess that's fine...

Funny thing my client's mom said

2010-05-17T08:26:00.001-07:00

"He'd give you the shoes off his back."

I should probably avoid making a regular "kids say the durndest things" deal of this, but I liked this one.

Community

2010-05-16T10:10:00.000-07:00

Many thanks to Social Work Blogs for the link! Really, I think a blogospheric community for social work could be a great thing, not so much because the blogosphere is teh futurez as because the work we do is better when we have more people to toss it around with.

Part Whatever

2010-05-15T12:31:00.001-07:00

I think I dropped the thread of the "My Horrible First Job" narrative long enough ago that it may have a sort of "Uncle Lenny Who Wants to Continue His Story Even Though You're Clearly Not Into It" quality now but hey.

One of the things about this job that I still can't figure out is that I am almost sure it was objectively horrible, but the people there all seemed...not exactly happy to be there, but not to get how bad it was. This may mean that I simply wasn't cut out for it. I get that. But I really don't think so.

How I figured it out was by trying to bond with them over how terrible it was, and getting nothing but a puzzled shrug in return. Even the ones who did hate it there didn't seem to be hell-bent on escape as I thought they should be. Take R, this Russian guy who participated in what I still insist was the clinic's policy of medicaid fraud, though some form of this idea would eventually get me in hot water, which I'm bound to write about later.

So R was a Russian, and Far the Fuckaway is filled with Russians. These are somehow not the same crew as you find down the Fuckaway Peninsula in Brighton Beach, where they have this whole community and their own restaurants and groceries and, it is known to be true, mob, really a whole Russian society in a concentrated neighborhood, bleeding out some into the borough.

Anecdotally, I'd say the ones in FtF were the ones who didn't make it, fell through one crack or another. This is a sample error, of course, because I only saw the ones who went to a Medicaid clinic for mental health, but the neighborhood just had a stench of surrender about it, and from what I know about it, again anecdotally but in any case from people other than myself, it just is not (or was not then) a place you would live if you could make anything else work.

So there were lots of them, and they surely had some combination of depression-the-brain-thing and depression-the-life-thing. But both are treated with meds, because circumstances are expensive to change, and you had all these middle-aged to old Russian people coming in for their meds once a month* and then, because of clinic policy, they'd come in once a week for counseling.

Now this is a good thing. If statistics are your thing, one hears there are studies showing therapy + meds works better than meds alone. I just happen to believe it as a matter of instinct, though I think the question is a bit more complicated, in that therapy helps certain people at certain times, and for instance you can do meds + therapy for a while with depression, and the combination may teach you how to deal better with depression such that you can just keep up your Zoloft or whatever (and maybe drop that too, or maybe not) and not go to therapy forever. Or for other instance, contrary instance, if you are a seriously mentally ill person who is being bombed with antipsychotics because they have to do something with you and people who are on three antipsychotics are usually too sluggish to be crazy in inconvenient ways anyone has to do anything about, therapy is some of the time going to be an exercise in futility.

This was silently acknowledged at Fuckaway. R saw the Russian clients, like twenty of them a day, and billed for full sessions, which is just absurd. I'll never understand how this wasn't caught during audits (ah, audits. The raison d'etre of Medicaid clinics in a way that demonstrates the assumed order of horse and cart these days, or perhaps I mean the agency of dog and tail in the wagging process.) My impression is he would talk to them, give them a little helpful advice maybe if they functioned on that level, and send them on their way.

Some cultures are more therapy cultures than others, if these generalizations ever mean much. Russians, I came to think, didn't see much point in talking about their problems. A lot of them were Jews, and you know, there's a certain culture of expecting and resigning oneself to unhappiness, see also under Freud, Siegmund and Mahler, Gustav. (I know. Mahler converted. But he was what my Grammy Hall would call a Real Jew, and no two ways about it.)

Every one of my own Russian clients--thankfully there weren't many, because I very quickly discovered the difference between language skills adequate to having an informal conversation or ordering a plate of vareniki and a glass of soviet mystery fruit beverage have very little to do with the kind of detailed, can't-skip-a-word-if-you-don't-know it verbal engagement of therapy--I say, every one of my own Russian clients resented our time together and made it clear they wanted their meds and on their way. Maybe this had nothing to do with Russianness. Maybe it had to do with my own poorly masked ambivalence or otherwise my iffy clinical skills. I can't know.

R lived in the Bronx, by the way. His commute was, doubtless, murderous. It's a mystery why he stayed there unless it's because the job was so demoralizing as to leave one in a state of defeated immobility. He was a sweet fellow, and you know what, I think he did quietly** share my bewilderment and disdain for the place. But I bet he's still there.

TBC I suppose...

*The psychiatrists were all Russians. I actually just called to see if one of them still works there because one day she read something inconsequential I wrote as a tiny piece of advocacy for a client and said to me "you won't be here long. You're too good for this place." It wasn't based on much, but it was the only kind thing anyone said to me in 10 months at that place and I think I may drop her a little note and say: I'm in a better place.

**Because I'm on Russia anyway, I thought of a line from Akhmatova: "there, everyone spoke in a whisper." Alright, my clinic wasn't exactly the lines to the prison in Leningrad, but there certainly was a culture of paranoid faked complacency. More on that soon, in fact.

Hate and the Public Defender

2010-05-11T12:53:00.001-07:00

...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.

Nobody puts Smearcase in a corner

2010-05-07T11:54:00.000-07:00

Hi this is Franklin. How may I provide excellent sentencing advocacy for you today? Heh. I was just thinking about how rotten it would be if we had to do certain empty, ritualistic bullshit that constitutes the most petty of management's ways of hazing labor. Thanks for taking the time to interview with me today, Mr. Person. Have I provided you with an outstanding social work experience?

This has nothing to do with what I'm writing about.

Oh, the subject line. About that. I don't even remember that movie or know the context of the given utterance. I am just thinking today about how I've backed myself into a corner, and how the world of social work, like the larger working world, is too specialized or has too inflated a sense of specialization.

The thing is I have this great job I miiiight be getting pretty bored of. On days when the normal hours, ample time off, and humane work environment don't seem to cast as long a shadow as the monotony of institutionalized class warfare; I say, on days when parting ways with my mattress seems an inevitable path toward stepping into the street and knocking people's hats off, I look around and think: oh shit. Lhude sing goddamn, indeed.

Does this have sort of a lot of profanity* for a blog about social work?

Well so what I'm fumbling my way toward saying is: what the hell else is there to do out there? I've been at this or approximately this for four years. I've supervised interns for two years, but it's not the same as working as a supervisor. Nobody's going to hire me as an institutional shepherd, and rightly so.

I did clinical work (as I started to say many postings ago, and as I will continue saying at some point soon) for a while, but even if I went back to that...for reasons having something to do with New York State licensing that is a whole other kettle of bitter, regretful, occasionally furious fish, I can't make what you might consider a lateral move to a clinical job for someone 5-10 years out of school.

On the other hand, I can't go back to the job of a beginning clinic worker for quite a few reasons involving salary, temperament, authority, dignity &c. &c.

How do people figure this stuff out? Actually I know this one. People work in organizations where there's up to go, and here there is no up, so I'm left wondering what the next step would be in an organization that didn't have essentially one thin layer of social workers.

Some sort of administrative job is clearly the goal, not because it sounds fascinating (to be honest I don't even know what admin jobs entail for the most part) but because I have in some sense settled for a field that gets no respect, and I want to one day be the guy who gets the smallest lack of respect. I want to be more and do more, in the vaguest possible way.

This is not the stuff cover letters are made of.

I may be stuck now in the position, if you'll pardon me while this turns into kvetching, you're in if you ever try to get a job waiting tables. You cannot possibly learn to wait tables, you begin to understand after a preponderance of rejections, unless you have waited tables before. And you begin to wonderin if the people who are now waiting tables have simply always been waiting tables, since there is no logical starting point--it's just tables all the way down.

*"shit" is obscenity, not profanity. But you take my meaning.

You can take it with you. Just not most of it.

2010-05-04T08:44:00.000-07:00

This was going to be what I posted about yesterday and then it wasn't. Now it looks like something of an afterthought, but it's still interesting to me so it's going to interest you too, dammit. Ok, or not.

So a thing about the Manhattan Detention Center, "The Tombs" to its friends, is that if you go there after work because you are a lazy nogoodnik and put it off all day, you can end up waiting in a creepy enclosed area as they fetch your client, daydreaming about how you would get out if there were a blackout. Oh, only me? Ok. As usual. This happens to me in spaces with big clanging doors (or in the case of The Tombs, lots of sliding doors. It's like Bartlett Sher designed the damn thing. Opera joke. Sorry.)

The other thing I do, perhaps to distract myself from the ol' neurotic fantasies, is read things on the wall if such there be. And last night I read this thing about the property that can accompany you from MDC (a county jail) to state facilities upstate if that particular luck is yours. "ONLY the following," says this sheet, and here's what:

1) Books
-Legal
-Religious

2) Religious articles
-Beads
-Kufi, yarmulke
-Religious medals on chains
-Prayer robe and guthra
-Prayer rug
-talit
-talit katan
-tefilin

3) Jewelry
-Watches
-Wedding bands

4) Legal Paperwork

5) Clothing
-Only the items worn when transported

No personal photos
No cigarettes
No toilet articles
No extra sneakers

Ok now I'm not completely sure why this struck me as quite so fraught, I say fraught with meaning. I'll venture this: my dad used to go out to a state prison and teach an English class, and a story he tells a lot is the one about watching new inmates get off the bus and seeing how terribly afraid they were at that moment. And I was just thinking how rotten it is, I guess, that you can't take a fucking photo of your husband/wife/partner/cat/cute niece who always says the funny thing/oldest friend who believes you'll be out of there soon/pony you had when you were a girl in Poland/house you grew up in/whatever helps you shut out realities such as peak oil, the cancelation of Friday Night Lights, and terms of incarceration.

But you can take your legal paperwork, which honestly won't do you much good if you're most people. (You'll take it to the law library and try to find things your attorney missed. You most likely won't.) And you can take your tefilin or your St. Christopher medallion for the happy reason that faith, rightly or wrongly invested, helps people survive the worst. And the not so happy reason that prisoners are easier to control if they think "this is bad, but at least I'm going to heaven later."

Also it's just interesting to see lists where someone tries to be exhaustive about examples of whatever so the kid in back can't raise his hand and say "yeah but what about my guthra?"

What we talk about when we talk about compassion fatigue

2010-05-03T19:46:00.000-07:00

It doesn't take that much energy to feel compassion for people, and it isn't a finite resource. That isn't the problem.

When I heard the term "compassion fatigue" in graduate school, I had a rare moment of living in the present. I filed it away and thought "when that happens, I'll deal with it." Oh, this isn't the thing I already talked about, by the way. It sounds like it's going to be the one about "the stories themselves aren't hard" but it's not. Variation on a theme mayhap.

What's exhausting and makes compassion (or even the ability to have people's stories penetrate through all the accreted formalist familiarity, come to speak of Jakobson) exhaustible is that you hear such a mix of compelling stories and, well, crap, that you begin to feel like the folks in the story who get all "yeah, yeah, we know this one: there's a wolf and it's going to fucking eat the sheep, you asshat."

This is a whole other topic: there are clients who, rightly or not, feel like they deserve our help more, because they seem to want it. So anyway if you see seven clients in a row who seem like anything you do will just sort of leave a soapy film of good intentions on their day and get washed off the next time they have the opportunity to commit larceny, you might do what I did which is to put off seeing someone who really wants help for like two weeks in which you could be writing them a good piece of advocacy.

To get there and to talk to him was to wonder if it's time to do something else for a while. I felt terrible. He gave what I like to refer to glibly as "good copy" which is to say he didn't tell me his story in stock phrases people use. You know these if your work is anything like mine. "Wrong place, wrong time." "Fell in with the wrong crowd." There are others I'll think of later. He also had gotten me a stack of medical records which eliminated one of the most numbing, I-am-in-a-Kafka-story moments of my job.

More importantly, though, he just didn't set off my bullshit detectors. I am sure they are sometimes calibrated wrong, and maybe he's a con man, and I don't mind that I'm sometimes going to make that mistake. But I feel reasonably certain, as certain as I get, that this guy wants to do something different and feels genuine regret about what got him where he is.

This was the guy I should have rushed to see. It's not important, because there's time, but it's dispiriting.

There's a little more to tell about tonight at the correctional facility lovingly known as The Tombs, but I'll post it tomorrow. The one thing that feels tackable-on is about doorknobbing, the process where a client (usually in therapy) asks a big question or makes a big reveal right as the session is over or a minute past over.

This was really bookending. At the beginning of the session, the guy tells me "I'm a man of faith. I thought about not coming down but then I thought, maybe it's that social worker, and I know you're here to help me get into a program. God is good." Or words to that effect. I don't begrudge people this, though I think it's not a good way to look at things, this "God capriciously chooses moments to make good things happen" theology, as featured on reality shows &c. I just ignore it and put it down to people getting through the day.*

But so the second bookend, it took me off guard. Very end of the interview, guard unlocking the door almost, he says "do you believe in god?" and I thought [sorry, this is going on really long for an afterthought]: I have a few options.

1) Do the old therapist's trick and say some formulaic crap along the lines of "It seems like you're curious about me. Do you imagine I believe in god?" This little act of emotional judo is supposed to facilitate transference, I guess, but I think it's at least half motivated by a wish for privacy and a need to arrange for it without asking for it directly. In any case, facilitating transference is 1a) useless and 1b) impossible when you meet with someone once or twice.

2) Do the old therapist's trick and say something a little more honestly evasive to the tune of "I can see why you'd be curious, but I don't think it's something that really relevant to what we're doing." Actually that one's not a trick. I respect that one.

3) Say "No, I don't" because the guy is an adult who has asked a question and there's little to be gained through options 1 and 2, and my need for people to know there are atheists in the world and sometimes they're the people who help you get out of jail (because religion may purport to be the source of all good intent, but it ain't) is irrelevant, and not valid to bring up on my own, but he asked. I didn't put it on my business card or anything, but now, if things work as they should, a devout person will know that non-believers are sometimes in your corner, failing to be purely evil.

So that's what I did, as you will have guessed.

*and, because I'm not a complete asshole, I leave room for the possibility I'm wrong about all of it. Just I don't think so is all.

Next up: the thing I saw on the wall. Oh, don't worry. It isn't a giant roach or anything.

A few words about a few words

2010-05-03T07:17:00.000-07:00

This is a little thing I do that seems probably unimportant: I try to use more or less the same words my clients use. If some kid tells me he smokes weed, I don't later ask about marijuana or pot, though my natural default is pot. If he tells me his mother passed when he was 12, I don't ask how she died but how she passed, though that particular expression doesn't quite taste right, as an old boyfriend of mine used to say about idiomatic/unidiomatic uses of certain phrases.

[Oh this isn't exactly relevant but I think it's interesting so I'm putting it in brackets of optional disregarding: a phrase I don't think I'd end up using back at anyone but that I found sort of unexpected lately is something that I would express as "that made him really sad" comes out, among some of my clients, as "he got really sad behind that." Huh! I love these little verbal fillips in the not very interesting way one loves a lilac or a shade of green: there isn't much to tell about it.]

I think about the limitations of this from time to time. I am emphatically not into trying to talk to kids in some way that implies I'm anything but their dorky middle-aged social worker. I try to be informal because formality in this case is a defense that doesn't make anyone's day easier, and I try to present as eager to understand (as opposed to already in the position of understanding), but I resolutely do not try to pretend to speak their language. I understand why some people in my position do it. Adolescents, maybe especially certain socioeconomic demographics of adolescents that I end up talking to, are like George in A Room with a View: you're lucky to get so much as a yes or no out of them.

At some point, language isn't yours to borrow, and it's condesceding to do so, and probably it wouldn't endear you to anyone to do it. As an extreme example, I hear kids every day on the subway dropping what I'm told is now called the N-bomb at a rate of once a sentence, basically using it as a pronoun. It's the obvious example of insider-outsider language, not even mine to disapprove though it jolts me every time.

There's no thesis here. I once thought about writing a paper about using clients' words. This fellow who lived in the residential facility where I did my first-year internship would use this really funny, maybe deliberately formulaic language and I found myself wondering about the purpose it served for him. I'm tempted to quote an example or two, as I'm fairly sure I read his obituary years later and it feels harmless, but I'm not sure.

Anyway I didn't write the paper because as it turned out I'm not really interested in conferences and the like. Sometimes, though, I still think about R and [oh, fuck it] "Chilicothe, Ohio" (an example he'd use when listing where people might live who were ignorant about HIV) and Winnicott's writing about transitional experience, but also Roman Jakobson writing about words in an almost quaintly systematic way in an essay I think was called "Functions of Language."

I was a linguist once, you see. Or wanted to be.

Hungry, Hungry HIPAA (in which I exaggerate for effect)

2010-04-30T07:01:00.000-07:00

How did this become the quintessential interaction of my trade?

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.

I mean...

2010-04-29T21:45:00.000-07:00

(Upon review, "readership" sounds grandiose. "Wherever shall I begin building my fan base?" In the blogosphere, readership is reciprocal, generally. What I mean is something more like a community, only whereas "readership" sounds grandiose, "community" sounds...well hey, as long as I'm going on way too long for a freestanding parenthetical: do you find that any time someone has a beef with social work they mention a particular song? Usually prefaced by "sit around singing [X]"? Ok I won't attempt to be mysterious where no mystery can really be found. The song is "Kumbaya." And one of those social work skills they never mention in class, like not flinching when someone tells you something horrible that happened to them because it is not helpful or conducive to further openness is not smacking the shit out of people when they mention "Kumbaya" as if to sum up your entire profession. Or not coming up with sarcastic song references to their profession, which is hard anyway. TPSAII: "community" is a bit far down the road toward "Kumbaya" for one's comfort. So let's just say: I'm figuring out if I can/want to be read much at all. Or if I'm just blogging into the void and for the entertainment of a few patient friends. Shall we close these poor overburdened parentheses now? I think we shall.)

Me vs. the Tea Party vs. Me again

2010-04-29T09:01:00.000-07:00

I keep writing half a post and leaving it to languish in the realm of edit. Hard to figure quite what to write now while I see if I can/want to whip up anything resembling a readership.

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.

RIP Alice Miller

2010-04-27T14:23:00.000-07:00

The Times has published this obituary for psychoanalist Alice Miller. I've had her books recommended to me over the years but know her primarily as an interesting minor character in Janet Malcolm's In the Freud Archives (possibly the most gripping and insightful book about psychoanalysis I've read.) As I remember it, Dr. Miller comes off in that volume as sympathetic and level-headed. I'd say this is a good nudge to read her books, but it's so hard to follow through with that kind of thing in my somewhat post-clinical life. Anyway, it seemed worth noting.

Further adventures of FPS in Fuckaway

2010-04-27T09:18:00.000-07:00

It's tough to remember whether there was a time when I thought I could make a go of it at the Fuckaway Center. I can sense doom at twenty paces, usually, and the writing required an especially large wall to fit on.

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?

The Deep End

2010-04-26T13:12:00.000-07:00

Part 1,
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.

Vorshtein

2010-04-23T14:37:00.000-07:00

I started to post about my first job, but it started getting long and maybe a little like a therapy session. I'm a little bit interested in people's stories of professional disaster, because I had a few, and tend to say to people "there are a lot of bad social work jobs out there" based on not that much evidence, but I can't help but think it's true. It might be interesting to post about later if there turns out to be much traffic around here. I saw a few hits from here and there already, which is gratifying.

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.

Why, yes...

2010-04-22T12:45:00.000-07:00

...I am posting a lot. Because the blog, it feels bare.

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

2010-04-22T06:57:00.000-07:00

And who does not love a donut? It occurs to me that there were donuts only because I work in a mixed setting, i.e. not only social workers--we're just a small department, in fact. The general absence of donuts, as I imagine it, in social work settings (and ok, yes, these are metonymic donuts...unless I mean synecdochal donuts) happens for a few reasons.

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.

Part II: Possible TL;DR

2010-04-20T15:38:00.000-07:00

My job involves a bunch of trips to Rikers Island. There's no apostrophe in that, by the way, just in case you were about to get all up in my spelling. I think it was named after a guy named Rikers, and it's just Rikers Island like Roosevelt Island is Roosevelt Island and not Roosevelt's Island. There is a 90s gay porn star named Ken Riker but he's not really involved in this story except insofar as there is very likely a prison-themed porn film out there called Riker's Island. I'm at the office and don't want the necessary search string in my browser history but I bet you a dollar.

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.

*Sorry, nobody really says "whatnot." I went to grad school in Chicago and find midwestern English kind of hilarious. My program was populated overwhelmingly by identical blonde 22-year-olds fresh out of psych B.A. programs with the same haircut, and one of them one day said "I was talking to my client and she was telling me about all this really terrible child abuse and whatnot." If this doesn't automatically strike you as hilarious, I probably can't explain.

**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

2010-04-20T14:55:00.000-07:00

If you want to know the actual reason this blog exists (and all that David Copperfield kind of crap) you'll just have to blame/thank my neighbors' lousy wireless connectivity. I was writing an entry on my private blog, wherein I whine about my life primarily, and then I hit publish*, and it vanished into space. Just this morning on the subway I read in Harpers about the star that would currently be recieving Orson Welles' broadcast of War of the Worlds if they happened to have radios, because radio waves go on forever, so it comforts me to think that my blog entry is out there, somewhere. Well, maybe not.

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.