Thursday, December 8, 2011

Somber Thoughts ~ Christmas Reflections

 What follows is a very personal reflection - my hope is that it in some way resonates positively with those for whom it may encouraging, and that it doesn't come across to others as self-indulgent.

There are different kinds of chaplains and therapists. Some have managed to live reasonably balanced lives, dealing with the inevitable life issues in an expeditious way which has left them none too worse for wear.

And then there are others.

Unfortunately, I belong in the second group. The group which has become known as the wounded healers. When we've got the hard knocks there's been no punches pulled - full force all the way, and often, not the network of supportive family and friends which gives that warm glow to the healing processes which, one hopes, follow.

Some wounded healers are more wounded than they are healers, and probably should look elsewhere than the healing professions. Admittedly, I've felt over the years I've come pretty close to that line on occasion. But then I have had the benefit of some really great support - much of it from my psychiatrist and psychotherapist of 20 plus years. A man who is so much more than his prescription pad, and whose own woundedness has lead him towards compassion and wisdom. And ever so-important is that he has an old world love and appreciation of the warp and woof of therapy which carries him so much deeper than the manualized approaches of much modern therapy.

So, I figure, if I had to be a wounded healer, I lucked out big time. I have an hour (not the weak kneed 50 minute hour many psychologists and psychiatrists seem enamored with) of about 60 minutes each week. I have phone access 24/7 when I need it. And, as important as anything else, I have a therapist whose fascination and passion for what he does probably hasn't lessened over the years.

At this time of year, I am especially thankful for my therapist. Because when I wrote the other day about this being a scary time of year, I was holding back, just a little. I'm terrified - by everything from my lack of a social network worthy of the name (I have about two friends), to the bitter cold and the oppressive shortness of the days, to the urges which blow over me like the northern wind to no longer be part of this life.

Depression, ADHD, executive dysfunction, and anxiety have had their way with my thought processes, and my ability to perform consistently except in situations which offer a) some form of structure without being stifling, or (b) highly stimulating - thus my passions for crisis interventions, the 3 am pager call to the ER, and so on.

Generally speaking, I have performed well with clients and patients - often those very ones referred to me by psychiatrists and psychologists frustrated that they could make little or no headway with them. Yet, the fact I have no magic letters after my name, to state that I am officially trained, inspected, and qualified, has made it difficult to finance a reasonable lifestyle.

Though I am on disability now - one which has interfered with my ability to work for some years, I hope one day to return to practice, and to leave a life of poverty behind. Yet, the reality is that the depths of despair I now explore are far deeper than any I've seen before. And the shortness of the days, and the confusion faced each morning of a sun rising after I have been up for two hours brings no relief.

My ability to work with others, and my own personal woundedness, co-existed in a kind of intricate dance of learning and of relationship, of opening myself to the other in that spirit of I-Thou of which Martin Buber spoke, or which Henri Nouwen simply called hospitality - creating that space where someone else could be completely herself or himself. How often was I to experience the delight of the small child when, in doing so, I realized I had also created such a space for myself.

Clients and patients of all ages with histories of trauma, whether from childhood sexual abuse, combat, kidnapping, and/or torture have more often than not been the patients with whom our (the patient and me) work has occurred, often with much healing. Fortunately, my learning process spared me:
  • the mythologies about the hopelessness of borderline personality disorder; 
  • the sense that I was entitled to respect and proper decorum from patients at all times, and should tolerate nothing less;
  • the crazy notion that a clinician can learn nothing of value from intentional conversation with a person who is psychotic; 
  • the false belief that there is nothing of value to be found exploring with a patient the "bewilderness" (a word coined by one of my first patients) of her or his delusional system;
  • the idea that some stranger unknown to me and perhaps frightened of her/his own shadow should do the emergency after hours calls because that was the "policy" of my agency; 
  • the belief that one cannot, indeed, should not even hope to turn a crisis intervention at 2:00 am into a meaningful therapy session.
I also had no great affection for the importance or status of an office. My clients and I have walked and run many miles together. I recall one summer observing my boss and a colleague walking along a main business street and, with some disdain, passing me by as I sat on the sidewalk in session with a client of very low income, who was known for missing office appointments.

Indeed, coffee shops and pubs have often served as my therapy rooms. And I had one teenage patient who was, in my opinion, quite properly prescribed Ritalin for his ADHD. He didn't want to take it; "Ritlain is a drug," he said, " and I don't do drugs." All with a perfectly straight face, based on his belief that the joints he enjoyed were less harmful than tobacco, and unworthy to be called drugs. And besides, all his friends said he was doing drugs because he was on Ritalin. I'd observed my young patient in his pre-Ritalin days and, if anyone benefited from the stimulant, it was him. Helping him to stay compliant with his prescription meant my meeting with him and his friends at a parking lot in a very tough part of the city where we had a loud and spirited discussion. My patient stayed on Ritalin, and his friends were able to observe the benefits and proclaimed it a righteous drug.

"You got to keep him on that shit, man," said one of his friends. That was the consensus, and I was asked to refer a couple of the others to his psychiatrist because they thought the Ritalin might help them to think more clearly.

So much for a nice swanky office. Therapy is almost never about place, and almost always about context.

These thoughts and memories both warm my heart and break it at the same time. Especially at this long, dark time of year. Without the energy which comes from working with patients, and part of a truly alive staff group, it's more difficult. I feel the contradictions more. Each day is harder, and somehow, at least some of the time, I remember to be mindful. My terminology is that "I need to invoke the mindfulness," but my therapist reminds me of the obvious - I statements, simple, declarative, in the here and now. I need to be mindful - in this breath.

A knee injury having resolved itself (to a point), I am back practicing karate - a real life saver for me. I've made an extra effort to keep in touch with my daughter, and have given the benefit of the doubt to my partner in terms of her seeming ambivalence about our relationship. Is it enough? Will it be enough? In this breath...I am mindful of this breath...it is enough...in this breath.

And my deepest wish is to again be sufficiently more healed than wounded that I can again do therapy with people, especially those who have been traumatized. As always, my heart is for the children, and also increasingly for the men and women who have carried trauma home with them from Afghanistan, and all those other places where war persists.

In this breath...compassion and love to all. Those are the best words I can think of with which to say, Merry Christmas!

2 comments:

  1. Compassion and love to you too, Daly. I think we could all use more of that in this season -- more compassion and love, less merchandising and obligations.

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  2. I agree with Robert, Daly. Your words are well chosen, and the sentiment they invoke is strong.

    Christmas is a difficult time of year for me as well. I've never had children, only have one sibling who is cut from a very different cloth than I and who has no children and has lost his spouse, leaving his alone and more stubborn than ever. And my husband's 2 daughters do not place us on the priority list at this time of year. Thank goodness for our abundance of good friends, but alas, most of them are busy with family at Christmas and don't have room for friends. I'd quite rather be away, and we have done that on several occasions at Christmas. With any luck, an impossible-to-resist travel special will appear before us and we will escape this frozen land.

    Wishing you all the best at Christmas - and always,
    Doreen.

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