Tuesday, February 9, 2016

Crazy Is as Crazy Does

When I read this article below, I thought "this is not surprising."  I have met many Social Workers in my profession and many are "licensed therapists" and they are cheaper than Psychiatrists and Psychologists so they frequently are the ones insurance will pay for when you are referred to a counselor.  I prefer Ministers they at least have God on their side and can't be worse.

When I was ill with Traumatic Brain Injury the credentials of the moron I was sent to was that of MSW, a Master in Social Work.  I knew right away I was not going to get the help I need or should have given my injuries as those require a specialized type of professional with duly the equal amount of experience, which my insurance had no desire to pay for.  Add to that  he was also a self obsessed moron, I knew that I would not.  And no I did not diagnose that myself, but two friends, one a clinical psychologist made appointments with him, did not disclose their intent or purpose but to actually see why I was deteriorating under his care.  They needed only one appointment and begged me to see someone else. I chose physical means from naturopathic, meditation, yoga and prayer. I started to recover at a much faster clip.

There is a cross line that many Social Workers have and that is they may not have the power to prescribe drugs but the ability to have people instiutitionalized, their children taken have state or municipal intervention without much documentation nor valid reasoning. They also neglect to do so in many cases for the same reasons they elect to do so - a matter of choice, time and personal issues.

This is not someone I would want monitoring anyone's care. This type of mental health issue is serious enough to warrant whether she should be in that field of work. Sorry but no I don't think anyone who has frequent hospitalizations for serious mental health problem is an position to offer anyone help with equally serious problems.

 I am sure she could find any number of related jobs that would enable her to utilize her credentials and her own experience without direct patient contact. Or maybe just find something else such as grocery clerk.   Thankfully she isn't. But one wonders how many more are like that in her field?

As this comment below from the article says.. she is as well.  We have a problem here clearly:
 This is one of my fears. I work in a group home for people who have serious mental illness and often I wonder if I could end up like them. I struggle with Depression and Anxiety and there have been times in my life where I could barely function. I often wonder if I can truly help the people at the group home when I struggle with mental illness myself. For example one of the residents struggles with major depression and will often come to talk to me about her struggles with depression and advise on how to cope. I feel like a fraud giving her advise when I struggle with just getting out of bed and coming to work. Sometimes I wonder if I would get fired if my supervisors knew how mentally ill I am.



How I went from social worker to psychiatric unit patient 


The Washington Post
 
I am a licensed clinical social worker. And, occasionally, a mental patient. Today, as I eat breakfast in an inpatient psychiatric unit, I am definitely more patient than social worker.

It is Monday morning, and I am eating breakfast across from a muscular, flannel-clad, Paul ­Bunyan-looking patient. Little pieces of his scrambled eggs keep landing on his copper-colored beard. I sort of want to motion with my hand at where the eggs are on his face, but I’m too tired, and I don’t really care. About anything.
My table mate is an odiferous, rebel-flag-T-shirt-wearing, hairy-eared, phlegm-spitting mechanic who, to be honest, would not normally be part of my social sphere. In my professional life, he could be my client. But right now, unshowered and unkempt, I’m looking pretty rough around the edges myself.

At least he is wearing real clothes. Like several others here, I am on suicide watch, so I’m required to wear a hospital gown. I’ve been stripped of my clothes, my ID badge, my degree and my dignity. The staff have even confiscated my bra, explaining that it might be used to hurt myself or others. As if “death by bra” were a common occurrence from which I need protection. Other patients have made the best of our clothing situation, showing runway-worthy ingenuity: Some wear the gown as a robe, others use it as a dress, or use one as a gown and another as an undergarment or sash.

In yesterday’s therapy group, I heard my table mate describe his experience with depression. Now it’s as if we share a secret lover — for to know depression is to make love to the manipulative beast, to learn all of her intimate quirks. Depression draws you to her with such power, making you feel that you’re a willing participant. As she leans in, she whispers in your ear that you are nothing, an incapable nobody, and she gives you murky-colored glasses to see through as a daily reminder.

Depression is seductive
She says that she will stay with you and be your only confidant. She sits on your chest to make getting out of bed difficult. She hangs her full weight off your shoulders, so that even showering or walking feels like an Olympic event. Depression helps you forget anything positive about your life and insists that you sabotage any attempt at living without her. She whispers that the only way out is to die, then reminds you subtly, every day, that you can’t even do that successfully.

The stigma of an intimate relationship with depression means that you can’t reach out for help until it’s too late. My Paul Bunyanesque table mate couldn’t get out of bed anymore to go to his mechanic’s job, nor to maintain a relationship with his girlfriend; I couldn’t get out of bed anymore to work at my Adult Protective Services social-worker job, nor to parent my 3- and 5-year-old daughters.

So what good are we?

After breakfast, I wander into the day room. To make the time pass, I try to guess people’s diagnoses. I think of all the resources and support systems I could set up for my fellow patients. Do they know about that new mental-health housing program? That guy could probably use his VA benefits to pay for his psych meds. Clearly that woman is not ready for discharge — and yet, there she goes. I keep it in my head; that’s not my role here. Social worker, heal thyself (first).

A couple of fellow patients and I play the dangerous, ever-popular game of “What you could use in this place if you really wanted to kill yourself?”

“You could stab yourself with a pencil,” I offer, knowing I’ll get no points for that one — too boring.
“Bundle your sheets together and use them to hang from . . . from . . . from something,” one patient remarks. As we all look around the room for something to hang from, I instantly regret playing this game. What if someone’s not kidding? I think. How irresponsible of me to join in.

“You could just eat the food they bring us,” I say, trying to lighten the mood. I look around. Mood definitely not lightened.

In the hospital, even the simplest tasks become an exercise in humility. I decide that for my major activity of the day, I will shower. I feel exhausted just thinking about it, but I request soap, shampoo and a towel from the 20-something psych tech.

“You’ll just have to WAIT,” she snaps, as if admonishing a whiny child. I hadn’t noticed that she was doing anything; she’s just standing there. I’m twice her age, I think to myself. At home I don’t have to ask permission to get shampoo; I must be really screwed up to need that.
She stalks to the supply closet and comes back. “Here!” she shouts, shoving a bottle at me.
“Can I have a towel, too, please?” I ask in my humblest Oliver Twist manner. (I don’t bother asking for soap; I’ll use the shampoo.) Meanwhile, I’m thinking, “Usually, lady, I’m on the other side of the desk from you, looking at my clients’ charts when I’m here checking on them or consulting.”

She rolls her eyes and brings me a towel. It is only big enough to cover my left nostril.

The shower in my room has no curtain and no handle, just a bare, stripped knob. I try turning it right or left, but I can’t get it to move. I figure maybe its operation is part of my Mini Mental cognitive exam, so I’m determined to figure out how to use it. Surely I can master a shower handle. I summon my years of education and of putting together furniture and toddler toys, but, alas, I just cannot do it.

 I add this to my list of failures in life and, reclothed, emerge defeated from the bathroom. I ask a nurse how to use it.

“Oh, honey,” she says with a slight laugh, “that one’s broken. Didn’t someone tell you? Use the one in the hall.”

I find the hall shower and maneuver the handle to produce a tiny stream of ice-cold water. This shower also has no curtain or lock on the door; anyone could walk in at any time. I feel so tremendously vulnerable, exposed and alone.

Was it worth all this to keep me from killing myself? Really?

This is perhaps my 15th hospitalization, the first being an 18-month stint as an adolescent, after suffering severe abuse at home. But I hadn’t been hospitalized in more than 13 years.
I thought I’d gotten my life together. I have a family, I got through grad school with a 4.0 GPA (after finishing the 10-year depressed-undergraduate plan), and I have a job. I’d thought that if I worked hard in therapy and in life, and took my medicine, I’d be immune to depression and hospitalization.

I was wrong.

It crept on me gradually. Over several months, my ability to do paperwork for my job began to dwindle. I’d call people and not remember whom I’d called. One day I drove to the store in a neighborhood I’ve frequented for years, and I suddenly didn’t know where I was, how I’d gotten there or how to get to where I was going. I pulled over and cried; I could not remember a time when the world was okay.

Protecting my children
Another day, I became disoriented and fell down a whole flight of stairs at home. Bruised and battered, I lay in a heap at the bottom for hours, sobbing. That night, I wrote goodbye notes to my children. Reading the notes aloud after I wrote them gave me pause and a chance to regroup: Even if I couldn’t deal with life, I realized that I wanted to be there for my kids. Those lovelies did not deserve to experience a disturbing, lifelong reality that their mother had killed herself.

I knew that I had to be in a safe place that would protect me from me, so I sucked it up and headed to the ER. After spending 16 hours lying on a gurney by the nurse’s station, I was brought to the psych floor.

Yet today, after my sad breakfast and lonely shower, I feel like I don’t belong here. Okay, I realize that I’m just as worthy of being here as anyone else, but I don’t want to belong here. I will work on getting healthy enough to go home.

I want to garner some respect — to loudly proclaim my credentials:

“I AM A SKILLED CLINICIAN. I AM ABLE TO NEGOTIATE COMPLEX CLINICAL PRESENTATIONS, CAREFULLY ESTABLISHING RAPPORT, AND I HAVE DEFTLY CONDUCTED INDIVIDUAL AND GROUP THERAPIES. I AM AWARE OF THE PSYCHOLOGICAL FORCES THAT UNDERLIE HUMAN BEHAVIOR AND EMOTIONS, AND HOW THESE FORCES RELATE TO EARLY EXPERIENCE. I AM CAPABLE OF GREAT INSIGHT, AND I HAVE HELPED OTHERS TO ACHIEVE INSIGHT AS WELL.”

Instead, I just glance over at the staff at the nursing station.

A nurse, chewing gum and not looking up from her paperwork, declares, “Nine o’clock. Lights out, Katz. Go to bed.”

Katz, a licensed clinical social worker, is a graduate of New Directions, a three-year postgraduate writing program offered by the Washington Center for Psychoanalysis, and editor of its literary magazine. She lives in Rockville with her wife, two daughters, two cats and two bunnies. This article first appeared in the online magazine Pulse — Voices From the Heart of Medicine.

2 comments:

  1. Clearly, I (respectfully) disagree with you, but yours is an interesting perspective. I believe I have better skills such as empathy because of my experience. The Post article was an excerpt taken from a larger, two-part article. Maybe reading the second part might change your mind, or maybe it won't:

    Part I: http://pulsevoices.org/index.php/archive/stories/595-a-day-in-the-life-of-a-psychiatrically-hospitalized-clinician

    Part II: http://pulsevoices.org/index.php/archive/stories/598-a-day-in-the-life-of-a-psychiatrically-hospitalized-clinician-part-3

    Thank you.
    -Liat Katz

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  2. Ms. Katz I read your second part and I believe that you believe you are serving your clients. What my concern is that you are fully disclosing your own mental health history to them or to their next of kin so that they are aware of this and how it can affect treatment - both negatively and positively - as that is what personal experience does, it changes perception. As for empathy/sympathy/compassion one does not need to have been homeless, have cancer, have a personal loss to treat grief, pain, disease. How tragic to think that unless you have walked in someone's shoes you are unable to relate,connect or help them. We all wear our shoes quite differently and one size does not fit all. Good luck and I hope you have a good life and a well one.

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