Friday, March 6, 2020

MENTAL HEALTH DAY

How time flies!** I've been at this for more than a year now and I don't come over to my own blog much. I'm taking a mental health day today and spending time in a cafe with Mr. Aimai and I suddenly really wanted to share some of the work with you all. (Victor, if you are reading, and Yaz, thank you so much for keeping an eye out for me! I think of you both all the time and look for you on the net).

Life at work continues to be enormously satisfying. There is something about passing that one year mark. I feel now like I've seen almost everything at least once.  On one memorable day I had to handle the possible new patients--multiple people who show up and just ask to be seen and have to be evaluated--and also a walk in guy who just wanted to have his hand held. This meant rocketing from an elderly clubfooted gentleman who was sent to us by his priest for too much sinning (Aimai: Is it a Cardinal or  Venal sin? Man: Its a MORTAL sin!" to a sad eyed elfin girl who insisted on speaking for the whole meeting through a large stuffed hippopotamus and who was working at a vegan cupcake store because of course she was. There was the elderly barfly from the wrong side of the white tracks who thinks Matt Damon stole his life story ("That was me working in MIT, I'm a genius, I've had my identity and my work stolen many times, I also wrote Fast and Furious--the God's Eye episode." ) There was the super paranoid schizophrenic who thinks he is "Just depressed" and thinks he has been treated for depression for 20 years instead of for schizophrenia. He is sure that an international conspiracy has robbed him of his life ("They are against me, that is why I'm not married." Aimai "An international conspiracy, if they are so powerful why aren't you dead yet?" Man: "Oh, well, maybe they are going easy on me." ) He is very snotty with me "No offense but I would rather work with a Psychiatrist or a Psychologist or someone with a Ph.D." Aimai "Well, I do have a Ph.D but not the kind you are looking for no, doubt.  However you will just have to make do with me as the Psychiatrists and Psychologists are too expensive to give you therapy, and you seem to need therapy." Him "OK, well, can you tell me in the five minutes we have left how to reduce my paranoia?" Aimai: "No. Not in five minutes. Come back regularly and we'll see what we can do."(Reader: he didn't.)

I have been fired quite a few times by patients who don't like to work with me but I've also had the enormously satisfying experience of having patients come back a few months later and tell my manager "I want to come back to work with Aimai, it feels like a boxing match but I know that something is happening, I can feel the change. My new therapist was a guy and he never said anything. What was the point?"   I found out that this guy--middle aged white ethnic guy--was coming back to me on the same day that I had another revelatory moment which I bundle into the observation that for some white ethnic guys, from an ethnicity which will not be named, shouting "shut the fuck up" turns out to be very soothing. They literally don't feel seen by women or therapists if you don't match the intensity of their emotional level.  I had a very wonderful, miserable, collapsed, chaotic, patient--the kind of guy who has a permanent black cloud hanging over their head and who always makes the wrong choice every time increasing his misery and his poverty and stress, limp in on a cane, back against the wall, struggling to manage his status and housing, to discuss his depression. He had injured himself having unsafe sex with a drug addicted homeless woman ("Really embracing sex and death at the same time, eh?" I said unsympathetically "Come on, Doc, that's harsh!")  Me: "Look, I've got to call it like I see it.  I get it but this is risky for you and her, we need to get ahead of this because you are at risk of losing your housing and you are distracting yourself with primal shit." He: argues, pouts, complains. "With all due respect, Doc you gotta let me make my point."  We were on a short time line and we had paperwork and other stuff to do to save his housing and I ended up cutting him off with the therapeutic adjuration "STFU for a minute" and  he gave an enormous sigh and got up to go and said, with a look of complete bliss "I feel better, I really do. I was so depressed when I got here and now, somehow, I feel better." I was telling this story to my coworkers in team , arguing that you have to co-regulate with your clients by meeting them at the intensity that they are at and then bringing them down to functionality. If someone says "I'VE GOT A PROBLEM" you have to agree at that level YES YOU DO AND I'M LISTENING or they just don't know that you are listening.  One of the others, who had handled this guy for a year before me, said suddenly "Oh my god, no wonder I never got along with him, I'm half Canadian."






**All patient information has been anonymized and changed so that no real patients are described. Descriptions are composites and not true to age, sex, gender, race, or diagnosis.

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