Hello again, poor little neglected blog.
I think I may have figured out a few things about why I have not been motivated to post. I am very firmly in the midst of my midlife crisis, exacerbated by having multiple sclerosis. I think midlife crisis, for me anyway, has to do with having to look at the fact that your ball is starting to roll downhill instead of up.
My son is graduating from high school in a few weeks. He's going off to college in a different state. I know I'll always be a mother, but my role as a mother will significantly change very soon.
I am also seriously downsizing my private practice. Rather than frantically trying to get new clients, I am trying to quietly maintain the ones I have and finishing up them without worries about replacing them.
Other people at age 50 may start to look forward to being able to retire, but it is still far enough into the future in order to feel like just a distant wish.For someone with multiple sclerosis, the future is very much now.
My body is failing me in ways that I should not have to deal with until I am much older or at all. I see people in their 70s traveling, spending time with the active hobbies...heck, just going to the mall and being able to walk to more than three stores without having to stop!
So my midlife crisis is this: how do I transition into the next phase of my life with integrity? How do I maintain relevancy without my role as a therapist trying to grow a practice? Growing my career, rather than downsizing my career has been my focus for my entire adult life. How do I continue doing... things that contribute?
Although I know that there are no new thoughts in the world, and in my writing voice is not stupendously great, I need to continue to explore my thoughts, to expand my subject matter, and remain connected to the world.
So poor little neglected blog, I am going to make a much greater effort to contribute to you, to find my voice, and create connections.
Thursday, May 9, 2013
Wednesday, March 6, 2013
Personality Priorities
Personality priorities I just got back from a Play Therapy conference. Two days training with Terry Kottman, a former professor at the University of Iowa in the prolific writer and trainer in the field of Play Therapy.
I have seen Terry present before. I may have even seen her five or six times. I actually kind of know her, and we are, in fact, birthday buddies. That is, we have the same birthday!
Terry is the kind of Play Therapist I wish I could be. She is smart and funny and so knowledgeable. She is the developer of Aderlerin Play Therapy. I learned something from her every time I go to see her even though many of the things she presents on are repeats to me.
One of the things I love and use frequently is the idea of personality priorities. Personality priorities is anAdlerian concept or idea that we all have a specific thing that our personalities strive to create. Terry has assigned different animals to each priority. Before I tell you which is which and how it works, think about this. Which animal of these for do you feel most connected to or the most like? I did not say the one you would most want to be. There is a difference. So of these four, which do you feel that you are most like:
1. An eagle
2. A lion
3. A chameleon
4. A turtle
Do you know which one? Now I will tell you what the four personality priorities are. We all tend to strive for one of these four things: comfort, control, superiority, or people pleasing. Can you tell which animal is which? Here's how it works. Eagles strive for control and strength. Lions strive for superiority. Chameleons are people pleaser's, and turtle's strive for comfort. Many people have one personality priority that is evident throughout their lives. Many people have one priority and one secondary priority. I am also convinced that priorities can change due to circumstances.
My personality priority is superiority. Within superiority, there are actually two subtypes. There is out- doing or being superior to other people. We all know somebody who was always trying to one up us in some way or another! But the other subtype, achieving, is trying to outdo your self into as many things as you possibly can! This is my personality priority (superiority), and my subtype (achieving).
I have known that trying to achieve many things as possible has a priority for a very long time. In high school, I was definitely an achiever, and was probably trying to be an outdoer as well. My goal in life was to have the most entries in the high school yearbook of anyone in my class. I am proud to say that my name in the index of the yearbook has more lines than anyone else. I sincerely hope that this is not the crowning achievement of my life!
I was well on my way to continue the trend of trying to achieve more and more things when I was diagnosed with multiple sclerosis. What I wanted to achieve in my life, was to make a name for myself in the field of Play Therapy. I became a registered Play Therapist in about 1994. Becoming an RPT-S (registered play therapist at the supervisory level ), was a relatively new credential, so on my certificate, my number is something like 420. That means that there were only about 400 people in the entire world who were registered as play therapists!
I really like to present and train so a major goal of mine was to try to present as many places as possible and become a world-class, well known Play Therapy presenter. Although I was diagnosed with MS in 1996, the symptoms and disabilities were not really noticeable until much later. I had several exacerbations, or worsening of the symptoms, but primarily I could walk around without a cane and hide many of the other small, annoying issues such as weak fine motor skills, or becoming fatigued easily. I presented in Iowa and Illinois at state Play Therapy conferences, and actually presented at the national conference in St. Louis in 2001 or 2002. (I forget which). But the symptoms were becoming more and more evident, at least to me, and I was becoming less and less able to do anything other than work and be a mom. Of course, I was working a full-time job in maintaining a part-time private practice which in itself is kind of a lot to do! But I was becoming less and less able to do anything extra.
When I was laid off from my job as a supervisor in community mental health, I was hoping to have the time and energy to do a lot of the things that would move my career forward. I briefly looked into going back to school for a Ph.D. in clinical social work and even took the MAT-Miller Analogy Test. The test is scored with percentiles rather than with an actual score. I scored in the 98th percentile of people taking the test who wanted to go into clinical social work and in the 99th percentile overall. I just had to tell you and brag a little bit! However, even as I was exploring the possibility, I realize two things. Number one, I didn't want to spend the money when it was getting so close to my son's graduation and entering into college himself. But the other reason was because I really don't have the energy to study for long periods of time while continuing to work.
Although I later realized that getting a Ph.D. would only be a way for me to achieve something else, this was the first time I realized that I am no longer a spring chicken and that the MS really does have an impact on my ability to do the things I'd like to do. I also realized that I cannot maintain the level of energy I need in order to be able to present to large groups of people. You need to be able to stand and move around a lot in order to be an effective lecturer or presenter. That is just not in my capacity any longer.
One of the things that people who have superiority as their personality priority strives to avoid, is feeling meaningless. I have known for a long time and I do not want my life to be meaningless. I am sure this is why I have always wanted to achieve something that will be remembered long after I am gone. Terry Kottman will be remembered long after she is gone. But I have had to learn to be content with the fact that my legacy will not be people remembering my name. I am not leaving behind a book or some new Play Therapy technique that will revolutionize the world of play. I am just going to continue to do my very small part by maintaining a private practice for as long as I am able.
What I have to remember, is that my legacy is not tied to my ego, this body, or this name. And just because I am not leaving some sort of corporeal reminder of my existence, doesn't mean that my work and my legacy is not reverberating into the future. I have to remember that doing good therapeutic work in and of itself is enough of a legacy and will hopefully reverberate by helping people to achieve greatness within their own lives.
I have seen Terry present before. I may have even seen her five or six times. I actually kind of know her, and we are, in fact, birthday buddies. That is, we have the same birthday!
Terry is the kind of Play Therapist I wish I could be. She is smart and funny and so knowledgeable. She is the developer of Aderlerin Play Therapy. I learned something from her every time I go to see her even though many of the things she presents on are repeats to me.
One of the things I love and use frequently is the idea of personality priorities. Personality priorities is anAdlerian concept or idea that we all have a specific thing that our personalities strive to create. Terry has assigned different animals to each priority. Before I tell you which is which and how it works, think about this. Which animal of these for do you feel most connected to or the most like? I did not say the one you would most want to be. There is a difference. So of these four, which do you feel that you are most like:
1. An eagle
2. A lion
3. A chameleon
4. A turtle
Do you know which one? Now I will tell you what the four personality priorities are. We all tend to strive for one of these four things: comfort, control, superiority, or people pleasing. Can you tell which animal is which? Here's how it works. Eagles strive for control and strength. Lions strive for superiority. Chameleons are people pleaser's, and turtle's strive for comfort. Many people have one personality priority that is evident throughout their lives. Many people have one priority and one secondary priority. I am also convinced that priorities can change due to circumstances.
My personality priority is superiority. Within superiority, there are actually two subtypes. There is out- doing or being superior to other people. We all know somebody who was always trying to one up us in some way or another! But the other subtype, achieving, is trying to outdo your self into as many things as you possibly can! This is my personality priority (superiority), and my subtype (achieving).
I have known that trying to achieve many things as possible has a priority for a very long time. In high school, I was definitely an achiever, and was probably trying to be an outdoer as well. My goal in life was to have the most entries in the high school yearbook of anyone in my class. I am proud to say that my name in the index of the yearbook has more lines than anyone else. I sincerely hope that this is not the crowning achievement of my life!
I was well on my way to continue the trend of trying to achieve more and more things when I was diagnosed with multiple sclerosis. What I wanted to achieve in my life, was to make a name for myself in the field of Play Therapy. I became a registered Play Therapist in about 1994. Becoming an RPT-S (registered play therapist at the supervisory level ), was a relatively new credential, so on my certificate, my number is something like 420. That means that there were only about 400 people in the entire world who were registered as play therapists!
I really like to present and train so a major goal of mine was to try to present as many places as possible and become a world-class, well known Play Therapy presenter. Although I was diagnosed with MS in 1996, the symptoms and disabilities were not really noticeable until much later. I had several exacerbations, or worsening of the symptoms, but primarily I could walk around without a cane and hide many of the other small, annoying issues such as weak fine motor skills, or becoming fatigued easily. I presented in Iowa and Illinois at state Play Therapy conferences, and actually presented at the national conference in St. Louis in 2001 or 2002. (I forget which). But the symptoms were becoming more and more evident, at least to me, and I was becoming less and less able to do anything other than work and be a mom. Of course, I was working a full-time job in maintaining a part-time private practice which in itself is kind of a lot to do! But I was becoming less and less able to do anything extra.
When I was laid off from my job as a supervisor in community mental health, I was hoping to have the time and energy to do a lot of the things that would move my career forward. I briefly looked into going back to school for a Ph.D. in clinical social work and even took the MAT-Miller Analogy Test. The test is scored with percentiles rather than with an actual score. I scored in the 98th percentile of people taking the test who wanted to go into clinical social work and in the 99th percentile overall. I just had to tell you and brag a little bit! However, even as I was exploring the possibility, I realize two things. Number one, I didn't want to spend the money when it was getting so close to my son's graduation and entering into college himself. But the other reason was because I really don't have the energy to study for long periods of time while continuing to work.
Although I later realized that getting a Ph.D. would only be a way for me to achieve something else, this was the first time I realized that I am no longer a spring chicken and that the MS really does have an impact on my ability to do the things I'd like to do. I also realized that I cannot maintain the level of energy I need in order to be able to present to large groups of people. You need to be able to stand and move around a lot in order to be an effective lecturer or presenter. That is just not in my capacity any longer.
One of the things that people who have superiority as their personality priority strives to avoid, is feeling meaningless. I have known for a long time and I do not want my life to be meaningless. I am sure this is why I have always wanted to achieve something that will be remembered long after I am gone. Terry Kottman will be remembered long after she is gone. But I have had to learn to be content with the fact that my legacy will not be people remembering my name. I am not leaving behind a book or some new Play Therapy technique that will revolutionize the world of play. I am just going to continue to do my very small part by maintaining a private practice for as long as I am able.
What I have to remember, is that my legacy is not tied to my ego, this body, or this name. And just because I am not leaving some sort of corporeal reminder of my existence, doesn't mean that my work and my legacy is not reverberating into the future. I have to remember that doing good therapeutic work in and of itself is enough of a legacy and will hopefully reverberate by helping people to achieve greatness within their own lives.
Sunday, March 3, 2013
A Change of Subject
I have discovered that posting about MS has its limitations.
How many times can you talk about what a drag it is to not be able to go shopping? So, while this blog will remain primarily a place for me to have a forum for discussing life with multiple sclerosis, I think it will be a lot more interesting if I talk about life as a therapist. My life may be slow and boring, but being a therapist and getting to know my clients is a lot more interesting!
I really want to talk about what it's like to be in the process of doing therapy. I know I could talk about diagnoses and what is known as "best practice therapy", but that's a lot less personal and a lot more boring.
I talked a little about countertransference in my last post. So I want to give you know a peek into the head of the therapist in the process of being a therapist.
My very first therapeutic job was as a "psych technician" on the mental health unit of a hospital, which was really just a glorified babysitting job. We were expected to observe patients and see what they were doing, write in the patient charts at the end of the shift, sit with a patient while they were on suicide watch, that sort of thing. But we also got to run some groups or talk with the patients one on one if they requested it.
This hospital had a mixed unit of adults and adolescents. I'd usually worked with the adolescent. I'm sure, in those days, that sometimes it would be hard to tell me apart from the patients. I was just out of undergraduate school which meant it could be as little as four years between me, an authority figure, and the kids on the unit. Of course, at the time, I had no concept of how the clients may be responding to me as a peer rather than a grown up.
With my bachelors degree in psychology, I was barely equipped to understand issues which would land teenagers in hospital psychiatric unit! At the time, there was a diagnosis called Over- Anxious Reaction to Adolescents, also known for us OARA. This is a defunct diagnosis because it's really sort of describing every single adolescents in a way, isn't it? It is likely that most of these kids had anxiety disorders, or depression, or were being abused, or were just engaging in some of the antisocial behaviors that teenagers engage in!
Nowadays, kids who are hospitalized have to be considered a danger to themselves or others, but at the time, I think parents could arbitrarily have their kids admitted for an attitude adjustment or something!
When I think about this job, they're actually at least four or five kids, and some adults as well, from whom I met a great deal about the therapist and patient interaction. I'm pretty sure I didn't do any long-lasting psychological damage to any of them! But I'm not sure that the interactions I had were anything other than just trying to listen to them. A really large part of being a therapist is really listening without judgment. This may have been my first learning experience of what it means to just listen.
It is much easier to give advice or send somebody to a psychiatrist for medication than it is to just listen and make a serious attempt to understand what is actually being communicated.
I think one of the most profound experiences of learning to listen was actually with one of the adults in the unit. When I look at pictures of myself now from that time, I realized how incredibly young I was and how incredibly young I looked! I can't imagine how anyone took me seriously! I look like Alice in Wonderland!
When the patients were suicidal, they are placed on something called "constant observation". This was the boring job of just sitting outside the patient's room and making sure that they didn't do anything to hurt themselves. Most of the time, the patients would just ignore us, but sometimes they would engage us in a conversation. I actually do remember having a lot of respect for the adults. There were a few who were psychotic. One elderly lady, who was obviously a very sweet and dignified woman when she wasn't psychotic, asked me to write a letter for her. She dictated to me "I am being held prisoner and someone is watching me." She then said, "Sweetie, what is your name?" I told her my name was Amy and she said, "Okay. Write this down. Nurse Amy is the worst most horrible f ***ing bitch in the entire world." So, I diligently wrote what she said, addressed the envelope to her son, and told her I would put it in the mail right away.
It would have been very easy to take this personally, or to try to explain to her that no one was holding her hostage. I'm not so sure that colluding in her delusion was such a smart idea, but I certainly could have made things a lot worse by becoming defensive.
Although this was a good exercise in just listening without judging or trying to fix things, there were other times as well when listening without fixing was the only course of action I could take. My inexperience and lack of training were large contributor to learning to listen as a course of action in interacting with the patients. I remember sitting with a woman and listening as she told me that she was powerless to change things in life. I remember trying to get her to understand that she had choices in terms of how she reacted to situations. I can't remember what her situation was, I do recall that it was something that was well within her ability to change. After an hour of attempting to get her to see that she did indeed have choices, and having her continue to tell me that he didn't do what I was talking about, I left her room feeling defeated and worthless. A few of the psychiatric nurses were very understanding with me, and one of them said "It sounds as if you have an expectation that you are a failure if you can't get a client to listen to you and make changes.". That was a statement which resonated for me for a long time! The therapist is not responsible for the changes in the clients. You can only listen, make a concerted effort to understand, and then invite your clients to listen to you while you provide a different way of thinking. The healing part is not in the advice. It is in the interaction.
That is enough for today, and I will try very hard to keep neglecting my blog for so long next time.
How many times can you talk about what a drag it is to not be able to go shopping? So, while this blog will remain primarily a place for me to have a forum for discussing life with multiple sclerosis, I think it will be a lot more interesting if I talk about life as a therapist. My life may be slow and boring, but being a therapist and getting to know my clients is a lot more interesting!
I really want to talk about what it's like to be in the process of doing therapy. I know I could talk about diagnoses and what is known as "best practice therapy", but that's a lot less personal and a lot more boring.
I talked a little about countertransference in my last post. So I want to give you know a peek into the head of the therapist in the process of being a therapist.
My very first therapeutic job was as a "psych technician" on the mental health unit of a hospital, which was really just a glorified babysitting job. We were expected to observe patients and see what they were doing, write in the patient charts at the end of the shift, sit with a patient while they were on suicide watch, that sort of thing. But we also got to run some groups or talk with the patients one on one if they requested it.
This hospital had a mixed unit of adults and adolescents. I'd usually worked with the adolescent. I'm sure, in those days, that sometimes it would be hard to tell me apart from the patients. I was just out of undergraduate school which meant it could be as little as four years between me, an authority figure, and the kids on the unit. Of course, at the time, I had no concept of how the clients may be responding to me as a peer rather than a grown up.
With my bachelors degree in psychology, I was barely equipped to understand issues which would land teenagers in hospital psychiatric unit! At the time, there was a diagnosis called Over- Anxious Reaction to Adolescents, also known for us OARA. This is a defunct diagnosis because it's really sort of describing every single adolescents in a way, isn't it? It is likely that most of these kids had anxiety disorders, or depression, or were being abused, or were just engaging in some of the antisocial behaviors that teenagers engage in!
Nowadays, kids who are hospitalized have to be considered a danger to themselves or others, but at the time, I think parents could arbitrarily have their kids admitted for an attitude adjustment or something!
When I think about this job, they're actually at least four or five kids, and some adults as well, from whom I met a great deal about the therapist and patient interaction. I'm pretty sure I didn't do any long-lasting psychological damage to any of them! But I'm not sure that the interactions I had were anything other than just trying to listen to them. A really large part of being a therapist is really listening without judgment. This may have been my first learning experience of what it means to just listen.
It is much easier to give advice or send somebody to a psychiatrist for medication than it is to just listen and make a serious attempt to understand what is actually being communicated.
I think one of the most profound experiences of learning to listen was actually with one of the adults in the unit. When I look at pictures of myself now from that time, I realized how incredibly young I was and how incredibly young I looked! I can't imagine how anyone took me seriously! I look like Alice in Wonderland!
When the patients were suicidal, they are placed on something called "constant observation". This was the boring job of just sitting outside the patient's room and making sure that they didn't do anything to hurt themselves. Most of the time, the patients would just ignore us, but sometimes they would engage us in a conversation. I actually do remember having a lot of respect for the adults. There were a few who were psychotic. One elderly lady, who was obviously a very sweet and dignified woman when she wasn't psychotic, asked me to write a letter for her. She dictated to me "I am being held prisoner and someone is watching me." She then said, "Sweetie, what is your name?" I told her my name was Amy and she said, "Okay. Write this down. Nurse Amy is the worst most horrible f ***ing bitch in the entire world." So, I diligently wrote what she said, addressed the envelope to her son, and told her I would put it in the mail right away.
It would have been very easy to take this personally, or to try to explain to her that no one was holding her hostage. I'm not so sure that colluding in her delusion was such a smart idea, but I certainly could have made things a lot worse by becoming defensive.
Although this was a good exercise in just listening without judging or trying to fix things, there were other times as well when listening without fixing was the only course of action I could take. My inexperience and lack of training were large contributor to learning to listen as a course of action in interacting with the patients. I remember sitting with a woman and listening as she told me that she was powerless to change things in life. I remember trying to get her to understand that she had choices in terms of how she reacted to situations. I can't remember what her situation was, I do recall that it was something that was well within her ability to change. After an hour of attempting to get her to see that she did indeed have choices, and having her continue to tell me that he didn't do what I was talking about, I left her room feeling defeated and worthless. A few of the psychiatric nurses were very understanding with me, and one of them said "It sounds as if you have an expectation that you are a failure if you can't get a client to listen to you and make changes.". That was a statement which resonated for me for a long time! The therapist is not responsible for the changes in the clients. You can only listen, make a concerted effort to understand, and then invite your clients to listen to you while you provide a different way of thinking. The healing part is not in the advice. It is in the interaction.
That is enough for today, and I will try very hard to keep neglecting my blog for so long next time.
Monday, February 18, 2013
countertransferancve
Transference and countertransference
I have already talked about intersubjectivity. Remember? Intersubjectivity is how I feel about you and how you feel about me. But it also includes my sharing with you what my experience is of how I feel about you. Countertransference, on the other hand, is also how I feel about you but it is not something I would share!
Transference is the idea that a client will transfer their feelings, either positive or negative, about other people including their mother or father, on to the therapist. When we recognize that a client is attributing some attribute to you which is clearly incorrect, then we can work on why a client may be misidentifying other people's responses to them.
For example, I was working with a kid in foster care. We were playing catch and at one point, because I have no athletic skill whatsoever, I accidentally hit him. We were playing with a very soft ball because I have no athletic skill whatsoever! However, he cringed and said, " Please don't hit me!". I said, "Don't you know that I would never hit you?" He said, "Well , I am 99% sure." This is countertransference. The kid was transferring his idea that all adults will hit him on to me. I am 100% sure I would never hit him, and even though he felt pretty safe and comfortable with me, he just couldn't imagine that there could be an adult who would not hit him since that was what he experienced with his parents.
Now, countertransference is a whole other ball game. Countertransference can either be useful or it can be very detrimental to the client relationship and the therapy. I think this is especially useful when working with kids, because I can always ask myself, "What would it be like to live with this child seven days a week?" There are many kids who elicits a desire to throw them right out the window! I have not had very many clients who I have disliked. When I do dislike them, I know this is something about them that needs to be addressed. That is eliciting behavior. The client is eliciting this by their behavior.
But sometimes the countertransference is something that I am transferring on to a client's and this is not useful for the therapy.
When I was working at LifeLink and had just been diagnosed with MS, this became a much more powerful issue for me. I had many clients, the parents of the foster children, who were attempting to recover from drug addiction. Something like 80% of kids in foster care, and least in Chicago, were placed there because their parents were addicted to drugs. I had many parents who were attempting to recover from heroin addiction. Heroin withdrawal is especially painful, and I would have many women say to me that they couldn't stand the pain and had to relapse. This made me crazy because it was very hard for me to think that they were having any harder time than I was, and I didn't need to be on heroin!
Of course this is a very false analogy, and I knew that it wasn't fair of me at all to suggest that are situations where similar in any way. Most of these women were from the south side and the projects and had no education or even opportunities for education. They were in the cycle of poverty and had been brought up in, at the very least, unsupportive families and at the worst, abusive families. Most of them could tell me about horrors they experience when they were young, including physical and sexual abuse, homelessness, parents being addicted to drugs, you name it. Did you ever see the movie, Precious? As horrific as the experiences depicted in this movie seem, they are not far from the truth. Most of the time, when working with parents who had been through these experiences, I had a lot of compassion. After the MS, it was more of a struggle.
Okay, now that I've gotten all intense, I want to keep writing about countertransference, but with the idea of letting you know that kinds of things that therapists think, that they will never share with you.
But that will be a topic for another blog.
I have already talked about intersubjectivity. Remember? Intersubjectivity is how I feel about you and how you feel about me. But it also includes my sharing with you what my experience is of how I feel about you. Countertransference, on the other hand, is also how I feel about you but it is not something I would share!
Transference is the idea that a client will transfer their feelings, either positive or negative, about other people including their mother or father, on to the therapist. When we recognize that a client is attributing some attribute to you which is clearly incorrect, then we can work on why a client may be misidentifying other people's responses to them.
For example, I was working with a kid in foster care. We were playing catch and at one point, because I have no athletic skill whatsoever, I accidentally hit him. We were playing with a very soft ball because I have no athletic skill whatsoever! However, he cringed and said, " Please don't hit me!". I said, "Don't you know that I would never hit you?" He said, "Well , I am 99% sure." This is countertransference. The kid was transferring his idea that all adults will hit him on to me. I am 100% sure I would never hit him, and even though he felt pretty safe and comfortable with me, he just couldn't imagine that there could be an adult who would not hit him since that was what he experienced with his parents.
Now, countertransference is a whole other ball game. Countertransference can either be useful or it can be very detrimental to the client relationship and the therapy. I think this is especially useful when working with kids, because I can always ask myself, "What would it be like to live with this child seven days a week?" There are many kids who elicits a desire to throw them right out the window! I have not had very many clients who I have disliked. When I do dislike them, I know this is something about them that needs to be addressed. That is eliciting behavior. The client is eliciting this by their behavior.
But sometimes the countertransference is something that I am transferring on to a client's and this is not useful for the therapy.
When I was working at LifeLink and had just been diagnosed with MS, this became a much more powerful issue for me. I had many clients, the parents of the foster children, who were attempting to recover from drug addiction. Something like 80% of kids in foster care, and least in Chicago, were placed there because their parents were addicted to drugs. I had many parents who were attempting to recover from heroin addiction. Heroin withdrawal is especially painful, and I would have many women say to me that they couldn't stand the pain and had to relapse. This made me crazy because it was very hard for me to think that they were having any harder time than I was, and I didn't need to be on heroin!
Of course this is a very false analogy, and I knew that it wasn't fair of me at all to suggest that are situations where similar in any way. Most of these women were from the south side and the projects and had no education or even opportunities for education. They were in the cycle of poverty and had been brought up in, at the very least, unsupportive families and at the worst, abusive families. Most of them could tell me about horrors they experience when they were young, including physical and sexual abuse, homelessness, parents being addicted to drugs, you name it. Did you ever see the movie, Precious? As horrific as the experiences depicted in this movie seem, they are not far from the truth. Most of the time, when working with parents who had been through these experiences, I had a lot of compassion. After the MS, it was more of a struggle.
Okay, now that I've gotten all intense, I want to keep writing about countertransference, but with the idea of letting you know that kinds of things that therapists think, that they will never share with you.
But that will be a topic for another blog.
Friday, February 15, 2013
Fatigue
Before I start, let me just say that another reason I know that I am not a writer is by the frequency that I put off completing started projects. I have lots of ideas and first lines, but getting them to some kind of fruition remains somewhat futile!
Now that I've said that, let me talk about today's topic which is fatigue. You may think that fatigue is only feeling tired and needing to go to bed or take a nap. However, fatigue includes muscle fatigue or even mental fatigue.
Did you know that most people will have to quit working because of MS actually do so because of the fatigue. I always thought I was pretty lucky that I don't have seriously excessive tiredness. I do have to go to bed early and sometimes would like to take a nap in midafternoon, but I generally am functional during daytime hours. However, I am actually greatly impacted by muscles fatigue. It really doesn't take much. In the morning when I go to work out, I can walk in relatively quickly and park my cane while I use the weightlifting equipment. At least two to three times a week I get on the elliptical machine. I actually think it's kind of fun because, as I have said before, this is not a movement I can do in real life. It's as close as I can get to running! My goal is usually at least three quarters of a mile. If I'm feeling pretty good after that, I will continue on for a whole mile. I can tell when it is time to get off the machine when my knees start to knock together and a have to use more hip muscles to get my legs to move the pedals. I am not winded. I am not breathing heavy or sweating. I would love to be able to stay on for half an hour or longer, but I also like to be able to walk to my car.
Even on the days where I don't get on the elliptical machine and only do weightlifting, it is still a struggle to get to my car without tripping. Once the car door is open, I literally cannot lift my leg high enough to put it into the car. I have to just sit down and then lift our legs physically with my arms.
This is the kind of muscle fatigue that is pretty debilitating. People who have jobs where they have to stand or do physical labor or lift things, it makes continuing to work an actual impossibility. For professionals such as myself, the need to stand is limited. They need to lift is limited. And, apart from picking up toys, there is just not much physical labor involved in what I do. This is why I have been able to go close to 18 years with multiple sclerosis and still work. And until I got laid off, I was actually working two jobs the entire time that I have had MS, because I have always maintained a private practice. Now that I only have one job, I absolutely remain ambivalent about not working. I probably over identify with my role as a therapist. Because I am not a real writer, the writing life does not seem to be a viable option for something else to do, and I really do love the work. But I am tired and they are days where I think I am shortchanging my clients because I am so not with it. Even when I use tricks like trying to space out my clients, I just lack motivation and energy.
Despite my ambivalence about stopping working, it is a real frustration that I am not viewed as someone who is not handicapped enough. I guess just because at any moment I might trip and fall, or because I might fall asleep in a client session (this has actually happened), the Disability Administration does not consider me someone who deserves to benefit from guaranteed health care or financial security. I know I sound a little whiny and bitter and petty today. But really I am not angry. I am just very confused about the definition of disability and am not sure what someone has to endure to receive some benefit. I am not trying to say that I want to be one of those "takers". I'm just fatigued and tired of wondering when I'll HAVE to stop working. I guess in a world where I have no control, I would like to feel a little control over my career, and being able to know that my insurance will not be at risk, will let me be a little bit more in control of my destiny.
Now that I've said that, let me talk about today's topic which is fatigue. You may think that fatigue is only feeling tired and needing to go to bed or take a nap. However, fatigue includes muscle fatigue or even mental fatigue.
Did you know that most people will have to quit working because of MS actually do so because of the fatigue. I always thought I was pretty lucky that I don't have seriously excessive tiredness. I do have to go to bed early and sometimes would like to take a nap in midafternoon, but I generally am functional during daytime hours. However, I am actually greatly impacted by muscles fatigue. It really doesn't take much. In the morning when I go to work out, I can walk in relatively quickly and park my cane while I use the weightlifting equipment. At least two to three times a week I get on the elliptical machine. I actually think it's kind of fun because, as I have said before, this is not a movement I can do in real life. It's as close as I can get to running! My goal is usually at least three quarters of a mile. If I'm feeling pretty good after that, I will continue on for a whole mile. I can tell when it is time to get off the machine when my knees start to knock together and a have to use more hip muscles to get my legs to move the pedals. I am not winded. I am not breathing heavy or sweating. I would love to be able to stay on for half an hour or longer, but I also like to be able to walk to my car.
Even on the days where I don't get on the elliptical machine and only do weightlifting, it is still a struggle to get to my car without tripping. Once the car door is open, I literally cannot lift my leg high enough to put it into the car. I have to just sit down and then lift our legs physically with my arms.
This is the kind of muscle fatigue that is pretty debilitating. People who have jobs where they have to stand or do physical labor or lift things, it makes continuing to work an actual impossibility. For professionals such as myself, the need to stand is limited. They need to lift is limited. And, apart from picking up toys, there is just not much physical labor involved in what I do. This is why I have been able to go close to 18 years with multiple sclerosis and still work. And until I got laid off, I was actually working two jobs the entire time that I have had MS, because I have always maintained a private practice. Now that I only have one job, I absolutely remain ambivalent about not working. I probably over identify with my role as a therapist. Because I am not a real writer, the writing life does not seem to be a viable option for something else to do, and I really do love the work. But I am tired and they are days where I think I am shortchanging my clients because I am so not with it. Even when I use tricks like trying to space out my clients, I just lack motivation and energy.
Despite my ambivalence about stopping working, it is a real frustration that I am not viewed as someone who is not handicapped enough. I guess just because at any moment I might trip and fall, or because I might fall asleep in a client session (this has actually happened), the Disability Administration does not consider me someone who deserves to benefit from guaranteed health care or financial security. I know I sound a little whiny and bitter and petty today. But really I am not angry. I am just very confused about the definition of disability and am not sure what someone has to endure to receive some benefit. I am not trying to say that I want to be one of those "takers". I'm just fatigued and tired of wondering when I'll HAVE to stop working. I guess in a world where I have no control, I would like to feel a little control over my career, and being able to know that my insurance will not be at risk, will let me be a little bit more in control of my destiny.
Friday, February 8, 2013
rewriting
I accidently deleted a blog I spent all morning writing! That is the kind of thing that I do it makes me so incredibly angry!
It wasn't saying anything spectacularly wonderful but I still don't want to have to re-write the entire thing and now I am wondering whether what was saying was anything worthwhile anyway. The ironic thing is that I was writing about depression and being able to override the anhedonia (or lack of enjoyment in life), and the feeling of being so unmotivated. The other ironic thing is that anger is very motivating and energizing so I will try again to write about depression and try to say something worthwhile.
Did you know that 41% of people with multiple sclerosis suffer from some form of depression. This is partially because the having the illness and dealing with all of the struggles. It is also partially because of physiological changes in the brain. Due to the plaques and the scarring the brain is less able to produce serotonin or to transmit serotonin between neurons. Physiological depression is more difficult to override than situational depression.
Therapy and mental illness are highly misunderstood. When I meet new people and I tell them what I do I frequently have people say something to me like "I'd better watch what I say to you"! The fact that people say that at all is actually diagnosable, but I generally don't spend a lot of time thinking about other people's mental or emotional difficulties if they aren't in therapy with me.
Actually, I think that everyone could benefit from going to therapy at least a few times. No matter how healthy you think you are, there are always things that shaped our behavior. We all have our memes, or entrenched belief systems that may or may not be accurate in therapy can help you to uncover these things and be more present in your life.
Depression is a continuum. The depression that I struggle with is very mild. The kid that I write about on this blog sometimes is not on the far end of the continuum on the other side, believe it or not. He functions. He goes to work and is able to get out of bed in the morning and do what he needs to do. People with the most severe depression can't even get out of bed in the morning. They are overwhelmed by sadness and hopelessness. They see suicide is a viable option to end the sadness and pain. These are the people who need medications the most! Most people with depression fall somewhere in the middle. These are the people who can benefit the most from therapy and who may or may not benefit from medications. These are the people who need to learn how to think different thoughts and change behaviors in order to keep from being overwhelmed by negativity.
I started this blog in order to feel that I can give people some insight into what it's like to have MS. I also started it in order to battle the very things that sometimes keep me from doing it! This blog keeps me feeling that I remain relevant, and this keep me from feeling overwhelmed by thoughts that I am worthless because I can do what I used to do. So here is my blog. Well written or not, it is as much for me and my sanity as it is for imparting any knowledge.
I started the blog that I deleted with this thought. I am not a real writer. Real writers write. They see a blank page and they want to fill it with their thoughts. They know how to share those thoughts encrypted in wonderful prose or in poetry. They know how to arrange the words into pleasing sentences in such a way as to grab the reader's attention and convey their messages so that people will want to read them. I am trying to arrange my words and my thoughts on the page so that you will want to read them.
I hope that you will continue to read it and that I won't delete any more of them on accident!
It wasn't saying anything spectacularly wonderful but I still don't want to have to re-write the entire thing and now I am wondering whether what was saying was anything worthwhile anyway. The ironic thing is that I was writing about depression and being able to override the anhedonia (or lack of enjoyment in life), and the feeling of being so unmotivated. The other ironic thing is that anger is very motivating and energizing so I will try again to write about depression and try to say something worthwhile.
Did you know that 41% of people with multiple sclerosis suffer from some form of depression. This is partially because the having the illness and dealing with all of the struggles. It is also partially because of physiological changes in the brain. Due to the plaques and the scarring the brain is less able to produce serotonin or to transmit serotonin between neurons. Physiological depression is more difficult to override than situational depression.
Therapy and mental illness are highly misunderstood. When I meet new people and I tell them what I do I frequently have people say something to me like "I'd better watch what I say to you"! The fact that people say that at all is actually diagnosable, but I generally don't spend a lot of time thinking about other people's mental or emotional difficulties if they aren't in therapy with me.
Actually, I think that everyone could benefit from going to therapy at least a few times. No matter how healthy you think you are, there are always things that shaped our behavior. We all have our memes, or entrenched belief systems that may or may not be accurate in therapy can help you to uncover these things and be more present in your life.
Depression is a continuum. The depression that I struggle with is very mild. The kid that I write about on this blog sometimes is not on the far end of the continuum on the other side, believe it or not. He functions. He goes to work and is able to get out of bed in the morning and do what he needs to do. People with the most severe depression can't even get out of bed in the morning. They are overwhelmed by sadness and hopelessness. They see suicide is a viable option to end the sadness and pain. These are the people who need medications the most! Most people with depression fall somewhere in the middle. These are the people who can benefit the most from therapy and who may or may not benefit from medications. These are the people who need to learn how to think different thoughts and change behaviors in order to keep from being overwhelmed by negativity.
I started this blog in order to feel that I can give people some insight into what it's like to have MS. I also started it in order to battle the very things that sometimes keep me from doing it! This blog keeps me feeling that I remain relevant, and this keep me from feeling overwhelmed by thoughts that I am worthless because I can do what I used to do. So here is my blog. Well written or not, it is as much for me and my sanity as it is for imparting any knowledge.
I started the blog that I deleted with this thought. I am not a real writer. Real writers write. They see a blank page and they want to fill it with their thoughts. They know how to share those thoughts encrypted in wonderful prose or in poetry. They know how to arrange the words into pleasing sentences in such a way as to grab the reader's attention and convey their messages so that people will want to read them. I am trying to arrange my words and my thoughts on the page so that you will want to read them.
I hope that you will continue to read it and that I won't delete any more of them on accident!
Thursday, January 24, 2013
Have you ever been fired from a job?
I actually have been fired three times and that doesn't count being laid off from my last job!
The first time I was fired was when I was in graduate school. I was working at a group home for developmentally delayed adults as basically a house parent. The agency was fairly new and had some administrative issues, to put it gracefully. When I first started, there was a very good house manager who tried really hard to stay on top of things. She would make sure that the home was well maintained that she had good communication with the line staff. I don't know why she quit, but when she did, things sort of went downhill. We went through a couple of relatively decent House managers in the short time that I worked there. The fact that they didn't stay was probably a pretty good clue about what was going on with the higher administration. The last guy they hired while I worked there (because he was the one who fired me), tried to take charge without really knowing the residents. We had an older man whose hygiene was n ot his main priority. Some of the residents were clearly severely delayed. But some of them were higher functioning. The gentleman in question was one of the higher functioning residents. He could even read a little bit at very lower-level. The new house manager told me that I was to make the man take a bath, physically, scrubbing him myself if I needed to. I tried to reason with him and explain to him why having a young woman physically give a bath to an older man may not be the best idea. He said "if you refuse to bathe him, you are being insubordinate and you are fired.". I refused to bathe the man and that was it. My first firing experience.
My second firing experience was much more traumatic. It was my third full-time job after graduate school. My first job at the Center for Children's Services in Danville was a wonderful experience. I loved the people there, my supervisor, and my clients. But I left to move to Chicago to get married. My first job in Chicago was at the Jewish Children's Bureau. I loved my supervisor and the people I worked with. I loved my clients, too. But I hated the casework that I was doing. So it got another job at therapeutic day school called Learning House.
The Learning House was the privately owned for-profit day school for troubled adolescents. At first glance it seemed lovely place to work. The kids were great, and I liked the teachers. My supervisor seemed clinically astute so I thought I could learn something from him. But there were troubles that began soon after beginning there. The owners/managers of the school had some real issues!
Codependence is a fairly well known topic. Most people think of codependence as assisting an alcoholic in remaining an alcoholic without meaning to. But codependence is actually a way of interacting with someone to keep them from or acting in certain ways. Everyone at that school had a codependent relationship with the owner, Mark. We all tiptoed around him to keep him from exploding or being angry about some slight. He would yell at the staff for something that was done unintentionally. When there was an issue, a simple directive stated in a polite way would have sufficed. But Mark's response was to yell and call people names.
The firing didn't happen all at once as it did in the first circumstance. I was unhappy there and felt that no matter what, I could not make Mark happy. My supervisor had arranged for us to have an intern from the University of Chicago. She was in the social work program and since my supervisor was not a licensed clinical social worker, I had to supervisor. She was wonderful. Very smart and capable. But it was evident to her that this was a somewhat toxic environment. Much of supervision with her was spent discussing how to navigate the politics and keep Mark happy. During that time, I actually got a new job. My dad knew how unhappy I was. He had me call someone he knew at Lifelink Corporation. They were looking for licensed clinicians for a new program in foster care. So I went to the interviews and I was hired! Hooray! Unfortunately, this meant that I would be leaving my poor intern fend for herself and without a social worker to supervise her. When I told her I was leaving, she said she didn't want to stay there without me. She spoke with her advisor at school and told him about the situation. She requested to change internships. When I told my supervisor that I was leaving, I also told him that the intern would be leaving as well.
I should've seen it coming. Mark was furious that I had told her that I was leaving before I told him. He was also furious that she was leaving and blamed it on me. He basically threatens to take my license saying that this was unethical. I'm pretty sure it's not. He made life very uncomfortable for me for the next week or so. He finally told me I was fired. This really was an incident where I could've said "you can't fire me! I quit!" He didn't give me any opportunity to say goodbye to any of my clients, and in fact canceled an appointment I had without telling me. I sat around and waited for the client, and when I called her, she said she was confused because market already canceled the appointment for me. Awkward!
I later found out that he told the kids that they could write the letters to say goodbye and he would send them. I never received any letters. He told them I had to be fired because of unethical behavior. I really wish I could sue his ass for defamation of character!
A couple of months later, my husband and I bought a new car. I had to verify my work experience for the last year. I had just started at LifeLink so not enough time had passed. I gave them the number of the learning house and they called Mark. A car salesman told me that Mark had told him not to sell me a car and that I was a bad risk. This is highly illegal. Nevertheless, we did get the car. Despite knowing that I had actually quit, the experience of being "fired" was uncomfortable for a very long time.
The last time, and hopefully the final time, that I was fired was recently from a side gig I had. I was doing professional presentations for Aetna. They would send me to various locations and I were present on a variety of topics including cultural sensitivity, stress management, positive communication, things like that. They would send me the materials including handouts and the PowerPoint and I would just present. I would try to add some material if it was appropriate. The last couple of times I was not well received. People didn't like that I went off script and they didn't like that I talked about my own experiences sometimes. So the company called and told me that I got some bad reviews. They gave me one final gig after that. I'm pretty sure the company that I was presenting to may have been told that I was being tested out. I was met with stony silence. No one participated in any discussion or activities. They didn't laugh at any jokes or ask any questions. Try to have a conversation sometime with someone who is paying any attention to you. It is a lesson in futility!
Now I am in business for myself and it is unlikely that I will fire myself. Clients fire you all the time, and I am able to keep this from feeling personal in most cases.
It is funny how your idea of what is really awful morphs when you are fighting a chronic illness. Being fired from the Learning House seemed to be shameful and embarrassing event. But when I look at it now, not only was it pretty meaningless in the grand scheme of things, but it's laughable that I could see that as any kind of a challenge.
Trying to put my pants on in the morning...That's a challengw!
I actually have been fired three times and that doesn't count being laid off from my last job!
The first time I was fired was when I was in graduate school. I was working at a group home for developmentally delayed adults as basically a house parent. The agency was fairly new and had some administrative issues, to put it gracefully. When I first started, there was a very good house manager who tried really hard to stay on top of things. She would make sure that the home was well maintained that she had good communication with the line staff. I don't know why she quit, but when she did, things sort of went downhill. We went through a couple of relatively decent House managers in the short time that I worked there. The fact that they didn't stay was probably a pretty good clue about what was going on with the higher administration. The last guy they hired while I worked there (because he was the one who fired me), tried to take charge without really knowing the residents. We had an older man whose hygiene was n ot his main priority. Some of the residents were clearly severely delayed. But some of them were higher functioning. The gentleman in question was one of the higher functioning residents. He could even read a little bit at very lower-level. The new house manager told me that I was to make the man take a bath, physically, scrubbing him myself if I needed to. I tried to reason with him and explain to him why having a young woman physically give a bath to an older man may not be the best idea. He said "if you refuse to bathe him, you are being insubordinate and you are fired.". I refused to bathe the man and that was it. My first firing experience.
My second firing experience was much more traumatic. It was my third full-time job after graduate school. My first job at the Center for Children's Services in Danville was a wonderful experience. I loved the people there, my supervisor, and my clients. But I left to move to Chicago to get married. My first job in Chicago was at the Jewish Children's Bureau. I loved my supervisor and the people I worked with. I loved my clients, too. But I hated the casework that I was doing. So it got another job at therapeutic day school called Learning House.
The Learning House was the privately owned for-profit day school for troubled adolescents. At first glance it seemed lovely place to work. The kids were great, and I liked the teachers. My supervisor seemed clinically astute so I thought I could learn something from him. But there were troubles that began soon after beginning there. The owners/managers of the school had some real issues!
Codependence is a fairly well known topic. Most people think of codependence as assisting an alcoholic in remaining an alcoholic without meaning to. But codependence is actually a way of interacting with someone to keep them from or acting in certain ways. Everyone at that school had a codependent relationship with the owner, Mark. We all tiptoed around him to keep him from exploding or being angry about some slight. He would yell at the staff for something that was done unintentionally. When there was an issue, a simple directive stated in a polite way would have sufficed. But Mark's response was to yell and call people names.
The firing didn't happen all at once as it did in the first circumstance. I was unhappy there and felt that no matter what, I could not make Mark happy. My supervisor had arranged for us to have an intern from the University of Chicago. She was in the social work program and since my supervisor was not a licensed clinical social worker, I had to supervisor. She was wonderful. Very smart and capable. But it was evident to her that this was a somewhat toxic environment. Much of supervision with her was spent discussing how to navigate the politics and keep Mark happy. During that time, I actually got a new job. My dad knew how unhappy I was. He had me call someone he knew at Lifelink Corporation. They were looking for licensed clinicians for a new program in foster care. So I went to the interviews and I was hired! Hooray! Unfortunately, this meant that I would be leaving my poor intern fend for herself and without a social worker to supervise her. When I told her I was leaving, she said she didn't want to stay there without me. She spoke with her advisor at school and told him about the situation. She requested to change internships. When I told my supervisor that I was leaving, I also told him that the intern would be leaving as well.
I should've seen it coming. Mark was furious that I had told her that I was leaving before I told him. He was also furious that she was leaving and blamed it on me. He basically threatens to take my license saying that this was unethical. I'm pretty sure it's not. He made life very uncomfortable for me for the next week or so. He finally told me I was fired. This really was an incident where I could've said "you can't fire me! I quit!" He didn't give me any opportunity to say goodbye to any of my clients, and in fact canceled an appointment I had without telling me. I sat around and waited for the client, and when I called her, she said she was confused because market already canceled the appointment for me. Awkward!
I later found out that he told the kids that they could write the letters to say goodbye and he would send them. I never received any letters. He told them I had to be fired because of unethical behavior. I really wish I could sue his ass for defamation of character!
A couple of months later, my husband and I bought a new car. I had to verify my work experience for the last year. I had just started at LifeLink so not enough time had passed. I gave them the number of the learning house and they called Mark. A car salesman told me that Mark had told him not to sell me a car and that I was a bad risk. This is highly illegal. Nevertheless, we did get the car. Despite knowing that I had actually quit, the experience of being "fired" was uncomfortable for a very long time.
The last time, and hopefully the final time, that I was fired was recently from a side gig I had. I was doing professional presentations for Aetna. They would send me to various locations and I were present on a variety of topics including cultural sensitivity, stress management, positive communication, things like that. They would send me the materials including handouts and the PowerPoint and I would just present. I would try to add some material if it was appropriate. The last couple of times I was not well received. People didn't like that I went off script and they didn't like that I talked about my own experiences sometimes. So the company called and told me that I got some bad reviews. They gave me one final gig after that. I'm pretty sure the company that I was presenting to may have been told that I was being tested out. I was met with stony silence. No one participated in any discussion or activities. They didn't laugh at any jokes or ask any questions. Try to have a conversation sometime with someone who is paying any attention to you. It is a lesson in futility!
Now I am in business for myself and it is unlikely that I will fire myself. Clients fire you all the time, and I am able to keep this from feeling personal in most cases.
It is funny how your idea of what is really awful morphs when you are fighting a chronic illness. Being fired from the Learning House seemed to be shameful and embarrassing event. But when I look at it now, not only was it pretty meaningless in the grand scheme of things, but it's laughable that I could see that as any kind of a challenge.
Trying to put my pants on in the morning...That's a challengw!
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