Disturb the comfortable, comfort the disturbed.

June 28, 2008 at 5:25 pm (my life, tales from the therapist's chair, Uncategorized) (, , )

I’m delving out bits of pieces of larger things I’m writing, so if some of these seem a bit truncated, that’s why.  I’m just trying to feel some of these things out, so thanks for reading…                    -Gynomite

I arrived at the interview and was immediately nonplussed: the neighborhood was terrible. It was only 9am, and already the streets were lined with young idle men, in various states of dress, eyeing each car that went by, laughing with each other, and leaning against businesses with names like “Taco/Gyro/Chinese House”. I was buzzed into the building and greeted by a large, shabby lobby stuffed with people. It was as if someone had dipped a grand hotel from the 40s in a vat of vanilla icing. The entire interior was dingy yellow and somehow sticky. I was directed to the library, which was bookless, where I filled out my application. Startled by a hacking cough, I looked up to see a shrunken older woman in front of me, with stringy gray hair, bulging eyes, and a huge grin on her face. She had a plastic cup tucked into her bra and peeking out of her shirt. “Hi mommy!” she squealed in a high-pitched voice. “Do you work here? You’re very pretty! Do you have any change for me? Like ten cents? Today’s my birthday, when’s your birthday?” She reached her hands towards the platinum blonde streak in my hair and I ducked away from her tobacco stained hands, my eyes guiltily shooting to the doorway, where I expected to see my future boss standing there with a clipboard, evaluating my interactions with this woman. “What’s your name?” I asked, and she replied Luann. I asked her if she could let me finish the work I was doing, and she said sure, but remained standing there, staring at me silently, grinning.

And I still took the job.

My official position was that of a supervisor to the 13 “service coordinators” that had offices on the same floors as the clients’ rooms. However, as my office was on the ground floor, where medicine and food were doled out, my actual job was to wrangle the clients into doing their day-to-day tasks. All. Day. Long. They came tearing into the office when they were excited. They came tearing into the office when they were upset. They came tearing into the office when they wanted something, or when they felt that the walls were closing in on them again.  When the door was locked, they banged on it without the social filter that tells you not to bang on doors for 20 minutes. They were childlike and needy 24 hours a day, and I felt lucky that I was only there for eight of those hours.

The building was old and crumbling, much like its inhabitants. This was a dumping ground, I discovered slowly, for people who have burned all their bridges. Most of them were very mentally ill on top of struggling with developmental disabilities and/or substance abuse problems. They were a handful, to say the least, and most of them had worn out their families long ago. This was their home. They had no where else to go, and our system doesn’t allow for them to have anywhere else to go. We were the only middle ground between hospitalization and independent living, and that is sad.

Prior to working there, I worked as a family therapist for wayward teen boys, a job that did nothing but instill hope in me day after day. Hope and frustration and sadness, sure, but mainly hope. Those kids had time to turn it around, and the nasty spectre of severe mental illness like schizophrenia didn’t have them in a choke hold. For some of them, it was looming, as schizophrenia is a disorder that doesn’t often strike until the early 20s. You could see it in their odd behavior, in their reactions to things. But for most of them, their behaviors were mere reactions to what they were feeling inside, and not a result of brain chemistry gone awry. They wanted to change, and they were bright and full of love and confusion and a thirst for knowledge about themselves. I loved it. They were spoiled brats that just needed to be pushed a little, and I loved pushing them.

I found myself trying to push my new set of clients, but the results were less effective. These people were without hope. Their brains had been altered permanently, and the medications they took gave them a whole new set of problems, including drooling, zombie-like behavior. I got very stern with a client who would insist upon cleaning my office for my pocket change, feeling unethical, only to realize that the money was secondary- this man only appeared to be calm during the 15 minutes that he was wiping down my furniture with paper towels. It was at Central Plaza that I developed my “mission statement” as a clinician: disturb the comfortable, comfort the disturbed. These people, I realized, were disturbed.

Lou, my office cleaner, lived in the room directly across from my office, so I saw him a lot. He was a skinny, older, pale man, often with his belt fastened too tightly just below his nipples. He would often come in and stand by the window, where the sun streamed in, and just exist there for long periods of time, blinking. When I asked him to tell me stories, he would tell me about how JFK survived his assassination attempt and is now retarded. Retarded JFK, he said, lives on an island somewhere now where they play with him sexually, but he’s ok with it because he’s retarded. When Lou cleaned my office, he would wet about 15 paper towels with water, balls them into cotton ball-sized shapes, and then swab my two institution-issue guest chairs before moving on to the two desks and whatever exposed surfaces he could find. The ritualized process took him about 20 minutes each time and was absolutely mesmerizing to watch because he was so meticulous and loving in his approach.  I once asked him why he was so careful with the furniture, he smiled at me emptily and told me that the furniture was alive, and that if you treated it well, it would do good things for you.   Without fail, whenever I paid him for cleaning, he would open his hand and hold it far below my hand and asks me to drop the change into his hand. Every time, he told me that you shouldn’t touch someone while handing them something, because touching is the same thing as hitting. I tried many times to assess if this meant that every touch hurts Lou, or if he has been abused, or if he is ok with any kind of touch, and I never get a relevant response. But it’s ok, because at least he’s on an upswing. In a downswing, Lou refuses to wear clothes and refuses to get off of his bed.

Niko was tall, white, and very skinny. He frequently had loose tobacco sprinkled in his salt and pepper beard. His eyes were never still, and all he ever did was ask questions like “if I had $14, do you think girls would go out with me?”, “How many coats do you own?”, “If I had $42, how much do you think the government would take from me, and then, do you think I could buy a series of hotels?”, “Do you lift weights?” If I tried to respond to him at all, he would always conversationally say “I just don’t like people taking my money, that’s all.” and wander off.

Sonya is one of my favorite residents.  She is highly delusional, highly self-aware, and very verbal.  She is quite insistent that Billy Idol fathered her 16 year old daughter, who lives with her grandfather now.  So sure that she named her daughter Billie.  Sonya stopped me as I walked up a flight of stairs one day, when I first got the job, and said “You like Billy Idol, don’t you?”  I nodded, intrigued, because I very much do like Billy Idol.  She nodded back at me, pleased.  “I could tell”.  When Sonya is having a hard time, she is convinced that the older, drug-bloated body she has is actually a fat suit, and will try to remove it.

Disturb the comfortable, comfort the disturbed.

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