Tag Archives: therapists

What? Me Network?

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JC Schildbach, LMHC

A few weeks back, as a favor to a friend, I was invited (compelled?) to speak with a small group of victim advocates—county employees who serve as a kind of official support system for those people directly impacted by a crime. The topic: sex offenders and sex offender treatment.

I agreed to the meeting several months prior, when I was still working directly in the field of sex offender treatment. Having moved away from that field, I hadn’t exactly been immersed in relevant information. As ‘luck’ would have it, though, the Josh Duggar situation provided plenty of focus on issues of law and treatment regarding sex offenses, and an easy access point to discuss much of the involved information.

I had not prepared an actual presentation–the kind with Powerpoint slides, and handouts. Rather, the victim advocates sent me a number of questions via email, and I spent the allotted hour attempting to provide straightforward answers. As with any specialized field, though, nuanced and complex answers are far more the norm.

A quick sampling of some of the (paraphrased) questions and the (overly simplified/incomplete) answers:

Q: What are recidivism rates for adult offenders versus juvenile offenders?

A: Much lower than most people think, in both cases.

Q: Is treatment for offenders a “one size fits all” program, or is it tailored to the specifics of the offender and the offense?

A: There are standardized “assignments” and program requirements, but, as with any form of therapy, it works best when the particulars of the people involved are taken into consideration.

Q: Do you see a lot of commonalities among offenders?

A: As with any ‘diagnosis’ or behavioral category, there are going to be a great many similarities—or those points where behaviors, and justifications for those behaviors, share many similarities—for example…

The lunch hour actually went by pretty quickly. And, despite feeling a bit nervous about providing accurate information without delving into boring details, nobody fell asleep. (Which reminds me, I promised to email some information about various psych tests, which I never did—and I also meant to ask about doing a quick once-over of my friend’s notes to make sure I hadn’t misspoke or inadvertently conveyed any muddled or inaccurate information).

At any rate, the lunchtime meeting was a good refresher about how necessary, and how difficult, it can be to properly ‘network’ within one’s chosen field. It’s quite easy to sit back and complain that people know so little about the specialization you’ve devoted a great deal of your working life to, without doing anything to address that lack of knowledge.

Happy face mad

Of course, it can be extremely difficult breaking through all the noise and confusion to relay one’s own specialized understanding of specific issues, or to have the patience to let the specialized knowledge of others in.

After all, we can all get bogged down in our day-to-day life. And going to trainings or other networking opportunities can feel like just another professional obligation—more about checking a box on a form, than about gaining knowledge and understanding that can truly help in one’s ability to help others—not to mention, the opportunity to meet and connect with other people who are potentially valuable allies and resources.

Still, I suppose we all have our fair share of networking disaster stories.

Take, for example, the time that I went to a breakfast fundraising event for the King County Sexual Assault Resource Center as a special guest of the Seattle Archdiocese (damn, that sounds important, doesn’t it? But, truth be told, I was actually the ‘plus one’ to my boss’ invitation as a special guest of the Seattle Archdiocese). Anyway, after the program of speakers, ranging from local media luminaries, to elected officials, to experts in the field of sexual assault treatment, to the families of sexual assault victims, as the time arrived for everyone to mingle and/or make a quick getaway to avoid mingling, I managed to upend a glass of water, which drained directly into the chair where I was sitting. Mingling in wet pants—not really a comfortable experience, or a good way to convey anything you want other professionals to remember about you.

Beyond various faux pas, I think many professionals go to trainings and seminars with those colleagues we already know—potentially insulating and isolating ourselves from other attendees. Whatever your impressions of people in the mental health field, plenty of us are actually introverts who find crowds and forced socialization to be extremely draining. For some, the same skills that make us effective in a one-on-one or group session, or even a phone-based intervention—such as being able to focus not only on a person’s words, but the whole of what people are communicating non-verbally—can make it very difficult to just mingle in a large crowd.

There is also the potential for fumbling when you’re on the ‘turf’ of some other specialization. I mean, imagine how potentially uncomfortable it can be when you work in the field of sex offender treatment, and are attending a conference for providers who treat the victims of such offenders. Ultimately, the goals are the same—to reduce the impact of such trauma, and combat the underlying causes of such offenses—but you’re definitely working different sides of the same street.

There are also several forms of specialization that can reach into most other areas of treatment—substance abuse, personality disorders, suicidality, and on and on. No practitioner has the ability to become truly well-versed in every possible situation they encounter. Ideally, though, they will learn enough to recognize when they need to refer out, and how to recognize the signs of those areas with which they aren’t particularly familiar.

I suppose this is all weighing on me a bit heavily, as I have my licensure renewal coming up, and need to make sure I have all of my trainings in order. I’ve done plenty of trainings, and perhaps a whole lot more personal study, over the past few years, but not all of that counts for official training credits.

On top of just staying abreast of one’s own field, and finding trainings of interest that fit one’s schedule and budget, the state instituted a requirement that all counselors have to have training in how to deal with suicidal clients at regular intervals. I’m trying to approach this positively. I get the reason for its necessity (although the real reason for the change in requirements had to do with previous problems in the state’s credentialing process that allowed people with little-to-no education in mental health to call themselves “counselors”—which led to multiple tragedies and other less-than-ideal outcomes).

Still, having worked in suicide prevention for years makes the requirement a bit redundant for me. I know and respect many of the people conducting the trainings, and certainly learn from them each time I have occasion to encounter them. But as a general topic area, I could be brushing up on or exploring other areas where I haven’t already spent years of professional focus, particularly given that the trainings are aimed at practitioners who aren’t particularly sturdy in their suicide prevention/intervention skills.

Mental Health practitioners are also required to take regular ethics trainings—I suppose for those therapists who can’t remember not to force their own views on people, not to run around blabbing about their clients, and not to sleep with their clients.

That said, I will look to make the most of my remaining trainings, try to be pleasant and sociable, and pay attention so that I might actually gain some new insight. And I vow not to be one of those terrible bores who offers up one’s own experiences during question-and-answer periods, just to show how knowledgeable one is, rather than actually seeking information from the experts providing it.

And perhaps I should just schedule one of those suicide prevention trainings ASAP—or maybe after I cast about a bit to see if any of my friends in the field have been blowing off that training too, and want to go along.

A Reframe for Dick Whitman OR Don Draper Gets Just Enough ‘Therapy’ to Go On Being Don Draper

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JC Schildbach, LMHC

(Spoiler Alert!)

Let’s imagine that Don Draper’s momentary breakdown—a realization of abandonment, followed by a phone call wherein he recounts his sins to Peggy, leading to an anxiety attack or some other form of emotional paralysis, which is essentially broken by a cathartic, sobbing hug with a stranger in a group “seminar”—is an honest therapeutic breakthrough.

don's anxiety

While many people have interpreted the final moments of the series as cynical—the smirk that rises on Don’s face as he sits in a meditation group, followed by the ring of a meditation bell fading into the opening of the Coke “Hilltop” commercial jingle—a better “reframe” for what happens with Don is that he recognizes how his own behavior has been impacting others, that he is able to identify his own feelings of emotional disconnection, and that he is able to gain some real acceptance of his situation and how to thrive in it.

Don's idea

In the terms of a therapeutic cliché, Don realized that when one cannot change one’s circumstances, one can change one’s response/attitude toward those circumstances.

Essentially, such a “reframe” relies on the acceptance of the idea that the “Hilltop” Coke commercial is Don’s concept (all apologies to Bill Backer)—an idea that hardly seems up for debate. Among other elements, in the final scenes of the final episode, Peggy’s plea to Don to “come home” involves the pointed appeal, “Don’t you want to work on Coke?” And the final words spoken, by one of the retreat leaders, before the Coke commercial closes out the series, are an invitation to greet the morning sunshine and bask in the possibilities of a “new day, new ideas, a new you.”

Don’s answer to Peggy’s question about working on the Coke account is, “I can’t. I can’t get out of here.” At that particular moment, it’s a statement of desperation. Don is panicked. He is stuck at a coastal retreat “somewhere in California” with no transportation.

But Don’s sense that he needs to be able to control where he is, and when he can leave, is about to melt away. After his moment of connection with fellow seminar-attendee, Leonard, Don realizes he can “work on Coke,” or any other account, so long as he abandons his need for control of the situation where he is working.

Don’s initial flight from McCann-Erickson is brought on by feeling he has lost control. He is called to a meeting for Miller Lite, only to realize he is one of many creative directors there—and not the creative director there. He quickly decides this is not for him, grabs up his catered box lunch, and hits the road.

Don’s need for control plays into his sobbing hug with Leonard—who details how he feels that his family doesn’t even look at him; that he doesn’t know how to give, receive, or even recognize love; and that “nobody cares I’m gone.”

don's hugg

In a moment of recognition and connection, Don realizes his family does not “care” that he’s gone, and that his idea of love is ill-defined at best. Of those family members he has tried to reach, daughter Sally and ex-wife Betty have told him to stay away, and that the lives of his sons are more stable in his absence. Stephanie, the niece of the (real deceased) Don Draper, both invites (the imposter) Don to the coastal retreat, and then leaves him stranded there, after telling him he is not part of her family (and after having her own desire for a therapeutic experience thwarted by what she feels are the judgmental and stereotypical attitudes about what she should value in life).

In the lead-up to Don’s hug with Leonard, it is only Peggy who urges Don to come home. And by “home” Peggy means back to work at McCann. It is Peggy alone who knows how to reach Don, and does so, rather than just accepting that Don does what Don does and leaving him to it. She appeals to the only thing that Don clearly loves—the pure joy of coming up with a winning ad campaign.

It’s possible to interpret Don’s brief breakdown as entirely self-serving—that he is distraught only because he has been abandoned instead of being the one to abandon, and because he lost the ability to just pick up and leave. He was even left without his usual means of numbing himself with alcohol and casual sex.

So when Leonard revealed his dream of being left alone in the dark on the refrigerator shelf, of course it struck a chord with Don. After all, Don’s whole career has been spent trying to get people to pick that particular item out of the refrigerator—the one that would make them whole. To do that, he needs to know how to connect with people like Leonard—people who have a sense of emptiness and who don’t know how to correct their emotional deficits. And now Don is trapped here with Leonard, in the dark and cold of that nightmare refrigerator where others are in charge of who gets in and out. That bit of recognition allows Don to plunge into his own feelings of sadness, if only for a moment, before he recognizes the value in what Peggy has told him, and the value of tuning into people like Leonard, at least until the end of the week.

It’s a fairly common misconception about therapy that such moments of insight and catharsis will lead to meaningful change, or that a therapist’s job is to provide a client with just the right piece of advice or insight to “fix” that client, and put the client on the right course for life. Part of that misconception can be attributed to “retreats” like the one where Don is stranded—certainly sold to the participants as a week of healing and life-affirming change. And, certainly, recognizing something lacking in yourself, and having a good cry can be helpful at times, but it doesn’t make you a different person. Real change takes will and work.

But if therapy is about meeting a person where s/he is, and helping that person to be the best version of who s/he can be at that time, and of using a ‘strengths-based’ approach that helps the person tune into their own abilities to address problems, then Don’s time away at the retreat is successful. Don not only has a moment of clarity and honest emotion; he gains acceptance about his own circumstances and how to change his response to them.

It is telling that in the final shot of Don’s family, we see them in a dimly-lit kitchen, Betty resignedly drawing on a cigarette, Sally, having assumed parental duties, washing dishes with her back turned to her mother and the camera. All this just before we see Don on a sunny cliff-top overlooking the Pacific Ocean and hear the opening words of the Coca-Cola jingle: “I’d like to buy the world a home, and furnish it with love.”

sally dishes, betty smokes

Don has spent a good portion of his adult life trying to fix problems with money and buying things, and exists in an industry where money and buying things is put forth as the answer to everything—even a broken home and the absence of love.

And Don has a significant history of childhood trauma and abandonment, and poor modeling from the adults in his life. A week of group seminars and meditation isn’t going to fix that.

But that week on the coast did give Don enough of a reframe to get him back to the work he loves, and to do that work successfully.

coke real thing

And that’s the real thing…or the realest thing we can expect from Don.

GRIEF, AMERICAN STYLE, or, I’m gonna sit here and drink until I hear “Raining Blood” so f*ck you!

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I’ve lived through a few Facebook funerals now, where somebody I’m connected to via Facebook, but haven’t seen for years…decades even…dies and the news is relayed on their page and often numerous others’ pages.  Or the news intrudes on completely unrelated posts as the awkward grief styles of the American public become all the more public.  I don’t think the American people in general deal with grief well, and my own personal grieving style tends toward an above-average level of avoidance and, uh, blockage.

I’m trying not to go there right now—to the awkward social media grief, or the blockage—even as I’m posting in a social media outlet.  But a friend of mine really did die last week, (and the post I was working on about swearing therapists decided to punch me in the brain, preventing me from working on it).  In some sort of weird and possibly misguided effort to maintain some level of privacy, I’m not going to name my friend here, although not naming him seems sort of like denying any kind of tribute as well as making this post that much more about me me me.

I will say he was a kick-ass guy with a wonderful wife and kids, as well as numerous other beautiful (in the drunk, ‘you’re my best friend!’ style) family members and friends.  I can’t say as I knew him well enough to give even a marginally adequate sketch of his life, but then there are very few people, even some of my siblings, for whom I could provide such a thing.  I have my own small store of personal recollections and connections, which I’m just not going to share here.  But we’ve been down too long in the midnight sea anyway.

I don’t know if keeping his name out of this would be considered a positive or a negative, because I just don’t know how these things work anymore.  Anymore?  Who am I kidding?  Even before “social media” existed, I didn’t know what to do with the various real-world aspects of grief.  Do I call the family?  Do I leave the family alone?  Do I show up on the family’s doorstep, sobbing, Crock-Pot full of chili and bouquet of sunflowers in hand?  What about donations to charities, the family, or…?

As much as we say the grief is about the deceased, ultimately, grief often comes down to “me me me,” especially for those of us who don’t know how to “do grief” or do the funereal etiquette properly.  We can become obsessed with how the death of someone impacts us, and how we are supposed to act in the face of it.   We can become obsessed with whether we are doing the right thing or not, even when nobody is paying all that much attention to us.  I can’t imagine that anybody is sitting around complaining that I have not made it clear that I am aware of his death, or what I intend to do about it.  I’ll show up for the funeral and work that all out there, or in the days after, or…

Me, I don’t do grief well at all.

Yeah, I’m a therapist, and I have completely inadequate training in dealing with death, and more importantly, the living left behind…perhaps all by design.  It’s not my thing.  It’s not anything I’m comfortable with…not that I should be allowed to claim the privilege of comfort at this point in time.  I truly love this man, and his family, and f*ck me if I know what to do with that.

So let’s change gears.  Here’s a little example of how I function in these situations:  Following a memorial service a few years back, I was somewhat mortified when my grief fog began to lift and I realized I’d been wandering around, a forced smile on my face, at seeing people I hadn’t seen in far too long.  The awkwardness of, “Hey, good to see you,” collided with, and perhaps overrode the awkwardness of, “One of our friends/family members died.”  It’s a fine line between grief and panic…grief and meltdown…grief and straight-up weirdness(?).

It seems like grief is one of those things I should have learned or maybe just known, like you’re supposed to know how to change a tire or unclog a toilet (or how you’re supposed to know all those stupid things that are supposed to be part of a wedding).  But I’ve largely managed to avoid engaging my grief skills, in favor of engaging my grief avoidance skills.  My father died when I was still too young to really understand what that meant.  And almost nobody else I know who died since then was really all that close to me when they went, either due to time and distance, or due to design.

I distinctly remember, back in the summer of my 11th year (was it my 11th?  Maybe it’s not so distinct) when my favorite uncle died.  Due to his prolonged illness, I had intellectualized his passing, had closed myself off from having to feel much of anything.  I didn’t want the hurt, so I wasn’t going to have it.  When my mom got the call, I sat on the couch between my younger brother and older sister as the Beatles’ “She’s Leaving Home” played on vinyl, pushing my mind into that song.  My uncle was gone.  I knew he was going well before he left.  “Something inside, that was always denied, for so many years…”

I will also say that in many instances, I kept my distance, which was usually just a matter of carrying the relationships on as usual.  I guess my attachment issues lead me to downplay relationships, to where connections most anyone else would call friendships feel more like acquaintanceships to me.

And perhaps even worse, my instinct to dull the pain often leads to making jokes, usually sarcastic comments, realizing only after I’ve begun unleashing them that I am saying things that are horrifically inappropriate.  I want to imagine myself, like Superman, realizing a missile has been launched, taking off to steer that missile out into space.  Only, like Superman and the missile, I end up blowing up the Phantom Zone instead, unleashing General Zod, Ursa, and Non, ultimately raining much more hell down on everyone, myself included, than I would have if I’d learned to keep my mouth shut, or to make appropriately staid comments.

I’ll say that right now, I’m trying to do this right.  I’m trying to let myself take this in, even as I am engaging in various forms of avoidance.  I can’t promise that I won’t just crawl inside a bottle for a few days, and then drag myself out, emotions appropriately muddled and washed downstream.  But I’m gonna try to feel this one for real, dammit.