Jonathan was one of our regulars; he had well over fifty admissions since coming home from Vietnam in 1970. He was another casualty from a war that we are still trying to understand and heal from. When he came back he had gotten married to his High School sweetheart who was a nurse at a local hospital, and had tried to settle down.
After a couple of years of heavy drinking and bouncing from job to job his life began to fall apart. First his wife left him, then his drinking burned out his family and he ended up homeless, living in the shelters around Boston.
He was a quiet, polite guy who always helped out around the detox. One of our counselors at the time was a Vietnam Vet who had also served in the Marine Corps, “In Country,” as Jonathan had.
Jonathan would talk to him often. However, if the topic of Vietnam came up he would give a little smile then walk away. He would refuse to discuss any aftercare plans that included programs with the VA. There were benefits available to him, but he wanted nothing to do with them. So he lived back and forth from the shelter to the detox.
At this point in my career I often worked overnight shifts a couple of times a month. On one of these nights I had just come back upstairs from doing patient laundry in the basement. Jonathan was sitting at a desk where we often did admissions having a cup of coffee and a cigarette. It was about 3’ in the morning. Patients often who were detoxing would get up in the middle of the night for coffee and a smoke. We never shoo’d them back to bed like many facilities would do.
There is something to be said for sitting with a patient at this time of the morning. They have just gotten up and the alcoholic defenses one would normally encounter in the daytime were not present. This was the first time that I had such an experience, but it would not be the last.
As I sat there with him, I watched as he stared off into the distance, swirls of blue smoke drifting towards the ceiling. After several minutes, I made the remark to him, “Geez Jon, it feels like you are not even here.” He took another long drag from his cigarette and slowly exhaled. “No, you’re right, I’m far, far away.” I thought for a moment and deciding to take a chance, and said to him, “Are you back over there?” I waited with a knot in my gut for the response. He kept looking straight ahead as he extinguished his smoke he had just used to light another one up.
“Yea, I’m over there,” he responded. “A lot of good men were killed for nothing…I should have been one of them.” “I’m not sure I understand what you mean?” “I don’t know if you or anyone can ever understand,” he said without changing his distant gaze.
Next there was a pause that felt like an eternity. Then he went on, “my platoon had been In Country for three or four days when we were involved in a heavy firefight with the VC.” He paused for a moment then went on, ‘we called for air support to get us out. I jumped onto one of the helicopters with four of my buddies and we started to lift off the ground. When we were about twenty feet off the ground we were hit by rocket fire. As we started to crash I was thrown clear.’
For the first time since sitting with him he faced me, “I was the only one that survived.” I felt goose-flesh take over my body; I was speechless.
As he finished that statement he began to uncontrollably sob, wretch, and rock back and forth in his chair.
It was type of sobbing that comes from a person’s soul and one feels like it will never end. I knew right away that this was probably the first time he had ever told this story to another human being.
Over the years I have had the privilege of people bearing their souls to me. Others have told me that I have something that allows people to open up and tell their tales. I do not know why this is so, but, I don’t need to know I guess. This is and can be both a blessing and a curse. I thank God every day for my sense of humor. Without it, I would be a “Dead Man Walking.”
Jon did go on to get services at the VA after that night, and yes, we did see him once and awhile back at the detox; not with his previous frequency however.
Thursday, June 28, 2012
Tuesday, June 26, 2012
The Dead Father
He had been on the unit, or I should say in bed for the first three days he was with us. Usually when a patient is unable to get out of bed for two or three days it can be attributed to chronic alcohol use or, a really bad cocaine crash (awake for days using). In this case it was the result of alcohol.
Since stays at the detox lasted three to five days only, I decided to go to his room and maybe bedside I could begin to do his paperwork.
He was in his early forties but the years of chronic alcohol abuse gave him the look of a haggard man in his late sixties. After asking him if it would be o.k. to sit by his bed and ask him a few questions, I took a seat.
As I was asking him various questions to complete the Bio-Psych-Social I could sense an intense sadness permeating from his being.
I asked him, “Have you ever had any sober time?” He replied “yes” he had a year once. I then queried him further, “what was it about that year that you were able to stay sober?”
His look became distant; all expression was gone from his face. It took him several minutes for him to look back at me. Then he responded, “well, we found out that my father was terminally ill…I was sober for the six months leading up to his death, then for six more months after.”
He then looked down at his bed and began to uncontrollably sob and rock back and forth. Through his lamentations one had the sense the agony was coming from the depths of his soul. This went on for a period of a couple of minutes (though when you are with someone going through this, it can feel like hours).
I then asked him when his father had passed away. Next, the shocker when he told me the year and it was thirteen years prior! There I had been thinking it was probably a fairly recent event and it was thirteen years ago.
He then went on to tell me that this was the first time that he had ever talked about it to anyone. In a way I felt privileged that this person had allowed me into his being.
He had not been able to maintain sobriety for more than a couple of days when he broke after a year clean. The issue of his father’s passing was on his mind every day; all day.
Part of his aftercare plan was to hook him up with a therapist that works in the area of unresolved grief issues. No longer did he want to live with the belief that men don’t cry, men don’t grieve.
Since stays at the detox lasted three to five days only, I decided to go to his room and maybe bedside I could begin to do his paperwork.
He was in his early forties but the years of chronic alcohol abuse gave him the look of a haggard man in his late sixties. After asking him if it would be o.k. to sit by his bed and ask him a few questions, I took a seat.
As I was asking him various questions to complete the Bio-Psych-Social I could sense an intense sadness permeating from his being.
I asked him, “Have you ever had any sober time?” He replied “yes” he had a year once. I then queried him further, “what was it about that year that you were able to stay sober?”
His look became distant; all expression was gone from his face. It took him several minutes for him to look back at me. Then he responded, “well, we found out that my father was terminally ill…I was sober for the six months leading up to his death, then for six more months after.”
He then looked down at his bed and began to uncontrollably sob and rock back and forth. Through his lamentations one had the sense the agony was coming from the depths of his soul. This went on for a period of a couple of minutes (though when you are with someone going through this, it can feel like hours).
I then asked him when his father had passed away. Next, the shocker when he told me the year and it was thirteen years prior! There I had been thinking it was probably a fairly recent event and it was thirteen years ago.
He then went on to tell me that this was the first time that he had ever talked about it to anyone. In a way I felt privileged that this person had allowed me into his being.
He had not been able to maintain sobriety for more than a couple of days when he broke after a year clean. The issue of his father’s passing was on his mind every day; all day.
Part of his aftercare plan was to hook him up with a therapist that works in the area of unresolved grief issues. No longer did he want to live with the belief that men don’t cry, men don’t grieve.
Thursday, June 21, 2012
O.K, the patient has just told you to "Go F@#K Yourself!" Now what do you do?
Let's begin with what not to do. First off, do not 'react' back. I have seen and heard inexperienced counselors do this and there is no telling where this will lead to; usually not to a very healthy place indeed. Phrases such as, "How dare you say that to me, should be avoided like the plaque."
I will get in the 'respect' factor in a little while.
Secondly, when an eruption like this starts I usually drop my head slightly (keeping my eyes on them) and hold my arms at my sides (in a non-threating manner) turning slightly sideways (defensive position) making sure I am at least an arm’s length away (another defensive position). I lower my voice almost to the point of it being inaudible and 'child-like.' Lowering the voice causes them to concentrate more on what I am saying in order to hear what I am saying.
I want the person to feel they are in control and I am non-threatening. This can greatly enhance the de-escalation process.
If the eruption began in and around the patient community I will ask them if we can talk in my office or another room. Usually they will.
When the person begins to 'come down' I will say something to the effect, "Wow, I am really concerned about you. You seem really angry and upset, is there anything I can do to help you out, do you want to talk?"
I like to use the following analogy, if you see a dog get hit by a car and you race to assist the animal, the first thing you should do is take off your belt and muzzle the injured creature. The reason being that in the process of trying to help him, he may feel pain and snap at you; much like the example above.
Alcoholics and Addicts can be hypersensitive; especially in early recovery. Therefore, as a professional in order to effectively help them, I must never personalize what they say to me (easier said than done sometimes). If you cannot do this then maybe you are in the wrong field.
Now as far as the 'respect' factor, when they are at a point of being able to truly hear me, I might say something such as, "you know, when you told me to go F-myself, I really wanted to know what was going on that you would disrespect yourself by making that kind of comment to me, thereby disrespecting me.
Psychic and emotional pain can definitely cause people to 'strike out' at others. Some of the’ reasons' patients may do this are many-fold; from the patient that is experiencing trauma flashbacks, to the person about to move on to another program and they just cannot say goodbye so they 'blow out' of the program instead.
It is important to not allow ones-self to get caught up in their drama, and maintaining a clear rational mind in order to focus on what is in that person’s best interest.
I will get in the 'respect' factor in a little while.
Secondly, when an eruption like this starts I usually drop my head slightly (keeping my eyes on them) and hold my arms at my sides (in a non-threating manner) turning slightly sideways (defensive position) making sure I am at least an arm’s length away (another defensive position). I lower my voice almost to the point of it being inaudible and 'child-like.' Lowering the voice causes them to concentrate more on what I am saying in order to hear what I am saying.
I want the person to feel they are in control and I am non-threatening. This can greatly enhance the de-escalation process.
If the eruption began in and around the patient community I will ask them if we can talk in my office or another room. Usually they will.
When the person begins to 'come down' I will say something to the effect, "Wow, I am really concerned about you. You seem really angry and upset, is there anything I can do to help you out, do you want to talk?"
I like to use the following analogy, if you see a dog get hit by a car and you race to assist the animal, the first thing you should do is take off your belt and muzzle the injured creature. The reason being that in the process of trying to help him, he may feel pain and snap at you; much like the example above.
Alcoholics and Addicts can be hypersensitive; especially in early recovery. Therefore, as a professional in order to effectively help them, I must never personalize what they say to me (easier said than done sometimes). If you cannot do this then maybe you are in the wrong field.
Now as far as the 'respect' factor, when they are at a point of being able to truly hear me, I might say something such as, "you know, when you told me to go F-myself, I really wanted to know what was going on that you would disrespect yourself by making that kind of comment to me, thereby disrespecting me.
Psychic and emotional pain can definitely cause people to 'strike out' at others. Some of the’ reasons' patients may do this are many-fold; from the patient that is experiencing trauma flashbacks, to the person about to move on to another program and they just cannot say goodbye so they 'blow out' of the program instead.
It is important to not allow ones-self to get caught up in their drama, and maintaining a clear rational mind in order to focus on what is in that person’s best interest.
Monday, June 18, 2012
Humor in Recovery & Health in General: Part II
In the first part of this series, the benefits of humor and laughter were cited from the research I conducted several years ago while working on my master’s thesis.
In this second part, I will present the results from research I conducted with therapists in the field on if and when they use humor in their private practices, and what types.
When asked if they employ humor when working with their clients: 48% stated they frequently use humor; 48% stated they sometimes use humor; 4% stated they rarely use humor; 0% stated they never use humor.
On ‘when’ they utilize humor: 80% use humor for stress relief; 68% to ‘reframe’ an issue; 64% when encountering issues of denial; 48% to break an ‘impasse’; 48% issues of self-esteem; 48% for educational issues; 40% for reality testing.
Another 32% stated they also utilize humor for the following:
1. Negative outlooks
2. To point out irony
3. Relational connections
4. Anytime I can
5. Encourage the therapeutic alliance
6. Ice-breaking
7. To strengthen the alliance
8. Get back on course
9. Re-direction
As far as the types of humor they employ: 80% situational; 60% witticisms; 48% anecdotes; 36% stories; 28% puns; 20% jokes; 16% parodies.
Definitions for the above:
Situational: Humorous situations from your own experience. Situational humor does not require that you memorize a punch line because it is based on a situation that
itself is humorous. It is a situation you personally have experienced.
Witticism: A remark that is amusingly clever in perception and expression.
Anecdote: A short account of a particular incident or event of an interesting or amusing nature, often biographical.
Stories: Self-explanatory
Pun: The humorous use of a word or phrase so as to emphasize or suggest its different meanings or applications, or the use of words that are alike or nearly alike in sound but different in meaning; a play on words.
Joke: Something said or done to provoke laughter or cause amusement, as a witticism, a short and amusing anecdote, or a prankish act.
Parody: Any humorous, satirical, or burlesque imitation, as of a person, event, etc.
So as we can see from the information above, it appears (at least in this research) that all therapists employ humor in their practice to some extent; the amount, when employed, and the type utilized differs often from therapist to therapist.
Humor can be beneficial in other ways to people in recovery. More than once I been speaking with a person in early recovery and they tell me the tale of being at a recovery meeting and being absolutely mortified by hearing members joke and laugh about a situation they found themselves in when actively ‘using.’ They failed to see any humor in what was being ‘joked’ about!
Well, I can understand and be empathetic towards their initial shock. However, (as I explain to them) this is quite common. Why? Humor can allow an otherwise extremely painful issue that no one wants to talk about; be talked about. Think of humor in this instance as a positive coping mechanism. By giving the issue a voice (even if initially they utilize 'Dark' humor to do so), they reinforce why would not want to return to the previous behavior and subsequent consequences that would entail.
When can humor be seen as a negative? I have had instances when working with a patient or client on a one-to-one basis when they will use humor as a ‘mask.’ I will ask them a question and if they feel uncomfortable, they will deflect the question by telling me a joke, making fun of the question itself, or tell me something amusing that either they or a friend did.
Another form of humor that needs to be handled with kid-gloves is that of sarcasm.
The definition of sarcasm is: Harsh or bitter derision or irony; A sharply ironical taunt; sneering or cutting remark; mocking, contemptuous, or ironic language intended to convey scorn or insult. Furthermore, it is from the Latin sarcasmus, which means ‘to rend (tear into strips) the flesh.
I am sure that many of us have heard the ‘colloquial’ phrase when a person yells at another in a derisive way, “Boy he ripped him a new…” That is sarcasm at its best (err, worst actually).
When leading groups and the issue of trauma comes up, almost to a person, they will state that the verbal abuse they underwent was significantly greater in damage that the physical abuse.
Can sarcasm then ever be beneficial? Often times I have found from a clinical perspective that men will employ sarcasm as a “safe” way to bond with other men. In our culture, most men have a difficult time telling another man that they ‘love’ them without feeling ‘weirded out’ (word used by patient). So long as the sarcasm is a two-way street, I have found it can be a plus.
In this second part, I will present the results from research I conducted with therapists in the field on if and when they use humor in their private practices, and what types.
When asked if they employ humor when working with their clients: 48% stated they frequently use humor; 48% stated they sometimes use humor; 4% stated they rarely use humor; 0% stated they never use humor.
On ‘when’ they utilize humor: 80% use humor for stress relief; 68% to ‘reframe’ an issue; 64% when encountering issues of denial; 48% to break an ‘impasse’; 48% issues of self-esteem; 48% for educational issues; 40% for reality testing.
Another 32% stated they also utilize humor for the following:
1. Negative outlooks
2. To point out irony
3. Relational connections
4. Anytime I can
5. Encourage the therapeutic alliance
6. Ice-breaking
7. To strengthen the alliance
8. Get back on course
9. Re-direction
As far as the types of humor they employ: 80% situational; 60% witticisms; 48% anecdotes; 36% stories; 28% puns; 20% jokes; 16% parodies.
Definitions for the above:
Situational: Humorous situations from your own experience. Situational humor does not require that you memorize a punch line because it is based on a situation that
itself is humorous. It is a situation you personally have experienced.
Witticism: A remark that is amusingly clever in perception and expression.
Anecdote: A short account of a particular incident or event of an interesting or amusing nature, often biographical.
Stories: Self-explanatory
Pun: The humorous use of a word or phrase so as to emphasize or suggest its different meanings or applications, or the use of words that are alike or nearly alike in sound but different in meaning; a play on words.
Joke: Something said or done to provoke laughter or cause amusement, as a witticism, a short and amusing anecdote, or a prankish act.
Parody: Any humorous, satirical, or burlesque imitation, as of a person, event, etc.
So as we can see from the information above, it appears (at least in this research) that all therapists employ humor in their practice to some extent; the amount, when employed, and the type utilized differs often from therapist to therapist.
Humor can be beneficial in other ways to people in recovery. More than once I been speaking with a person in early recovery and they tell me the tale of being at a recovery meeting and being absolutely mortified by hearing members joke and laugh about a situation they found themselves in when actively ‘using.’ They failed to see any humor in what was being ‘joked’ about!
Well, I can understand and be empathetic towards their initial shock. However, (as I explain to them) this is quite common. Why? Humor can allow an otherwise extremely painful issue that no one wants to talk about; be talked about. Think of humor in this instance as a positive coping mechanism. By giving the issue a voice (even if initially they utilize 'Dark' humor to do so), they reinforce why would not want to return to the previous behavior and subsequent consequences that would entail.
When can humor be seen as a negative? I have had instances when working with a patient or client on a one-to-one basis when they will use humor as a ‘mask.’ I will ask them a question and if they feel uncomfortable, they will deflect the question by telling me a joke, making fun of the question itself, or tell me something amusing that either they or a friend did.
Another form of humor that needs to be handled with kid-gloves is that of sarcasm.
The definition of sarcasm is: Harsh or bitter derision or irony; A sharply ironical taunt; sneering or cutting remark; mocking, contemptuous, or ironic language intended to convey scorn or insult. Furthermore, it is from the Latin sarcasmus, which means ‘to rend (tear into strips) the flesh.
I am sure that many of us have heard the ‘colloquial’ phrase when a person yells at another in a derisive way, “Boy he ripped him a new…” That is sarcasm at its best (err, worst actually).
When leading groups and the issue of trauma comes up, almost to a person, they will state that the verbal abuse they underwent was significantly greater in damage that the physical abuse.
Can sarcasm then ever be beneficial? Often times I have found from a clinical perspective that men will employ sarcasm as a “safe” way to bond with other men. In our culture, most men have a difficult time telling another man that they ‘love’ them without feeling ‘weirded out’ (word used by patient). So long as the sarcasm is a two-way street, I have found it can be a plus.
Tuesday, June 12, 2012
Humor in Recovery & Health in General: Part I
Prior to entering the field of psych/addiction my life consisted of writing comedy bits and song parodies for the Charles Laquidara morning show at WBCN-104.1 FM in Boston, as a member of the “Not before Breakfast Big Mattress Players.” Evenings would find me out on the Boston Comedy scene; From “Stitches Comedy Club” in the Paradise Rock Club on Comm-Ave, to working the once a week restaurant comedy ‘Hells.’ My pal George MacDonald always referred to those once a week shows as a place, “Where the jokes never work, the audience never laughs, and the show never ends...”
I also had a once a week comedy show that I hosted at a Mexican restaurant in Saugus while being a comic bartender there.
So naturally, my comedy background would take over when I had to choose a thesis topic for my Masters in Counseling Psychology.
The title of my thesis was, “A Contemporary View of the Efficacy of Humor as a Therapeutic Component within Addiction Counseling Relationships & Health in General.”
In my review of literature I found that many of the benefits of laughter & humor that had been viewed as strictly anecdotal over the years had been empirically researched and found to be valid.
Over the past several decades empirical research data has indicated the direct benefit of humor in areas such as:
1. Reducing stress, anxiety, and tension
2. Promoting psychological well-being
3. Raising self-esteem
4. Improving interpersonal interactions and relationships
5. Building group identity, solidarity, and cohesiveness
6. Enhancing memory (for humorous information)
7. Increasing pain tolerance
8. Elevating mood
9. Increasing hope, energy, and vigor
10. Counteracting depression and anxiety
11. Enhancing creative thinking and problem-solving
12. Increasing friendliness and helpfulness
13. Intensifying mirth
14. Being contagious (induces mirth in others)
15. Increasing interpersonal attraction and closeness
16. Exercising respiratory muscles (www.aath.org)
At the present time current research on all scientific fronts is looking to the possible benefits of humor in additional areas such as:
1. Reducing respiratory infections
2. Treating asthma
3. Enhancing positive lifestyle choices
4. Improving diabetes
5. Increasing longevity
6. Improving immune function
7. Raising endorphins levels
8. Treats cancer
9. Fights off infections
10. Lowers blood pressure
11. Reduces heart disease
12. Exercise benefits equal to jogging
13. Leads to significant weight loss (www.aath.org)
I utilize my sense of humor when I am working in the addiction field; whether I am presenting an educational group in the day program where I work, or, when meeting with a client one on one.
I will go more into depth on this in part II of this series of blogs.
Both the word “humor” and “humanity” have that “h-u-m” beginning. No accident I believe. Humor is one of the characteristics that separate us from the rest of the animal kingdom (well, with the possible exception of dolphins – the research goes on in this area however, lol).
Humor allows my clients to feel they are on equal footing with me; I am not above them. I am there to work for them and with them. I personally have found that it can greatly enhance the therapeutic relationship.
In Part II I will discuss the research I conducted with therapists working in the field. The types of humor they employ and when they employ it. I will also discuss the cautions a therapist needs to be aware of when utilizing humor in the therapeutic relationship.
P.S. If you enjoy my blogs please pass on my link to your friends. http://willydrinkwater.blogspot.com/
I also had a once a week comedy show that I hosted at a Mexican restaurant in Saugus while being a comic bartender there.
So naturally, my comedy background would take over when I had to choose a thesis topic for my Masters in Counseling Psychology.
The title of my thesis was, “A Contemporary View of the Efficacy of Humor as a Therapeutic Component within Addiction Counseling Relationships & Health in General.”
In my review of literature I found that many of the benefits of laughter & humor that had been viewed as strictly anecdotal over the years had been empirically researched and found to be valid.
Over the past several decades empirical research data has indicated the direct benefit of humor in areas such as:
1. Reducing stress, anxiety, and tension
2. Promoting psychological well-being
3. Raising self-esteem
4. Improving interpersonal interactions and relationships
5. Building group identity, solidarity, and cohesiveness
6. Enhancing memory (for humorous information)
7. Increasing pain tolerance
8. Elevating mood
9. Increasing hope, energy, and vigor
10. Counteracting depression and anxiety
11. Enhancing creative thinking and problem-solving
12. Increasing friendliness and helpfulness
13. Intensifying mirth
14. Being contagious (induces mirth in others)
15. Increasing interpersonal attraction and closeness
16. Exercising respiratory muscles (www.aath.org)
At the present time current research on all scientific fronts is looking to the possible benefits of humor in additional areas such as:
1. Reducing respiratory infections
2. Treating asthma
3. Enhancing positive lifestyle choices
4. Improving diabetes
5. Increasing longevity
6. Improving immune function
7. Raising endorphins levels
8. Treats cancer
9. Fights off infections
10. Lowers blood pressure
11. Reduces heart disease
12. Exercise benefits equal to jogging
13. Leads to significant weight loss (www.aath.org)
I utilize my sense of humor when I am working in the addiction field; whether I am presenting an educational group in the day program where I work, or, when meeting with a client one on one.
I will go more into depth on this in part II of this series of blogs.
Both the word “humor” and “humanity” have that “h-u-m” beginning. No accident I believe. Humor is one of the characteristics that separate us from the rest of the animal kingdom (well, with the possible exception of dolphins – the research goes on in this area however, lol).
Humor allows my clients to feel they are on equal footing with me; I am not above them. I am there to work for them and with them. I personally have found that it can greatly enhance the therapeutic relationship.
In Part II I will discuss the research I conducted with therapists working in the field. The types of humor they employ and when they employ it. I will also discuss the cautions a therapist needs to be aware of when utilizing humor in the therapeutic relationship.
P.S. If you enjoy my blogs please pass on my link to your friends. http://willydrinkwater.blogspot.com/
Wednesday, June 6, 2012
The Boy in the Basement
The bed count at our detox was 28. Out of these, we would usually keep four beds for ‘holding.’ A holding bed was one that a patient might get if he or she were accepted to an aftercare program but had to wait for an opening at that program.
These patients would help around the detox; assisting the weekday chef in preparing and cooking meals, helping those of us on staff with the laundry, and the general clean-up of the facility.
Tim was one of our “holding” patients. He usually could be found helping the chef with food prep and running across the street to get food supplies from the local deli. When one conversed with him, he always had a smile but would seldom answer in more than a couple of words. I use to wonder what was really going on in his head, or, was he really just that quiet.
With all of our patients, I would read their histories, talk with them, and try to see just when their addictions started them on the path of self-destruction. From this I would try to work with them on possible aftercare plans to assist them in keeping their addictions in remission.
Easier said than done.
Tim’s life story had major holes. A history is only as detailed as a patient will allow. A good counselor will try through compassion & empathy to build trust with a patient so they will fill-in the missing pieces. This can be critical to their sobriety. Does this person have another mental illness that may be preventing him or her from obtaining and/or continuing sobriety? Has the person been a victim of trauma, grief, abandonment; untreated affective disorders?
Tim never spoke of his father. He would speak affectionately of his mother. One time he briefly spoke of an older brother that left home at sixteen. When I tried to ask him a little more about his brother, he just smiled and walked away. At the time I really did not think too much of it. Many of our patients would say very little about their families. Either their addictions had burned-out their relationships with them, or, their own shame, remorse and guilt would not allow them to think of their families.
One Monday morning I came into work and Tim was already helping-out in the kitchen area. The first item on the staff agenda when we came into work was to hear the report from the previous two shifts. It gave us a “feel” for what had been going on. Had some patients been going through a hard time emotionally, physically? What had the general mood of the detox been?
While we were listening to report that morning Tim zoomed past us to go down into the basement to get some canned goods for that day’s food-prep.
It could not have been more than a couple of minutes when we heard this un-godly screaming and sounds of slamming and pounding from the basement. I jumped up and with another counselor and we raced to the basement. The door that led to the supply room was quirky and sometimes would latch behind one after entering through it. This was the reason we kept a key on the inside, pegged on the outer side of the door jamb. In addition, there was another passageway out. He was screaming too loud to even try to tell him about these possibilities.
He was screaming, hollering, and trying to kick the door down as if he were being chased by the devil himself. My partner and I soon realized that we had left our keys on the staff desk in our haste to get downstairs. I told my partner to go back up and grab his keys while I tried to keep him calm.
Tim kept screaming, “You’re just like my f*#@+g father! “Let me out you f*#@+g bastards, let me out! “I’ll f*#@+g kill everybody if you don’t let me out."
“Tim, take it easy, take it easy,” I told him. As my partner returned with the keys I could hear Tim slump to the floor. By this point in time, all the staff had raced to the basement.
When I opened the door, Tim was sobbing on the floor. The type of sobbing that comes from the bottom of a person’s soul. I waved everyone out and sat next to him on the floor.
The sobbing continued for quite a while. Slowly it began to dissipate and then, stopped. As he began to take long deep breaths, he stared straight ahead. I could tell he was no longer in the detox; his mind was far away, at a previous place in time. In a monotone voice he started to speak;
'When I realized that I was locked down here I freaked out. When I was really young my father was a heavy drinker and after dinner at night he would lock me in a basement closet until breakfast the next morning. He would tell me not to yell or scream or my mother would pay the price. One time I did start yelling until I heard my mother beg me to stop, for he was beating her because of my yelling.’
That’s why my brother left home at sixteen. He was the first one to get the “special” after dinner treatment. When he left, I guess I was naturally the next choice.
I have been in the field for over twenty years now and there are still stories like this one that rise to surface once in a while from my subconscious. Just when I think I have heard it all…another story presents itself…
These patients would help around the detox; assisting the weekday chef in preparing and cooking meals, helping those of us on staff with the laundry, and the general clean-up of the facility.
Tim was one of our “holding” patients. He usually could be found helping the chef with food prep and running across the street to get food supplies from the local deli. When one conversed with him, he always had a smile but would seldom answer in more than a couple of words. I use to wonder what was really going on in his head, or, was he really just that quiet.
With all of our patients, I would read their histories, talk with them, and try to see just when their addictions started them on the path of self-destruction. From this I would try to work with them on possible aftercare plans to assist them in keeping their addictions in remission.
Easier said than done.
Tim’s life story had major holes. A history is only as detailed as a patient will allow. A good counselor will try through compassion & empathy to build trust with a patient so they will fill-in the missing pieces. This can be critical to their sobriety. Does this person have another mental illness that may be preventing him or her from obtaining and/or continuing sobriety? Has the person been a victim of trauma, grief, abandonment; untreated affective disorders?
Tim never spoke of his father. He would speak affectionately of his mother. One time he briefly spoke of an older brother that left home at sixteen. When I tried to ask him a little more about his brother, he just smiled and walked away. At the time I really did not think too much of it. Many of our patients would say very little about their families. Either their addictions had burned-out their relationships with them, or, their own shame, remorse and guilt would not allow them to think of their families.
One Monday morning I came into work and Tim was already helping-out in the kitchen area. The first item on the staff agenda when we came into work was to hear the report from the previous two shifts. It gave us a “feel” for what had been going on. Had some patients been going through a hard time emotionally, physically? What had the general mood of the detox been?
While we were listening to report that morning Tim zoomed past us to go down into the basement to get some canned goods for that day’s food-prep.
It could not have been more than a couple of minutes when we heard this un-godly screaming and sounds of slamming and pounding from the basement. I jumped up and with another counselor and we raced to the basement. The door that led to the supply room was quirky and sometimes would latch behind one after entering through it. This was the reason we kept a key on the inside, pegged on the outer side of the door jamb. In addition, there was another passageway out. He was screaming too loud to even try to tell him about these possibilities.
He was screaming, hollering, and trying to kick the door down as if he were being chased by the devil himself. My partner and I soon realized that we had left our keys on the staff desk in our haste to get downstairs. I told my partner to go back up and grab his keys while I tried to keep him calm.
Tim kept screaming, “You’re just like my f*#@+g father! “Let me out you f*#@+g bastards, let me out! “I’ll f*#@+g kill everybody if you don’t let me out."
“Tim, take it easy, take it easy,” I told him. As my partner returned with the keys I could hear Tim slump to the floor. By this point in time, all the staff had raced to the basement.
When I opened the door, Tim was sobbing on the floor. The type of sobbing that comes from the bottom of a person’s soul. I waved everyone out and sat next to him on the floor.
The sobbing continued for quite a while. Slowly it began to dissipate and then, stopped. As he began to take long deep breaths, he stared straight ahead. I could tell he was no longer in the detox; his mind was far away, at a previous place in time. In a monotone voice he started to speak;
'When I realized that I was locked down here I freaked out. When I was really young my father was a heavy drinker and after dinner at night he would lock me in a basement closet until breakfast the next morning. He would tell me not to yell or scream or my mother would pay the price. One time I did start yelling until I heard my mother beg me to stop, for he was beating her because of my yelling.’
That’s why my brother left home at sixteen. He was the first one to get the “special” after dinner treatment. When he left, I guess I was naturally the next choice.
I have been in the field for over twenty years now and there are still stories like this one that rise to surface once in a while from my subconscious. Just when I think I have heard it all…another story presents itself…
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