Dancing and Jousting

Yesterday I wrote about the dance. As I thought about it i realized the dance falls on a continuum with consensual dance on one end of the scale, jousting on the other, and assorted activities in between. The continuum is therapy, the points on the continuum are the degree of cooperation between the therapist and patient or what we call the "therapeutic alliance."



Obviously it is easier to help someone who wants help. Some people are completely defiant and must be fought every inch of the way to "better." Others are oblivious and either do not or cannot participate in the treatment process. The ideal is an individual who will open their mind and consider the advice given and even give it an honest try. The person participates by asking questions and working with the therapist in a collaborative effort.



Teachers know the joy of an open and willing mind. It is much the same for a therapist. I have been reflecting about therapy. I remembered how I was focused in school to learn the classifications of mental illness. I studied the symptoms, development, medications, treatment strategies, theorists, and the rest of the academic material. When I actually began working with people I felt awkward. I was thinking too much and I was inexperienced. As time passed, I learned to simply relate to patients as people. Whatever their problem, they were people. Mental illness was only one aspect of them. I had much more in common with them than I had different.



Our hopes, fears, and dreams were similar. We watched the same TV shows, listened to the same music, laughed at the same jokes. The academic information is important, but it must be digested and permeate the therapist so it is able to come out in helpful and human ways. Good therapy is a helpful conversation. A conversation that leaves the patient educated, in better humor, and holding more hope. Hope is the best thing I can give someone. To pass on hope, one must also possess it. Otherwise it will be sensed as false hope and empty disingenuous words.



It is all about relating. To connect with another person and to engage in a common task gives me a rush. No matter if I am trying to help a patient or talking with someone in a coffee shop - it's all good to me. People are interesting. Their lives are full of fascinating experiences. So many experiences come and go and will go unrecorded and unnoticed by most of the world. That is why I feel fortunate to learn the little secrets a person is willing to share with me.



Whether I am dancing or jousting, I am doing therapy. I keep learning and in turn I stay full of wonder and gratitude. The good hearts outnumber the a-holes 10 to 1 in my experience. Many of the a-holes just start out that way. Once they stop posturing and let down their guard they end up being the most fun.



These are just a few more rambling thoughts about therapy.



Until the next time

John Strain

The Dance

Getting to know someone is a dance. It cannot be hurried. Corners cannot be cut. Attempts to get around the dance only sabotage the original intent of closeness, intimacy, and friendship. Wine needs time to ferment, seeds grow in their own time, and the dance of personal connection must not be hurried or avoided.



Along those lines, new admissions constitute a sort of dance. Today for instance, an individual came to the hospital. At first he was quiet and only stared. It could have been mental illness, fear, anger, or a drug induced state. The quiet ones raise my anxiety more, because I have to guess what is going on in their mind.



From silence he began to posture and threaten subtly. Our response is to give him latitude, but be ready - some lines cannot be crossed. We offer support, comfort, and encouragement, but if it is refused and met with anger, threats, and defiance, we have to respond. Gentle but firm direction was explained to him. This often escalates the situation, but some patients need the structure imposed on them, because they cannot control themselves. In a strange way, taking control brings them comfort. This individual danced to the edge of us taking control, but stepped back. His behavior stayed near the edge, but the initial pressure was released.



He continued to be elevated and wandered in and out of my office, which is on the unit. In my office, he did not recognize appropriate boundaries. He picked up things from my desk. At one point, he walked out of my office with an item. I felt he was baiting me to say something to him so he could respond. He eventually returned and flung the item back on my desk. Finally, I told him to leave my office and I would talk to him tomorrow when he was calmer. This was a critical point in the dance. I was setting a limit after allowing limits to be violated.



He looked at me after I told him to leave responding with, "F&*K you then." As he walked away I told him that I am here to help him, but I cannot help him when he behaves in this way. I told him I respected him and required similar respect. This time the dance got closer. He apologized for being an asshole. He came into my office. He said he needed help and asked if he could talk to me. I agreed. He sat down and I shut the door.



We began just talking, about school, sports, family, problems. He opened up more and more, his demeanor completely changed. His posturing was over and I gained a small measure of his trust.



Tomorrow I return to dance some more. It is interesting work.



Until the next time

John Strain

Die Hard Chiefs Fan

I am a die-hard Kansas City Chiefs fan and this year it means I am dying hard. It has been painful. Last year the Chiefs began the year with 10 straight victories before their defense went on holiday. Visions of post season play danced in my head. They won games they should have lost, and every call went their way. The Chiefs could do no wrong. This year, they are losing games they should win. The refs seem to be against them and opposing teams play as if blessed by their own personal fairy godmother.



It is going to be a long year, but that is why we are called "die hard." I am loyal to my team. Fair weather fans just jump to another team, usually whoever is winning. For me, there is no glory in that approach. For a die-hard fan, the victories are sweeter, but the defeats are harder kicks to the groin. Oh the pain of it all.



Well, 0 and 3 is not so bad. They can still salvage the season. Yeah, that's the ticket, there is light at the end of the tunnel. Oh, who am I fooling, we're doomed. I think I have a little Charlie Brown in me.



So here's to the Boston Red Sox fans and The Chicago Cubs fans. We all drink from the same cup of disappointment each year, but someday it will be sweet victory.



Until the next time

John Strain

I Met My First Blogger

Have you met a blogger before? Saturday night I met Riri (Irina) of Riri's Brain Dump in New Orleans. She was visiting New Orleans from Toronto, so Barbara and I with our friends the Murphy's met her at her hotel and took her on a nickel tour of the French Quarter. We had the usual fun and Riri is a very nice person. There were no surprises there. I felt like we had already met, and I suppose we already had. Blogging never ceases to amaze me. The writing helps me learn about myself. The comments and other blogs help me learn about and meet other people. My world has expanded, but the world seems smaller.





John and Riri outside her hotel.





Sampling the good food of New Orleans -shrimp, ummmm.





Will it fit?





This one's nice.





Faye, Barbara (John's wife), and Riri.





She's done this before - reminds me of Becky's 50th.





Riri talking with Faye, a new friend.



We had fun and it was nice to meet Riri in person. Her blog will be even more interesting to me now. If you get a chance to meet another blogger, my advice is - do it.



Until the next time

John Strain

The Great Wake Up Race

Today was the eighth annual Great Wake Up Race, which is sponsored by our State Psychiatric Hospital. The weather was perfect. It was sunny and clear with temperatures in the low 70's. The 5K course wound through the quaint streets of Abita Springs, LA and finished on the Tammany Trace, which is a rails to trails project.



I exceeded my own goal by running a 21:03 translating to a 6:47 pace for the 3.1 miles. I finished 4th overall out of about 100 runners and second in my age group. Barbara walked the race and my friends Marty and Cindy also ran the race.



One of the best things about races is you get to drink beer at 9 AM without being looked at funny. Here are a few photos from the event:





Barbara crosses the finish line



Cindy, Marty, Barbara, and John after the race



Marty and Cindy pose after the race



John just after his arrest - Just kidding





Now it's off to the yard work.



Until the next time

John Strain