Monday, December 29, 2014

Working the detox shift!

My latest and newest and fanciest job role is as a volunteer/intern/thingymadoo at a hospital in Brooklyn. I am working in the detox inpatient ward. To cover the basics, my co-workers are absolutely lovely, my atmosphere is grand, and the patients are at their very best. That is, considering the horrors of withdrawal, I have been very impressed with their smiles and decency. More amazing than that is the types of people I've met. These patients are coming into the E.R. of the hospital, are then interviewed, and then, depending on their rating on the "You an addict, son!" scale, they are then sent to outpatient services, inpatient services, or sent out to stop whining, get a cab, and go home.

Now, I want you to imagine the type of person you would meet at an inpatient detox center. Be honest. First thoughts. Are they old? Young? Professional? Extroverted? Depressed? Mean? Sickly? What do you see? Who is this person?

You can erase that person. Well, maybe not.... Most likely, however, the person you just drew up is unlike anyone I have met in the hospital yet. Not to say that whoever you viewed is not the more typical type or overall, more commonly seen in these settings. The surprise to me was how many of these people were NOT who I was expecting, nor who you would expect, I am sure. I've seen people in their 30s, 70s, 50s. Women, men, muscular, heavy, thin, blonde, bald, tattooed, with glasses. Some homeless, some with respectable jobs. Others don't want to get well. They just came to detox for a place to sleep and free food. Although, the fella who did this was the one who saw me watering the plants one day and the next day said, "I watered them for you today, flower girl."

They all had one thing in common, though. They all wanted to call their mother. Many of them relapsed because their mother was sick. Many are addicts because their parents were addicts, or because their kids are addicts. Others because they became addicted to prescribed medication or they were stressed or lonely or depressed. I met a chef, an introverted intellectual, a mother whose daughter graduated from John Jay.... There have also been many couples. They detox together, they relapse together. As one co-worker said, "They're starting to call us 'Sandals Detox Center' because of all the couples who are starting to come."

Some of these individuals only drink, only do benzos, only do opiates. Some think smoking cigarettes is awful. Though, cigarettes aren't allowed, anyway. Most of these people have been hospitalized or detoxed or in a special community for addicts before. Others are in for the first time and are very nervous and scared of being judged. They're not bad people. They know they're not bad people. And they want everyone else to know their not bad people. Some of them are just better at showing it than others. We don't know what they've been through, where they've been, what they've seen.

There's no real point to this blogamadoo.... I just wanted to share the experience, the stories. This is just a beginner's tale that I may add future stories and facts to for your benefit, and my own. We can learn about these people, their illness, and the path to a cure (or treatment) together.

Not to mention, the reminder that it is indeed a disease. An illness. A sickness. As another co-worker explained, just like any other disease, we have medication and upkeep. Sometimes we forget to take out medication and take care of ourselves, so our body warns us. Seizures, blackouts, shaking, hangovers, quivers, and various other symptoms remind these people that they are unwell. However, fortunately, they have some control over this sickness. They can get better and overcome it. As a matter of fact, at least half the staff are ex-addicts of one sort or another. They got better, they made a life for themselves. Judgment and cruelty are not cures. My view is: help these people, be part of the solution, or get out of the way.

Monday, December 8, 2014

The Great Irony

What do you say when a friend texts you late at night, "I want to die." ?

You ask, "Do you really want to die? Should I be concerned?"
"Of course I do. My life is f*cked up"

This conversation continues. You ask several times, "Do you plan on harming yourself? If so, how do you plan on doing it?"
Followed up with, "Do you plan to be alive tomorrow?"
He responds with vague answers; not truly answering, or just changing the topic altogether. He seems serious.

You put aside the books you were studying. You minimize the document you were just working on titled, "What is a counselor?" and you open a webpage with a list of suicide hotlines.


This means you have put aside your education, your future career and livelihood to help someone. Not a client or a patient, possibly not even someone you consider a friend. Many professionals in the mental health field would say that it is not your job. That the person should contact someone and you should focus on your own stuff. However, that wouldn't be their advice if the person texting you were willing to pay, would it? Of course, if you don't have a license, that would be illegal... but you're getting off topic. Point being- what do you do? No compassionate and decent human being would just go back to their schoolwork after hearing something like that.

This is the sort of conflict anyone with empathy and patience has encountered. No doubt, the older one gets, the more calls of desperation you are likely to receive. And the answer only lies in the person in the moment facing the situation. There is no wrong answer (between speaking to them or pawning them off to someone else), from a professional and ethical aspect, this is entirely subjective. It depends on how capable you view yourself to be, what you believe your role is in this person's life, and how you think you will respond in the worst case scenario. If things go downhill, there is no good solution or outcome. Most people in this position will find a way to blame themselves, no matter how much time and effort they devoted to the person at risk, or how many resources they recommended. On the other hand, if things turn out being okay, you need to learn to take credit. Not necessarily dancing around singing, "I saved a life! I am the best person who has ever lived!!" but... just taking a moment to recognize the good deed, the skills you have, and an appreciation for yourself. This is the part most people forget to celebrate. Saving a life is not minor feat. Many (if not all) of the biggest names in the mental health field have experienced losing a patient or client. Win or lose, it will be traumatic. So, no matter what the outcome, self-care and even therapy may be necessary.

Of course, sometimes you may also get impatient with the people you are dealing with. Oftentimes, self-harming people will ask for advice, then tell you everything you advise is stupid and wrong. This can be so, so very frustrating. Or they make the horrible statement, "I have the hardest life ever." Pretty sure you're not from Sudan or Syria, dude! Keep in mind, however, that to them, their life is THEIR hardest life ever. This makes it a lot easier to empathize. It's no competition, but everyone who is hurting is looking for a reason. An explanation for the bad things and the pain, even if there is nothing there to blame. Sometimes you just have to tell them, "Yep. Life is hard."

Validation is way more comforting than hearing, "No! Life is good! Stop being sad, chum!" I can say from firsthand experience that when you're bummed out, being told you're wrong and that everything is sunshine and lollipops, you just want to stab yourself (and the other person) in the vulva and watch the knife come out through the larynx. Positivity is not always the answer. While hope for the future is nice, it's not always realistic. Feeling understood and less alone is the goal. Of course, maybe don't convince them that there is absolutely no reason to hold on and they'll only become more miserable throughout life. That might not be the way to go, either. Let's aim for a healthy middle, shall we? Life is awful, but we're all miserable together. So, we aim to enrich other people's lives and we try to make our own lives as decent as possible. Being dead is super boring, anyway. If nothing or no one else, you, you who is giving them your love and care, you'll be there and you want Mr. Sadface dude or lady to improve your life. You probably benefit from this person being alive in some way (accept it- we're all selfish jerks), so let them know that. Maybe they're working on a project that you want to see completed, or they owe you money (but they have all the time they need to pay you back) or... whatever. If it's someone you've yet to meet in person, all the better! Try, "My goal right now is go to _____ with you!"

Keeping someone alive is NOT easy. Keeping them from harming themselves is an exhausting, long-term process. So, I think common sense is key. Whether you're up for the task or not is the first step. Don't take it on because it's the "right thing to do" or it's a new challenge. That's stupid. Don't be stupid. If you KNOW you can handle it on all levels, and the person at risk refuses to contact anyone else, then giving it your all is worthwhile. Of course, there should still be 911 on the other line. It shouldn't be all on you, anyway. Don't tell the whole neighbourhood and have a suicide block party... no. That might be fun, but probably not helpful. Just contact a close friend or family member (of yours AND of Mr. Sadface) and see what wisdom they can offer or if there's anyone they think you should talk to that may help. Again, that's if Mr. Sadface won't contact a hotline or anyone. A professional is ideal. You may feel like you're betraying this person's trust or they may get angry at you, but... get over it. Priorities. His/her life or his/her trust?

So... that's all my suicidey advice for today! I hope you don't run into a situation like this anytime soon, but now you're fairly prepared if so.