Working in mental health

Have you ever had your ankles licked at work?

That’s an experience I had at a new job this week.

At the job interview, there was a mild air of desperation as the managers upsold the more ‘senior‘ role that I was ‘much more suited‘ to than more general, part time role I was applying for. My reaction was shock and amazement as my ego sat up and stroked her hair.

Now I know why.

From the first morning of induction, we were locked in the conference room because my client was thumping the windows and swearing loudly about how much she hates me.  The next day I hear coming in at number #1 on her ‘future goals list’ is ‘Get Amy fired‘ as she eyeballs me whilst draped over reception articulating the words ‘power’ and her ‘challenge’.

This is from someone who had rapport with her previous case manager and faced with a conveyor belt of changing staff and caregivers, she is fighting hard in a pretty powerless situation.

It’s pretty intense working on the coal face of mental health. Ten clients with heavy stories and mental health diagnoses live onsite in adjoining one bedroom units. It is my job to oversee the day and troubleshoot any disagreements, disputes or episodes that may occur. Learnt at uni that emotions are contagions, now seeing it in practice, it can only be described as mercurial. Watching how the shifting sands change rapidly is a lesson for me to not get too attached to how I think things may go, and to live wholly in the every changing moment!

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At handover, we sit with diagrams of coloured zones and conversations about clients ideally being in the green ‘wise mind’ zone where things are flowing and avoiding escalation to the red ‘risky’ mind where adrenalin and cortisol take over. But this same learning tool is used to educate staff on their own wiring as we aren’t immune to the waves. Every time, I cope it from my client, a staff member has been there with a knowing smile offering support, the oxytocin hit may be enough to keep me coming back tomorrow.

I did expected a challenge, but I didn’t expect to be the target of such intense behaviour. Of course, it is possible to rationalise it in terms of amygdalas; inability to emotionally regulate and don’t take anything personally but honestly, I feel like I’ve been thrown into a war zone. By lunch time on the second day, I notice I have become more desensitised.

Self care has zoomed up the list. I drive to a nearby forest on the way home forcing myself into a jog-walk spontaneously stopping to hug a wise tree elder to clear the stress and mild panic experienced that day. I can feel the cortisol spikes hoping to release them. Some of my predecessors fell to the scary burnout.

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Social norms exist in another stratosphere and I’m jumpy as I’m escorted to my car in the hope that my client won’t find which one it is as property damage has happened before. I get inside and exhale. Putting all the skills to work: some laughter, some philosophy, some getting physically fit.

When we work with the horses, we demonstrate firm boundaries. Otherwise, the large animal may either mindlessly walk on top of you and/or be in a place of unease and fear at who is in fact the leader which makes them feel unsafe. It is these skills that work best with my client. With a horrific history of insecure attachment and distrust, she requires clear boundaries and crystal clear communication to build trust and feel safe. The ‘no hands on’ rule is constantly tested when she latched onto my ankle in reception refusing to let go. My horse mentor talks a lot about ‘fight, flight or freeze’ and how we have a predisposition to one of these. My client is a fighter- fierce, vocal and lightning sharp. I am a recovering fleer who now holds my ground and I’m learning to dial up when necessary. This job is going to call on me to embody these on a daily basis.

Sometimes we don’t get what we expected, but it may be just what we need. Here’s the philosophy part: walking it out to see how far I can go with it. At the moment, I’m not seeing a huge silver lining but I know there is one. I know I have choices available and that I create my own path. For now, being in the fire with a fighter is challenging, beyond my map to date. It is questioning the beliefs I hold about my self, the helping profession and wider system at play, what is enabling and empowering behaviour. Everything will be turned over and hopefully deeper truths accessed along the way.

Send me your love, I will gratefully receive it.

 

3 thoughts on “Working in mental health

  1. Totally sending you love Ames – what a huge challenge you have taken, but your ability to analyse, your calmness, your strength and generosity shines through – all the very best with this and other clients!

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  2. To the working girl.

    Wow!!! What a confronting stark post this one is! As a student of psychology, you are certainly being exposed to the raw side of the profession. Are you now wondering if teaching would have been a preferable choice? A softer option? Somehow I get the feeling that you are seeing this ‘senior suitable’ role as a massive challenge. I look back to my student rotations in the Psych wards which I remember as being so weird and different from any norms at 19 years old that I had ever experienced. Now you are older, much wiser and stronger, Amy, than I was then. You have grown into the most amazing insightful and capable woman, dear niece. However, be kind to yourself, seek help when needed and make good choices where necessary. You and your family need you to be nourished. Keep hugging trees, laugh, meditate, run and find comfort in your animals and hopefully the 2 legged species too! You are the most important one in this scenario. As a fellow member of the caring profession, I feel we can only do so much and then it is over to the patient/client. For the client with mental issues I imagine it can be much trickier than those with physical ailments. However, there have been many rewards and I hope you will reap these too. Your post had so many words I had to look up, e.g. ‘amygdalas’! It must be a good feeling in a way to be earning some money and not studying.

    Your father told me last week how proud he is of you. Not sure if he has said it to you, Amy, but thought you should know! His birthday today, of course. Hope to see him soon. Spent some time with your mum over the weekend which was nice. She is still keen to look at a property in Bellingen so I will probably go with her in a few weeks. Yes, I am so sad about Allan it is hard to contemplate how Lyn will be without him, always by her side and she his for over 50 years. Such a team were they. Tomorrow, I fly up for a very emotional day. I will pass on your love to Lyn and Clayton, who was so close to his Dad. He will be the one to support his Mum most I think.

    So, best away, do something meaningful and walk the dog. Much love to you and a great big hug, From your FG. 💋

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