Ever Have One of Those Days?

ninety percent of the time I am on. I mean ON! I connect up with people, get intimate with them in sessions (emotionally - get your head out of the gutter), and generally get tears flowing, them having AH HA moments and such. Well today was a bunch of arm folding, mistrust, and a feeling like the clients felt like I was hasseling them.

Hey, let's face it. THis is real life. Some days it's peanuts, some days it shells. I can't expect everyday to be thunder and lightening flying, God rushing in, and miracle after miracle taking place - as it seems to happen (in my own mind of course). Still, when clients aren't motivated in having simple conversations and are THAT paranoid, I need to back off.

One client was so rigid I excused myself and left them almost in mid sentence. Why push when someone is so resistent? I don't need to work harder than them. So I let the Nurse and the Psychiatrist grab the rest of the information that was needed. I know when I am not welcome. The funny thing, the client in the end thanked me. Can you imagine that?

But hey, therapy is a give and take scenario. Both parties have to involve themselves in order to have some success. Sometimes the rewards are great - almost inspiring! Other times they plop on the floor and need to be swept up. Do you think I want to engage myself in every person who enters my room? Well actually my percentage rate is very high, because I give a damn. I felt frustrated today when I left the interview room because I truly wanted to help this person who was just released from a psychiatric hospital and still seemed a bit (alright a lot) unstable. But again, I know the limits to the counseling arena.

Then came the next client and it was almost a repeat. They too were guarded, didn't want to talk about their past, or talk about their past traumatic experiences. The best interview of the day was with a psychotic Spanish Speaker who grinned a lot and thanked me for the help.

Oh well, it could have been worse. One good thing, days like this helps me appreciate the times that are really special.

It is over eight years here and we, as an organization have serviced over 16,500 people with mental illness. That is amazing! I have literally seen thousands of people and trust me a day like this is very rare for me. If it continues to be the same, perhaps I too need to go through counseling. I don't want my connection with God to get permanently closed.

May you all have great mental wellbeing.

A Calm Day

For the past umpteen days we have been working our tails off and I haven't had a moment to settle down and gather my thoughts. I love writing this blog in particular because of how important the work is that we do here. Crisis stabilization is insane work. We have to nestle up to some people that are literally nuts and try to fix them to the best of our ability. This takes patience, team work, good ethics, and a compassionate heart. I am proud to state that I have these qualities and the years of experience to prove it - and I don't.

Who did I see today? This was an average day. A client that has regular suicidal tendencies, an alcoholic, a person who hears voices to harm themself and has never taken psychiatric meds, who is almost fifty years old and homeless. A person with mulitiple personalities (five) who get's violently paranoid. A spanish speaker who had major depression and psychosis who was off their medication for two months. A young person who wanted to go back into a hospital after just being released because life is too overwhelming. A foreigner who had a scuffle during immigration interviews at the airport. And on and on and on. Each day is another saga, another soap opera, another sitcom.

I have always thought that this job would be perfect for primetime televison. Each day could highlight cases, the crazy staff, and our administration that tries hard and places more responsibility on an already overburdened staff. Sound like good viewing? There is a lot of comedy for sure.

So it is now August and the entire staff can't believe it is coming up on the holidays. I can. Yes it's been a fast year. That is because we are so busy in doing meaningful work. I remember what it was like when I was a kid with nothing to do. My friends might have been away and I was bored and watching the times slowly tick away. Now I blink my eye and it is six o'clock. WOW! HOW DID THAT HAPPEN?

May you all have great mental health.

Shaken and Stirred

It is interesting how life circumstances grabs hold of you and doesn't release it's ugly grasp. I got some bad news today - well possibly bad news when my tennant gave me thirty days notice he was moving out. Why discuss this in a psychological sense? Because it demonstrates how our personal lives effects us all.

Paying first and last to me, one would think I would be professional and place it into an account for a rainy day. Well living paycheck to paycheck and having a fixer upper in the desert has zapped my funds. So now I wonder how on Earth I will make ends meet at the beginning of the month.

Of course today I had sessions with some very troubled people. One I felt I made an exceptional connection with and really explained how they can self counsel themself. However while waiting for the psychiatric interview the person had melt down after melt down. Rare for me, but it does happen. Then another client who had no stopped cried throughout our interview began getting angry and demanded for the psychiatrist to see them. What a day. Ba Blam bam BAM!!

Luckily I see life through spiritual eyes. Obviously I need to address my financial issues with more diligence. My recent raise is helpful, but being a family man now I have some hard facts to face. Private practice? Dive head first into a gaming opportunity with promising financial rewards - plus at the same time work with my life long best friend? Persue a book deal, or market my two books on my own? The later is confusing because I haven't a clue about marketing. One thing for sure, if I am unable to solve this financial crunch, my therapy skills may lack. In this setting it wouldn't bode very well.

So I have some thinnin to do, as Rickey Ricardo would say. One thing for sure, I have unsurpassed skills, a great heart, and perserverance. Just one look at all the construction jobs I have been doing lately shows I can tough things out and create incredible beauty at the same time.

Thanks for your prayers and kindness.

May you have enhanced wellbeing.

Changing My Approach

After having thousands of client sessions it has occurred to me lately that I have turned into a kind of repetitive robot. Of course I listen well, go with what clients tell me, and have great compassion. Well at least I delude myself into thinking about myself that way. What has changed is how not I am - predictable.

I had four client sessions today and each one went very differently. One was strictly on having the client avoid their past thinking and focus on creating a relationship with self - a compassionate relationship with self in the here and now - ongoing. Another session was focused on how a client can literally treat themselves like they treat others - which was contrary to how they have lived their entire life. The next was focused on reasons why a person shouldn't jump out of their moving car - a thought that had haunted them for fifteen years. The last was convincing a person to obtain free medication at their designated mental health organization instead of purchasing it black market on the street. One intriguing day that seemed to literally fly by!

Today was an easy day. I avoided the writing down the regression process and focusing on the needs of the core wounds that have been neglected for years. Yes I included this in our discussions like I always do because it is an eyeopening experience. Still their were more burning issues that needed to be handled instead. It is as if I am moving away from my familiar mode and really honing into what presents itself - though I still have more room for improvement - thank God.

I loved it when a former client of a week ago showed up to support a friend and was all excited to see me. It seems that this person is in a drug treatment program and she got to share about the Spiritual Psychology approach I taught her. Well not only has it affected her, a number of clients got really inspired! It is as if the ripple from the pebble I tossed at her is affecting others and so on - at least that is my prayer.

Life is short. I see it, vicariously live it through the people I counsel, and let's face it we all know friends and family members who are struggling or are deceased. Hey I am 52 years old going on 90 and going on 15, my hope has always been leave this world in a better place when I ultimatley leave. Lord knows I try in my interactions in mental health, in the home improvement projects I do with friends, family, and in my relationship, and with my books on self healing and spirituality. Our bodies are merely rented. It is short term - believe me. I can't believe I am in my fifties! I used to play baseball it feels only a few months ago. The last upper division softball game I played in was fourteen years ago! My oh my has time flied!!!

So I listen to others, make some suggestions, give love, and try to learn from my mistakes. An interesting life, but it is the only one I've got so I make the best of it.

May you all have enhanced wellbeing.

So Much To Say

I don't know what took place this past week, but I have seen everything!!!! The psychotic, majorly depressed, highly anxious, the paranoid, and people so manic they couldn't keep their body still. I try to view people in crisis in a neutral way, trying to avoid my judgments, but often wonder how I would cope if I too was in their state.

The human mind is fragile. Given the proper circumstances anybody can become volitile to the point of homicide, can become psychotic, depressed and anxious. We all to some point get bipolar. I have had restless nights where I could barely sleep and was wrecked the following day. If the worries of the world hit me so hard for a lengthy period of time I could easily be seeking out the services I provide from others.

It is sobering to work with clients battling addictions when I too have my own. I get addicted to hard work, worrying about finances, and about how to improve my relationship. I also have a thing for junk food, and even though I have stopped my substance abuse many years ago, I often wonder how easy it would be to tune out and turn on to my old favorites.

It is nice having a human moment, removing me from my pedistal like so many clinicians do, and become really honest about my life in comparison to the clients I help. We really aren't that different. Yes I have a doctorale education, but I still am a flawed human being trying to live life to the best of my ability. THere is always room for improvements - that's for sure.

Enjoy one another and have a wonderful weekend.

Family Therapy

When it comes to crisis management, a key component is simultaneously treating the family. Our families are intimately wired into our psyche, whether we interact with them daily, weekly, yearly, or haven't for years. Why does our family get under our skin so easily? It baffles the mind. But, like a dagger to the heart, the interactions with family can create madness.

Often in the crisis setting, family members will be abusive. You would think folks would control themselves in the presence of others, but often this just isn't so. I have witnessed families beat on one another, today saw a parent berate their grown child, I have had to remove friends and family members from the room for causing a scene - and they weren't seeking treatment!

You would think that our facily brings out a person's basic nature. I myself love the appreciative folks who understand what we do at the crisis room on a daily basis, however this is far and in between.

What people don't consider is people with mental illnes don't function on the same level as people that are "normal". In fact many parents don't realize their child at 15 years old is not as logical, not as well versed in worldly matters as they are and function at a much lower level. Today the mere fact that the person's child couldn't live life "to their rules", they got mad, loud and had to be spoken to by yours truly. Where is it in my job description to interact with people who weren't even my client? It is essential however to keep the Crisis room as free of crisis as possible!

The mind is an interesting beast. If it doesn't want to acknowledge the fact that something is wrong - ignorance is bliss - it will delude us into feeling that everything is just fine. I had a funny experience with this myself one day as I walked down the street with a friend and walked right into a parking meter. Everything was fine with my walk and my conversation with my friend, but when something I didn't want to acknowledge stopped me in my tracks, I was forced to deal with it.

May you all experience enhanced wellbeing.

Taken for Granted

We all to some extent felt taken for granted. True? Well if you are a human being this feeling is common. Well today was a banner day of my feeling used and abused.

Why do certain people feel obligated to milking out every one of their desires and still make you feel that your 100% effort wasn't good enough. Case in point: A person was brought in by the police who was feeling suicidal and had lost all hope. They were kicked out, taken advantage of, "everybody is against me", you know the speach, and all they wanted to do was die. With that being the backdrop, I did everything I could to show this person kindness. I got them a hotel to sleep in, got them free medications, set them up with a facility that helps provide housing and jobs, but because I couldn't care for their migraine headache, it was as if I became an axe murderer!

I could have placed the person on a 5150 hold because they had a plan and felt hopeless. However knowing the facility they would be sent to and the fifteen minutes they would look at my paperwork and laugh at it I tried to work with the person. Now as I figuratively pull the knife out of my back I wonder if I handled this the right way. Oh no, they weren't going to kill themselves. This person has children they adore. I understand they had a confrontation, the police got involved and this has had to be the lowest point of their life. I don't understand why the person picking up the pieces (me) had to put up with all their Bu.. sh..

This wasn't the only person who was unruly. Another person was so fixated on securing Klonipin that when our psychiatrist didn't prescribe it, they asked the address of another clinic they could go to to obtain it. I refused to answer. "The doctor is recommending this other medication for you. Besides if you are to admit into substance treatment the facility won't allow to admit using this." I replied.

The clients have from day one tried to prescribe their medication. Of course many of them know best, however the drug seekers, who refuse to look at their personal issues and opt to hide their pain through drug use and psychotropic medication are the biggest self prescribers of all. I just want to know why these folks find their way to my interview room on a daily basis?

Then the clincher of the day was being called into the main administrators office. Not my boss, but my boss's boss. Confusing? I had turned somebody away from our facility because we were booked solid and we had no more time slots available. The person left causing a scene, as they normally do, and the administrator watched an angry idiot being idiotic as they left the facility. Was the person suicidal? Were they a threat to others? Not really. This big baby showing is again typical of people with a severe mental illness who don't know how to get their needs properly handled. They refused a referral to another urgent care, and didn't want to even think about showing up to our facility the next morning to get the free medication the county provides through us.

Now the secret is no longer. We are busy pretty much every day. If we were open on the weekends like we used to, our doors would be filled at that time too. The pinch of county mental health services is being felt at this very moment and people are scrambling to our facility to fulfill their needs. Most folks are patient, appreciative, and easy to work with, however we will get the abusers of the system who have nothing and try to squeeze every dime out of their free care. "When is my food arriving!"

May you all have enhanced wellbeing.

An Unexpected Day Off

My busy work week came to an abrupt end today in having to stay at home and supervise kitchen cabinets being installed for the second time. They were much too shallow and needed to be redone. Isn't it easier to follow the plans mapped out? Now the cabinet company has to lose the profit of making new cabinets, paying for an installers' time, and disrupting the customer's lives. It's too bad. The company does A1 work. I for one am not going to suggest them to others because of the screw up, the not showing up when promised and the missed days of work I had to go through. So I miss out on providing proper help to people in crisis - something I live for.

It is nice to have a passion, and the confidence in doing something you love. Not many people can honestly say they love the job they do. In fact, most would say they are working to just pay the bills. With my new raise, maybe I can pay my bills too?

To augment my income I have to be crafty. Do a home improvement project here and there, write some books and try to market it myself. Have individual sessions, though my private practice has tanked due to all the manuel labor I have engaged in lately. My latest project is developing a psychological game for Facebook.com - which should be a real hoot.

Boring life? I don't think so. I am so busy I barely have the time to talk to my own mother. Obviously balance is not in my personal make up as of yet - but I am hopeful.

So with the sound of drilling in the background and a sense of muted satisfaction, my babysitting day has just begun. I am the house mother today. Caring for ailing pets, doing the laundry and I have a monumental task of filling these awaited cabinets with stuff. Now I don't mean just stuff - I mean STUFF. I am in a relationship with somebody who has plenty of EVERYTHING. If there is a specialized kitchen tool - she has it - plus it's back up in case something happens to it. It's a wonder we have room to walk around this place - and that's when everything is shelved!

I think guys are different. Give us a microwave over, a toaster, a George Foreman grill, and condements, and we are set for life. Paper plates and paper towels will suffice. I think at my condo I had one vase. Who needed flowers? Shoot a remote control in one hand and a hamberger in the other made for the best evening. I don't even think the station ever changed from ESPN anyway. Oh maybe for Survivor Man or Man Versus Wild.

So I am Mr. Mom today. Bored out of my goard as I await the cleaning and organizational project that rapidly approaches me. Yeah right - day off. Shoot I'll be working more hours but at least I don't have to do the damn paper work.

I appologize to my replacement for the day. She is about to go through Friday hell while I am stuffing another load of laudry into the machine.

May you all have enhanced wellbeing.

Big Baby

We get them every once in a while. The big baby. These individuals use and abuse us, fail to follow discharge plans and return unannounced demanding service. The fact is, we offer limited services. Period.

When the county set us up eight years ago, we were contracted to see a person, get them referred to a full service provider, and limit our interactions with somebody to once, twice, or at most three times. That is it. We are viewed as a crisis center and charge the county accordingly. For a department of mental health facility, they charge the county much less. We are here for a reason. Get people in a real crisis not only emergency care, but to head these people in the proper direction for continued care. Some of our clients do not want to hear this one bit.

We had a person who continually abuses us show up again today who wouldn't take no for an answer. They had every excuse in the world why they didn't follow up on our discharge plan and didn't request to be seen again, but demanded it. So one by one, each member of our crisis staff had to talk to the person and decline them in our own special way. This was the first time I ever saw our Psychiatrist get into the mix! Do you think this helped? Of course not. The temporary supervisor had to be called in.

"Mommy, mommy, I want!" Was repeated by this grown child over and over again. This person had learned an irritating way to try and get their needs met. "Are we there yet?" "Are we there yet?" Sorry, but no referral no service.

One would think this isn't very therapuetic, but trust me, this is the best medicine. We can not provide the hands on care individuals like this really need. In missing out on medication for a day or two and getting into the proper care facility can set people up lifelong. We are a temporary band aid on the boo boo compared to them.

So quit your complaining, and your crying, and talking to every single person in earshot. We all see your game and know what you are doing. You are trying to manipulate a system set up by the county, and the county is not going to bend it's rules to provide inadequate long term care to appease you.

Before and After Picture

One thing is for certain. People, after visiting the Crisis Center literally change. Years ago I proposed to invest in a Poloroid Camera and take a before and after picture to show folks of the physical changes created after addressing a core issue and releasing it. Many say that the crisis center is not designed for counseling - but medication management. That might be true, but when people start discussing their deep wounds it is necessary to work upon them in order for enhanced mental health to take place. Taking the proper honoring focus and care miracles tend to take place on a daily basis.

I love walking somebody back into our unit that is afraid, and looks like they have lost all hope - because I already internally know their after picture. It is beautiful when even big dudes who have gang banged for years, touch upon a core wound and start sobbing like a baby. And thank God they do. If they never released this pent up crap it could be the ignition wire to violence or suicide.

At first the showing of this kind of emotion used to strike me funny. I fought hard against laughing in people's faces - to be brutally honest. What was really going on was my discomfort internally and laughter made it humorous and less humane. It took some doing, and a lot of counseling to honor people while they released this pent up garbage. Now I view it as if it is a cough or sneeze. This is the thorn in the Lion's paw and I am with as much sensitivity as I can show, simply removing it with love.

Nobody, well only a spattering of clients throughout the years has seen therapy that works so quick and so effective - if I do say so myself. This is not an arrogant statement whatsoever. This I report with all humility. Trust me, I don't do the work anyway - believing that I am insignificant, but given the right compassion God works right through me. Trust me, half the words I say just fly out on their own accord. I couldn't script this shit. I studied Spiritual Psychology for this very reason: "Get out of the way and let The Father do the work."

I like what I do - except for the redundant paperwork that drives me that the staff nuts. But hey, now paperwork, no paycheck is how I see it.

May you all have enhanced mental health

Date Rape Drug

Every so often a person comes into our facility perfectly fine one day and the next something is drastically wrong. One's family suspects their child was slipped a "Mickey" during a party and suddenly they are in a scramble to gain their child's sanity again.

We seen this, not often, but people do tell stories of going to a party and never being the same. Suddenly they just aren't right. Their are strange feelings in their intestines, they feel people are watching them and plotting against them, strange talking is suddenly heard in their head. Did someone in the FBI implant something on them?

Let's be honest, their is a contingent of shady individuals who like what they see, feel unable to court this person properly, and want to use a "wonder drug" to achieve their prey. In doing so, the consequence to this selfish behavior can lead to somebody having severe mental health issues for the rest of their lives.

Unfortunately the people who victimize these people would never read a blog of this nature. Would they be educated? Have a conscious? I doubt it.

It is people like me who try to assemble the pieces, work with the families, and try to help them grieve. This is a loss on many fronts and individuals close to the person go through the traditional grieving process: Denial, Anger, Bargaining, Depression, and finally Acceptance.

We may never regain the whole person - depending on the amount of the drug given to them. Sometimes all we work for is stability. However with the current effectiveness of psychiatric medicine, and a few new ones about to hit the market, there is more hope for a functional future.

I often believe that being good looking would open doors. I have seen beautiful women driving incredible cars, and wearing clothing that surpasses the attire of Hollywood starletts. In this case being good looking makes beautiful, unreachable types targets. Be on guard. Especially in social settings. Don't take your eyes off your glass if you choose to drink. Know the people you are around - if you are able to do so. Your sanity may depend on it.

May you all have enhanced well being.

Pleasently Pleased

From time to time we have special trainings at the crisis center. It is a way for the staff to learn new techniques, for administration to impose new regulations or approaches - as was the case yesterday - and for the staff to get a break from the hectic pace of their units and interact in a relaxed state with one another.

RCCS I believe was the approach taught, is the focus of listening to a client and being aware of their power being taken from them. It is easy to forget how difficult it is when somebody takes away items you enter a facility with. At first we ask, "Do you have any sharp objects, weapons, or lighters on you?" If so, they are taken away and given back upon discharge. I would be taken back a bit if items were taken from me, "My Items", and would wonder what in the hell I was setting myself up for.

It is an interesting experience to be locked into a facility for a few hours since the front doors are closed and patrons need to be let in and out due to the overall facility being a psychiatric ward. There are people who have lived at this site for years. I would wonder, especially if I had a severe mental illness, if I too would get admitted there.

Now in a controlled environment, we monitor what is seen on the television, we close the office doors to talk about the clients in private - further separating the staff from client, and we force them to use a wall unit to light cigerettes on in the back patio. In moments these people are thrust into an institutionalized setting.

Being aware of this is the first step, making people comfortable, talking with them in a friendly manner and listening to their needs and desires was the thrust of the training. So often social workers fail in this very important area. How often do we thrust our will onto somebody and treat them like we have hundreds, even thousands of others, and turn this facility into an assembly line? Our company wants to honor each client and look at them as unique individuals first off, and wants to give each indivual the opportunity for that special "Ah ha moment" in which they get clarity into improving their life path and a desire to achieve real goals for themselves. What percentage of the folks we see are able to achieve this? You would be surprised with the advance in medication, and the power of a simple human to human connection.

So with renewed hope, and a nice one day break, I face this day with an open mind and heart, knowing full well that some psychotic individual, on the edge of having a break down will cross my path. Just another day in paradise for me.

May you all have great mental health.

It's About Time

After five years I am getting a raise. Son of a gun. My salary at the job had topped out and at first my supervisor tried giving me bad reviews as an excuse for not obtaining a raise. When I pushed her she admitted there wasn't the budget for it. Five years! It's about time!

What am I going to do with the little bonus that probably get exed out due to taxes. I can eat, purchase vitamins soarly needed, I could buy gas to get to and from work. Wow the options are endless. Four percent. Maybe I'll retire in a year.

I think I have it bad and then I talk to my friends. It seems like everybody is hurting. One hasn't worked for months, another could only find extra work in the movies which kinda pays his bills. My sister found a great job which shows that there are good jobs available - all it takes is luck and who you know before you get a break I guess.

At work I interview folks weekly who have lost jobs, leading to losing their homes, causing families to split up and suddenly have found themselves living with mom and dad again. It is difficult when you reach forty years of age, live with the parents and feel like a failure. Imagine if you had a severe mental illness in addition. Not a pretty picture.

As I grew up my parents always told me I wore rose colored glasses. I tended to see everything in a positive light. When the hard reality slaps you in the face on a daily basis that people aren't working, sleep out of their car, haven't eaten for three days, and smell like filth the rosey tint definitely fades.

Does this mean that I am not positive, that I've lost all faith or hope. No far from it. I'm a healer. Period. I have seen incredible healing, transformation, and shock in people on the brink of life itself flowering into incredible people!

I will leave with a heart warming true story - in which I will switch a few facts to protect confidentiality.

A number of years ago I worked at one of the swanky Malibu inpatient residential treatment centers and worked with the ultra wealthy. These people were the movers and shakers who had lost their way - so to speak. One client I had the honor to work with had a partner who made a mint in a consumer product in high demand. This person had over twenty suicide attempts and had been at the facility for months before they were handed over to my care. It took us a month and we located the core issue, worked on the issue fully and tremendous healing took place. It was as if the light bulb shot on and there was no shuting it off.

When it was discharge time my boss couldn't believe the quick turn around and advised the person to spend more time there. He was collecting over $20,000 a month and it was clear what his motivation was. Now wavering the client asked me how I felt. I was confident and suggested this person go to my university to keep learning more and more about the Spiritual Psychology approach I taught them.

I heard from the person a few times and then about three years later received an invitation in the mail. The person not only graduated with a masters degree in Spiritual Psychology, but also their partner had also gone through the course and received a masters as well. Yes, transformations really do take place!

Supervision

I have been questioning higher ups in administration. I think it is the classic worker versus authority issue so many have. Alright, I have. Years ago I was corporate treasurer for a production company in Hollywood. I realized at that point there were two ways to motivate my workers, treat them with kindness, as if they were children needing molding, or motivate them with discipline. Obviously I am not very good at being a bad parent so I learned praise, having them point out what needed improvements, and spent times on coming up with a plan of action together. Twenty years later many of my workers still gather for Karaoke singing and celebratory parties to commemorate that great times!

Having this supervisory background, recent events at my placement have felt demeaning. It is as if the police is write something down on the permanent record first, then discuss it later. Which to yours truly doesn't really fly.

I remember twenty five years ago when I was cleaning swimming pools. Yes, you should have seen me in my shorts, my tan, and my Greek Godlike body. You know what, this really hasn't changed. Anyway, at this time I learned that pools that I couldn't stand eventually were lost - they were usually leafy, moldy, and having insufficient equipment in which the owners refused to replace. This may be happening at my current placement.

I have had a good run at this job. For eight long years I have had numerous supervisors, some good, some poor. One thing dominates - I have never ever had a single note written in my personell file. Pretty interesting, wouldn't you think. In seeing roughly eight hundred people a year for eight years and not a single write up, it shows the direction this firm has gone into hiring a disciplinarian. And now the pool has suddenly become moldy, filled with leaves, and the equipment is running poor. As a result I am frustrated, but it doesn't hold a candle to many of my coworkers sentiments.

Too bad. What we do for Los Angeles county and beyond is miraculous! Where do people go to when they are in a crisis and they have no insurance or Medical? To us is where they go! We have recently seen our 16,000th new person! That is a lot of crisis.

I have taken a cut in pay to work at this firm for a reason. I felt it was noble work. In fact I am sure of this fact. Now with a family I may change directions and move to the money grabbing game instead. Eight long, very fulfilling years that are now fading into the background due to a faulty filtration system.

When my last supervisor quit, due to acute anxiety attacks, I pondered taking the position. The salary increase was enticing, however I love to work in the trenches. Still I sat down with the regional manager, threw around some ideas I had about the position, but didn't pursue it at all. My coworkers sure wanted me at the helm and now I can see why.

So I slowly see the crossroads ahead of me. Let's see which path I decide to take.

Oookaaayyy

Interesting turn of events - to say the least. When I get angry about the job, something is definitely wrong. I never ever get this way because I love my work mates and appreciate the amazing clients who have suffered incredible ailments and have overcome so much trauma in their lives. Unfortunately I have had a human week. A week that has been filled with anger, reflection, and regrets. Regrets? Well as a doctor I could be working at a better paying job for sure, but I know all to well that in the crisis arena I shine.

I came into the building today and was immediately met by our office manager. They were throwing a celebration for me and a few other people in the building for our ideas of beautifying the facility. My idea of a waterfall in the front lobby got the top mention and I was being honored. Not making a note of this, I showed up late to my own celebration! Well better late than never and I showed up to scattered applause as I took the award and said a few words.

Then the other great news: I am getting a raise! This didn't come from my boss - but from his! I am definitely having a bipolar week. The ups and downs are unreal. Maybe I need some Abilify, though I do like the ups!

We had to close our door today at 11:00am - a first. We had already admitted eighteen people and the doctor wasn't capable of seeing any more. This is happening with more regularity. Unfortunately there is a down side to life and I get to see it daily. People get abused, their loved ones die, and many have never been treated.

We as a staff talk about a lot of subjects in a given day. It usually is driven by a comment or a name. One patient I saw today was Jesus. I actually counseled Jesus! Now I remember seeing Jesus when I lived so many years ago in a haunted house so talk about seeing a being of pure white light spread like wildfire around our office. It seems as if I wasn't the only one having a close encounter with the paranormal. Let's face it we are energetic beings. Some of us can let our light shine right through. You see these happy beings at sporting events when fans and players are euphoric, you see it with musicians, you see it with proud parents, and I am sure you too have had joyful moments. With the clients that come to the crisis room, they are far from the light.

How can we wake people up that are stuck in the dark? That is the key to therapy. We all have the positive wired inside of us. Asians are well aware of Yin / Yang. Though while stuck in a rut and angry as I have been in recent days, it can be a challenge to release the attachment to being right, getting revenge, and moving forward. But, it can be done and quickly.

A quick shift workshop is in order. It would take hours to type about it and still you may not get the experience. Stay tuned, this can be of great benefit to everyone.

May you all have great mental health.

What The F....

Today was one heck of a day! It started out with my best friend telling me his traffic court appeal was turned down. Just because he pulled around a driver, rubber necking to see a policeman give somebody a ticket, he was pulled over for driving too fast. My friend brought in charts and the Judge laughed at them. $240 dollars later my friend left rejected.

Then it was my turn. In not stopping a person from getting out of the building yesterday I was punished. Not following protocols in mental health has led to a domino effect - which was somewhat tragic.

Of course nobody died, but the way things got handled felt like a crime - well at least in my mind. I of course never make mistakes, and I was mistaken to think that the well groomed couple happily leaving the facility needed to be detained.

At the point of the people leaving I had a few choices - 1) Ignore the voice in my head telling me I might have screwed up and tell the staff. 2) Play stupid and ignore the situation where eventually the staff would wonder what happened to the individual. Not aware of a number 3, I opted to contact staff and let the chips fall where they may. Which led to some punitive action towards yours truly.

What happened? Is it more important to be punitive than corrective? This act is getting really old. But as I was told, that 1% time when our guard is down, something serious might happen. What a f'd up way to look at life - but we are in a litigious society and lawyers are on the prowl waiting to pounce on us good doers. But the story get's deeper.

Because the one clinician had to get involved in returning the person to the facility they were contacted and on their own accord returned with their partner confused, angry, and upset. In doing so accusations were flying, a formal complaint towards my coworker was written, and an investigation of the case is now underway. What the f...

I blame myself. So what if I had a few hours sleep, had a dental appt earlier that morning and was ready to pass out upon my arrival to the job. So what if interns have to stay awake for twenty hours in their residency. I learned that when I am not rested simple mistakes can cause huge ripples.

How can I tell my coworker how sorry I am? Another coworker was investigated by patients rights because I told an irate client their name upon leaving. I am still trying to brown nose my way around that one.

I thought I would enter this industry to be of help. Now I feel human, flawed, and upset.

Hopefully the next day will be better. I know what I do 99% of he time. Being human is a new experience - humbling I would admit.

WOW!

Have you ever had one of those days? Well today was that day for me. What do I mean by one of those days? Well, all I can say is I am so glad today is coming to an end!

It started out as a typical Scott day, you know, wake up on Dad's couch after working on tiling his house all weekend and feeling dead to the world. Then rushing to the dentist to get some stiches out. You know the typical morning ritual. Finding out the my friend the dentist has a doggy door he is throwing out which caused me to rush over to his house a few miles away, picking it up, and dropping it off to my dad's. You know pretty typical in my world. There is a need, something comes up in conversation, and then something manifest's itself for the good of me or others - sometimes both.

But when work began it was not that ordinary - no not one bit! The office had a wall cut out and our room was expanded to twice it's size! More room meant more mayhem! There were new staff members, rushing this way and that and then the bomb was dropped - somebody was placed on a hold and unknowingly yours truly let them out of the building. OPPS.

So the scramble began, searching this person down and contacting the police. Yes - that's right. If somebody has a hold written on them and they get out the police need to provide assistance. Luckily the person was called on the phone and reluctantly came back to our facility. What luck!

But this is where the saga gets interesting. The person was sent back from the hospital and accusations about a staff member were described. Not good. A scandal perhaps? Is the news going to show up here? Were false accusations made? Even though the person was psychotic, it is important to hear them out and we did. Therefore the hold was relinquished - a rare thing indeed. Obviously the meetings and the Pow Wows about this are about to begin and I am curious where this merry go round is going to end.

We've, in our eight years have had a few scandals here. Some have gotten ugly, some have cost our company a pretty penny. You would think that those in mental health have got their shit together, and I hope the person in question does because I love them very much. Only time will tell however.

What started out typical was everything but in the end. Lots of questions being asked, lots of holding one's breath, lots of impatiently waiting for... well let's just see.

May you all have enhanced mental health.

Performance Review

Well it was that time again. The annual performance review is always a favorite time for me. Of course I am sarcastic about this. I literally hate being evaluated by a higher up who is never in the client sessions with me, listens to the heresay of the office, and basis their opinions on some kind of secret guide or appearences in the hallway.

I had a past supervisor who based their review on keeping salaries to their minimum. Therefore every rating was on the low side. Last year, not having a boss, the regional manager of the company sat down with me and gave me high praise! I was shocked! In interacting with this person, we had from day one not only got along great, but also managed to make each other laugh constantly. So I knew that they were going to give me high marks. On this day, meeting with the new supervisor had me a little aprehensive.

At work I try to keep things light, laugh around with my fellow workers and push the edge of harrassment - knowing my limits of course. Did my antics disgust a few of the more prudish workmates? Did my easy going attitude show I wasn't professional enough? Especially with individuals in a crisis? To many folks that don't see my skills behind the closed door sessions they may take my blue jean attire, and my lengthy sessions as me trying to buddy up with people. Obviously this couldn't be further from the truth. I dress this way for a reason - to kind of blend in with the less fortunate population I serve.

So there I was seated with my supervisor, waiting for the hammer to fall. I see so many people in a year, one or two were bound to make some kind of complaint I thought. Then it started the page by page critique. What impressed me the most was their being right on the mark! I was shocked. I heard about me - the professional me, the communicating me, the helpful me, the social me, the compassionate me, the creative me. Did my supervisor have a hidden camera?

After the ups and downs of working in a difficult setting where it is literally live or die situations on a daily basis I was acknowledged. The mark of a great supervisor is letting their workers know their strengths and work on their weaknesses. And trust me, not one mention was made on my deficits which was a first. Trust me there are many and I am somebody who does appreciate the criticism. Obviously, if you knew anything about my personal life.

So the reviews are great, a raise in salary has been promised, and maybe I can afford to keep the vacation place in the desert!

May you all have great mental health.

Hugs

Connections with clients are the name of the game in psychology. Without a positive interaction with the person seeking your counsel - why bother? Why bother with the industry if you are there only for the paycheck and trust me that isn't too great at my level. You would think that crisis counseling would afford a great level of pay because we literally are saving lives, but that just isn't the case.

How often do we actually connect not only at an intellectual level with somebody, but through the heart, and even to the soul? Crazy question? Not really.

Let's face it, we are not robots. We are emotional beings whether we admit it or not. And trust me, we interact with our emotions more than we care to admit. If we are in a fowl mood - it's emotions. When we want to blame people for making us feel angry, depressed, or anxious - it's our emotions. When we feel unworthy in relationships, at work, or in our creative pursuits - it's our emotions that are leading the way!

How do we shift our emotions? When anger takes hold it can be a difficult beast to release. You first want to ask yourself if you want to let go of your attachment to being right. In the Win / Lose, we all lose - even the winner. In focusing on living life with a loving heart - no matter what the circumstance - God works through you.

I get tested especially - though I am sure there are those who get tested more. I put myself in the front lines in which people are so fed up with their emotional state, the governmental system which has failed them, and all they want to do is release their frustration if they feel "disrespected" by yet another person. Eight plus hours of this at the jobsite can drain you - trust me. Then what keeps me going? The heart to heart connections that can be easily achieved if you are willing to let down your guard and love the person who is seated in front of you. Who cares if they are a different color than you. So what if they have two heads. Gay, straight, have Aids, are Lepars - bottom line everybody is deserving of love.

I had a few great sessions today. Well in all actuality they all went pretty well. Even when I think the client and I aren't on the same page I at least make the effort and try to show them I care about their fate. In just the effort alone I get rewarded. Often people open up and share the sensitive information they have been hiding inside for years! That is my real reward. In fact after doing this today I got a huge hug! Who would have thought the angry person I brought into the facility would leave teary eyed and happy?

If I don't receive the huge bucks, hey, a great hug is appreciated - along with the food the drug reps bring in from time to time.

May you all have great mental health.

Counseling While In Pain

A true mark of an athlete is playing with pain. Well, my athletic days are long gone, though time to time I do have to work with pain. Pain can be a good thing. At least that is what Dr. Bernie Segal said at my graduation from The University of Santa Monica so many years ago. According to Dr. Segal, pain is what motivates us to change and be better. In fact, he wished pain upon us all. Thanks a lot dude! Your wish has come true numerous times and the last horrah was when my tooth was extracted on monday. So a day later, I staggered into work thinking that everybody can see the knife still hanging out from the place my wisdom tooth once occupied. And of course Dr. Segal was right - I had a string of incredible sessions.

Interviewing clients when I am not one hundred percent makes me more empathic. Well aware of my own suffering - which is usually momentary - I interview people who have to tolerate not only physical difficulties, but emotional ones on a daily basis. Some have to endure psychosis! For years!

I am reminded of one client I interviewed when I first started working at the Urgent Care almost eight years ago. This person told me they were never treated, was in their mid forties, and for well over twenty years had been tormented by voices and visions at bed time. At times this person actually felt people grabbing her! It made me wonder if schizophrenia is simply a sensitivity to the Beyond? Who really knows? Maybe they can see through the thin vale between our reality and the paranormal? Still for twenty years being tormented, it must have been something way out of their paranormal existence to bring them into seeing me!

Pain is a part of everyday life unfortunately - or fortunately depending on Dr. Segal's outlook. It is the amount of pain that is the real issue. In my youth, my friends and I had a saying - "A little pain never hurt anybody." Yuck yuck. It was probably something drummed into our heads while playing little league baseball. Trust me, now that is a sport filled with pain. I used to get hit by pitches, have balls bank off of my shins, sprain fingers, slice my knees up sliding. In fact I still have raspberry scars on my hips from sliding in Semi-Pro ball. Me of all people, who hates pain sure choose the wrong sport to pursue. Thank God I didn't fall in love with Football like my best friend Mike. He has now had seven knee surgeries because of that foolishness.

Pain is not going to go away. How we confront it shows our character. Some fear it and some embrace it. I tend to do both, given the circumstance. One thing for sure. I am going to floss and take plenty of vitamins from now on to avoid going through that pain again!

SEE YA!!!

It's friday. Thank you God. Yes I had one day I didn't come in due to cabinet hell at home. Yes one day this week I only saw one client. However, in the last two days I saw EVERYONE!!! Oh my was it busy! I saw so many unique cases that stretched my clinical skills to their limit. I loved it on one hand and hated it on the other. Yes I love helping people in need, but can it be one at a time and at a leisurely pace.

Pregnant women, suicidal people, homicidal people, psychotic people, people that didn't have a friggin clue. And now the weekend is approaching quickly. I have one more client to present and am leaving in the next forty five minutes. So I wanted to chide in before heading back out to my desert oasis.

With all the kidding aside. Or should I write complaining. I had the pleasure of teaching a new intern the ins and outs of our facility, how to interview clients, and how to attack the massive amount of unneeded paperwork that our facility demands. Of course the paperwork is needed. "If it wasn't documented, it didn't happen" is our slogan. Do you realize I have had nightmares about not getting in a chart in the proper allotted time period? I joked with the intern today about spending more times on the paperwork then the one to one client sessions. In all actuality it is true.

One thing that perked me up today was the feedback from the intern. They loved my presence with the clients, how I honored them and gave them ample time to simply speak and search their minds for answers. It felt good to be noticed. It had been a long time since a neutral observor was in one of my sessions and I let down my guard and simply was myself. It was with a very difficult client who was placed on a hold. Even in these sessions compassion can be shown. This is what I am leaving behind. Not just that but the madness at home.

Madness? When your home is all torn apart and the cabinet makers make your cabinets too thin it can grate on your nerves. Trying living for weeks without a working sink. In fact we don't even have one attached! Everything is in boxes - but thank God I have a vacation home to go to. My excuse for going there - I needed to transport some shelving there.

Got to run. I have to make my last report. SEE YA~!

Tick Tock Tick Tock

What a rare day. Absolutely no clients for me yet and I have three hours to go. Life has been in hurry up mode for as long as I can remember. Today it is suddenly on STOP! So this is what it is like to drop your shoulders, breath, and have time to simply think. I like this. It's as if I am in the desert and just taking in the beauty of life. Does life really go on at this pace? Is there relaxation, short conversations with coworkers, then time to kick back and type on one's blog? Today there sure is.

Because we are strapped for space and have too many workers and not enough computer terminals, I rushed out of the office and found an adjacent office that was vacant in which I could use. For hours I have watched me in others as they race around, accomdate people, rush paper work in before its deadline, and gave the automatic smile that works so well in mental health circles. You know what I am typing about, the head slighly tilted, the grin big and genuine, and two steps later when out of sight the scowl returns. Well at least we don't greet people scowling.

In the larger facility I work in is a long term, lock down Hospital for those with extreme mental illness. Most look over medicated, some look like characters from a haunted movie. Unfortunately this is real life and many of these folks have been committed here for ten to fifteen years!

When I first started working here I feared these people. I often heard stories of them randomly striking people for no good reason. I need to walk past them in the hallway from time to time to bring clients some food from our cafeteria. With hands holding a tray I am vulnerable to the Thorizine shuffling gang.

Years ago my younger sister worked in mental health with this particular population. For a man it would be slightly easier, for a woman the is small and petite some of these folks are threatening. In the long run my sister got abused and left the industry for good.

Abuse towards staff happens with some regularity. It depends the temperature, since the heat of the summer tends to bring it on, it depends on adherence to medication, in fact there are a lot of factors that will breed violence. The most important aspect is having a cohesive staff that will see the signs, communicate clearly, and takes swift action.

Tick tock, there goes a coworker home. How great is it to have some thinking and reflecting time.

May you all have great mental health - I could use a few days of this.

Desperately Seeking Dr. Scott

Years ago I watched the movie Desperately Seeking Susan. I think it was Madonna's first acting role. In the movie this guy is detained from his normal pattern, trying to pursue some woman, and can not get back home. Well that is at least what I remember. Well today this happened in my life.

At home we are undergoing kitchen renovations and our new cabinets were manufactured too thin. I mean we can't even put plates into our shelves because they are literally five inches thinner than what we original had and asked for. This is where my saga of the day began.

In contacting the company who installed them , they agreed to send out a representative to meet with us. We were assured the person would be there around noon. Well I don't know about you, but when I keep a commitment, this is "my word". I make it a priority to be there and if I can't I will call - like the true professional I am. Time in the psychology world is extremely important - especially if a client is going through a crisis - which is normally the case for me. Well noon came, one o'clock came, two came and suddenly I was in crunch time for work. At this time we amp up and it is important to be at work and involved. Still no representative.

Now if I had a clone, I could take care of both matters. Dr. Scott could see clients and at the same time domestic Scott could point out why twelves inch deep shelves, which are actually ten and a half inches, don't accommodate twelve inch plates. Torn I waited till three o'clock and in frustration took off towards work. This was an interesting decision in making clients more important than pleasing me. But that is how I can be and often times am. Today I gave the cabinet company five hours of my time and couldn't wait any longer. That's what I give to me, that's what I give to you. I try to meet people in the middle.

Trust me, I was sick of hassling the representative, thought he wasn't going to come, so I took off. Then in calling work from the road learned that a coworker was called in to take the shift of a morning person who got sick and was there to cover my shift as well. A REPRIEVE! God stepped in!

When I turned around and headed home I was shocked to find out the representative called and was there fifteen minutes after I returned home! Better late than never!

I hate when I am out of my routine. I know it is a part of life to adjust to problems, to adjust to changes in mood, to move forward in the face of adversity, and today was a test of this for me. But why did I get so angry and upset?

It shows me where I am at internally, when I get angry it shows me that something underneath needs addressing. Something inside is definitely out of balance but what? Is it physical? Yep, I have been working hard of not only busting out a kitchen and working on my place from sun up to midnight. Is it mental? Yes, I have been more negative in my thinking than positive. (Hey let's face it, I am human too). Is it emotional? Absolutely, mother's day was more of a priority in fixing my place and moving old cabinets to the desert home than driving down to San Diego to be with mom. And Spiritually I had been on vacation from God for a while. Thank God a friend emailed a link to a choir to me today. This sure plugged me back in.

As you can see, I look at all issues holistically. Tending to all the levels gives us all the best odds for enhanced mental health.

As for now, the representative came, understood our dilemma and promised to make it right. I wonder how many thousands of dollars is this going to cost.

May you all have great mental health

Seizure Disorder with a Mental Illness

When the brain has hiccups (seizures) it places mental health workers in kind of a bind. Psychiatric medication can exacerbate a seizure disorders causing seizures to take place if a person is not on medication to stablize their condition. What is amazing to us is people often forego their seizure medication for years and only want to treat their psychiatric symptoms.

A Seizure disorder is a brain ailment. Sometimes it is from heredity, sometimes it is from a head injury, and sometimes it is from substance use. Why clients argue vehimently about being sent away from our facility to take care of their seizure disorder is baffling.

Have you ever had a seizure or seen somebody having one? It isn't a very pleasant thing. Each time the brain has a seizure it causes brain damage. Fast forward to being elderly, Dimentia is a real concern for those who have had brain ailments. Wouldn't you want to protect your brain? It seems obvious to most. However those with a mental illness will complain and even throw fits if they don't get the elixer that fixes all their problems. And in all actuality we prepare the scripts, keep them in the client chart, and in as soon as a day later - after visiting a medical doctor the client can waltz in and out of here with their psychiatric prescriptions.

Somebody came in today who had been off of their medication for almost a year, and when we found out they had a seizure disorder we sent them away - as usual. The reaction from them was amazing! It was as if they wanted to argue their way into a grand mal seizure!

I had a client with a seizure disorder that was relentless. When the person was an infant the disorder started. As a teen they developed a learning disability, as an adult the seizures became so debilitating that eventually had to be solved with radical brain surgery. Why risk this? Why argue with the professionals that have experience with this?

May you all have great mental health.

Delusions

Today must have been the annual delusional day. Almost every client had a delusional disorder. People believing they were a different person, another believing the family was plotting against them, another was so paranoid it was important to just keep talking, remembering names and dates so I couldn't get in a single word. Now I am probably the worlds most patient guy but after a while even I was getting irritated.

On one session a coworker was brought in to translate. I was giving him side comments because he was a mental health trainee. "This is a text book example of delusions of persectution". "See how her story is her organizing principle". In this case I became more of a teacher than a clinician - but what can I do? This is strictly a medication management issue and from this point on it was my duty to convince somebody who believed the medication was another ploy the family was using to control them.

As I tried to get the client out of their story for the fifth time, they suddenly stopped in mid sentence and looked at me with a smile saying - "I trust you." Wow!!! Where did that come from I exclaimed to my coworker.

Mental illness at this extreme is facinating. When extreme I marvel at what an individual must endure day in and day out. It would be a hellish existence to constantly feel the Government was spying on you or the T.V. was giving you secret messages. But this is their normal. Without the voices they would be out of their element.

I remember watching a show last year about a married couple, up in their years, that were both deaf. A new procedure was developed that promised both of them hearing. At first they were excited, but the family was sceptical. They would be experiencing something for the very first time that they may not be prepared for was the consensus. Well in the long run the family was right. Having hearing was a difficult transition - more for the wife than the husband who seemed to struggle at first, and then go with it. The wife was overwhelmed with this new sense, similiar to patients of mine who have stablized and decide to go off their meds, and abandon their own self work. Why? Because the old habits are so ingrained in their way of being that it is too much of a hassle for them to take the effort in changing for the better. Hey, let's face it - this is extremely normal. I do it. I promise myself to cut down on sweets, eat healthier and excercise more often. What do I do? I come home, scoop out some ice cream, sit on the couch and watch television. Oops. Even though I feel better when I am active and eating healthier, chocholate chip ice cream and American Idol will always entice me.

May you all have great mental health.

Trainee

We have been training a lot of new workers lately. Some are interns and get a crash course here about real mental illness in action. Some are trained professionals looking for extra work to pay the bills. Still others are there for whatever reason - and we learn a ton of them. Today was a real blessing, having somebody seemingly level headed who withstood all the jabs and puns of the staff while handling a busy work day where clients needed to be sent away because we were so busy.

I could imagine walking into our office and seeing a flamboyant Doctor who dresses up every day as if he were attending a costume party. Yours truly with hair flying everywhere wearing my signature Mickey Mouse shirt. And other staff of all orgins from China to Iran to Korea to the deep South, to the Phillipines, etc., etc. It's like we have our own united nations!

I think this is awesome! I love learning about different cultures, customs, and languages. I can botch pretty much any language on the planet - with pride.

So today was the starting day of a new MFT intern who was trying to gain hours and experience towards her license. When the jokes started flying she held her own and tossed in a few jabs herself. This is the joy of working here. We as a staff have to let of steam and we do so while grazing the fine line between sexual harrasment and comedy. Oh, we know the limit line and never ever cross it. Trust me starting a statment and using silence is a real hoot - and we do this professionally! We also can morph a person's last name into something almost suggestive, but we stop just short of the limit line.

I wonder what the people in the waiting room must think when we all break into spontaneous laughter. I wonder how those who are psychotic must feel. "Are they laughing at me?" "Are they ploting against me?"

We have a few ongoing jokes that are repeated every week. Even if we don't repeat them, someone will eventually ask if we did. Of course with the new person we had to tell the darn Jose joke.

A woman friend of mine told me a joke about a man who had two members. His girlfriend was astonishe when she saw this. The man told her, yes he had two and he call the first one Jose, and he named the second "Hose B". Trust me, this joke has had so much mileage that we laugh at the mere mentioning of Jose. The Doctor is trying to make up a new joke for Jorge - but we've all tried to squander it.

So now you all know the inner workings of a staff that puts itself on the front line day in and out. If it wasn't for our wackiness, we too would be interviewing for a new job.

May you all have good mental health.

Realization

From time to time my brain clicks together and I get a big ah ha moment. It happened today while I was waiting for of all things a haircut. Years ago I had a client with multiple personalities freak out and run out into an adjacent neighborhood. What made me think of this person today was an unknown - probably because rushing after him still impacts me today. I searched street after street and found him hiding behind a car. On one hand it was very humorous, as if he was playing in an adult hide and seek game. On the other hand he looked petrified as if he was in terror for his life!

I rubbed my hair, as if saying goodbye to a familiar friend. Why on Earth would he do this? And then it hit me - this was his defense mechanism. When threatened our mind goes on the blink if our resources don't match the level of stress. This client was detained from doing his ritual of spending money - a source of soothing himself was gone and he reacted as a child would, running away and hiding.

When I walked up to him - a client I had a three month relationship with, he didn't recognize me. My client wasn't even there!!! This is mental illness at it's worst. Where was my client? Where was the person that told me the unmentionables done to them, told me I was the only one who ever cared, and wanted to face the demons that tormented on a daily basis their existence and wipe them out of their life forever!! So I reminded them of this (as delineated in my Doctor Dissertation). I reminded the client of our relationship, their life, how wonderful they were, and slowly the person looked up to me and cried. What can you do with somebody who's mind shuts down when under stress. It is as if their mind needs to be rebuilt and slowly given natural stressors in slow, manageable doses. Will their mind ever heal? This client went pretty far in their recovery process and was actually able to not only have a relationship for the first time, but move in with the person as well - talk about stress.

The realization today was in the disociative phenomenon in which the mind blanks out and another aspect within simply takes over. This particular client was aware of nine distinct personalities, which we dealt with extensively.

Therefore, for clinicians, it is extremely important to go slowly with clients, and monitor their reactions to the material that is surfacing for them. If it is too demanding - back off. Help them regain their center and acknowledge them for the ability to do so. It is not for us to heal large chunks of their ailment at one time. Therapy is a process that needs to progress at the client's pace.

Who thought waiting for a haircut could help me deepen my understanding of the defense mechanisms of the brain?

Good mental health to you and yours.

Peripherals

Today I really became aware of all the little things I do in a work day. Oh yeah I see my four to five clients, interact with the psychiatrist and will contact mental health providers for additional information. That is a given. However that is just the beginning of the job.

On a typical day, I get called to the front waiting room, will interview somebody to see if they are appropriate for our service. If not I will give them referrals and send them away. Sometimes I have to play peace maker if somebody is too violent or paranoid to enter our facility. Other times, if we are too busy I need to send people away which has insensed them into being violent.

Today a person came back to our facility after being sent away for a medical clearence - many times we need to see if someone is using substances, pregnant, or needing to get back on their antiseizure medication. When they return we need to search down their chart, look through it, find their medication script, or track down the psychiatrist and make him fill out one. Often their charts are located in another building in which we have to walk through a group of psychiatric clients held for life and looking for an excuse to lash out at somebody.

Now the phones are another issue. Often the calls are from pharmacies that need the doctor to change medication because the insurance doesn't cover it. Once again we have to search for the chart and search for the doctor and call the pharmacy back.

THe worst is placing clients on a hold. At this time we have to make a million calls, fill out more forms, deal with an ambulance who have to transport people in a gurney - bolted down - which often triggers them to violence.

If you are good at boxing, crisis work is a perfect match for you.

I laugh about all this because I thought I went into this field to help people. Little did I know it was helping people find their chart so I can scribble into it.

Early Morning Shift

Every once in a while I am asked to trade shifts with coworkers. So this morning I pushed myself out of bed a few hours earlier, drove down a freeway with light traffic and made it to work in record time! 7:00 am for me is when I roll over in bed. Suddenly I found myself at work trying to wake up.

Our doors open around eight to the public, but the real internal work was at hand - preparing the paperwork for the staff. Basically my job description changed from doctor to copy boy. How humbling was this.

The steady rythmn of the copy machine was kind of soothing, though the next job wasn't - colating. Try preparing thirty charts with about thirty pages inside of it. The work was tedius and if this was my daily job I would shoot myself. How does the earlier staff cope with this? Each day I take for granted that the charts are ready, in perfect condition, and even our discharge papers are in abundant supply. This morning I painstakingly prepared the forms that simply were always there for me, appreciating the efforts of the unsung heros that suffered the collating, hole punching, stapling, and refilling toner cartriges as an everyday routine.

I hate toner! Why does it always spill on my pants! These smudges will never come off! But my comrades never complain, they seem to wear these shrap metal stains with honor.

Last week I asked a coworker if she dreamed about feeding the scanner, now that we are transitioning into electronic record keeping. She replied "Yes", with a sadness to her soul. No wonder she is grumpy all the time. Wait - - She was grumpy before she even had that job.

The morning crew has to audit the charts from the day before. If a code number is omitted, or a signature left without a title next to it, these folks are on it like white on rice, leaving nasty notes in your box for you to complete your errors! I think the auditors get there frustration out in this process. After years of preparing the paperwork it could breed anymosity. Perhaps that is the reason why so many postal workers go "postal".

With a new appreciation for the office staff, I once again face the flow of people eager to get their medication fix, just in time for the weekend. Today I am a lot wiser, appreciative, and injured - I hate papercuts!!

Gadzooks!

What a week we're having. A brief respite though yesterday, but today we began sending people away at 2:00pm. What rich cases. Domestic violence victims, Cancer patients, Drug addicts, someone who had their first psychotic break. If you want a great education about mental illness, this is the place to be.

I loved the reaction I got from the person who was almost choked to death by their partner two days earlier. It was like a lightbulb went on in their head. When wounded from an early age and never really bonding with another person, it is natural to try to make that bond with somebody - anybody who shows interest in us. However if we are wounded and stuck in Erick Ericksons "Mistrust Phase" of development, we tend to seek others that are at that developmental level as well. It is natural that these early developmental period relationships can foster anger, paranoia, and violence. In learning how to heal this developmental issue, people can grow in amazing ways! The client was giddy as they left which warmed my heart. Then I was off to my next subject.

Probably the most tragic experiences for a human being is learning they have cancer. Then life is suddenly a death sentence. Oh yes, we all are destined to die, but that will happen sometime in the distant future. When that timeline is brought quickly forward, well, you can imagine the panic it puts people in. These clients are a God send to me. It helps me place life into its proper perspective. We all die. Then what? Even though I have had loads of paranormal experiences I have never died. What happens then? And that was what was on the client's mind. They were freaking out and as a therapist, if this issue was unresolved inside of me I would have been freaking out too. Without faith, an upcoming death would incapacitate the best of us. But how do we get faith? Especially when the obvious signs haven't been given to us. It's those subliminal clues that can lead to our enlightenment, if we allow them to. Perhaps that was why I was compelled to write my recent book on the paranormal experiences I had while living in a haunted house almost thirty years ago. It changed me. As would it to the average person. I saw and felt things that freaked me out! I had been compelled to write about it and in a week it should be out on Amazon.com. This client would eat up the pages of it, because step by step I shared my progression from spiritually ignorant to being enlightened - and still I am very apprehensive about death.

I lead a very rich professional life and days like this helps me appreciate my health, my coworkers who somehow keep their sanity, and my connection to God.

May you all have great mental health - PLEASE!

The Day After

What a zoo it was at the Urgent Care yesterday. I was concerned on my drive to work today that there was going to be another repeat performance. Monday and Tuesday were beyond busy, but so far, today has been only completing the charts from the day before.

It is like an Accordian at times here. One day you can't sit, another that's all you do. It is nice to catch your breath when the pace slows, but with the budgeting troubles the county is in, our numbers have increased substantially.

In the aftermath it is difficult to relax. Hypersensitive to the buzzer up front and the ringing of the telephone, in a moments notice we have to spring into action.

The staff laughed today about a complaining client who had been waiting to see the doctor for a few hours. Yesterday the wait for him was five! Yes, when a person has a mental illness minutes, even seconds can feel like an eternity. We, okay I thought of a specialized mechanism for the complaining types who repeatedly knock on our door. We would simply ask them to stand there and move their chin slightly forward, as when we depressed a button - a hand would whip around and smack them in the face. Well describing it in print isn't as funny as it sounded, but obviously the entire staff is a bit frazzled from the day before and it is only Wednesday!

How do you handle the chronic complainers? We have no security but can call other adjacent units for additional staff. Do we rush them to the front, like we normally do? Do we usher them out of the facility, even if the medication they seek would do them wonders? Do we continually give them food, cigarettes, water, change the T.V. channel for them like we do constantly and complain about it later? Or do we try to ignore them as they amp up and get louder?

Isn't mental health a real gem?

Overall the real issue is for the staff - me included - to find a mechanism to keep ourselves in balance no matter how busy or slow it gets. The slap mechanism in one's mind goes a long way. We as a staff tend to get musical and sing out appropriate songs like Madonna's "Borderline".

It takes a rare breed to be of service. We sure aren't in this field for the money it seems, though a raise or more private clients would be very nice, thank you very much. I think of us as Weebel Wobbles. We wobble from time to time, but we just don't fall down.

Good mental health to you all.

Too Much!!!

Thinking it couldn't get busier I was wrong. Today took the cake! It wasn't how busy we were, but the caliber of client that came in today. On some days we are busy, our room is filled and clients seem to talk to each other, make new friends, and tolerate the sometimes five hour wait. Not today! The clients today were psychotic, angry, demanding, and ready to square off fighting.

Today I wore a lot of hats. Waiter, office supply getter, medical record runner, phone answerer, complaint department, mom, staff leason, and still had time for an hour staff meeting, seeing five clients, and finishing all of my charting.

This type of day on one hand is thrilling. THere is no down time. It is go, go, go and the day is over. On the other hand, when people are breaking into the facility after they were turned away, when non clients are demanding food, or looking like they want to get into a fight, well that's not too thrilling to me.

This place would make a good sitcom or reality T.V. show! We get it all here. If you want to learn about mental illness, spend a day at our facility and just observe. We had everything today from the demon posessed to those psychotic - and more!

At times I feel like an exorcist. You may laugh about that statement, but trust me, to many - including myself - demonic attacks are real. Why do I feel that way? Because I've lived in a haunted house, felt held down by evil spirits and when clients talk about this phenomenon, I can relate to them.

So I order a lunch for the demanding person. Help another fill out a complaint form because a staff member "disrespected them", and barely have the time to go to the bathroom. I think it's been a week since I've been able to take a break. Yes, by law I need to, but when we are pumping, the whole crew needs to be working in the trenches.

Why do I remain? Until I win the lottery - and I don't even play it, or if I got a better job offer, or if my new book becomes a best seller, I am stuck in psycho land just trying to survive.

Good mental health to you all - please.

Treating Other Professionals

It shocks me when I need to treat other professionals in the mental health field. I can understand working with people who have substance treatment licenses because it is a two year college degree. However I have worked on many therapists who have burned out and even a few Psychiatrists! Let's face it - we are all human. When the stress of life gets too overwhelming, even the president, I'm sure, needs some counseling.

What I like about treating these individuals is them having the mental capacity to look deep inside themselves. Not that many individuals have the mental capacity to look at oneself - only wanting a white little pill to cure what ails them. In fact, on a daily basis, I have to remind people that medication handles 50% of their problems and the other 50% needs to be worked out in therapy.

In the session today I was reminded about a great Psychological approach that was developed in the turn of the last century called Psychosynthesis. This is a spiritually based approach. Roberto Assigoli, a student of Frued's, believed man wasn't driven by sexual desires, but a desire to be whole. He believed in being created in the image of God, we had that image (blueprint) inside of us. It was taping into this blueprint that made us whole.

What keeps us not whole? Assigoli believed that when we were living in the here in now, we were whole. What pulls us out of this place is past or future thinking. The past thinking usually involves unresolved issues from our past. The future thinking involves us feeling so unsafe that we have to plot our every move. How long can you stay present in the here and now?

I love the saying: The past is history, the future a mystery, but now is a gift and that is why it is called the present."

As we remain in our blueprint, connected to God and amazing experience results. I call it "THE BUZZ". Ever feel it? How often have you felt connected to Our Creator? The opportunity is to allow the buzz remain and expand. How long can you hold on to it?

May you all have great mental health.

Paranoia Will Distroy Ya

It comes with the territory. Treating individuals who are paranoid. You can spot these people a mile away. They wear seatshirts with hoods, dark sunglasses, and slump low in the chair at the corner of the room. Many have headphones blasting in their ears. Most look so angry they could punch holes into the wall. Often these people trigger me. Who wants to put their head in an angry Lion's mouth? Unfortunately for me I have to treat them.

Every once in a while these people are lucid. They can carry on conversations, they want to be helped and seem to, on a certain level be normal. It is the angry ones that make threats I can not stand. Hey, I'm human and I know these folks need the service we provide. Imagine if there wasn't any psychiatric medication for them? This planet would have self destructed years ago.

Our plan of action is to rush these people through our doors. Until they are stable on medication, psychotherapy is impossible. Yes I can give them some tools to curb their anger, and often will, but when somebody doesn't trust you and sees you as being part of a Government plot against them, a therapuetic bond is impossible to achieve.

Today we had a person completely paranoid and irritated - a favorite of the entire staff. NOT. At first this person shook my hand, smiled, told me they remembered my face then started to get angry with me. Fast forward a few hours when they left, they shook my hand and told me they remembered me. Here is an example of a brain ailment. Could you imagine living your life this way?

We have staff that really connect with these people. They become compassionate, communicate well with these people and often redirect them into calming down after getting agitated. They to me are heros. In the face of anger they remain calm and loving. I can do this under most circumstances but fail miserably when people taunt or glare at me.

Antipsychotic medication is crutial for the treatment of paranoia. Unlike the movie about the schizophrenic musician on skid row where they didn't get him to take proper medication, people respond very well to the current meds and go on to become functioning members of society.

Cutters

There is an undergroud movement that doesn't get much attention. It pertains to cutting on oneself. When the emotional pain is so great, those who don't have the emotional tools to handle their state will resort to physical torture on themselves. Why? For the average person this behavior seems upsurd!

The average person will have the emotional resources to handle the stresses of life. For individuals that have surpassed their ability to cope, it is almost like a minor suicide attempt. It is as if a person is tipping their toe into the pool to test the water.

For proper mental health the real issue is not our issue - or the problems that confront us, the real issue is how we relate to ourselves as we face our issues. Basically how we are with ourselves in any given moment is the ultimate issue!

How are you with you when you wake up, drive to work or school, interact with a parent, the boss, or a teacher? That is a great gauge on how you are doing with yourself. Ultimately how we treat ourselves is how we treat other individuals. Therefore it is critical to treat ourselves with dignity and compassion.

When we cut on ourselves, we give ourself the message that we dislike us. This is a red flag. If our relationship with self is at such a low place that we begin harming ourselves, professionals need to get involved. Without the proper tools, approach, and guidance, this behavior will not fade on its own, in fact more extreme measures tend to take place - suicide. This is why there is such a high number of suicide attempts made by teenagers. They tend to lack the proper tools to work through dark upset.

Therapy in these cases can be very successful. In learning how to tend to the hurting part inside of us that we hate and transforming that "inner relationship" is the key to not only cutting, but to overall mental health.

As I told a client today, "We are with ourselves 24/7 for everyday of our life. How do you want your relationship with yourself to be from now on?"

Tender Loving Care

It always amazes me when the conditions for a psychological assessment flow perfectly - regardless of the ailment. Two cases back to back today worked out like a dream. Both were people suffering from psychosis who were gaurded and "just there to get on meds" as they said.

Two different techniques had the same result - instant bonding - a process that generally takes six months if you are lucky.

The first client was delusional - unfortunately this person was very high functioning and the scheme her mind created made a lot of sense to her. THis "organizing principle" helps the mind make sense of the situation and for a therapist we need to avoid taking it away from them. "So the government is spying on you through your T.V. What makes you suspect that?"

The other person had voices screaming in their head. Possibly the result of a past head injury. Even with the voices going on we connected. I listened, my replies made sense, and then I saw a spark of happiness inside of them and made a comment. It was as if we became instant best friends! Ergo the magic of psychotherapy. Now on the same page, let's do some healing work.

It is an interesting feeling, making an intimate connection with somebody so fixated on their delusion, or psychotic, or in the midst of a panic attack. This is sacred ground to tread. This is why I continued my education and received a Doctorate. I had a knack of caring so deeply that clients took notice, opened up, and I needed to learn how to properly close them up. The key word is UP because that is how to finish sessions - on the Upswing!

How do therapists close up clients? This is an art form. This can be a dance. It is being sensitive to what is happening in the moment, being caring, honest, and above all - real. The robotic speaches or the do as I say, not as I do approach tends to fail miserably. If there is nothing to say, then say nothing, but love them internally. It is in the loving connection that heals the most.

Everybody, underneath is exactly the same. Mother Theresa said it best. "When I treat people on the streets of Calcutta, I see Jesus in all his disguises." When the disguise is removed and your heart is shining, God speaks.

Wishing you all good mental health.

Is Everybody Mentally Ill?

In the past eight years we have seen over 15,800 different people at the Urgent Care. Many return six to eight times - that is a lot of crisis sessions. At times it feels like I am in a Horror Movie as the undead come crawling in trying to satisfy their thirst for human blood!

We were basically set up to serve the Los Angeles County area though we have seen those vacationing from foreign countries, those living on an island off the L.A. Coast, people from Vegas, New York, etc, etc, and how great is it for these people to have a place like this to go to where they don't need to have insurance to get their psychiatric and emotional needs handled.

A year ago I looked up on the computer how many people I had seen in a year's time - the number was over 800! Wow! THat number even shocked me. One by one we try to make a difference. Listen to what they talk about, give some suggestions, make a call or two, bring a family into the room and hash out differences. I like what I do because it is instant gratification.

This is in marked difference with my last job - working with the learning disabled. I worked with the same clients for more than two years and barely saw any changes. Oh yes, they changed - they were able to use soap in the shower, create a marketing list, and clean their apartment, but it wasn't crisis work where frowns turn to smiles on an hourly basis.

Don't get me wrong. I am not complaining about the sessions. I love meeting new amazing people who have suffered greatly and desire to do what it takes to change for the better. I really admire those with HIV who have to not only take a slew of medication, but also psychiatric medication added to it. I have difficulty taking vitamins on a daily basis. Imagine taking twenty pills three times a day!

The Los Angeles Area seems to be a magnet to not only the mentally ill, but also to homeless people. The weather is so great year round. I'd rather be homeless here then in Chicago. Imagine suffering through a winter's night there without a home? And shelters can be breeding grounds for brutes. Fifty percent of the clients I've seen here have lived in or live in shelters.

One by one, day by day, year by year adds up. I feel proud. Maybe I have provided the needed relief to a few of these folks. One thing for sure I am a great listener and give them a lot of time to vent. My support staff at first got upset with this, but haven't complained much recently. I figure if that was me in the chair opposite of me, I would want somebody to hear me out - so I do.

Every month or so I wonder if it is time to move away from this place because the stress level is very high. If I find a job with the same benefits and better pay I'd consider it. I feel I've got this down, why not test my skills elsewhere? Only time will tell, but one thing is for sure. There will never be a lack in the Los Angeles area for clients. Now finding clients that can actually pay me for my work is the ultimate issue.

Good mental health to you.

Complaints! Complaints!

Yes I understand we have a difficult job. Yes I understand that it is difficult to learn paperwork, systems, and protocol. Yes I understand that the clients have been waiting for five hours to see the Psychiatrist. Do I have to hear all of the complaints?

The staff today was worse then the clients. "The computer doesn't work for me. I give up!" One said. I'm tired of calling the help desk!" Said another. "Who stole my paperwork?" Questioned another. I have to go, move my client to the front or no one will translate for them." Demanded another. When twenty people are vying at one time for attention, at times it can be a bit much.

"Try closing down the computer and starting over." I reply to one. Did you look at the chart order sheet?" I asked another. "I saw Johnny shredding your documents", I replied with a smile to another. But when the Psychiatrist entered the room everybody leaped to attention! But as the first person was about to speak his phone rang and he started to talk about the Smart Car he had his eye on.

Hurry up and wait. This has been a long occuring model around the crisis room we as a staff are all too familiar with. We have tried to fight it, even complained to the doctor about it, but you can only mold Jello into a mold for so long and it will eventually ooze back into its original form. Trust me, the doctor will find a way to see twenty people, talk about cars, clothing and Jessica Alba. Only if she knew about the crush he has on her.

So with confidence at an all time low with the department heads, who does the staff turn to - yep - yours truly. I should wear a sign on my forehead - "The Complaint Dept." I knew I signed up to help those in crisis, little did I realize it would be the staff I worked with that would dominate my time.

May you have good mental health

Homicidal First

Well a first happened today. A patient came in wanting to kill their parent and the parent sat in on the session. Well there goes my Tarasoff warning - they heard it all. In fact they knew it very well. Often a parent will be the target of rage - mostly to those with a learning disability. The average person can suppress these feelings and I am sure they often happen to even the best of us. When the brain is altered with Schizophrenia, hasn't matured, is under the influence of a substance, the gate that stops our rage can be damaged and violence can ensue. In this case it was a question of hospitalizing this person or not.

I hate making these decisions when it can go either way. The client didn't have the harmful thoughts currently, but it had become a daily affair. The parent was aware of this and trusted their child. So I needed to get the client to sign a contract for safety - something that doesn't hold much weight in court, but makes me feel better. The client and I then devised tools and strategies in case rage occurred.

What was interesting was the focus on the color of the wall. Certain colors made this client get angrier during a fit. The antidote - paint. First of all painting soothed this client, and secondly taking action may be the best medicine. And referring to medication - it was changed of course. The psychiatrist and I felt confident that this person would do much better on his elixor.

I couldn't imagine being this person's parent. Parents try so hard to provide, nurture, and mold their children. How frustrating it must be to hear the younger version of yourself confess desires to terminate your life. But the parent was given resources to contact, the client was given a bottle of meds in one hand and a paint brush in another, and now it is up to them. Will I worry about them? Hopefully not - I got a signature on a worthless piece of paper to protect my license.

Peace to all.

Off The Hook!

Busy time once again. Down a co-worker to jury duty and had to pick up the slack. Being busy makes the day go by fast! Part of me likes it, another part wants me to fiddle around with the computer - blogging about new insights, and playing backgammon against the rude people from England who quit right before you beat them.

I enjoyed today. I saw people who, without medication would be living in asylums. Today's medication is amazing. One person came in, who I had seen a few times before - I recognized his face but not his smile. He was psychotic as hell a few months ago, now he is stable enough to work - as a roofer!

I like most aspects of my job - even if I have to interact with people just out of the psych ward and barely present. It sometimes surprises me when they smile, say something insightful, then go back into a stupor. It shows you that a person exists under the ailment. I take my hat off to those that work closely with the chronically ill.

The movie Awakenings with Robin Williams is a must see. It depicts a man hungry to connect with catatonic patients. I have experienced clients like this only a few times and found it frustrating. They were so petrified they simply stiffened up and went into mental hiding. I can't even imagine the type of abuse these folks must have experienced - if that is the cause. Mental illness to that level often has a family history element or hard core substance usage.

A sad note was having to walk a person who was placed on a hold to the lock down unit in our complex. After listening to them give a disertation on why they didn't need to be hospitalized the documents had already been signed (this time not by me). But after all the negotiations ended, they dejectedly took the "death walk". Trust me, this client had it good. With no insurance and looking at a facility like County USC or Harbor UCLA to go to, La Casa has a great, compassionate staff, our same Psychiatrist in whom the client already had a relationship with, and better food I am sure.

Now I am not knocking the county facilities, but having hordes of clients who are in extreme states with you, or a cozy place where you can watch the Dodgers woop the Diamond Backs on the T.V. I choose La Casa.

Just another busy day. All my paperwork is done, and I am pleased.