So I’ve got a problem. I can’t write. Not for me. Not for you. Not for anyone. I can’t do it.
In my head, I hear you say, “oh Laura, of course you can. You’re doing it now. Just sit down and do it. Write it on paper with pens or markers or mechanical pencil. Write big or write small. Just let go and do it. It’s the only way.”
In my head, because we’ve got this whole conversation going now, I say, “It’s not that easy. You don’t get it. I can’t just go and do it. I keep trying. And trying and trying. But when I sit down to write, I…well…I start...” My voice fades off.
“You start…” you prompt.
“I try,” I say again. “I’ve been trying. I know what I want to say. I just can’t say it. When I get close to saying it, I start leaking.”
“Leaking?” you say.
“Leaking,” I nod. “For the past week, when I try to write, I start leaking.”
“Oohhh,” you say, nodding, as though you see what I’m saying. We both know you clearly don’t, but I’m being obstinate and worked with people who made me dig for information all day, so I just nod, definitively, which is clearly maddening for you.
We sit in silence for a moment or two while you ponder what to say next, and I ponder the power of saying nothing at all. Not talking feels so very much like not writing: infinitely satisfying in the moment. Infinitely easier in the moment. Rather like death in the long-run.
“So anyway,” I say, right as you open your mouth to start to speak, because that’s always how it works, and I stop myself, hopeful that you’ll say something profound or leading or opening or something that will make me share more, so I stop myself mid-“anyway” and say, “oh sorry, what were you going to say?” right as you stop yourself and say, “oh no, go ahead,” and we’re stuck in this awkward moment of “go aheadness” that could last a long time if we both keep trying to be polite, and I am GOING to be polite alright, because I already told you I’m in an obstinate mood and I don’t really want to write anyway.
“No really,” you say loudly and obnoxiously, a little too insistent for my avoidant liking. “You go. You said you were…leaking?”
“Yeah,” I say, mad at myself for ever mentioning it. “When I try to write, I leak. I don’t cry. I just…my eyes leak.”
“Leak…water?” you ask, with a helpless shrug.
“Last time I checked. I kept hoping for wine but…yeah. It’s not crying. It’s just leaking. Water. I don’t even know what I want to write about. I just sit down, and I center myself, slow down my mind and start typing, and I start leaking. I can’t help it. And then it’s all just downhill from there. I don’t want to deal with it.”
“That sounds like crying,” you say, challenging.
“It’s not crying. It’s just leaking.”
“I think you’re crying.”
“I am not. Anyway, I shut off the hose at the source. I’m not leaking anymore.”
“How did you do that?” you ask.
“I stopped writing.”
“What were you writing about?”
“I don’t know. Anything.”
“What were you leaking about?”
“I don’t know.”
“What do you want to write about now?”
“I don’t know.”
“What do you want to do about this?”
“I don’t know.”
“Oh,” you say.
We sit in silence. I bite on a fingernail and you twirl your hair, spin your ring on your finger, scratch your head. There is nothing more to say: there’s no way to fix something if you can’t identify what’s broken.
Autodidact: (n) a self-taught person. Poet: (n) a person who writes poetry. Autodidactpoet: (n) A blog full of thoughts from a self-taught writer.
Friday, July 29, 2011
Sunday, July 17, 2011
Cleaning the Drain
I have started writing about trust more times than I can count. I never get very far. I don't expect to get very far this time, either. I think the issue is that I can feel it—the lack of trust—the trustlessness if I must make up a word for it. It goes hand in hand with betrayal. I can't write about that, either. The feeling, the sense, the felt-sense of it all sits in my body and congeals at various places like too much food and gross slimy stuff built up in the kitchen sink. At first, the water drains slower and slower and, eventually, the water doesn't drain at all. It just sits there, growing stuff, overflowing when the faucet is turned on or when it leaks, sending its sliminess all over the floor.
At this point, the water is just dripping through and the rational part of my brain is saying, "just sit and write it out already! Reach down there and open the drain. You know what to do. Butt in chair. Fingers moving. Go now."
"No no," I fight back. "It's draining, see? It will open soon enough. It will open on its own. I don't need to reach down into all that slimy stuff. And besides, I have a sink in the bathroom. Or I can use the hose outside. I don't really need to use my kitchen sink." But I do need it. I keep using it, thinking it will drain; thinking the slimy gross stuff can't really be all that bad. I give it a little push every now and then. Stir it up a bit and encourage a little water to go down, but mostly I let it sit, and let it built up, and it's become apparent that it's not going anywhere. Plus, I have a leak in the faucet, so the steady drip…drip…drip…is filling the sink by the day. The water is murky, and it's not draining anywhere near fast enough to stop the overflow from coming, but I keep using the damn sink.
The more crap that gets built up in the drain, though, the harder it is to find the drain. The longer it sits, the slimier and messier and grosser it gets, the less I want to stick my hand in there. But I know: that drain is going to be blocked for good pretty soon, and I don't want slimy water all over my floor.
This metaphor is tired and gross. I told you I couldn't write this.
***********************
"The problem is," I told her, hands shaking, my heart beating in my ears, "I don't feel like I can trust people."
"Yes, you do," she said. She rolled her eyes. Looked away. Dismissed me and everything I was saying.
"I do what?" I asked, confused.
"You do trust people," she said. She looked at me with something that tried to be compassion. "Sure you do." She lowered her chin and looked in my eyes, but I had no idea what her eyes were saying.
"I do?" I asked, purely because I didn't know what else to say.
"Sure you do," she said again.
"Okay." I shrugged. If she says I do…I guess I do?I didn't even know what to say; didn't know where to take that, so I let it hang there between us. She said nothing. "Maybe you're right," I said, trying to clear the air. She still said nothing. "It's just…it's whatever. It's fine," I said.
"Yes," she said. "You're right."
"I'm right?" I was definitely losing where we were going.
"Yes," she said, in a voice I think she believed was gentle. "You're right. You are fine."
"Okay," I said, shrugging it off. Apparently there was nothing else to say. I was wrong.
* * * * * * * * * * * * * * * * * * *
I don't tell you because I'm afraid you'll also tell me I'm wrong. I'm afraid I am wrong. Or that it's something I can't admit to, because it makes me weak, or bad, or weird or sick or messed up. So I don't clear the drain, because delving into that mess would take time, and it's not something I can do alone. So I let that drain fill and fill and fill. But as the sink is filling, it's getting harder and harder to exhale.
Only good things can come from cleaning out that drain. It would mean I can fill it with good, clean, safe water. It would mean I could leave it empty and scrub it till it shines. It would mean I can wash my dishes in my sink again, and I won't have that constant worry that, one day, the damn sink is just going to spill everywhere. That would be a relief.
But right now, that dirty dishwater is standing between me and others like a moat, and even though I don't like it, it's necessary. It feels necessary. It just feels better that way. This way, I don't have to touch the slimy stuff at the bottom, and I don't have to worry about people getting too close. I feel not ready for that good, clean water. Not deserving of that safe, nice water. If I don't let the slimy water out of the sink, then maybe no one can hurt me. Then I don't need to worry about good things I don't deserve coming my way. If they insist on coming, I'll spray them with dirty dishwater, and that will scare them away for sure.
*************************
So how do I tell you? How do I find the words? How can I tell you what this thing living in my body looks like? Smells like? Sounds like? How can I tell you the things it whispers in my ear? The things it sneaks into my brain when I least expect it? It's not something concrete. I can't say, "I don't trust X group of people," because it isn't that. I can't say, "when I'm in X situation, I find that I don't trust the people around me," because it isn't that either. It's not one thing. It's not ever just one thing. I can't just say, "I don't trust men," because it wasn't just a man that hurt me, and it isn't all men. I can't say, "I don't trust women," because it wasn't all women, and it isn't just women. I can't say I don't trust strangers, because it was a group of strangers and friends. I can't even say it's limited to just people-people, because it was professionals, too. And family. Also family.
And me, too. Perhaps the hardest thing of all is not trusting me.
***************************
Now this is written, and there isn't even a hint of movement in the water. I've written all about sinks and drains and gross slimy stuff and nothing about what I should have said. Perhaps it's just not time to find the drain. Perhaps I can hold on and keep it in the sink for just a little longer…after all, I have a sink in the bathroom…or I can use the hose outside.
Welcome to BALTIMORE!
I grew up going into Baltimore to visit family, to go to the Inner Harbor, to take my sister to doctors appointments at Johns Hopkins, and to go to museums. I can remember driving through streets of what were surely at one time nice row homes that were starting to be boarded up. Row homes that were burned up, boarded up, falling down were a common site along one road we drove on to get to the hospital and to the inner harbor. Every time we went through, my mother would sigh.
“What is it?” either my sisters or I would ask from the backseat. “What’s wrong?”
“See those houses boarded up?” my mother would say. We would all look up from our games of tic-tac-toe and hangman and become solemn. “Those poor people,” my mother would say, locking the doors of the car.
“What?” we would ask. “What about the poor people? Do people live in those houses? Where did they go? Why do they look like that? What happened to that one? Why doesn’t that house have a roof? Why is that one falling apart? Where are the people?”
“They’re poor,” my mother would say. “Their houses got boarded up.”
“But why?”
“Because they couldn’t take care of them.”
“But who lives there?”
“Poor people.”
“But why did you lock the doors?”
“Because this area isn’t very safe.”
“But why isn’t it safe?”
“It just isn’t.” She would pause and we would nod, knowing that was all the answers we ever got, and likely all we would get this time as well. We stared out the window at a world we couldn’t imagine or understand, but that made us sad in a place deep in our hearts before turning back to our games.
Both sides of my family grew up in Baltimore. My mother’s parents lived there as children until they were married, and then came back later when my grandfather worked at Johns Hopkins. My father’s parents, and his entire family, have lived there forever and have never moved. They all started out downtown, and I grew up listening to stories of living on Lombard Street and going to the deli for corned beef. Stories about distant relatives living on Anne Street or Aliceanna Street or owning the shop off of Caroline Street near Orleans Street. The streets themselves are foreign to me, as they are to all my relatives at this point, but their names are as familiar to me as if I had grown up there. There are old family pictures in black and white of the old Baltimore—the way the city used to look when it was bustling and clean and beautiful. At least, that’s how it lives in the stories. It always sounds like a cultural hub: my grandfather grew up near the “Italian section” and the “Polish section” and tells stories of friends with last names like “Frank Spaghetti” or “Sam Spumoni” and “Earl Kozlowski.” The other side of my family is Jewish, so they tell stories of delis with corned beef and rye bread, pickles in huge barrels, and coddies. I really wish I could have seen the Baltimore they knew.
I went to college in Baltimore, but was far enough from the city that the woes of the city didn’t really affect me. During my 3 years of college, I volunteered at two different Baltimore City schools, which was where I got my first taste of what life in Baltimore was really like. It was there that I met children who talked about their incarcerated parents as though going to jail was as normal as going to the grocery store. One little boy told me excitedly that he had gone to visit his daddy in jail, and how his daddy was so nice because he bought him an orange soda from the vending machine. I worked and played with children who told me about the cockroaches and rats they saw in their kitchens, and how they made sure to save their milk from lunch because they would be hungry before bedtime because mommy didn’t buy food for dinner. I handed out notes afterschool about men who had been seen trying to pick up children in a silver car, warning parents to keep their children inside, and I entertained kids inside afterschool when we couldn’t go out to the playground because men in cars attempting to take pictures of children had been spotted repeatedly around the school. I talked to a 3rd grader whose 17-year-old brother had been shot, and I was at the school when a group of 5th grade boys left to walk home and then came running back because one of the boys was hit by a bus and killed. I was among the volunteers that saw the boys, heard the news, and then put on a happy face to play with his younger sister so she wouldn’t know until her parents came.
The billboards are something else I remember about driving into Baltimore. Haunting faces of children in black and white on signs reading: CHILD SEXUAL ABUSE. LEARN THE SIGNS. just weren’t something I saw in my still countrified little town of Frederick. Women with black eyes on billboards reading, “Well, he said he was sorry,” and one I swear I didn’t make up in my memory that says, “A woman is your friend. Don’t beat on her.” The “slogan” for Baltimore for a while, at least while I was in college, was BELIEVE. A black sign with white letters reading only the single word, I remember the irony of driving down streets like the ones pictured above with billboards reading BELIEVE everywhere. It was almost insulting as even I would wonder, “what the hell are we supposed to believe in?” (Some of the domestic violence billboards are still there, along with signs on buses and the metro that say: “Thou Shalt Not Kill. Exodus 20:13. Look it up” with a picture of something that looks like a knife and blood).
I went to a neuropsychology lecture last week, and the psychologist started his powerpoint with a big, “WELCOME TO BALTIMORE!” on the first slide. The next slide said, “There have only been 149 homicides…” and the next finished “…so far this year.” The homicide rate in Baltimore is number 4 in the country, and it makes the top 10 “most dangerous cities in America” list. In 2009, 21% of Baltimore city residents had income below the poverty line, and 10.8% lived with income 50% below the poverty line. 29.4% of children in Baltimore are living below the poverty line. I can’t remember the exact racial breakdown, but the city something like 68% African-American. It remains one of the most segregated cities in the US.
When I was living in Ohio, I worked in both Dayton and in Cincinnati. Working at the community mental health center in Dayton, I saw some people who were struggling financially. I had an elderly man walk to the clinic to see me because he didn’t have a car and didn’t have money for the bus, and it took him 5 hours to walk to the clinic. We saw people on a sliding scale, and by the end of my year there were able to accept Medicaid. I saw a couple rough kids, heard some difficult stories. In Cincinnati, I saw a very mixed group of clients. At the children’s hospital, we saw clients on Medicaid, but also saw clients with private insurance. I saw clients from well-off parts of Ohio, and also clients from the hills of Kentucky.
And now I have moved back to Baltimore, and I am working downtown in the middle of the city. Right smackdab in the middle of the mess. The clinic I work in accepts only clients on Medicaid (clients with private insurance go to another location). Some of the stories I am hearing are similar to the ones I heard in Ohio, but for the most part, the magnitude of the poverty is completely different. I have several clients who have been homeless in the past 6 months. I have several clients who are homeless or all but homeless now. Clients who were evicted from their homes, all of their belongings were put out on the street, and the doors were locked. By the time they got home, all of their belongings had been either stolen or broken and they had nowhere to go.
All of the children I see have developmental disabilities or, at the very least, developmental concerns and behavioral issues. I am seeing 17 year olds with high levels of lead per recent blood tests (likely due to lead in the pipes of wherever he’s living), and it is almost certainly the lead that has caused his developmental disability. I am seeing many children born to drug-addicted mothers who were born addicted and spent the first two weeks of their lives in the hospital detoxing. Now two years old, one of these children engages in almost constant, severe self-injury. I am seeing lots of kids in foster care, or kids who have been in foster care, or kids who are living with family members because their mother/father have been killed or are incarcerated. I have seen mothers that are illiterate, who bring their 17 year old daughters to the treatment session to help remember what I say, but the 17 year old dropped out of school in 9th grade, and she also can’t read. I had a mother who couldn’t concentrate on what I was telling her to do to decrease her child’s tantrums because she was so worried that I wouldn’t give her son a snack at the end of session. “Miss Laura, the other lady we saw, she gave him chips AND a juice box. She always gave him juice AND chips, and she was always real good to him. They’re always real good to us here. You can give him chips AND a juice box, right Miss Laura?” Part of me wonders: what if this kid is tantruming just because he’s hungry? What if all these problems are just due to the fact that the kid doesn’t get enough to eat? Part of me wonders: is she even here to get help with her kids behavior? Is she hearing anything I’m saying? Yes, I assure her, both verbally and nonverbally. Yes. I can be good to you, too.
I have learned to assess for barriers to treatment, and the barriers to treatment here are too many to name. Mom has a disability. Client is homeless. Mom is illiterate. Mom has 3 children with disabilities. Family has no transportation. Client is deaf and mom knows no sign language. Mom has post-traumatic stress disorder, or depression, or bipolar disorder, or borderline intellectual functioning.
In order for these families to come and see me, their child’s behaviors have to be pretty bad. Pretty disruptive. Pretty concerning. And they are: aggression, self-injury, tantrums, noncompliance, 8 year olds who aren’t toilet trained, and 6 year olds with no functional communication. They expect me to “fix” their child. They really think they can bring their child to me, and in one hour, maybe a couple sessions, I will work with the child and have him “get himself together.” But instead, I tell them that I will be giving THEM the tools to work with their child. “Special kids need parents with special tools to help them,” I say. “I don’t expect you to have those tools right now, but through our work together, we’ll figure out what those tools are. You have taken all the right steps so far to end up here, so that tells me you already know that you and your son need some help. You know your child better than anyone else, and you are his best helper. I’m going to give you some tools to try, and sometimes things are going to get worse before they get better. He’s going to be testing your patience even more than before. I’m going to be here to support you through that, and we’ll have to trouble shoot together. The important thing is you’re going to have to be really consistent. That’s how you’re going to see improvement. Let’s do it together.”
They nod. They tell me they understand. They tell me they’ll be consistent. They demonstrate time-out the way I explain it, and we set up behavior charts. I send them away with handouts and laminated picture cards and schedules and token economy charts with Spongebob or Justin Bieber or whatever that kid happens to like. And then they come
back, and I say, “how is his behavior?”
“It’s the same. He’s bad as ever.”
“Did you try the timeout we talked about?”
“Yep, I did that. It doesn’t work.”
“How many tantrums did he have this week?”
“It was constant. All the time.”
“And how many times did you use the timeout we talked about?”
“One time. It didn’t work.”
And we start again.
But then they tell me their stories and I don’t know how I expect them to be consistent. I don’t know how I can expect them to think about 3-step guided compliance and proper time-out procedures when they can’t read the handouts I gave them. When they don’t have a consistent place to live. When they are worried about how they’re going to feed their kids. When they are worried about their child’s safety. When they have 6 kids under the age of 6 in the house because their sister just moved in with them with her kids, and 6 kids in a 2 bedroom apartment is just too many.
So they leave, and I feel disheartened that I can’t help them…but the next week they come back. And they keep coming back. I know I must be doing something right, because they come back. At the very least, I guess, they like me, because they keep coming back to see me. They must feel like something is helping, because they are trying. They are coming. So we keep trying, and trying, and trying again.
The thing is, is that they do try. They are trying. They are giving this life their all, and it’s just too damn hard for any one person to navigate with the hand they’ve been dealt. So they try, and I try, and if we’re lucky, something will happen. I give their kids chips AND a juice box. I give them picture schedules and session notes in the simplest words I can manage. I praise them for trying. I give them bus tokens. I show them and tell them and practice with them, and have them show me, and tell me, and practice with me.
Then they leave, and I try to let them go before the next client comes through the door.
“What is it?” either my sisters or I would ask from the backseat. “What’s wrong?”
“See those houses boarded up?” my mother would say. We would all look up from our games of tic-tac-toe and hangman and become solemn. “Those poor people,” my mother would say, locking the doors of the car.
“What?” we would ask. “What about the poor people? Do people live in those houses? Where did they go? Why do they look like that? What happened to that one? Why doesn’t that house have a roof? Why is that one falling apart? Where are the people?”
“They’re poor,” my mother would say. “Their houses got boarded up.”
“But why?”
“Because they couldn’t take care of them.”
“But who lives there?”
“Poor people.”
“But why did you lock the doors?”
“Because this area isn’t very safe.”
“But why isn’t it safe?”
“It just isn’t.” She would pause and we would nod, knowing that was all the answers we ever got, and likely all we would get this time as well. We stared out the window at a world we couldn’t imagine or understand, but that made us sad in a place deep in our hearts before turning back to our games.
Both sides of my family grew up in Baltimore. My mother’s parents lived there as children until they were married, and then came back later when my grandfather worked at Johns Hopkins. My father’s parents, and his entire family, have lived there forever and have never moved. They all started out downtown, and I grew up listening to stories of living on Lombard Street and going to the deli for corned beef. Stories about distant relatives living on Anne Street or Aliceanna Street or owning the shop off of Caroline Street near Orleans Street. The streets themselves are foreign to me, as they are to all my relatives at this point, but their names are as familiar to me as if I had grown up there. There are old family pictures in black and white of the old Baltimore—the way the city used to look when it was bustling and clean and beautiful. At least, that’s how it lives in the stories. It always sounds like a cultural hub: my grandfather grew up near the “Italian section” and the “Polish section” and tells stories of friends with last names like “Frank Spaghetti” or “Sam Spumoni” and “Earl Kozlowski.” The other side of my family is Jewish, so they tell stories of delis with corned beef and rye bread, pickles in huge barrels, and coddies. I really wish I could have seen the Baltimore they knew.
I went to college in Baltimore, but was far enough from the city that the woes of the city didn’t really affect me. During my 3 years of college, I volunteered at two different Baltimore City schools, which was where I got my first taste of what life in Baltimore was really like. It was there that I met children who talked about their incarcerated parents as though going to jail was as normal as going to the grocery store. One little boy told me excitedly that he had gone to visit his daddy in jail, and how his daddy was so nice because he bought him an orange soda from the vending machine. I worked and played with children who told me about the cockroaches and rats they saw in their kitchens, and how they made sure to save their milk from lunch because they would be hungry before bedtime because mommy didn’t buy food for dinner. I handed out notes afterschool about men who had been seen trying to pick up children in a silver car, warning parents to keep their children inside, and I entertained kids inside afterschool when we couldn’t go out to the playground because men in cars attempting to take pictures of children had been spotted repeatedly around the school. I talked to a 3rd grader whose 17-year-old brother had been shot, and I was at the school when a group of 5th grade boys left to walk home and then came running back because one of the boys was hit by a bus and killed. I was among the volunteers that saw the boys, heard the news, and then put on a happy face to play with his younger sister so she wouldn’t know until her parents came.
The billboards are something else I remember about driving into Baltimore. Haunting faces of children in black and white on signs reading: CHILD SEXUAL ABUSE. LEARN THE SIGNS. just weren’t something I saw in my still countrified little town of Frederick. Women with black eyes on billboards reading, “Well, he said he was sorry,” and one I swear I didn’t make up in my memory that says, “A woman is your friend. Don’t beat on her.” The “slogan” for Baltimore for a while, at least while I was in college, was BELIEVE. A black sign with white letters reading only the single word, I remember the irony of driving down streets like the ones pictured above with billboards reading BELIEVE everywhere. It was almost insulting as even I would wonder, “what the hell are we supposed to believe in?” (Some of the domestic violence billboards are still there, along with signs on buses and the metro that say: “Thou Shalt Not Kill. Exodus 20:13. Look it up” with a picture of something that looks like a knife and blood).
I went to a neuropsychology lecture last week, and the psychologist started his powerpoint with a big, “WELCOME TO BALTIMORE!” on the first slide. The next slide said, “There have only been 149 homicides…” and the next finished “…so far this year.” The homicide rate in Baltimore is number 4 in the country, and it makes the top 10 “most dangerous cities in America” list. In 2009, 21% of Baltimore city residents had income below the poverty line, and 10.8% lived with income 50% below the poverty line. 29.4% of children in Baltimore are living below the poverty line. I can’t remember the exact racial breakdown, but the city something like 68% African-American. It remains one of the most segregated cities in the US.
When I was living in Ohio, I worked in both Dayton and in Cincinnati. Working at the community mental health center in Dayton, I saw some people who were struggling financially. I had an elderly man walk to the clinic to see me because he didn’t have a car and didn’t have money for the bus, and it took him 5 hours to walk to the clinic. We saw people on a sliding scale, and by the end of my year there were able to accept Medicaid. I saw a couple rough kids, heard some difficult stories. In Cincinnati, I saw a very mixed group of clients. At the children’s hospital, we saw clients on Medicaid, but also saw clients with private insurance. I saw clients from well-off parts of Ohio, and also clients from the hills of Kentucky.
And now I have moved back to Baltimore, and I am working downtown in the middle of the city. Right smackdab in the middle of the mess. The clinic I work in accepts only clients on Medicaid (clients with private insurance go to another location). Some of the stories I am hearing are similar to the ones I heard in Ohio, but for the most part, the magnitude of the poverty is completely different. I have several clients who have been homeless in the past 6 months. I have several clients who are homeless or all but homeless now. Clients who were evicted from their homes, all of their belongings were put out on the street, and the doors were locked. By the time they got home, all of their belongings had been either stolen or broken and they had nowhere to go.
All of the children I see have developmental disabilities or, at the very least, developmental concerns and behavioral issues. I am seeing 17 year olds with high levels of lead per recent blood tests (likely due to lead in the pipes of wherever he’s living), and it is almost certainly the lead that has caused his developmental disability. I am seeing many children born to drug-addicted mothers who were born addicted and spent the first two weeks of their lives in the hospital detoxing. Now two years old, one of these children engages in almost constant, severe self-injury. I am seeing lots of kids in foster care, or kids who have been in foster care, or kids who are living with family members because their mother/father have been killed or are incarcerated. I have seen mothers that are illiterate, who bring their 17 year old daughters to the treatment session to help remember what I say, but the 17 year old dropped out of school in 9th grade, and she also can’t read. I had a mother who couldn’t concentrate on what I was telling her to do to decrease her child’s tantrums because she was so worried that I wouldn’t give her son a snack at the end of session. “Miss Laura, the other lady we saw, she gave him chips AND a juice box. She always gave him juice AND chips, and she was always real good to him. They’re always real good to us here. You can give him chips AND a juice box, right Miss Laura?” Part of me wonders: what if this kid is tantruming just because he’s hungry? What if all these problems are just due to the fact that the kid doesn’t get enough to eat? Part of me wonders: is she even here to get help with her kids behavior? Is she hearing anything I’m saying? Yes, I assure her, both verbally and nonverbally. Yes. I can be good to you, too.
I have learned to assess for barriers to treatment, and the barriers to treatment here are too many to name. Mom has a disability. Client is homeless. Mom is illiterate. Mom has 3 children with disabilities. Family has no transportation. Client is deaf and mom knows no sign language. Mom has post-traumatic stress disorder, or depression, or bipolar disorder, or borderline intellectual functioning.
In order for these families to come and see me, their child’s behaviors have to be pretty bad. Pretty disruptive. Pretty concerning. And they are: aggression, self-injury, tantrums, noncompliance, 8 year olds who aren’t toilet trained, and 6 year olds with no functional communication. They expect me to “fix” their child. They really think they can bring their child to me, and in one hour, maybe a couple sessions, I will work with the child and have him “get himself together.” But instead, I tell them that I will be giving THEM the tools to work with their child. “Special kids need parents with special tools to help them,” I say. “I don’t expect you to have those tools right now, but through our work together, we’ll figure out what those tools are. You have taken all the right steps so far to end up here, so that tells me you already know that you and your son need some help. You know your child better than anyone else, and you are his best helper. I’m going to give you some tools to try, and sometimes things are going to get worse before they get better. He’s going to be testing your patience even more than before. I’m going to be here to support you through that, and we’ll have to trouble shoot together. The important thing is you’re going to have to be really consistent. That’s how you’re going to see improvement. Let’s do it together.”
They nod. They tell me they understand. They tell me they’ll be consistent. They demonstrate time-out the way I explain it, and we set up behavior charts. I send them away with handouts and laminated picture cards and schedules and token economy charts with Spongebob or Justin Bieber or whatever that kid happens to like. And then they come
back, and I say, “how is his behavior?”
“It’s the same. He’s bad as ever.”
“Did you try the timeout we talked about?”
“Yep, I did that. It doesn’t work.”
“How many tantrums did he have this week?”
“It was constant. All the time.”
“And how many times did you use the timeout we talked about?”
“One time. It didn’t work.”
And we start again.
But then they tell me their stories and I don’t know how I expect them to be consistent. I don’t know how I can expect them to think about 3-step guided compliance and proper time-out procedures when they can’t read the handouts I gave them. When they don’t have a consistent place to live. When they are worried about how they’re going to feed their kids. When they are worried about their child’s safety. When they have 6 kids under the age of 6 in the house because their sister just moved in with them with her kids, and 6 kids in a 2 bedroom apartment is just too many.
So they leave, and I feel disheartened that I can’t help them…but the next week they come back. And they keep coming back. I know I must be doing something right, because they come back. At the very least, I guess, they like me, because they keep coming back to see me. They must feel like something is helping, because they are trying. They are coming. So we keep trying, and trying, and trying again.
The thing is, is that they do try. They are trying. They are giving this life their all, and it’s just too damn hard for any one person to navigate with the hand they’ve been dealt. So they try, and I try, and if we’re lucky, something will happen. I give their kids chips AND a juice box. I give them picture schedules and session notes in the simplest words I can manage. I praise them for trying. I give them bus tokens. I show them and tell them and practice with them, and have them show me, and tell me, and practice with me.
Then they leave, and I try to let them go before the next client comes through the door.
Wednesday, July 13, 2011
Telling Stories
I went into psychology, in part, because of my love of stories. When I engage with people through hearing their stories, there is this instant where we connect—a moment where I get a glimpse into the story through their eyes. Sometimes, these stories are hard to hear. Sometimes, I come away and the stories feel like they are more than I can bear. I don’t take this business of holding stories lightly. Our stories are central—they are the core of who we are, where we’re from, what makes us up. Our stories are uniquely us. I am fascinated and amazed by the stories we choose to tell. The stories we choose to keep locked in our closets behind the winter coats, sealed in our kitchens beneath the knives and lidless tupperware, hidden in our bedrooms under the bed where it only comes out at night. I am fascinated by the timing of telling our stories, who we tell, who we don’t, and why. I am intrigued by what we tell ourselves about the stories. The stories we create to make sense of our stories. It’s fascinating.
Of the parents I have seen in the past few days at my internship site, about ¾ of them came in with the same surface story. “My kid,” they tell me. “He cries. He screams. He throws himself on the floor. He won’t listen to me, ever. He hits his head on the ground and on the wall. He throws things. He bites me. He hits his brother.” I come out and write the same goal for each client: “Decrease tantrums with aggression and self-injury.” But each story is different. One child’s mother became teary because she thought her 2 year old tantrumer would never be able to sit still and learn. Another expressed anger that her 4 year old tantrumer disrespected her when he wouldn’t listen. Another said she could deal with the tantrums and self injury, if only she could get her three year old potty trained. One family is nearly homeless again. Another drives two hours to come see me. The last one brings her 3 kids and her nephew on the bus to come to session. One has been incarcerated. Another works the night shift. The third is an unemployed single parent. The first child’s behavior is likely due to prenatal drug exposure. Another child’s behavior is due to severe receptive and expressive language delays. Another child’s tantrums are related to his lead exposure, or perhaps the family history of autism, or perhaps another reason altogether. One mother had to take her child to 4 pediatricians to get a diagnosis. Another knew what the problem was because he was just like mom’s brother. The third went straight to one of the best developmental pediatricians in the country. There are so many stories. I ask each parent similar questions, trying to understand the cause of the behaviors, how we can best get them under control, make them more manageable, understand the function of them, get to the root of why they’re continuing, why they’re increasing in intensity and frequency. But parents don’t think in those terms. They don’t want to answer those questions. They want to tell me stories.
“What typically happens right before Kiddo has a tantrum? Have you noticed any pattern to it?”
“Well…there was this one time….”
“Remember, we’re looking for patterns. Something that is the same every time.”
“What do you mean?”
“Sometimes parents notice that maybe their child always has a tantrum right before they leave to go in the car, or maybe it’s always when they ask him to do something…can you think of anything like that?”
They pause. “Well,” they say slowly, “there was this one time…”
And I listen to the story.
I saw a really fantastic kid the other day. His mother expressed concern that he might have autism.
“MOM!” he exploded, embarrassed. “I TOLD YOU! I DON’T HAVE AUTISM!”
Mom continued describing her concerns, and I listened. Later, mom mentioned it again.
“MOOOOOM! You’re not listening to me! I told you! I DON’T HAVE AUTISM!”
The third time this happened, I stopped mom and turned to Kiddo.
“You seem pretty angry when mom says that she’s worried that you might have autism.”
“Yeah!” he said. “Because I don’t have it. I don’t. I don’t know what my problem is, but I know it’s not autism. It’s not that.”
“What does it mean to have autism?” I asked. He paused.
“I don’t know.”
“What have you heard about autism?” I asked.
“I don’t know.” He paused again and I waited. “It’s kids who are retarded,” he said.
“You know, that’s something that I’ve heard kids say before. Where did you learn that?” We had a fantastic conversation about what autism is and is not, about what other people think autism is and is not. Ultimately? No, he doesn’t have autism, and we discussed that, too. But if I had just up and said, “Kid, you don’t have autism,” it wouldn’t have been nearly as effective. Instead, I stopped and uncovered the story: what does it mean? Where did you learn about it? Who taught you that? What do other people say? What if it’s true? What if it’s not? The fear became three dimensional. It became a story, start to finish. It became part of his story. I became part of his story, just as he became part of mine.
I saw a family, too, that is so burdened with stories, so heavy with the weight of everything they have to bear, that the stories couldn’t even be told. There was no animated, “well there was this one time,” or “the other day, you know what he did?” or “Let me tell you…!” There were facts that leaked out of tightly pursed lips into the room that suddenly felt far too small. Facts that were hints at stories that are too dangerous, too real, too shame-laden and difficult to bear. Those stories don’t get told, but are hinted at as I’m tested for how much I can handle, and perhaps, how much can they can bring themselves to tell. These aren’t even stories of the deepest darkest secrets of the family. These stories are the stories they are living now, and we both know my privileged, white, educated self can’t even imagine the reality. We both know there’s nothing to say but, “wow, I imagine that’s so difficult,” when really, I can’t imagine it at all. And that’s all part of the evolving story.
Parts of this have been sitting around for a week now, and I really want to finish it. I hate leaving things unfinished. I have a lot I want to say. But I can’t say it. So I’ve been sitting on this for a week, thinking about it on the drive to work, thinking about it on the metro coming home, thinking about what I know I want to say in the quiet moments before I go to bed at night. And then I sit down to write it and my inner critic goes wild with “NO WAY! DON’T SAY THAT!!!” So I get up and wash dishes or walk the dog or pack lunch for tomorrow and sit back down and think, “okay NOW. NOW is the time for me to write it.” I stare at the page. I type a few words and erase them. “Just tell the story, Laura. Just say it. Just tell the story. Tell the story of why you’re having a hard time telling the story. Make up a story. Just start getting the words on paper, and the story will come.” But it doesn’t. It just doesn’t.
This story I want to tell needs to be an interactive process. I need to be sure that as I say it, as I type it, it’s heard. I need to make sure I hear this story, because I don’t know that I’ve listened to it. I am pretty sure it’s not something I have written about even in my “for my eyes only” pile of writing. I can’t. I need someone to witness the story, to hold it in their hands like a baby bird or a lightning bug—something fragile, it is something that should be cupped gently. Speak in a whisper when you’re around it. Don’t startle it or scare it off. This is why it can’t be told: I’m scaring off my own story.
I keep telling myself there’s no point to write it as a blog post because “there’s no point” to it. There’s no larger take-home message. No big epiphany or wise thought. It would be storying a story purely for the sake of storying it.
After that line, I was stuck again, so I read back what I’ve written (aren’t you thrilled you get to read this entry-without-a-point, complete with the author’s writing process annotated into the text? I knew you were). One line sticks out to me, sticks with me: “There were facts that leaked out of tightly pursed lips … Facts that were hints at stories that are too dangerous, too real, too shame-laden and difficult to bear.”
Some stories are untellable. Sometimes, they feel too dangerous, too real, too shame-laden and difficult to bear. Sometimes, even if they are stories that have been told before, things change and they become dangerous and real and shameful once more. Or maybe it’s a tiny part of the same story that becomes a story in its own right, that makes everything new and different. But even if it’s a tiny thing; part of an old story; a tiny, old story without a point, it doesn’t make it easier. It just doesn’t. Fortunately or unfortunately, that’s all part of the evolving story.
It’s all part of my evolving story.
What are the stories you tell others? What are the stories you don’t? Where do they sit in your body? Where are you holding your dangerous, real stories? Are they shame-filled? Are they angry? Are they sad or beautiful or depressing? Where did you learn they were untellable? What would it take for them to be told?
Of the parents I have seen in the past few days at my internship site, about ¾ of them came in with the same surface story. “My kid,” they tell me. “He cries. He screams. He throws himself on the floor. He won’t listen to me, ever. He hits his head on the ground and on the wall. He throws things. He bites me. He hits his brother.” I come out and write the same goal for each client: “Decrease tantrums with aggression and self-injury.” But each story is different. One child’s mother became teary because she thought her 2 year old tantrumer would never be able to sit still and learn. Another expressed anger that her 4 year old tantrumer disrespected her when he wouldn’t listen. Another said she could deal with the tantrums and self injury, if only she could get her three year old potty trained. One family is nearly homeless again. Another drives two hours to come see me. The last one brings her 3 kids and her nephew on the bus to come to session. One has been incarcerated. Another works the night shift. The third is an unemployed single parent. The first child’s behavior is likely due to prenatal drug exposure. Another child’s behavior is due to severe receptive and expressive language delays. Another child’s tantrums are related to his lead exposure, or perhaps the family history of autism, or perhaps another reason altogether. One mother had to take her child to 4 pediatricians to get a diagnosis. Another knew what the problem was because he was just like mom’s brother. The third went straight to one of the best developmental pediatricians in the country. There are so many stories. I ask each parent similar questions, trying to understand the cause of the behaviors, how we can best get them under control, make them more manageable, understand the function of them, get to the root of why they’re continuing, why they’re increasing in intensity and frequency. But parents don’t think in those terms. They don’t want to answer those questions. They want to tell me stories.
“What typically happens right before Kiddo has a tantrum? Have you noticed any pattern to it?”
“Well…there was this one time….”
“Remember, we’re looking for patterns. Something that is the same every time.”
“What do you mean?”
“Sometimes parents notice that maybe their child always has a tantrum right before they leave to go in the car, or maybe it’s always when they ask him to do something…can you think of anything like that?”
They pause. “Well,” they say slowly, “there was this one time…”
And I listen to the story.
I saw a really fantastic kid the other day. His mother expressed concern that he might have autism.
“MOM!” he exploded, embarrassed. “I TOLD YOU! I DON’T HAVE AUTISM!”
Mom continued describing her concerns, and I listened. Later, mom mentioned it again.
“MOOOOOM! You’re not listening to me! I told you! I DON’T HAVE AUTISM!”
The third time this happened, I stopped mom and turned to Kiddo.
“You seem pretty angry when mom says that she’s worried that you might have autism.”
“Yeah!” he said. “Because I don’t have it. I don’t. I don’t know what my problem is, but I know it’s not autism. It’s not that.”
“What does it mean to have autism?” I asked. He paused.
“I don’t know.”
“What have you heard about autism?” I asked.
“I don’t know.” He paused again and I waited. “It’s kids who are retarded,” he said.
“You know, that’s something that I’ve heard kids say before. Where did you learn that?” We had a fantastic conversation about what autism is and is not, about what other people think autism is and is not. Ultimately? No, he doesn’t have autism, and we discussed that, too. But if I had just up and said, “Kid, you don’t have autism,” it wouldn’t have been nearly as effective. Instead, I stopped and uncovered the story: what does it mean? Where did you learn about it? Who taught you that? What do other people say? What if it’s true? What if it’s not? The fear became three dimensional. It became a story, start to finish. It became part of his story. I became part of his story, just as he became part of mine.
I saw a family, too, that is so burdened with stories, so heavy with the weight of everything they have to bear, that the stories couldn’t even be told. There was no animated, “well there was this one time,” or “the other day, you know what he did?” or “Let me tell you…!” There were facts that leaked out of tightly pursed lips into the room that suddenly felt far too small. Facts that were hints at stories that are too dangerous, too real, too shame-laden and difficult to bear. Those stories don’t get told, but are hinted at as I’m tested for how much I can handle, and perhaps, how much can they can bring themselves to tell. These aren’t even stories of the deepest darkest secrets of the family. These stories are the stories they are living now, and we both know my privileged, white, educated self can’t even imagine the reality. We both know there’s nothing to say but, “wow, I imagine that’s so difficult,” when really, I can’t imagine it at all. And that’s all part of the evolving story.
Parts of this have been sitting around for a week now, and I really want to finish it. I hate leaving things unfinished. I have a lot I want to say. But I can’t say it. So I’ve been sitting on this for a week, thinking about it on the drive to work, thinking about it on the metro coming home, thinking about what I know I want to say in the quiet moments before I go to bed at night. And then I sit down to write it and my inner critic goes wild with “NO WAY! DON’T SAY THAT!!!” So I get up and wash dishes or walk the dog or pack lunch for tomorrow and sit back down and think, “okay NOW. NOW is the time for me to write it.” I stare at the page. I type a few words and erase them. “Just tell the story, Laura. Just say it. Just tell the story. Tell the story of why you’re having a hard time telling the story. Make up a story. Just start getting the words on paper, and the story will come.” But it doesn’t. It just doesn’t.
This story I want to tell needs to be an interactive process. I need to be sure that as I say it, as I type it, it’s heard. I need to make sure I hear this story, because I don’t know that I’ve listened to it. I am pretty sure it’s not something I have written about even in my “for my eyes only” pile of writing. I can’t. I need someone to witness the story, to hold it in their hands like a baby bird or a lightning bug—something fragile, it is something that should be cupped gently. Speak in a whisper when you’re around it. Don’t startle it or scare it off. This is why it can’t be told: I’m scaring off my own story.
I keep telling myself there’s no point to write it as a blog post because “there’s no point” to it. There’s no larger take-home message. No big epiphany or wise thought. It would be storying a story purely for the sake of storying it.
After that line, I was stuck again, so I read back what I’ve written (aren’t you thrilled you get to read this entry-without-a-point, complete with the author’s writing process annotated into the text? I knew you were). One line sticks out to me, sticks with me: “There were facts that leaked out of tightly pursed lips … Facts that were hints at stories that are too dangerous, too real, too shame-laden and difficult to bear.”
Some stories are untellable. Sometimes, they feel too dangerous, too real, too shame-laden and difficult to bear. Sometimes, even if they are stories that have been told before, things change and they become dangerous and real and shameful once more. Or maybe it’s a tiny part of the same story that becomes a story in its own right, that makes everything new and different. But even if it’s a tiny thing; part of an old story; a tiny, old story without a point, it doesn’t make it easier. It just doesn’t. Fortunately or unfortunately, that’s all part of the evolving story.
It’s all part of my evolving story.
What are the stories you tell others? What are the stories you don’t? Where do they sit in your body? Where are you holding your dangerous, real stories? Are they shame-filled? Are they angry? Are they sad or beautiful or depressing? Where did you learn they were untellable? What would it take for them to be told?
Monday, July 4, 2011
Another Day
She prays.
In the place of silence where un-negotiated power lies
she struggles to breathe an air thick as oil.
The liquid sticks to her heart
fills her lungs, slugs through her arteries and veins leaving her
breathless
attempting to rise
ashamed, even,
afraid
to show her face to the sun.
Struggling to move the iron boundaries in place from her youth
fences she never erected
the crippling familiarity of control infiltrates her spirit
as she pushes, unsuccessfully, at the invaders of her soul.
Her limitless potential a thing of the past, her
heart rate slows and her body stills to a point of
just getting by
overwhelmed by the thing they call living
her heart wonders what it has done
cries out
to the broken heart of the world
aching for solidarity in the breaking
ready
to give up the fight, she whispers
Bless me, mother, for I have become everything you never wanted me to be.
And she rises
to face another day.
In the place of silence where un-negotiated power lies
she struggles to breathe an air thick as oil.
The liquid sticks to her heart
fills her lungs, slugs through her arteries and veins leaving her
breathless
attempting to rise
ashamed, even,
afraid
to show her face to the sun.
Struggling to move the iron boundaries in place from her youth
fences she never erected
the crippling familiarity of control infiltrates her spirit
as she pushes, unsuccessfully, at the invaders of her soul.
Her limitless potential a thing of the past, her
heart rate slows and her body stills to a point of
just getting by
overwhelmed by the thing they call living
her heart wonders what it has done
cries out
to the broken heart of the world
aching for solidarity in the breaking
ready
to give up the fight, she whispers
Bless me, mother, for I have become everything you never wanted me to be.
And she rises
to face another day.
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