Wednesday, July 10, 2013

Tuesday's Postmortem

So, I once worked with this kiddo for about 6 months, several times per week.  It was intense.  However, even with working at this intensity, we had seen minimal progress, I was transitioning to a different clinic, and mom was fed up.  Mom had been fed up all along: tired of dragging her kid's butt to sessions, tired of not seeing progress, and tired of her kid's problem behaviors.  Mom was fed up when we didn't see progress after week 2...but something about my charming smile and winning ways [this is sarcasm] kept her coming.  It was touch and go every session...will they show?  Will they drop out?  Will they be back?  I kept expecting them to drop out, they kept coming and saying they weren't going to come back unless they saw some changes.  When I told mom I was leaving the clinic in 3 weeks and she would have to be transferred to a new therapist, she left the session, called my supervisor, and told her she was dropping out of the program prematurely.  I wasn't surprised, but I felt guilty and disappointed.

In supervision that week, my supervisor announced that we would spend the first bit of our hour together doing a "postmortem" for the client to determine where things went wrong, what we could have done differently, how we could have prevented this from happening, and what we can do to prevent premature terminations in the future.

I had never heard the word "postmortem" used in this context before and it (a) pissed me off, because I knew exactly why they dropped out and there wasn't anything I could have done about it; (b) made me feel even more guilty than I already felt; and (c) felt unnecessarily morbid and unsettling, like the client had died and not merely decided to pursue alternative treatment options.

At any rate, when I sat down to write tonight, I did my nightly procrastination, followed by my nightly routine of looking at the clock and saying "HOLY CRUD IT'S WHAT TIME!?!?" I then cursed myself for committing to this stupid challenge, swore I was going to give it up, and then swore I was going to finish it.  I then sat down again to write, went and changed my laundry to the dryer, emptied the dehumidifier, let the dog out, considered whether I should take a shower tonight or in the morning, texted my sister, looked at the clock and said "HOLY CRUD IT'S WHAT TIME!?!?!" and sat down to write.  At that point, it was time to start lamenting about having nothing to write I did, right on schedule.  I stated that I have nothing to say, nothing to share, don't want to I went to the bathroom, cleaned up from dinner, texted my other sister, turned on my Bob Marley Pandora station, and sat down to write.  "What did you write yesterday?" I wondered.  And then I remembered: yesterday sucked.  A lot.  So much, in fact, that the only thing I did was write a couple crappy haikus.

"You should write a postmortem for yesterday," I thought.  Much like when my supervisor used that word, it (a) pissed me off; (b) made me continue to feel badly about yesterday; and (c) felt unnecessarily morbid and unsettling.

"Not everything has to have a postmortem and be thought about to death," I countered.  "Call it a bad day and move on.  Bloody hell, must you always be so analytical?"

"It would be something to write about," I argued back.  "Write about how you hate the word postmortem and why.  And then talk about why yesterday sucked.  Figure out why it sucked.  FIGURE OUT WHAT IT MIGHT MEAN TO WRITE A FREAKING POSTMORTEM." 

I don't want to.  Yesterday was a day that felt like 15 steps backwards.  I don't know why.  I don't know how I got there.  I don't want to know. 

My brain, however, is anxious and perseverative at times.  It's why I love my work with the anxious kiddos.  It's because, to an extent, I GET it.  My anxieties are different (I'm not, for example, anxious about fire alarms, or thunderstorms, or whether the ingredients in my shampoo that goes down the drain after I wash my hair are going to destroy the Chesapeake Bay).  My recurrent, perseverative thoughts are internal and tend to focus on matters not relating to my favorite breakfast cereal or that one episode of "Baby Einstein."  But I still get it.

One of my favorite things to teach anxious kids is that they have "worry bullies" on their shoulders.  These worry bullies...they lie.  A lot.  They tell you things and make you believe things that just aren't true.  We draw pictures of our worry bullies that look like anything from circles with squiggly lines coming out of them to intricate dinosaurs with rows of big teeth.  We talk about the exact things those worry bullies say--and let me tell you, they're mean.  If you've never met a 7 year olds worry bully, you're lucky.  They're ugly creatures. 

Once we have the worry bully idea established, I teach my kids that they are smarter and stronger than any old worry bully.  They can teach the worry bully who's boss, and they can start pushing back when the worry bully starts acting up.  We knock the worry bullies off of our shoulders and we step on them, we yell at them, and with one particular child, we even had to flush them down the toilet (his were a particularly resistant breed).  Then, we learn the difference between SUPER COOL AND AWESOME YOU thoughts and worry bully thoughts.  We get to be stronger than the worry bullies and just don't let them push us around anymore. 

Yesterday, my worry bullies won.  These days, I can usually talk myself out of bad worry bully days.  They're not as strong as they used to be, and I know their tricks.  I'm familiar with all the ways they try to "get me" and hook me in, and I know their lies.  But I fell for it yesterday.  They got me good.  Worry bullies that I haven't seen in months popped out in swarms.  I fought them off for a while, and then I just gave up.

Everybody always asks "what would you say if you were your client?"  Truth be told, I hate that question.  The answer is always either (a) that I don't KNOW what I would tell myself if I were my own client because I don't have that kind of perspective on my own problems, dammit, or (b) I DO know what I would tell myself, and I've told myself that statement a bagillion times, but it's OBVIOUSLY not working if I'm still not getting it, right? 

Today falls into the latter category...but anyway, if I was my client, I would tell myself: "You know what?  Bad days happen!  There are ALWAYS going to be days that the worry bullies win.  The important thing is that you know that's what happened and that you try again tomorrow.  At this point, you might as well just pick up your worry bullies, pin them to your shirt, and say, 'hey buddy, you're comin' with me today, alright?  Just remember that I'm in charge!'"

I would also tell myself, "hey, how many days have you beaten the worry bullies?  SO MANY!  You've gotta let them win every now and then!  The worry bullies won today?  No big deal!  Maybe they'll win tomorrow, maybe they'll lose.  Worry bullies are tricky critters.  Good thing you're smart enough to deal with them!"

But that's not what I'm saying.  Instead, the worry bullies are clamoring for attention and I'm feeding them.  I'm throwing them a freaking party with balloons and a bouncy house and everything, and I'm getting them all hopped up on cake and soda and letting them run RAMPANT out there, not even questioning them at all.  I should.  I know I should.  I should go and flush them down the toilet is what I should do...but my brain is let's say tomorrow.  Tomorrow I shall slay the worry bullies...and when it's done, you better believe that I'm going to chortle with joy. 

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