Disclaimer: Each of my client cases are fictional. They are compilations of hundreds of client situations I have encountered throughout my career. This is to protect the confidentiality of my clients. Anything that may resemble a real person or family is simply a coincidence.
I once had this angry teenage client (well, I’ve had many angry teenage clients). This particular teenage client was angry at his family, at being forced to come to therapy and at life in general.
Early on in our work together, his mom brought him to my office and he refused to get out of the car. I eventually made my way down to the car and proceeded to do therapy in the parking lot; I stood in the hot summer sun and sweated through my work outfit showing him that I was not the enemy and I wanted to be a source of support. (Years later the by-then-less-angry teenage client and I joked about that hot summer day and how I was standing on the parking lot pavement trying to convince him that therapy wasn’t that bad).
Week after week his mom dragged him into my office, he plopped down on the couch and gave one word answers to my very interesting and probing questions: how was school?, what did you do this weekend? how are things with your parents? You can only imagine how loudly my clock ticked during those very quiet sessions.
I consulted with his psychiatrist who was my colleague and would regularly seek his advice; the kid doesn’t want to be here, he doesn’t talk, I feel like I am wasting his parents money, am I making any difference? This wise mentor, a thoughtful man of few words, repeatedly told me that I was helping the client; by just being present for this kid, I was providing a calm and stable place for him, a safe place so that when he was ready, he would have someone to talk to, a place free from pressure or anxiety that he experienced at home.
I worked with this kid for years, I feel like I prepped for the SAT’s and got ready for graduation along side him. The hours and hours of drudgery in my office eventually turned into moments of laughter, silliness and connection. The laughter came at a snail’s pace, often after months of my patience, his yelling and even throwing things (not necessarily at me, just towards me, primarily due to the very small square footage of my office). Over time he began to share things in session, confide in me, and actually hear me. There were moments he even paused to consider and actually acknowledged that perhaps something I said had merit.
I later contacted the psychiatrist to tell him that he had been “right”. The kid had, in fact, opened up and really used the therapy time to his benefit. My presence, in the beginning, was enough to build a foundation for trust so that when he was ready he could utilize the connection, the safety and the comfort we had created in this therapeutic relationship.
I know my mentor was smiling at my shift as I was smiling at my client’s shift; both of us had learned to trust the process and each other. If we are patient enough, yes, progress happens.
How many of you know I have a website? I don’t talk about it much (read: never), but I was just over there checking on it and thought you might want to go on over for a visit and say “hi”.
The site talks about me and my practice, Laurie Levine LCSW LLC. There is a bit of my professional background, my ideas about therapy, a confidentiality policy and then a more involved page about the different services I provide. I have included information about fees and policies and a contact area as well.
There is a spot for this blog where each post that is published here is also published over there. Sometimes potential clients may find the website from a web search, or from one of the therapy search engines to which I belong (Psychology Today, Good Therapy, Theravive), but they don’t necessarily find this blog. I wouldn’t want them to miss any of my ramblings, so I include the blog in both spots.
There you have it, the official run-down on the Laurie Levine LCSW LLC website. How would your day be complete without such vital information? 🙂
Let’s talk about high school reunions. My 30th reunion was this past weekend and I was unable to fly North to attend due to a much too heavy Fall travel schedule here in the not-so-South South. Several of my friends attended and based on the pictures, texts and phone calls I have received in the post-reunion de-briefing everyone seemed to have a good time.
I sit with high school kids every day, in my office, who share their pain about feeling left out, being different and believing that they are alone in suffering through this hell we call adolescence.
I have two thoughts running through my head as I re-read those last two paragraphs:
1. Why would anyone choose to go to a high school reunion after swimming in that pool of hormones and insecurities for four entire years?
2. By the time we are 48, isn’t it nice to realize that everyone has joys and worries, emotional maturity does happen and no one is supposed to weigh at 48 what they did at 18?
I was looking at a photo of my son and his tenth grade buddies and commented to my husband, “this picture will be priceless in 30 years”. Simultaneously, my son saw the hair loss and belly expansion in his future and wonders “how can I make it stop?”
Would I really make it stop if I could? There has been so much living and learning over the past thirty years.
When I sit with distraught, angry and sad teenagers, I know my “I’ve been there” mentality is not what can help them. I can listen and validate, sometimes I can throw in a story or advice (my favorite to share is that I skipped class once; Mr. McKerron’s 11th grade Honor’s English class because I hadn’t finished the reading for a quiz. As I left the cafeteria that day, I walked head-on into Mr. McKerron). That was my story and my shame having to explain to Mr. McKerron ( who spared me from any harsh detentions), but my telling it does not help these kids learn their life lessons. They need to experience their own “bustings” and consequences to develop their own personal morals and values.
When I want to shake my clients and explain that the “popular people” have insecurities and worries just like they do, they roll their eyes at me as if I am clueless. I get that it feels miserable at this moment in this teen’s life and I know that she doesn’t know that the pain will subside and heal in thirty years time. In the meanwhile, I give her the tools she needs to believe that she is as wonderful as the next girl; what are her strengths, what makes her feel good, how can she fill herself up with joy when she is feeling so low?
Everyone has suffered in some way – insecurities are universal. I didn’t know that then and I know these kids don’t know it yet. As I looked at the beautiful photos of my high school classmates I know that they each have happiness, troubles, insecurities and great laughs. Some have more money than me and less BMI than I, but at 48, I know that we all have bad days, silly annoyances and big challenges, even the popular ones!
I first saw it on FB (that won’t surprise anyone. 1. that it was on FB and 2. that is where I get my news alerts).
A friend had posted that her husband, who works at the Navy Yard, was safe. Confused, I turned on the television only to learn that yet another person had taken innocent lives with a gun.
My first reaction was out and out anger. I was pissed!
After watching too much news coverage on the local news, I returned to the ‘source’ and saw a friend’s FB post about “death to the Yankees” (clearly a die hard Red Sox fan). I gently asked if he would consider squashing or obliterating the Yankees in light of the recent news. He had, of course, not heard about the tragedy at the Navy Yard and quickly deleted the unintentional faux pax (Yankees or no Yankees).
This most recent tragedy is really eating at me. I am an emotional person and always experience the sadness and loss of these senseless acts; but the amount of anger that is upon me was unexpected.
Tonight a client told me about his five year old misbehaving. Apparently this adorable kindergartener had “decorated” his bathroom with his sister’s make-up. He did this not once or twice, but as of last night, FIVE times. His dad and I discussed his consequences and how they escalated in severity with each new lavatory masterpiece. We questioned what might be driving his behavior: negative attention, resentment at sister or just a budding artist?
Five times? He took his sister’s make-up five times? What can his parents do to help him learn from his mistakes? How can he convey whatever the message is that he is trying to communicate? There is clearly something amiss in the dynamics of this family system.
I return to the latest violence. Five times? I wish it had only been five times that some mentally ill person had taken a gun and redecorated the lives of an innocent family. What is the dynamic of this system? How many consequences need to occur before some parents somewhere get their act together and stop this misbehaving?
I can still be stunned when one of my kids looks at me as the “grown-up”, the one to make a decision, the one to make it right. Is it me, my peers, we adults that have to curb the insanity of this misbehaving?
I feel powerless.
I can vote, I can lobby and I can work diligently on the issues of mental health, but I can’t stop this insanity. An elementary school, a high school, a college, a movie theater, a marathon. These are our places, these are our lives, these are our friends and families that are getting killed – when will the grown ups make it stop?
After long days at work I can’t have the radio on during my ride home; I need the silence. One day last week I saw ten clients in a row. Poor planning? maybe, but due to scheduling, it is how it played out. Backing out of the parking spot at my office exhausted and heading home, my brain started to process the day and all that was discussed in my office:
Memories of sexual abuse, divorce, psychosis, anxiety, obsessive compulsive disorder, adoption, grief and loss, addiction, anger management, bipolar disorder.
That is a heavy day, and yet, despite the exhaustion, I felt really good. I am making a connection with a teen who, a few months back, literally sat in my office for an entire session without saying one word. Through an art therapy exercise, a young woman is beginning to feel some relief and joy. A college freshman looked bright and positive for the first time since I met him a few weeks ago while talking about his new job. And, I got a big thank you from a woman who sat on my couch this fall sobbing about her recent separation; she is now stable on medication and reunited with her husband.
At the red light on Fairfax County Parkway, I shiverred imagining what would happen if my walls could talk. Like the toys coming to life in Toy Story when the kids are absent, are my walls processing all that happens within their bounds?
Days like that can be emotional and wearing, but yet so promising. I have the privilege of witnessing these beautiful transformations. People are often at their lowest when we first meet and then via baby steps, they start to feel less hopeless, perhaps even hopeful as they make their way on to joy. It is so rewarding to be part of this process.
I do hope that my walls appreciate what it is that they get to be a part of, I sure do.
I remember when I was in my mid-twenties, had just received my Master’s in Social Work, and was working at my first job with the Prince William County Department of Social Services. I worked for a special grant program in the foster care department. I had a supervisor that had been at the agency for decades and I remember meeting with her about one of the families on my caseload. She was advising me on how to proceed with the family and I thought, while sitting in her stark government office, “how will I ever know what to do?”.
At that point I was feeling a bit confident about the intake session, that first appointment when you meet a family. It was straightforward, fairly prescribed and basically just gathering information about the family, getting history and demographics. I didn’t think I could mess it up that badly. What was supposed to transpire in the subsequent sessions terrified me. There were treatment plans to be written and decisions to be made about how to help the family, what services they needed and the idea that I was supposed to provide some kind of counseling? I.WAS.PETRIFIED.
Fast forward twenty years.
Last week a couple came into my office. Within the first thirty minutes of the intake session I had diagnosed each partner, assessed the faulty dynamics of their relationship and had a plan in my head as to how to proceed. Each client isn’t always as simple to assess, but I have continually been amazed at how I have learned, grown and developed as a therapist over the past two decades.
I don’t always do it right; I have clients disagree with me, get angry and even, yes, fire me, but overall I feel like I can get beyond the first intake session without crumbling into my own panic.
I have worked with certain clients for a period of months to years. Not only have I witnessed them change, grow and heal, but I have been able to see my patterns and skills improve as I work with these clients on a regular basis.
I have shared in other blog posts about my peer supervision group. These are the women that hear the panic; when I have a difficult client, or one of those “OMG I DON’T KNOW WHAT TO DO NEXT” moments I can’t call them fast enough. We have spent hours processing cases and guiding one another with clinical advice. The good news is that I have many more “Ah, that was a great session” moments than the aforementioned sessions, but when I am faced with a difficult case, it is so nice to have these talented clinicians with whom to consult.
I am not writing to toot my horn. I am simply writing because I have these moments that I realize, “I know what I am doing” and it makes me giggle. I can still picture that young woman in her supervisor’s office in the early 90’s, what a long way we’ve come.