Ariel Gordon shares some insights from her work in mental health care.
I received my creative arts therapy certificate in 2013 after nearly three years of studying music therapy, art therapy, movement therapy, and drama therapy. Since that time, I’ve interned at a center focused on welcoming every type of mentally ill adult, talked a multitude of individuals off the figurative ledge, and lost an equally disconcerting number of friends to self-harm. Between the homeless veterans, the runaway queer teens, the suicidal street musicians, and my own personal existential crises, I have a fair range of knowledge and experience. Here are some of the lessons I’ve gained from these times, places, and people.
1. The man who wanted to be loved
When I was interning at a day center for the mentally ill during my undergraduate studies, I met a man who had recently been released from prison. He had no particular diagnosis, but the moment I met him, I could tell he had difficulty understanding concepts and expressing himself. Nonetheless, he was one of the kindest and most sincere men I have ever met. If he hadn’t been a 40-year-old jailbird who lived in his mother’s basement, I would have been lucky to date a guy like him. Alas, he was not a catch. When it came to his personality, however, he was the most talkative, agreeable, and fun client I’d met up to this point.
What was special about this man was his desire to be loved. He had an insatiable appetite for food and money, and we couldn’t provide him with enough. As soon as I got him to try out art and dramatic performance, it became clear that what he also craved was approval. He would often draw himself as a young man, much younger than his actual age. Alongside this character of himself, he would draw a safe and comfortable home. He would leave out his mother and prefer to live with a significant other, and he would often tell me how much he liked me and the work I was doing with him. This work, of course, was primarily just talking to him, giving him attention, and showing him I cared about his well-being. He taught me about his inner-child, the one who needed a guide and leader in a way that not even money or a wonderful meal could satisfy.
2. The tough guy
During this same period of time, I also met another gentleman, I will refer to him as Charlie. Charlie was something of a tough guy, but a disarmingly likable one. He had all the exciting stories to share about his past and his knowledge of mafioso. Charlie was definitely a “cool kid” and he knew it. He liked to have his posse of well-respected and tough guys sit around one particular table. Some days they’d accept me into their group. Other days, I’d feel they were testing me or avoiding me.
One day, Charlie made a comment along the lines of, “You don’t do anything here. You’re the only intern who just sits there doing nothing.” This comment hurt me quite a bit. Previously, I felt confident, useful, and liked. I felt he must be right and quickly began to think I had made some mistake, was in the wrong field, and couldn’t do anything well. Then I thought, maybe he just doesn’t like me. Sure most of the time, we got along well, but I already knew that not everyone is going to like me. Not everyone has to like me. Of course, it could very well have been something he blurted while off medication or while on a drug or in withdrawal from a drug. He might not even remember saying it.
That’s when it occurred to me: This probably isn’t about me at all. Most of what a patient or client does to or with me has nothing to do with me, and I can’t take these things personally because the priority isn’t my feelings, it’s the patient’s recovery. My goal is to give them the tools I can to function in everyday life. Indeed, it may have benefited both of us if I discussed this outburst with him. In the moment, however, all I was focused on was how it hurt and how it triggered counter-transference for me. This was not beneficial to the client, certainly, and only caused me stress that could have been detrimental to the client/therapist alliance.
3. The lost ones
When it comes to the loss of people I care about, there is no way of taking it easily. There’s no “getting over it” or moving on. These moments affect a person for the rest of their life. This reality can become a challenge when the healer (the therapist) loses a patient, friend, or family member. Even losing a complete stranger to suicide or other self-destructive behavior can be extremely painful. That’s when you learn another necessary lesson: Not everyone can be saved. There will be people I meet along the way who I bond with or come to feel concern and care for, and these people may end up in a grave before I am mentally prepared for this. There is no doubt I am likely to blame myself and assume I could have helped them if I had done something differently, said something better.
This is not always the case. What I’ve had to learn (and I still struggle with) is the fact that, despite all my best efforts, there will be individuals who cannot be helped, or refuse to accept help. To get caught up in believing otherwise is only going to harm my own mental health. As a rule of self-care, it is always important to keep expectations of oneself and others in check. Just as you wouldn’t tell another therapist that they are at fault for a patient’s or client’s death, it is equally cruel and unfair to say the same to oneself.
4. All the lonely people
The most valuable lesson I’ve learned during my time involved in the mental health field is that patients are present to be helped. This may seem obvious, but a surprising number of individuals in the field maintain the belief that sick people come to them for recreation or in hopes of getting drugged up. Sometimes this is the case; as a matter of fact, it may often be the case.
That does not downplay the individual’s sickness. If a patient comes to your office seeking drugs to abuse, they clearly have a disease; an addiction. This is not something to resent or judge, it is an opportunity. For one reason or another, the patient is present and now you have the chance to help them cope with whatever it is that has hooked them onto their addiction. This applies as well to other mental illnesses. Your patient may be a pedophile or a rapist or a murderer, but these are his or her symptoms. Whether they are present because of court-mandated sessions or because they made the choice, a certain level of unconditional positive regard is a necessity.
This is not the same as excusing them, forgiving them, or ignoring their faults. Your forgiveness is not the important part of the therapy. What you want, think, or do is not the patient’s healing. The necessary piece is helping the patient to accept their actions and find ways to function without the destructive behaviours, if this is possible. If not, the patient must know what sort of actions to take next, whether it be prison, a psych unit, or other necessary steps to protect themselves and others.
Based on these experiences and lessons, I cannot claim to be an professional therapist. I can’t even say I have in fact seen it all. At this point, I would not be knowledgeable enough to sit in the therapist’s chair and change lives. There is always more to learn and explore in order to be the best at the job as possible. No man or woman can perfect the art of remodeling the mind, which is essentially the job of the therapist. However, moving forward, it will benefit me, and possibly you, to become more cognizant of choices you make, things you say, and what you feel about your work and those you work with in any setting. Everyone must go through his or her own experiences and make the choice that is judged to be most fit for a particular case. No book or exam or license can dictate the right response. As intimidating as it may be, a new way of thinking and behaving may be helpful. Strength is really knowing when to follow the traditional route and when to act naturally and from the heart. These moments will define your career and feed your passion.