... on social work

it is often said that social work is a pretty thankless job.  and even though i am new to the profession, i have seen this to be fairly true. when people are in a crisis, psychotic, being hospitalized for severe symptoms, or unable to meet their most basic needs, i am guessing that the last thing on their mind is remembering to say thanks.  and i can assure you that when working with someone who is in a crisis, being admitted to a psychiatric hospital, or does not have a place to sleep or clean clothes to wear, the last thing i am concerned about it getting a 'thank you.'i know that the same can be said of many other professions and that a lot of our work today is challenging and testing.  i didn't choose this profession so that i could be thanked, nor do i assume that i deserve anything for doing the job i am paid to do. but in a profession where you are constantly giving of yourself-- your heart, your energy, your love, your education, your best attempts to help--it's nice to have your 'cup' refilled, if you know what i mean.  and today i was given the best thank you i've ever received. her story is not mine to tell, but what you should know is that, like many other people who have been diagnosed with a severe mental illness, she spent a significant portion of her life hospitalized. over medicated.  incorrectly diagnosed. in a fog. homeless.  accused of using illicit substances. she has been receiving mental health treatment for 30+ years which has included visits with several psychiatrists, psychologists, doctors, nurses, social workers, policemen, therapists, and case managers.  she has been tested on several anti-pyschotic medications that did not help, and finally found one that did.   and because of the symptoms of her mental illness, her life has been hard.  she's had to give up on old dreams and find a different way to live. we've been working together for around six months, and i can remember the day we first met as she told me about the one person who has made a difference in her life.  the psychiatrist that was there for her when it seemed as though no one else was, the only person she felt that had provided her with any kind of real help. i remember being both happy and sad after she told me that.  happy that she had received some help, but sad that she could recall just one person out of all the people who had been involved in her treatment.as our session was drawing to a close today, we began discussing symptoms of her diagnosis and how far she has come.  i am always fascinated by our conversations and the insight she has to offer regarding what it feels like to be psychotic, to hear voices, and  to live with a mental illness. i find myself constantly humbled in this field of work; while i can understand the symptoms and different approaches to treatment, what i know is that she is the expert.  she is the one who has lived with the mental illness.  she knows what it feels like.  'i've had a lot of therapists and hospitalizations in my lifetime' she explained, 'and i'm not really even trying to compliment you when i tell you that you've surpassed them all.'  she continued on to say that i had out-shined the psychiatrist she had spoken so highly of on our first session and that she couldn't believe  a 'twenty-something' year-old girl had something new to offer to make her feel like herself again.i asked her what she considered to be helpful.  what felt different.  and what specifically about our therapeutic relationship seemed to be working. she had three specific responses-all of which are applicable reminders on how to treat one another:

• "1.  you stay focused. you hold me to high expectations.
• 2. you treat me like i matter. like i'm not a mental illness or burden on society, but rather, a person.
• 3.  you're genuine."

she didn't mention the therapeutic approach i utilized, or my improved understanding of the purpose/dosage of each of her 16 medications.  she didn't say it was because i completed a treatment plan on time or gave her the best advice.  she didn't talk about arriving on time for scheduled appointments or my knowledge about mental illnesses. that stuff didn't even matter.....i will never forget the way her eyes watered up just a smile was spreading across her face.

 "Don't lose your heart" she said, "because it's changing mine." 

    the field of social work is challenging and trying.  there are catch-22's and ethical dilemmas.  there are problems with no solutions. and there are answers but no short cuts.  there is stigma.  there is giving up and being frustrated.  there is a past to overcome and a future to find. and too much paper work.  there are long work weeks and emotionally challenging situations. obstacles to overcome, bridges to build. barriers at every corner.  and then there are the people.  and they make it all worth it.