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Text of the page (random words):
ithout informing him i have had patients tell me not to bother calling who then call a week later asking to be put back on the schedule i ve been fired twice by the same patient and then when i call the next week she resumes with me as though nothing happened i have basically taciturn non communicative patients ask for the teletherapy session and then be floored when i point out that we need to be talking or its not much use one thing that i do now that is entirely new i send cards to a lot of my patients just cheery notes so they have something to hang on to between sessions the borderline patients often have both separation anxiety and lack object permanence so they love it the paranoid ones love it too but they scold me fondly for putting too much information into it since they believe that their housemates are creeping into their rooms at night and reading things left out but its ok one told me i keep it in my pocketbook so no one else can see it but you should really know better the letter had said i look forward to our next session on ___ date ok got to run the day begins posted by aimai at 5 24 am 4 comments email this blogthis share to x share to facebook share to pinterest friday march 6 2020 mental health day how time flies i ve been at this for more than a year now and i don t come over to my own blog much i m taking a mental health day today and spending time in a cafe with mr aimai and i suddenly really wanted to share some of the work with you all victor if you are reading and yaz thank you so much for keeping an eye out for me i think of you both all the time and look for you on the net life at work continues to be enormously satisfying there is something about passing that one year mark i feel now like i ve seen almost everything at least once on one memorable day i had to handle the possible new patients multiple people who show up and just ask to be seen and have to be evaluated and also a walk in guy who just wanted to have his hand held this meant rocketing from an elderly clubfooted gentleman who was sent to us by his priest for too much sinning aimai is it a cardinal or venal sin man its a mortal sin to a sad eyed elfin girl who insisted on speaking for the whole meeting through a large stuffed hippopotamus and who was working at a vegan cupcake store because of course she was there was the elderly barfly from the wrong side of the white tracks who thinks matt damon stole his life story that was me working in mit i m a genius i ve had my identity and my work stolen many times i also wrote fast and furious the god s eye episode there was the super paranoid schizophrenic who thinks he is just depressed and thinks he has been treated for depression for 20 years instead of for schizophrenia he is sure that an international conspiracy has robbed him of his life they are against me that is why i m not married aimai an international conspiracy if they are so powerful why aren t you dead yet man oh well maybe they are going easy on me he is very snotty with me no offense but i would rather work with a psychiatrist or a psychologist or someone with a ph d aimai well i do have a ph d but not the kind you are looking for no doubt however you will just have to make do with me as the psychiatrists and psychologists are too expensive to give you therapy and you seem to need therapy him ok well can you tell me in the five minutes we have left how to reduce my paranoia aimai no not in five minutes come back regularly and we ll see what we can do reader he didn t i have been fired quite a few times by patients who don t like to work with me but i ve also had the enormously satisfying experience of having patients come back a few months later and tell my manager i want to come back to work with aimai it feels like a boxing match but i know that something is happening i can feel the change my new therapist was a guy and he never said anything what was the point i found out that this guy middle aged white ethnic guy was coming back to me on the same day that i had another revelatory moment which i bundle into the observation that for some white ethnic guys from an ethnicity which will not be named shouting shut the fuck up turns out to be very soothing they literally don t feel seen by women or therapists if you don t match the intensity of their emotional level i had a very wonderful miserable collapsed chaotic patient the kind of guy who has a permanent black cloud hanging over their head and who always makes the wrong choice every time increasing his misery and his poverty and stress limp in on a cane back against the wall struggling to manage his status and housing to discuss his depression he had injured himself having unsafe sex with a drug addicted homeless woman really embracing sex and death at the same time eh i said unsympathetically come on doc that s harsh me look i ve got to call it like i see it i get it but this is risky for you and her we need to get ahead of this because you are at risk of losing your housing and you are distracting yourself with primal shit he argues pouts complains with all due respect doc you gotta let me make my point we were on a short time line and we had paperwork and other stuff to do to save his housing and i ended up cutting him off with the therapeutic adjuration stfu for a minute and he gave an enormous sigh and got up to go and said with a look of complete bliss i feel better i really do i was so depressed when i got here and now somehow i feel better i was telling this story to my coworkers in team arguing that you have to co regulate with your clients by meeting them at the intensity that they are at and then bringing them down to functionality if someone says i ve got a problem you have to agree at that level yes you do and i m listening or they just don t know that you are listening one of the others who had handled this guy for a year before me said suddenly oh my god no wonder i never got along with him i m half canadian all patient information has been anonymized and changed so that no real patients are described descriptions are composites and not true to age sex gender race or diagnosis posted by aimai at 7 22 am 2 comments email this blogthis share to x share to facebook share to pinterest sunday december 22 2019 my new life all information about patients or staff has been anonymized and altered as to gender age race and history in order to provide anonymity to everyone i am entering my sixth month working with people with psychotic disorders schizophrenia schizoaffective a mere bipolar with psychotic symtpoms seems like a walk in the park i fell into this job being offered it after being turned down for three others it is in an awful building physically he a homeless shelter in it as well as one for sex offenders the population we serve are severely disabled by their psychosis impoverished frequently homeless or hospitalized i have both male and female patients and some who are gender fluid or in transition i have people who hear voices and have command hallucinations to hurt themselves and i have people who are merely delusional and have fixed and unrealistic or bizarre beliefs about their own lives and that of the people they meet i have paranoid schizophrenics a whole other ball game i have professionals occasionally who manage their symptoms and lead an ordinary life and people who are nearly catatonic and utterly lack insight this work is so new to me that i am frequently reminded of my early days as a new mother my husband and i would turn to each other and say can you believe it because we could remember the time before before needing a babysitter to leave home before needing to plan ahead for baby disasters for me the time before includes being in control of my own time instead of working like everyone else how did i miss this nine to five monday through friday i get up at five thirty shower and get on the bus and take myself to a cafe for an hour to make notes to myself about the day ahead or the day before or to read for my trauma class which meets most monday nights at a nearby university for two and a half hours then i get on the subway and head into work aiming to be there by 8 15 and work without a break or only stolen breaks until five when they kick us out of the building because it is too dangerous to stay later if i come in at 8 30 the homeless men and women are leaving the shelter for the day and walking into work through the ugly basement door that is assigned to us is like walking through a cloud of smokey zombies the ones who are my patients greet me happily the others who are in various stages of sleepy distress or confusion simply ignore me if i leave early at four thirty they are coming back into the shelter and there is a lot of sadness and despair pooling in the hallway and the elevator i found this daunting at first and there are other people in the office who tell me that they never take the elevators at all because of anxiety about being attacked or because for an entire summer someone was peeing in the elevator and they never found out who it was the significance of the awfulness of the building is this my civilian patients those who come to us from the outside world that is not defined by poverty and mental illness have a really hard time accepting that this is their new life that their new life with their mental illness brings them into close contact with poverty trauma grief homelessness there is a safety net for our patients and we are it we treat our patients with the utmost love and respect but the environs are scary and the prognosis is not good mental illness such as our patients suffer is no respecter of class or race and even a wealthy suburban white family with everything nominally going for it can buckle under the weight of the demands that a family member with very resistant mental illness like schizophrenia or psychosis can place on it let me take a moment to praise the people i work with i can not tell you how beautifully the other social workers and nurse practitioners and doctors that i work with treat our patients every patient has someone on staff who just loves them its almost absurd some times the way everyone has their personal angel advocate who will say to you spontaneously i just love x such a wonderful person even about people who at first glance seem completely unconnected to reality and to their surroundings i have a patient who i will call gandalf who has been hearing voices since his teen years he is now very very old he comes in and sits in my office and we have intermittent conversations while he is dialoguing with his inner voices when we do speak he is courteous and thoughtful but what he says is often very bizarre one of my proudest moments in treatment in our first session is when he commented on flowers i had in my office and after listening to what i had to say about the flowers he said dismissively that his voices thought the flowers are not important i said i think the flowers are important because they help people recognize the passing of time as the flower grows from bulb to flower to seed and also because they beautify the surroundings after a long long long pause he suddenly said i think i disagree with the voices i think the flowers are important imagine that i brought this up with one of the other practitioners and they said to me when i worked with gandalf he wouldn t come into my office because he thought there were bears in there he has really come a long way their voice as they said this was so full of love and respect for gandalf and for the work we are all doing trying to as we say hold and contain these patients so often lost and disconnected from everyone else in their lives posted by aimai at 7 07 am 9 comments email this blogthis share to x share to facebook share to pinterest sunday november 18 2018 i m back not sure how to handle the new privacy issues i seem to have been gone from my own blog for so long that just finding it and finding my own way in was quite the struggle the reason is that for the last two years since 2016 i have been back at school getting my msw and interning at two places where i felt that the privacy issues for my clients and or patients were too complex for me to handle with a quasi public blog that s even more true now that i ve graduated and begun my first full time job as a newly minted lcsw however i also feel like i really want a place to explore some of the theoretical and intellectual issues in my new work which is providing clinical care to people with psychotic disorders so i think i will open up my blog again to at least post about the things i m reading and the issues that arise for me theoretically while doing this work so stay tuned posted by aimai at 12 21 pm 17 comments email this blogthis share to x share to facebook share to pinterest monday january 30 2017 combating the sore loser meme the boston globe published a story today about the mammoth pro refugee immigrant rally in copley square yesterday i was still nursing a broken toe and didn t go and i d be kicking myself for missing it but broken toe on the other hand i forsee plenty of chances to rally and protest in the near and far future so i m not heartbroken there were two quotes from republicans in the boston globe story charlie baker gave mitch mcconnell s response which was to pretend that this was all business as usual and that the courts would fix things somehow not a constitutional crisis not an unconstitutional act not immoral just kind of not great but if we d all calm down and let the grown ups handle it things would be better the other was from trump s ma campaign manager interesting that they couldn t get one or two of our few republican state reps to comment and he gave the other party line you were warned you can t complain now actually what he said was even more interesting deliberately drawing attention to the fact that president obama had delivered this mild rebuke to the republicans after his election he said elections have consequences and president trump promised to do all this during the campaign paraphrasing we are going to hear a lot of this in the future but its not really an answer to the protests we aren t protesting because we don t realize the election had a consequence that put trump into power we are protesting because his actions are illegal immoral and we don t like them this has nothing to do with the legitimacy or otherwise of his election and it has nothing to do with numbers for or against his policies it has to do with legal illegal moral immoral justice and injustice and this is a point we need to be making to the remaining trump voters as well as to the voters and non voters who were essentially on the fence or ignorant of the choice they were making or voting out of spite we need to emphasize as people already do in their signs the larger moral and safety issues i also think we need to start banding together in affinity groups an...