Today I had lunch with my friend, P. (she shall remain anonymous because she doesn't know that I'm writing this. yet.) I've told you about P. a lot of times-- she is an amazing powerhouse of a woman: a feminist, a mother of six, a Social Worker (the real kind, with the licenses and stuff), a Mormon, a writer, a thinker about social issues, and she's working on her PhD in social work. I've watched P. work (she is the clinical director at the drug and alcohol tx center where I work and was also the director of an enormous domestic violence shelter where I worked) and she is, to me, a model therapist. In the face of a screaming client, she is firm and calm. Despite the deep-rooted struggles of the clients that often cause them to lash out and blame others for their frustrations, P. always prioritizes their needs and sees beyond the requisite diagnoses to the raw, vulnerable person. I can tell you how hard that can be, but you know. In residential treatment centers, staff members have unusual relationships with clients. The women and little kids who are living at our center are being watched 24 hours and sometimes, instead of watching for ways in which we can help them in their treatment, or watching for their safety, or for opportunities to intervene and be a supportive, strengthening force, we watch for them to screw up. We sometimes anticipate, without cause, that we will be lied to, manipulated, and treated poorly. I wonder if they feel the same way about us. I think they must.
P. and I talked about therapeutic boundaries today and the emphasis that current practice is placing on care workers keeping themselves at (more than) arm's length away from the client (literally and metaphorically). I'm distressed by the assumption that the social worker and the client (or consumer, or whatever term you prefer) must be so far away from each other that one person is always vulnerable and examined, and the other is beyond reproach (at least in the office, tx milieu, or group therapy). P. remarked, "If they only knew..." and I laughed, knowing that my badge and keys don't make me any saner or "put together" than any of our women. What separates me from our clients is privilege. If I hadn't been given all that I have (school, money, love, support), there is a reasonable chance that I, too, could be a meth addicted mother who hasn't got a home or car. There are very few links in the chain that separate most of the people I know from being in serious trouble. Is this right? I think it, and say it, but I don't know if I just feel how dangerously close my life could have hit bottom (or could in the future, who really knows?) because every time I work I do the math of my own life.
We talked more about therapeutic boundaries and I lamented the lack of touch in most treatment centers. I was taught very well by two amazing women who work with adolescent girls, about the power of fingers on an arm, or a hand on the back. It's not easy to learn, and even more difficult to do well, but the gaps that can be bridged are enormous. At once, a connection can become warm, energized, or, most amazingly, familial. P. told me about a tx center in Canada where a kind of guru woman has developed a program for girls with eating disorders that is based on the richness possible in more personally connected therapeutic relationships. The center is an old house and every girl has an adult mentor and, as far as I could tell, the eating disorder was secondary to the whole health of the girl. As P. talked, I felt my heart kind of racing, because I knew you would be right there with me. THIS is what we can do. Whatever crazy scheme we hatch in the years to come will not be without connection and intimacy with those with whom we work.
Again, I have gone on far longer than I wanted. I'm thinking about you and others in my posse and dreaming that Bill and Melinda Gates will single us out for our charter school (or whatever we'll end up with). Here's hoping that when the cash comes through, there's enough for me to get a new pair of jeans and some Dansko sandals.