Visceral

An interesting experience today. I am still thinking about it, obviously.

I was working on case management stuff in the office this afternoon and was slightly aware that an issue was happening in the next office over with a client that was endorsing some psychotic features as well as homicidal and suicidal ideation. I let my supervisor know that I was available if they needed help but never heard anything. About a half hour later, I was preparing to leave and I peeked down the hallway to see if everything was OK. My supervisor gave me the thumbs up sign and so I headed for the door. It occurred to me to check on my friend, the clinician dealing with the client, but I dismissed the thought thinking that I would just add to the drama rather than just letting it pass.

As I walked down the hallway, one of our psychiatrists said, "Alison, someone's calling you..." Sure enough, it was my friend. Now I'm kicking myself for not going to her first. I walk into her office to see what's up and she tells me that she just wanted someone to walk out with her. "Absolutely" I tell her. I wait for a moment as she gathers her things and notice that her face is crumpling. Getting red and emotional.

It hits me then that she just had an awful experience with that client. "What happened with that?" I ask. Her tears start fall and she is embarrassed. "Don't tell anyone that I'm crying", she says. "He just got to me." He got to her. My heart sinks for her. I know that feeling. Poor girl. They sometimes have this way of making you feel so vulnerable.

I tell her what I knew of the situation and tell her that it sounded scary enough. "It was that...but there was something about him. The way he was looking at me and he kept talking about voices that were following him. He was just so creepy. I think I got scared that I would be left alone with him." She pauses and then goes on. "You know how sometimes people tell you something and then suddenly you want them to stop, like you don't want to know anything else about them? Like it is too much? He just kept endorsing all these scary things and I just wanted it to stop. I don't want to be responsible for all that."

I shudder and believe her 100%. I didn't see him or even read his file, but when someone makes you react that fiercely, you have to listen. That visceral, gut reaction is so telling. And I think it goes off for different reasons. Sometimes it is a professional instinct. I think in today's instance, though, it was something different. Something more primal--like "you are a threat to me." To see her so shaken, I wonder if it was something about good vs evil. She clearly felt unsafe and threatened after only knowing him for an hour. What makes a teenager like that? I guess I find myself wondering if he was actually evil.

What is it about those people? What makes them so sick? How capable are they of committing the most horrific of crimes? How inevitable is it? How soon?

I am home now but keep thinking about my friend and sorry she had to cross paths with someone that sick in such an intimate way. In her tiny office in the corner of our little agency. In the afternoon when most everyone was already gone. When the snow was starting to fall and the sky turning grey and ominous.

"He's sick and needs help but I don't want him in our program." I'm remebering her saying. Her tears were falling again. "There's just something about him." She tries describing him again. I get the impression this young man knew his thoughts were demented yet almost got a high talking about them.

My friend and I are both small females. Young, blond, kind. Although we have our strengths and belong in this field just as much as the next person, days like today make me remember that we are perhaps more vulnerable than some of our cohorts.

She ultimately ended up cutting the evaluation with this client short "because of the weather" and I'll sit with her when she does the second half of it. My supervisor intervened by grabbing this boy's father and assessing for weapons in the home and making a plan to ensure that this boy would be monitored until he could get more help. This boy's father didn't take my friend's concerns seriously normalized the boy's thoughts. He's not going to do anything, we suspect.

It makes you wonder if this father has become so helpless when it comes to his son that he has to normalize things just to get through the day.

Working in this field does interesting things to your perspective, sometimes. I was telling my husband the other day how happy I get when I see teenagers do positive things because I have started to think that all teenagers are on the verge of spending their lives in jail and/or be addicted to drugs.

At the same time, those of us in the field understand the spectrum of what type of people we can help. Our version of normal. For our agency it's: Conduct Disorder? Check. Substance abuse? Check. Truancy? Check. Criminal behavior? Check. ADHD? Check. Runaway behavior? Check. Bipolar? Check (if medicated). Psychosis? No. Homicidal ideation. Not if active.

So now I say a small prayer for my friend. Heavenly Father, help her forget that scary person. Help that father find the right treatment for this boy. Keep us all safe from the sick people.