Tuesday, October 07, 2014

Ayelet takes a shot in the dark

Woke up this morning at 3 am with a pounding heart. Not unusual, but hasn't happened for a while. Work has been very stressful; I walked in on one of my subordinate, joking around, giving the Nazi salute and saying"Heil Hitler" -- and my supervisor seemed more pissed at my reaction than her action -- i.e., I said in front of others, "Please don't do that" rather than taking her aside to discuss it.

I stood my ground and refused to give a written statement of my actions, because I didn't want it to be used against me, and my supervisor backed down. But only enough to meet with me and the subordinate to say that some jokes aren't appropriate for the workplace.

For the workplace? What about ANYWHERE?

That, and some other work shit I don't want to get into, has me on edge. Which could be another reasson for the insomnia and tachycardia. So I went online, did a little shoe/jewelry shopping, and while surfing MSN came across an incredible article: Ambitious plan to treat mentally ill inmates, built on a father’s anguish

By his count, Francis J. Greenburger has built or owned more than 20,000 apartments over the past 50 years.... Yet for all of his 20-million-square-foot empire, the project Mr. Greenburger may be most excited about — certainly the one he is most determined to build — is a 25-bed center to treat convicts with mental illnesses. 

"These aren’t criminals,” Mr. Greenburger said during an interview last week at his 15th floor office at 55 Fifth Avenue. “These are people who have committed crimes, mostly because they don’t know any better or they are acting out on impulse. And study after study has shown that prison only makes this behavior worse.”

I couldn't agree more. So I sent him my resume with this note:

Subject: Social worker committed to re-entry and reintegration for ex-offenders with mental illness‏   
         
Dear Mr. Greenburger,

I just read the New York Times article about your new initiative and had to write to you immediately. I don't know if you are hiring, but your organization is doing exactly what I have hoped to do since I entered John Jay's forensic psychology master's program in 2002: advocate and care for people with serious mental illness who are entangled in the criminal justice system. Because recovery is possible, but only in an appropriate and therapeutic setting.

In addition to my MA, I have my LCSW and CASAC, and I am a certified substance abuse detoxification acupuncturist. I've treated parolees, probationers, and other court-involved clients in a forensic outpatient substance abuse and dual diagnosis treatment program, I provided clinical supervision for 16 counselors in Beth Israel's methadone program, and I have some experience in supportive housing. I would like to submit my resume for your consideration, or just to meet you and share ideas.

Sincerely,


Ayelet's name and 11 more letters

I forgot to mention Andrea Yates, who really catapulted me into this field, but I think it's still a pretty good letter.

I also interviewed for a different re-entry job at an agency that assists young ex-offenders with career development and placement. It's very clinical, because in order to go from being a drug dealer to being a legit employee, you have to make significant changes to your mindset. I sent them my resume on Saturday, and on Sunday the CEO emailed me to ask me to call and set up an interview, which I attended a week ago.

I thought it went well. I interviewed with him and his second-in-command and sent a thank-you email as soon as I got home. I think he intended to forward it to the second-in-command, but responded instead:

She has the passion, that's for sure

I do share your connect ability with the guys

I bet [name redacted] would like her

Haven't heard anything, but it felt good to be interviewing. To get my LCSW I spent way too long in a job I hated way too much. So I'm going to explore my options aggressively if I'm not happy. I've worked tirelessly for my current agency, I've been incredibly productive and creative, and yet I still get blamed for everything that goes wrong. Like being saluted with "Heil Hitler." So if I get a better offer, or even an equivalent offer, I'm moving on.
Copyright (c) "Ayelet Survivor"

Friday, October 03, 2014

Speaking in tongues: The Fake-Nice Social Worker, the Angry Psychiatrist

I have always been a straight shooter, speaking my mind and letting people know exactly how I felt about what they are doing. That is not always effective; it failed me spectacularly in my first job out of social work school. Now that I'm a manager and have to deal with outside agencies and clients at a fairly high level, I have to be effective. If' I'm annoyed at someone, I can't just tell them. It's simply not pragmatic, because then they'll get annoyed too and won't do what I want them to do.

Deliberately managing how I speak and interact with people feels duplicitous and manipulative to me, but for most of the world I think it falls under the category of "diplomatic" and "think before you speak." So I'm learning how to control and strategically deploy my tone of voice, rate of speech, and choice of words. (Apparently being a manager means managing yourself more, not just your subordinates.)

Right now I've developed two basic modes of communication that are more effective than the Ayelet blunt go-to of "This is how I feel and what you have to do because I say so." It sometimes surprises me how effective they are.

The Fake-Nice Social Worker


This is the tone and demeanor I employ when I'm trying to get an annoying person to stop doing the inappropriate thing they're doing, like calling me or a case manager incessantly to check on their application (still in progress, just like it was yesterday) or showing up at the residence every day to see if they're qualified to apply to live there when they are not. (This actually happened.) Or when I'm trying to get them to do something they are reluctant to do.

In person, FNSW begins with a big smile, like I'm seeing one of my nieces or nephews and I am delighted they're there. On the phone, I add an element of delighted surprise when they identify themselves and I greet them. Then I ask how they're doing, pretend I'm interested in their answer and respond accordingly, and speak in slow, soothing cadences with lots of pauses. Unlike my usual rapid-fire peppered-with-witticisms verbal delivery.

I guess I use a similar tone when I'm conducting therapy with clients who are fragile and need more emotional holding, but then I have a clinical justification for not talking the way I usually do.

When I lay the bad news on them, my tone and expression turn tragic, like I'm so sorry I have to tell them this and it just isn't fair but lamentably, that's the way it is and I am powerless to do anything about it. I explain painstakingly why the bad news has to be and offer hope that maybe some other solution will work out, or, if there is something they can do, encourage them to do it as though their doing it is personally important to me.

I hate being in FNSW mode. It feels completely artificial and manipulative. But I can't think of another way to get people to thank me for giving them bad news.

The Angry Psychiatrist


This is the tone I use to convey extreme disapproval without getting loud or abusive. It's called "the Angry Psychiatrist" because I've never met a psychiatrist who actually yelled at me, yet they manage to convey extreme quiet disapproval. Psychologists don't seem to have the same stricture, because I've gotten yelled at by good ones (Albert Ellis) and bad ones (Dr. Jerk).

AP is also delivered more slowly than my normal discourse, but the pauses are ominous, to give them time to take in the measured disapproval. I explain in painstaking detail why what they are doing or saying is inappropriate or inaccurate, such as an agency again sending us one check for several clients when we requested, in writing far in advance, separate checks for separate clients. I clearly and slowly detail the negative consequences that such conduct will likely lead to if they do not change what they are doing.

My psychiatrist friend Joey hates when I make fun of psychiatrists, but it was actually an argument with him that inspired me to create this persona. I think at one point he said, "Well, I'm very sorry you feel that way" and I cried, "Don't do that! Don't talk like I'm an annoying patient and you're the angry psychiatrist!" I don't think he's done that since, and I would much rather he yell at me than treat me like a difficult patient.

I have to be careful how much I use AP because at the end of the day it still reveals you're angry. But it's much more effective than yelling and getting frustrated.
Copyright (c) "Ayelet Survivor"

Wednesday, October 01, 2014

I know it's been a long time...

Lately I've been taking more to Twitter than blogging to express myself. Maybe because I'm really, REALLY busy at work, which is generally a good thing. Also because I just survived a hellacious monthlong battle to get my insurer to cover one of my antidepressants at my dose, not their idea of what my dose should be. (And I totally had to twitter-shame them into it.)

I'm doing okay, but if you really want to know what's going on with me, I suggest following @ayelet_survivor.
Copyright (c) "Ayelet Survivor"

Sunday, August 31, 2014

Practice makes perfect?

Never ceases to amaze me how bad I am at online dating, or dating in general. OKCupid is known for having tons of men who send out generic emails to tons of women in hopes of playing a numbers game -- maybe a few will respond. Here are a few examples:

  • Hi pretty how you doing today that is a lovely smile you got right there on your profile pic. Do me a favor always keep that smile on your face.  
  • You have a contagious smile and look that invited me to your profile. I am writing you with hope of sustaining a connection with you, i feel we have a lot we could explore together, i would love to learn more about you if you don't mind. Go through my profile and write me back if anything about me piques your interest. Honesty is important to me and i love the simple things in life. This is my first time on a dating site and am hoping to make it count.....I look forward to your response. Hugs
  • Im Jack, just wanted to say in all honesty. you have to be one of the most beautiful women I have seen in forever. you have stunning eyes and a stunning smile. simply gorgeous   
  • Just wanted to say you are truly a beautiful woman...you seem intriguing and classy..I'd love to get to know you better...if you give me the opportunity to... 

But recently I got an initial email that sounded a bit more sincere:

You have one of the best profiles I've seen... gorgeous photo, of course; you really did put some time into it and have a nice way of expressing yourself. Anyway, in addition to liking your comfortable and also confident look in your photos, thought we'd have some things in common... Would be great to hear back from you.

Normally I wouldn't have responded, because he is not Jewish and "somewhat serious" about Catholicism. But I thought he sounded interesting in his profile, and his picture was cute, so I responded:

Thanks :) I like writing, and when I'm with friends, I'm always comfortable & confident. You express yourself well too.

It's been two days, and no response. I'm wondering why. Possibly he's busy; it's Labor Day weekend, after all. But why be so enthusiastic in an initial email and then completely ignore my response? What did I do wrong? Should I not have suggested that I'm only comfortable and confident around my friends? Did I not sound interested enough in him?

Or maybe that's just his initial email to everyone, and someone prettier and younger also responded to him.

I totally suck at dating. Online and offline.
Copyright (c) "Ayelet Survivor"

Thursday, August 28, 2014

You're not an addict. You're a borderline.

Yesterday I was at an all-day "safety" training, which intends to teach employees how to de-escalate clients who are very upset or angry. The idea is to calm them down verbally before they become physically violent, although you also learn how to break out of various ways people can grab you.

During the training, the topic of mental illness and violence arose -- understandably, since we work with people who have mental illnesses, some of whom occasionally might become violent. The trainer, a program manager, was talking about one of her residents who frequently displays aggressive behavior.

"She's a borderline," said Tessie Trainer. "You know what a borderline is, right?"

Well, no, I don't. I know that some people have borderline personality disorder, and that many of them have difficulty managing their anger and impulsive behavior, so sometimes they are aggressive or violent towards others. (Or themselves.) But it always bothers me when people use psychiatric diagnoses as adjectives. I'm not "bipolar" or "a bipolar." I have bipolar disorder, but it's not my only or my primary defining characteristic.

This became even more striking when Tessie explained how our formerly homeless clients have been marginalized and stigmatized for being homeless or abusing substances. They've been ignored, stepped on, attacked, and labeled.

"I tell them, 'You're not an addict, you struggle with substance use,'" she said.

I didn't think it was my place to point out the glaring inconsistency. First of all, I'm still on probation. Second, I didn't want to call her out in front of everyone. But it bothered me. If we're not going to stigmatize our clients for their substance use, we shouldn't stigmatize them for their psychiatric illnesses.
Copyright (c) "Ayelet Survivor"