Tuesday, September 27, 2011

Up and down, precipitously

Work today was very busy. I don't know why I ever thought that the patients at my last job -- mostly on parole from state prison -- would be inherently more interesting than the patients at my current job. I don't think it's a confidentiality violation to say that today one of our patients came to get medicated without any pants on. Heroin users are fascinating.

So I was busy and happy all day. I didn't have to tell the guy to put his pants on; that fell to CM the clinic manager. But I was occupied with various tasks and really enjoyed being busy and thinking hard. Thinking is a big part of my job. Thinking and coming up with solutions. And at various points, I was able to stop (metaphorically, not physically) and realize I was happy.

But on the subway ride home I was miserable. Thinking about the upcoming holiday and how I don't want to be a single person at family tables. I felt some painful twinges around my left ovary and started worrying that my fibroids have spread from my uterus and that now I have ovarian cancer. And the worst thing about that wouldn't be dying. It would be losing the chance to have children.

I don't know how I skyrocketed from near-euphoria to planning my death. But I'm wondering if it's related to the hard candy I had earlier in the day. CM keeps a big bowl of candy in her office, and I'm in and out of her office frequently, so occasionally I dip in. I had a healthy lunch, but I'm wondering if I'm so sensitive to sugar that it could affect my mood that dramatically. Or if it was just me feeling happy when I was busy and needed, and sad when I was alone and ignored.
Copyright (c) "Ayelet Survivor"

Sunday, September 25, 2011

This is when not having family is hardest

This year the Days of Awe hit in 3-day cluster bombs. That means 6 meals per holiday that I have to scramble for invitations. I just can't do it. Alona invited me for second day lunch on Rosh Hashana. Just her, her husband and children. I don't have to pretend to be "normal" or happy. I can just be myself.

But I can't do that in front of strangers. If I look tired or sad, they'll want to know why, and I can't tell them, so I'd have to make something up. I'm tired of lying. And if I ask for an invitation but then feel too terrible to attend, that's just rude. That's what I did Pesach 2009 -- I lined up 4 meals and only went to one. I called to apologize after the holiday, but I still felt bad. Better not to ask.

But that means I'll spend a lot of time alone, which also isn't so good for me. When I'm alone I tend to ruminate about my situation. How I'm 41 and single, and my prospects are dimming. How I'll probably never get married and have children. And fear this is what the rest of my life looks like -- alone in an increasingly cluttered studio apartment.

I don't want to go to my sister. I'm tired of how she mocks me in front of other people, belittles me and then pretends it doesn't matter. Not to mention breaking most of her promises to my detriment. And I'm still angry at my mother for screwing up my adolescent development. I don't want to see her, because she can't do anything about it. Or rather, she refuses to do anything about it. People do bad things to me and are never held accountable. The driver of the car that hit me, the personal trainer who injured me, the co-workers and bosses who treated me so unfairly. I can't stand to see so many people hurt me and get away with it. So if the filthy pervert isn't going to be punished, then his enabler is. Somebody has to be.

I'm not looking forward to Tishrei this year. I wish I could just sleep through it. Last year I asked God -- I begged -- to write me in the Book of Death if my life wasn't going to be better this year, if I wasn't going to find a husband and have my own family. My friend Margalit pointed out that this year I'm doing better professionally -- I'm not being harassed or mistreated at work. Which is something. But it's not enough to live for, if every day I come home to an empty apartment like RoboCop.

Every year until last year, I asked for a better year, and everything always got worse. Last year I asked for death, and it got marginally better -- but only after more excruciating suffering. I don't know what to ask for this year, because my prayers are never answered. Whether I ask for a husband or to die. Whether my life gets better or worse, it's completely arbitrary, and I have no control over it. So there's no point in praying.

When I first became observant, I tried so hard to follow the minutiae. (Except shmirat negiah, of course.) I tried to make sure I heard every shofar blast on Rosh Hashana and Yom Kippur. But I still got sick, got fired, got dumped, got into fights with my roommates. Last year I didn't hear the shofar at all. This year I don't care if I do.

I don't know what to do. I don't want to sit at strangers' tables. I don't want to try to meet new people, because until they really get to know me, I have to pretend to be normal when I'm not. I'm just tired of trying.

Last week I found a strange purplish-black bulge on my arm, near my elbow. I assumed it was either a new mole (I have many) or a blood blister. It fell off Friday night leaving only a small slash in the skin. Like some kind of bite. Now I'm convinced it was a tick bite and I'm going to get Lyme disease. And I cannot live with bipolar disorder, bad knees, intermittent back and shoulder pain, bad sinuses, and Lyme disease. There's no circular rash, so I doubt my doctor would believe that it was a Lyme-bearing tick without any evidence. I guess I could ask the PA at work if he thinks I should go see a doctor.

But if I develop Lyme disease, I'm going to end it. I have too much to deal with already. I can't handle another major health crisis on my own, and if I get any sicker, my life will not be worth living.
Copyright (c) "Ayelet Survivor"

Saturday, September 24, 2011

Awarded

A dear friend (former social work school professor) named Katherine Gordy Levine, who blogs at http://emotionalfitnesstraining.com,  asked if she could nominate me for a blog award, if my readership was under 200. Well, I've had numerous visitors in the past, but I don't think more than 200 people read my blog on a weekly basis, so I accepted. It's called the "Liebster Blog" award.


The goal of the Liebster Blog Award is to spotlight your favorite up-and-coming bloggers. Rules are:

1. Thank the giver and link back to the blogger who gave it to you.
2. Reveal your top 5 picks and let them know by leaving a comment on their blog.
3. Copy and paste the award on your blog.
4. Have faith that your followers will spread the love to other bloggers.
5. And most of all - have bloggity-blog fun!

Katherine's blog choices were:

Daniel Voyager at http://danielvoyager.wordpress.com
Dr. Fran Babcock at http://drfranbabcock.wordpress.com
Don at http://bwinwnbwi2.wordpress.com
and a fifth she is still deciding on.

My first blog choice was easy: Foster Parenting Adventures (http://fosterparentingadventures.blogspot.com), by Tikun Olam. A clinical psychologist, TO chronicles her work with underprivileged teenagers, and has also opened her home to several foster children, including a beautiful little girl that she and her family are hoping to adopt. It's written from both a clinical and personal perspective, and is always moving -- whether wrenching or jubilant.

I also love Patchwork Girl in Black and White (http://thepatchworkgirl.blogspot.com). The Patchwork Girl writes about her life honestly and openly. She is anything but the typical single modern orthodox girl living in NYC, and she always has something interesting and heartfelt to discuss.

I also love Sweet Rose (http://sweetrose.blogspot.com), although she hasn't written much since she got married. She wrote about her struggle with depression while working on and obtaining her MSW so that she can work to alleviate others' pain.

A friend of mine who has survived both divorce and ovarian cancer writes Scope (http://scope-wend.blogspot.com) to process her feelings.

Another friend, a psychologist/rabbi, writes the blog JewPsy (http://jewpsy.blogspot.com). Always has something interesting to say.

So to these five bloggers, I ask that you pass along the Liebster Blog award. Choose five small blogs you like and write about them, and see what happens. No pressure; if you can't think of anyone, feel free to decline. But this is a nice little way to get the word out about some smaller blogs -- like yours and mine.
Copyright (c) "Ayelet Survivor"

Thursday, September 22, 2011

Still here, more or less

I've been blogging less and less lately. Initially I thought it was because I was just too damn tired from getting up at 5:30am and not being able to fall asleep by 10pm. But I think that I say a lot of what I have to say on Facebook, since, after all, I have two identities to write for and I get a ton of feedback, which is mostly useful.

But I can't write as extensively on FB as I can on here, unless I write a Note. The problem is, I have all these feelings I don't know how to handle. The anger at my mother and her pervert boyfriend. Don't know what to do about that. And there's the PJSD, the anxiety about disappointing the clinic manager, since I know how critical she is of the counselors. The uneasiness about being in the undefined middle between the counselors and clinic manager -- not really supervising or being supervised by either.

I'm still so new to this treatment modality, and so often I feel put on the spot and clueless. I don't always know how to handle situations, and it seems that sometimes CM the clinic manager expects me to. Which terrifies me. I know I'm still new and have some leeway to make mistakes, but that knowledge doesn't always stave off the panic I feel when she says, "What do you think, Ayelet?" and I have NO IDEA what I should think.

Like today. A counselor asked me to see his patient, who is dealing with a very nasty family tragedy. I'm not going to give any details, but it seemed -- from the way the patient described it -- that there was a lot of miscommunication going on between patient and patient's adult children. And there was some urgency, because a family event was happening this Saturday, and the patient didn't know what to do.

If something like that had happened at my last job, I would have suggested that the adult children come in with the patient for a family meeting. But at this job, non-patients are only allowed in the clinic after 1pm (patients are medicated between 7am-1pm).

The smart thing to do would have been to bring the patient to CM's office and ask about family meetings. But I didn't do that. I let the patient leave, and then spoke to CM. Who was perfectly nice -- said I was still new, and this was okay. But I know how frustrated she gets at the counselors who are struggling. And I don't want her to feel that way about me. I had to call the patient and leave a voicemail explaining that the meeting had to take place after 1pm. And hope that the patient gets the message before bringing in some children.

A similar incident happened a few days ago. Same counselor, different patient the counselor wanted me to see. The counselor took me to the medication area, where the patient had just finished drinking his methadone. The patient didn't want to see me and denied there was any problem, a very different version of the story he had just told the counselor.

I tried to get the patient to come back to the counselor's office without talking to him in an open area -- because that's a confidentiality violation. But he refused to come back. It was an awkward situation, and I don't think I handled it well. Because I did end up speaking to the patient, a little. Mainly he insisted he was fine and didn't need to see me, but still: confidentiality.

CM pointed out to the counselor that he should have called me into his office to meet with him and the patient. And I felt bad. I think CM could tell I felt bad, because for the rest of the day she was extra nice to me. Telling me how much she appreciates everything I do, apologizing if I was in her office showing her a chart and the phone rang. I don't want her to think that she needs to handle me with kid gloves, but I guess I'm a little scared of her.

All this tells me that I need more supervision. I thought I would be meeting with my supervisor individually once a week, and then have the social workers' meeting as well every week. Not happening. I'm not getting much individual supervision, and the group meeting is often canceled. So no wonder I'm worried I'll screw up. I'm not getting enough guidance!

I did email my supervisor and ask if she would be able to schedule some regular supervision time. Maybe I'll share that I'm feeling a bit lost, and don't want to let CM down by screwing up.
Copyright (c) "Ayelet Survivor"

Saturday, September 17, 2011

Do I want to go to this event?

The Education Committee of the Metropolitan Chapter of the NYSSCSW presents: The Role of Forgiveness in the Working Through of Traumatic Events – A Dialogue 

Through intensive therapeutic work, opportunities to transcend traumatic events and achieve post-traumatic mastery are possible for people. This workshop will discuss components of post-traumatic growth as conceptualized by Richard Tedeschi, and link the question: Is forgiveness necessary to the process of working through and healing from traumatic events – especially those involving victimizations – and if so, why? A brief statement about “forgiveness therapies”, and the controversy surrounding it, will be offered. Clinical vignettes will illustrate instances in which traumatized patients have grappled with the question of forgiveness and what it has meant to both forgive and not to forgive. Significant time will be given to participants, for a dialogue about these inquiries. 

The Presenter, LCSW, BCD, CGP, has treated survivors in individual, couple and group therapy for over 25 years. She has published on the subject of the efficacy of psychodynamic group treatment for women with histories of childhood sexual traumas, the relationship between sexual abuse and eating disorders and the need for defiance in women with abuse histories. A relational psychotherapist and psychoanalyst, The Presenter maintains a private practice in the East Village and is senior faculty of the Postgraduate Group Therapy Department as well as Training Analyst at the Psychoanalytic Psychotherapy Study Center. 

I recently joined the New York State Society of Clinical Social Work (NYSSCSW) for mentoring, experience sharing, referrals, etc. In many ways it's similar to the Association for Behavioral and Cognitive Therapies (ABCT), of which I'm also a member. Except that for some reason, most of its members are very analytically oriented. Diametrically opposite to the CBT proponents from ABCT.

I've been interested in learning more about trauma therapy because many low-income patients in New York City have survived some form of trauma. And right now I'm really struggling with the topic of forgiveness, as I feel so many people have badly hurt me and gone unpunished. The personal trainer who blew out both my knees. The SUV hit-and-run driver. TONS of former toxic co-workers. My mother, for bringing a filthy pervert to live in our house. But I'm not sure I believe that psychoanalysis is a really practical answer to my clients' trauma histories. Most of them can barely afford food and rent, let alone weekly psychotherapy. Psychoanalysis isn't an option for them.

On the other hand, it's free, and what else am I usually doing on a Sunday?
Copyright (c) "Ayelet Survivor"

Thursday, September 15, 2011

That "you-screwed-up" face

I know I haven't been writing much lately. In part because there is no dating activity to report, in part because work is going well and I'm more or less happy. My co-workers geniunely seem to like and respect me, there's no harassment or accusations of unethical behavior. I had my first counselor-development-let's-not-call-it-clinical-supervision-but-that's-really-what-it-is meeting, and it went very well. But I'm still affected by PJSD, and that sometimes puts me in an anxious mood.

This morning I was called in to speak with the clinic manager, who runs the clinic but is not my direct supervisor; that honor falls to the Director of Social Work, or whatever her title is. My supervisor is in charge of all the social workers in all the clinics, so she rotates. I don't see her every day. Or sometimes, not even every week. I think that's part of the reason I often feel confused and lost. I'm making a lot of judgment calls, and maybe I should be bringing more questions to her. If I can reach her.

"Close the door," said CM. My heart sank. "I want to apologize."

Basically, I had followed her lead in resolving a problem, and we had kind of bungled things. Not in a critical way -- nobody died or lost their job or had their children taken away by ACS -- but we should have handled things differently. Very differently.

But before she spoke, I could have sworn she was wearing that "you screwed-up" face. It's a face that ranges from disappointed to disgusted, and I've seen so many bosses wear it. Have I lost the ability to read people? Is she difficult to read? Do I need more supervision?

Tomorrow we have a social workers' meeting -- we're supposed to have one every week, but sometimes it gets canceled. I have a feeling this will come up for discussion. It will be interesting to see the feedback and direction I get on this.
Copyright (c) "Ayelet Survivor"

Wednesday, September 07, 2011

PJSD: Post-job stress disorder

"Job" meaning my previous job. I'm terrified of screwing up at this new job, and that makes me anxious. Which makes me ask the clinic manager (CM) a million questions, because I'm kind of scared to do anything without her explicit approval. Which kind of annoys her, I think. Which makes me more anxious. It's a vicious circle.

Today was very busy. We had simultaneous crises to handle -- two patients on one counselor's caseload. Very different, very serious problems for each of them. Not his fault at all, but I had to really step in to help him manage everything. And I wasn't sure exactly what to do for both of these patients.

I'm still the new girl. I don't know all of the agency policies and procedures. I don't know how to handle every situation that comes my way -- it's my first time working in a methadone program, and only my second job out of social work school. And I've only just recently met the clients -- I don't know them well at all, and don't know their history at the clinic.

So when I don't know how to handle a situation, I go to CM. And she's busy. Several counselors are out on leave, so we're short-staffed. CM frequently gets mildly exasperated at the counselors who are there. Sometimes I'm afraid that if I go to her, I'll just exasperate her more.

I think she can tell I'm anxious. She's made a point of thanking me a few times for doing my part as we deal with crisis after crisis. But during the third major crisis of the day, CM asked the client a question: "How did you know that?"

"The social worker told me," the client responded. CM shot me a look. Not a glare, but a sort of "why did you do that" kind of look. Crap, I thought. I shouldn't have done that. But I didn't know what kinds of things we do and don't tell patients in this program.

We didn't really resolve the issue because we didn't have enough information. The client was a recent transfer from another clinic, and we didn't have her chart. CM promised to speak to the client tomorrow to see if she can sort things out.

After the client left, I asked, "What should I have done differently?"

CM looked at me quizzically. "Nothing!" she said.

So maybe I'm not screwing up, but I feel like I'm screwing up and that makes me scared that I'm really going to screw up.

I know that I take CM's demeanor way too personally. And I know that being anxious and acting anxious is only going to make things worse. But I'm still reacting as if I'm in my last job, when I did keep screwing up.
Copyright (c) "Ayelet Survivor"

Monday, September 05, 2011

Nu, so call me already

I joined a Facebook group called "Nu, Let's Set 'Em Up!" Its purpose is to facilitate setting up single people. So far, I haven't gotten any dates from it. I've been introduced to one man, and it's not going anywhere.

This is the profile his niece posted:

42 y/o Trekkie UWS Paramedic Male seeks Ballabusta 

My uncle, age 42, never married, is the youngest of 4 sisters and 1 brother. Both parents have passed, his mother to breast cancer when he was only 10 years old. 

He grew up in a small farming town in [New England State] in a Conservedox home. He began focusing on Orthodoxy in his late 20's and over the years has grown and grown into the observant, Modern Orthodox man he is today. After years of trying to build up the small orthodox shul in his hometown, (he was the president and was responsible for ensuring there would be a minyan on shabbas as well as a hiring a Rabbi for the high holidays,) when the attempt to hire a Rabbi full time fell through, that Rabbi told him he should move on. 

With further pushing from his sisters, he moved to the Upper West Side in Manhattan with hopes of finally completing the next stage in his voyage in orthodoxy: finding his soulmate and, please G-d, raising a family. He is fit (an avid bike-rider), enjoys heated discussions, can quote you many a classic film, pop culture reference, history etc. -extremely book smart- and of course anything from Star Trek. He is a dog-lover, though he has no pets at this time, and will go out of his way to help others-I guess that’s why being a paramedic is his chosen profession-and is often the peacemaker of the family. He keeps up with the news and what’s going on in the world and in technology, he was on twitter years before it was popular, and of course is always doing his best to grow in his Judaism. He keeps kosher, shabbas, and davens with a minyan whenever he can. 

Please contact me if you would like more details or photos. He really deserves a special woman in his life who will help him continue to grow and who he can laugh and enjoy life together with and I hope to, G-d willing, be able to dance at his wedding soon!

Sounds okay. So I wrote to the niece:

Hi Niece,

I'm 41 and live on the Upper West Side. What is your uncle's name?

Ayelet

She gave me his name, and gave Uncle Paramedic (UP) mine. He friended me and we started corresponding:

August 4, 2011
Ayelet: Hi! You have a really super niece who loves you very much 

August 7, 2011
UP: Thanks, She is indeed a great person. And it is a pleasure to make your acquaintance! I see we have Plonit and her husband Plony as mutual friends. I've had Shabbos dinner at their place many times.

I'm not really close with Plonit and Plony. But it's a start.

A: They are certainly characters. So how are you enjoying our lovely weather today? 
UP: I've been tooling around in an ambulance all day. It's unusually busy for a Sunday.In fact we're going to a late job right now! 
A: Lots of people collapsing in the heat?
UP: No, mostly it has been respiratory problems.

Let's see if I can get to know him a little better:

A: So what do you like to do when you're not tooling around in the ambulance?
UP: Riding my bike, walking the neighborhood, reading, editing Wikipedia, checking up on my friends on Facebook, Twitter, and Foursquare. Etc.

Editing Wikipedia? Didn't know that was a hobby. And how much does he Twitter? I started twittering a while back, but I only do it sporadically. Thought it was mainly for celebrities and interesting people.

A: What articles have you edited? ;)

August 9, 2011
UP: Many. Mostly cleaning and fixing things.
A: But what kind of topics? History? Culture?
UP: Easier to show than to explain:

He gave me a link to a list of the articles he's edited.

UP: By the way, may you have an easy and meaningful fast today.
A: Impressive! You have an easy fast as well. Let's hope it's our last Tisha b'Av in mourning.
UP: Indeed prayer is needed. Only divine intervention could rebuild the Beis Hamikdosh with the current political situation. 
A: It's pretty terrifying.

No word for the next five days.

August 14, 2011
UP: Hi again! Instead of just messaging each other, would you like to meet? I find I don't really get to know people unless I meet them in person. Maybe for lunch Monday or Thursday?

How can I meet him for lunch when I'm working? Unless he's willing to come to my area. But my first two weeks on this job were a mad scramble among the several clinics in this hospital's methadone maintenance program. Lunch plans won't really work for me.

August 15, 2011
A: I'm starting a new job today, so meeting for lunch is probably going to be difficult until I get into a real routine. It probably makes more sense to talk on the phone first. My number is 212-xxx-xxxx. Please don't call past 9 pm, my hours start very early in the morning and I go to bed early.
August 16, 2011
UP: I will.

No phone calls. No emails. Until:

August 21, 2011
UP: I'm having trouble hitting near 9pm, when's the time I shouldn't call *before* so I have more of a target to aim at?
A: Well, I'm usually not home before 4 p.m. My schedule is very hectic this week, I'm going to a bunch of different locations and trainings, but I should be home every day by 6 at the latest.

And... silence. I guess twittering, editing Wikipedia, and saving lives is keeping him very busy. He commented on one of my FB status updates yesterday, but he hasn't called. I'm on the verge of unfriending him. And starting to understand why there's a singles crisis. Even if I give him the maximum benefit of the doubt, it's possible our schedules just don't sync. 

Copyright (c) "Ayelet Survivor"