Midlife Musings and my Second Career

I've wanted to write here for weeks but I keep fearing someone will read what I've written and the career I've spent years developing will vanish. At the same time because I'm unable to write, tell people or do something about it, my brain is turning against me and trying to kill me, as the author Susan Rose Blauner calls it in her book "How I stayed Alive When My Brain was Trying to Kill Me." But those of us in this profession know we don't really want to hurt ourselves, we just want the emotional pain to go away. A little more than 10 years ago that emotional pain came at me with an unrelenting vengence due to my inability to truly help a loved one with her own emotional pain. Today I fear I face another battle with this disease the DSM calls Major Depressive Disorder, because of my inability to make the emotional pain inflicted upon others, by a system far greater, larger, and more powerful than myself, go away. A system dedicated to punishment over treatment even when treatment is mandated.

I feel like I'm working in a Treatment Community (TC) which is a name as old as it's original model "Synanon." Synanon was founded in 1958. The following is a quote from the website synanon.org

"I am proposing a counter-philosophy, a rather old-fashioned, commonsense approach to things: 'Good boys and good girls get good things -- bad boys and bad girls get bad things.' This idea is the very basis of Synanon. We are a father principle phenomenon which rewards good behavior and punishes bad behavior."

This style of drug treatment developed into the type where punishment includes scrubbing toilets with toothbrushes, wearing signs such as "don't believe anyting I say, I'm a liar," etc.

We like to think such "treatment" has all but disappeared today but my current experiences only show the punishment has become cloaked in mandates from other systems which pay the bills.

I don't remember how old I was when i went to my first wake but I imagine I was fairly young. Culturally I was raised Irish-Catholic. Even more specific I was raised Bronx-Irish-Catholic, or a BIC, if you will. This meant what was important in life was anything Irish, Politics and The Church or more specifically what Parish you came from. If someone asked you where you lived in the Bronx you didn't say, Fordham or Bedford Park or Parkchester but rather St. Nicholas of Tolentine or St. Raymonds or St. Simon Stock.

The first wake I remember was that of my grandfather, my father's father, John Drohan. He came to the US in the early part of the 20th century from Carrick-on-Suir, Tipperary. Unfortunately my family was not one for keeping good records or passing down oral history so I'm not sure what year it was exactly or why he came, leaving behind all of his family. He did return once, during "The Troubles," when my dad was an infant and his brother a few years his senior. But why they did I don't really know either.

But back to the wake. I remember it was very crowded. I remember no one told me what to expect or what to say and feeling very out of place. I didn't see my grandfather very often though he didn't live far. In fact he lived with us until his drinking, not getting any better, caused my parents concern that he might accidentally fall over the third floor banister while drunk, and kill himself. So they found him his own place and supported him there. I do remember his brogue however.

Irish wakes were made famous by James Joyce and films usually associated with Spencer Tracy. But those wakes took place before they were moved from the family home to the sterile, somber, and sober environs of the contemporary funeral parlor.

All this comes to mind because I attended the wake of a friend one evening this week. It's probably the first wake I've attended where most of the attendees were people I knew and who also were contemporaries of the deceased. Most had already lost their parents, as did "Walt," I'll call him. Walt was only 45. As of yet we don't know what happened. Not having been able to reach him, a friend called the police who found him dead in his apartment.

Walt didn't have an easy life. He got into drugs and alcohol at a young age, got into a lot of trouble though most of it was minor scrapes with the law, decided to join the Navy for a cure but as we all know, he took himself with him and a couple of years later was discharged for too many more "minor" infractions. He also suffered from schizophrenia and while the medication kept him mostly stable it also took a toll on his body. Through it all he kept up his attendance at 12-step meetings, reaching out his hand to others, being there for his siblings and parents and always having the time to stop and chat when it seemed like that was what you needed from him most. When I found myself in a psychiatric hospital for a few weeks due to a severe bout of major depression about 10 years ago, Walt was one of my constant champions. He visited, he called, he cared and perhaps most importantly he knew what it was like, and then some.

About six or seven years ago he began to lose his vision, he lost it completely a few years later. It didn't stop him from showing up at meetings, setting up chairs, helping with coffee, etc. This isn't to say he didn't have his own trips back to the hospital at times or that he didn't feel sorry for himself when everything got to be too much, he was human after all. But he was also resilient and a great power of example to us all despite the cards he was dealt. He became a practicing Buddhist during the last years of his life. I hope it brought him peace during his last moments on this plane of being.

As I grow older I've come to embrace the idea that life is waiting around for the next bad thing to happen. Sometimes I'm able to enjoy the good things that happen while I'm waiting too.

I've been struggling with the idea of whether continued work in the addiction field is what I want to do. I've just spent 6 years getting an education to do so and now that the education piece is somewhat complete (we can always learn more) I've been struggling with whether it's a good place for me to be. For the past 4 years I've been working primarily under an OMH license with patient's whose co-occurring disorders are substance use. Now I'm back in an OASAS licensed agency with patient's whose co-occurring disorders are mood and personality disorders. There's no real difference. Because I'm a licensed social worker I can work with MICA (Mentally Ill, chemically dependent--such a positive sounding title) patients. Now my patients are much more environmentally complex and demanding. They all come mandated with some criminal justice, Child Protective Services or Department of Social Services involvement which means any one case can have me answerable to a 1/2 dozen different agencies. And what this really means is that treatment is an after thought. After all the paperwork, accountability, oversight, is done. I run one psychotherapeutic group a day and one psychoeducational group a week and that's it. I carry a caseload of 20 patients. I try to see a couple of patient's a week for individual therapy but they are only available 4 hours a day and during those 4 hours they have non-therapeutic groups to attend as well as mine, a few breaks and a lunch hour. Not much time to see an individual client for anything other than, "here sign this release so I can speak with your housing case worker." The rest of my day involves staff meetings where we learn about the latest form we have to add to our repatoire, discuss which one of our clients owes us money because they haven't bothered to go to social services to get their medicaid turned back on, which clients have been lost to contact and why, how come the census is so low and why we haven't been getting referrals. Then there are the phone calls and phone tag played with our patient's "other" case managers in their shelters, at DSS, at CPS, at Drug Court, at transitional housing, at DCMH, at Family Court, at Criminal Court, at Probation, at Parole, at TASC, at DTATI, at VESID, at inpatient, with their primary care physicians their psychiatrists, psychologists, their nurse practitioners, their transportation, their medicaid HMO, and others I'm sure I've forgotten at the moment. Then filling out the daily forms, remembering when to fill them out, who they go to (in house or direct) faxed or phoned, emailed or snail mailed, remembering the few weekly reports and the monthly reports due at the end of the month all of which simply have to do with reporting on attendance, whether or not they had an excused absence (which must include another piece of paper as proof of excuse to be filed) and urine drug screens (UDS) and breathalyzer tests. Supervision? Lunch? Ha!

Everytime I think of all this I go back to the first class I took in graduate school which discussed "the poor laws," as they were hundreds of years ago in England. They are based on the belief in original sin and that all humans come into this world with a trace of evil. Both my patients and myself come to see my primary responsibility not as a treatment provider but as a warden. It's my job to catch them doing something wrong and either do something about it or let someone else know about it who will. Big brother has arrived, and he's me!

I stumbled across this website invisiblepeople.tv The site tells the stories of different individuals and families across the country who are faced with the challenges of life without housing permanency. Be sure to explore the whole site by hitting the About and Road Trip U.S.A. buttons on the Home page. The title of the site comes from the story of a man described on the

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