Midlife Musings and my Second Career

Welcome to my first Midlife Musing. Well, midlife may be a misnomer. I'd have to live to 110 in order for that to work, but with life expectencies ever expanding, you never know...

I decided to apply for this position "on a whim and a prayer," so to speak. I really didn't believe I had time to take on one more project but it just seemed like a good idea at the time and well, if offered, how could I say no, and if not offered, well I'm really busy anyway. I'm sure many of you know the drill. Work, family, graduate school, volunteer obligations, etc. etc.

But here I am on a practice run. The SW bloggers don't actually all group together until the end of August but it's been suggested we get started when so moved.

At the moment I'm sitting at work (note, it's after 5 everyone) and avoiding finishing up my "book report," for my "Clinical Social Work with Children" class. What better way to do so than begin my blog. So briefly let me introduce myself...

I'm Deirdre Drohan Forbes, 55, with two grown children, and a husband of 30 years, Thom, who is home at the moment because that' s where he works as a freelance writer.

I received my Bachelor of Journalism (BJ) degree from the University of Missouri School of Journalism in 1975 and only re-entered the classroom in 2002 when I decided I wanted to become an Addiction Counselor. I was lucky enough to earn my Credentialed Alcoholism and Substance Abuse Counselor/Trainee (CASAC/T) hours through Westchester Community College with the help of Dr. J who happened to be a NYU SSW alum. Who knew community college could be so tough?!? But I loved it and will be forever grateful to him for preparing me for graduate school work. I'm so glad I decided to do the CASAC study before becoming a full service Social Worker with an MSW degree in her hand. I wouldn't have been ready to do that first, but more about that some other time.

I'm in my third and final year of the One Year Residency (OYR) program in the Silver School of Social Work. I am about to return to the main campus after spending 1 1/2 years at the lovely, quiet, close knit, small student populated Sarah Lawrence Campus in beautiful Yonkers (they'll tell you it's Bronxville, but it's really Yonkers. I know, I grew up in Yonkers).

I'm a bit nervous about that but that's for another blog. In fact I'm more nervous about the book report I mentioned at the beginning of this blog and better stop here and get myself back on track before I suddently discover it's Thursday and I've got to hand in the finished project at 8pm.

If you got this far, I hope you'll consider leaving a comment, let me know about you or at least sign up to receive my regular missives. Thanks for reading !

Deirdre

The past few days it's been looking like my second career might have been a big mistake.

I was connected with some very disturbing information regarding trading in a LMSW for a LCSW a few years down the road. There's been some vehement venting from the newly graduated or to be graduated as well as long time graduates of schools of social work --though primarily NYU. Seems a message went out from the alumni association letting others know that their ability to acquire a LCSW can be in jeopardy for a number of reasons including the location of employment.

Apparently there's been a reinterpretation of the rules and regs as written by the OP (Office of Professions) which comes under the Dept. of Education for NYS. You no longer can become a clinical social worker without working in a strictly 45min. session type of agency licensed under the Office of Mental health, OASAS and a couple more. Hospitals and Schools no longer count. In fact it seems difficult to determine for certain what type of agency does count. Obviously this severely restricts the type of work one does, if one is hoping to obtain a LCSW.

The discussion on the has been focusing on doing private practice as a LMSW with paid supervision from a LCSW. This type of work, in the past, has been acceptable work toward obtaining a "C." Apparently this is not so any longer. Most social workers I know have private practices "on the side" in order to supplement their poor pay. This would be virtually impossible under this interpretation. Or at least very difficult. And for me, since deciding to go into the field, one of the ideas in the back of my head, was to someday during "retirement" have a small practice for monetary, mental health and helping reasons. I'm not sure now if that will happen. Everyone talked about how flexible the MSW degree was and how it can be used in so many places doing so many different things. My heart has always been in doing community/policy/advocacy work and in truth I might have attempted to acquire a MPH or even a law degree, were I to know this would face me down the road. But one year away from the end I'm not about to give up. But I'm very disappointed with this discovery.

I urge readers to join the list serve group I mentioned above to keep informed of this ongoing issue. Being selfish here, at this stage in my life any wrench thrown into "my system" and slowing my progress down is difficult to manage.

Deirdre

It's over. The summer semester that is. It was really hard. Social work with children and Research 2. Five books, 5 papers/projects, and a myriad of relevant (or not so relevant depending how you feel) academic articles all within 7 weeks both courses twice a week, and all the while working a full time demanding job. I was never so happy to have a semester end. But it's bittersweet. It also means I'll be leaving the Sarah Lawrence Campus and heading down to Washington Sq. Most of the students I worked with are heading to the STAQ campus, otherwise known as St. Thomas Aquinas in Rockland County. I loved Sarah Lawrence despite the fact that we had less of a choice in courses, even electives were mapped out for us because of the limited amount of students they can't offer the variety you get elsewhere though I managed to take three mini courses of my own choosing over the past 2 years.

I spent my first semester at Washington Square. For some reason I thought it would be easier taking one course a night 2 nights a week instead of 2 courses a night, once a week. The travel and travel time was difficult but it became more of a struggle when faced with sitting in a room for 2 to 3 hours made for 8 to 10 people and stuffed with 20. I never thought I was claustrophobic until taking class in those small rooms. The other classroom was actually not too bad except for the fact that the chair/desks were bolted to the floor and all right on top of one another. I managed to always confiscate an extra chair without bolts and pull it to the side of the room for some extra leg and wiggle room instead. That classroom I believe was 24 students. I must admit I was surprised to be so uncomfortable in an expensive private school. I thought that's why the school got the big bucks--better seating and smaller classes--guess I was wrong.

At Sarah Lawrence we had "real" seminars with 8 to 15 people sitting around large round tables with professors lecturing and students sharing thoughts. The only thing I missed from downtown was the library. Sarah Lawrence, for all its reputation as an expensive womens college with a penchant for writing, had a rather small inadequate library. So I do look forward for that reason to be going back downtown. And yet my primary reason for the move was to cut down on the travel time. I live in Westchester. Sarah Lawrence was on my way home; Washington Sq. was the opposite direction. When class ended at SL it was a 10 minute ride home. When they ended at Washington Sq. it was more like 80 mins. as I would leave my car at work (98th St. and Madison) and take the 6 down to Astor Place and with my schedule, that was 2 nights a week! For Sept. I'll be doing it 1 night a week and I'm thinking of driving down to school and pay the discounted garage fee which would cut about 40mins from my commute. But that's 6 weeks from now--it's time to take some deep breaths and enjoy NOT having to worry about such things for the moment.

I hope some other bloggers join soon. I feel like the lone voice ...

More to come

Deirdre

As time draws closer to the beginning of school and we find ourselves (hopefully) writing for a larger audience, I feel the need to get a bit more serious. While my previous blog having to do with the woes of LMSWs becoming LCSWs is certainly a serious matter in thinking beyond ourselves I came across the story below.

What I found disturbing about it was it's lack of widespread coverage. Maybe the coverage was there but in googling it, it seemed to me limited in its scope . I came across it in a blog and then googled the first two lines of the article to see where it ran, and the Baltimore Sun, a highly respected news source, came up.

One of the respondents in the comments section of the site, questioned why this seemed so unusual as it happens on a daily basis to "ordinary" citizens. And there is my point. This wasn't an ordinary citizen and unfortunately we need this type of situation to arise to make a larger point.

I returned to school, to beomce a CASAC, in order to work with those who struggle with addiction. At that time I began to realize the importance of advocating on a macro level while treating individuals on a micro level. I hoped being formally educated in social work would help expand my knowledge and aid me in fulfiling my life work. In 2003, I founded Friends and Voices of Recovery/Westchester. Our mission is to inform and educate others on issues such as stigma and discrimination effecting those in recovery and those seeking it.

I have an email list serve and send articles such as the one below, out to the members for their edification. Seeking social justice is central to social work. Seeking social justice for any marginalized population is certainly important, I happen to want to focus on one such group. The story below is an example as to why--Deirdre

By Doug Donovan
Baltimore Sun reporter
8:18 PM EDT, August 7, 2008

When the shooting stopped, two dogs lay dead. A mayor sat in his boxers, hands bound behind his back. His handcuffed mother-in-law was sprawled on the kitchen floor, lying beside the body of one of the family pets that police had killed before her eyes.

After the raid, Prince George's County police officials who burst into the home of Berwyn Heights' mayor last week seized the same unopened package of marijuana that an undercover officer had delivered an hour earlier.

What police left behind was a house stained with blood and a trail of questions about their conduct. No other evidence of illegal activity was found, and no one was arrested at Mayor Cheye Calvo's home in this small bedroom community near College Park.

This week Prince George's police arrested two men for orchestrating a plot to deliver marijuana to the addresses of unsuspecting recipients -- among them, Calvo's wife, Trinity Tomsic.

Yet neither county Police Chief Melvin C. High nor Sheriff Michael A. Jackson have apologized to him, his wife or her mother, Georgia Porter, for the raid that traumatized the family and killed their black Labrador retrievers, Payton and Chase.

Thursday, Calvo called on the U.S. Justice Department's civil rights division to investigate the raid and other similar actions by Prince George's law enforcement. He said officers burst into his house without knocking or announcing themselves, in violation of the warrant they had.

The full story...
www.baltimoresun.com/news/local/bal-mayor0807,0,4563211.story

And an interesting commentary:
www.huffingtonpost.com/robert-creamer/the-death-of-dc-suburban_b_117879.html

--
There are many paths to recovery, ask me about the one I walk.

Deirdre Drohan Forbes, Chair
Friends and Voices of Recovery

Circulars which slip from Sunday papers announce the purpose of this buying season. School is calling. There are uniforms, back packs, notebooks, text books, pens and laptops winking from the pages of the glossy advertisement, calling us to attention.

The house is filled with whispers of a new school year and the possibilities it holds. My daughter returns soon, my son returns tomorrow, and I return more quickly each passing of the calendar year. This, may prove to be my last.

Our son packed his car less tenuously than last fall. This second September was proof that a little age did bring wisdom. His father and I took that which did not fit inside his Civic and promised to meet him at his dorm a few days hence. We were to take the extra time to explore--the Catskills, other towns, each other. Neither he nor I could remember the last time we took some time alone.

We pulled into New Paltz on Friday afternoon. Another college town beginning to come to life after a long summer slowdown.

The air felt like a warming lotion penetrating the skin. The sun was bright. The sky was expansive and the sound of youthful eager voices captured my consciousness. It was their time and it was awash with possibilities.

How lucky I thought, as envy whispered in my ear like a two-faced guardian sometimes offering goodness and sometimes beseeching me with the dark. They were half my age. More than half my age. To think of having all that precious time before you. What I could do with all that time. If only ...

I slipped off the curb. Lost somewhere in the ether of youth I did not note we were coming to the end of the walk. My ankle gave way and grabbing my husband's arm I managed to keep my body from completely decending to the asphalt. I looked up at my husband and said, "I'm all right," like a cat who slips off a window sill only to right itself quickly and look you in the eye as if to say "What are you staring at, I meant to do that."

My husband and I spent part of Labor Day weekend in Cooperstown. For those who cannot tell a baseball from a hockey puck, Cooperstown is home to the Baseball Hall of Fame. My husband discovered just last week, by serendipitous circumstance, that his childhood hero, one of the greatest of all time home run hitters, Harmon Killebrew, was going to be a guest speaker at the Hall of Fame that very weekend. We re-arranged a few things, left our daughter in charge of the 4 cats and 1 pit bull and headed to the wilds of Ostego county.

Most people would never notice anything different about my husband that day, but after 30 years you pick up on otherwise imperceptible cues. He was anxiously excited. He remarked, "I can't believe I'm getting to do this," quite a few times during the 4 hour drive upstate. I didn't need to put my ear to his chest to hear his heart rate's rapid knock or view the quickened breath to know what was going on.

We took our seats a few minutes before Harmon was to appear. I pulled out a newspaper to keep me busy and as I did so he slowly pulled from a large mailing envelope the illustration he hoped to have Mr. Killebrew sign. Half way through the program I noticed the strangest behavior I had ever seen in this man.

My husband is a fidgety twitcher. He channels his ADHD through rapid movements such as shaking and jingling the 3 Chinese Coins, 2 (Hudson) river rocks and various coins of American currency in his cupped right hand inside his pants pocket. Only recently did he give up biting his nails to the quick. But the most obvious movement is his up and down leg shaking while seated in a chair. So of course the sight of such would cause me no upset. But this night he didn't move. As far as I could tell, he sat through the entire Q & A, without rattling a bone.

Total stillness. There could be no explanation other than his being paralyzed by his own excitement. So, to my great surprise just as the moderator said we have time for one last question my husband's hand went up and out for the microphone. Sorry, I don't remember what he asked. I was too busy using his camera to take pictures of the scene. But I did know he went with the original illustration by Bill Gallo of the NY Daily News, inorder to bring home Harmon Killebrew's autograph. But alas, there was no such opportunity available. He shrugged it off but I knew better. Inside that 55- year-old man was the 10-year-old boy kicking dirt and throwing down his helmet having just struck out with the bases loaded and the winning run on second.

Tomorrow evening my inner 10-year-old will enter the fall semester with some new pens, notebooks, binders and bag with a rapid heartbeat, sweaty palms and great expectations for her final year at school. While my husband and I ate dinner later that evening I braved telling him that I was sad this was my last year of school. That while there were a few classes I found tedious, for the most part it's been one of the most gratifying, engaging, stimulating and enlightening periods of my life. I said I didn't know what I would do when it was over. So for me too it's the bottom of the 9th, the bases are loaded, 3 balls and 2 strikes, I swing and...

UGH!!! I am so envious of full time students. While for the most part I have been blessed with remarkable professors and great classmates, for the past 2 years I have, by way of my own choice, had no choice, in choosing them. Being on the Sarah Lawrence Campus limits choice, actually removes choice, from choosing what courses and what professors I wish to take. Being an OYR student limits choices no matter what campus you're on. Realistically, I can only take evening classes. Now that I'm back on the main campus those students suffering the same predicament no longer surround me. Students who have choice surround me. And envy strikes.

Yesterday a group of 20+ (that's number, not age) Policy Practice students met for the first time. It was a last minute invitation so it was graciously stated that if we couldn't make it, it would be understood. Of course it happened to be a day at work when two out of 5 clinical staff members we're going to be out. Our census happened to be low; there were no planned intakes and my supervisor felt I could sneak away for a couple of hours.

Around the conference table each student sat and introduced themself. Then we learned who our advisers are. I was pleasantly surprised to learn I would have one adviser who is in the Policy Practice specialty. I was sure I'd be assigned an advisor who had nothing to do with the program and instead had all the other OYR students at NYU. Ah, the power of negative thinking...

Anyway, I'll let you in on a secret. My first choice for Social Work school was Hunter, Not NYU. Why? My major interest was/is CO--community organizing. I only applied to Hunter and Columbia first time around. I got into both full time programs. I guess I was expecting some benefactor from above to come down and hand me a blank check for my education. Columbia gave me lots of money in terms of loans but when you're over 50 you don't have that much time to pay them back and we were just getting excited about having paid off our mortgage--especially with 2 kids (plus me) entering college. So I turned them down and unfortunately when the benefactor didn't show up I had to turn down Hunter to keep my full time job, which shortly thereafter I lost anyway when my agency closed. Certainly that was an ironic bump in the road.

I got a new job and applied to Hunter's OYR program, twice. Both times I got to the interview stage and thought I did well, but both times I was rejected. I decided enough was enough and scrambled to see if there was anyplace else whose admission process was still open. Almost overnight I got in my applications to NYU and Fordham. I got accepted to both. I finally chose NYU, known for its clinical focus, as I decided I was doing CO anyway in real life. Voluntarily mind you, but doing it nonetheless. Was I doing it well? Certainly not as well as I hoped but being born into a political household (Dad was an attorney, state assemblyman, had political appointments to numerous projects and conventions and retired as a Court of Claims judge) I imagined I’d picked up some training by osmosis. When I get upset with a policy, be it work, school, government or the local grocery, I usually get mad. The next thing I know I'm trying to organize a group to help change it.

While I had a decent amount of clinical skills having recently been educated to become a CASAC (by a former NYU PhD social work student, mind you) and having spent a couple of years practicing those skills in the field, I decided knowing more in that direction couldn't hurt. And it hasn't. I'm honored when allowed to participate in client’s recovery.

But then the head of the Policy program mentioned that for the first time in NYU's history a CO course would be offered in the spring and she'd be teaching it. At first I got very excited. Then I realized two things. 1. I'm sure it would be offered on a daytime schedule, so I couldn't take it and 2. I have no electives left to take. I did that by way of mini courses so I wouldn't be working full time, doing my internship and taking 3 courses all in my last semester of school !

Then I asked if there were any post graduate programs (post MSW) that I could take in Policy or CO. The Professor looked at me questioningly and asked "right after finishing graduate school?" And I thought why not? And while I can't wait to graduate and I can't wait to be finished with all this work and start applying it, I just love learning and don't like the idea of not being in school. Who knew?

So I have to work on my envy issues. I'd like to be 30 years younger and 30 pounds lighter too. Maybe I can work on one. I'm afraid the other one aint' in the cards.

Have a great year all!

I'm in Albany tonight. When i was a little girl my father would spend far too much time in Albany, or so I thought. My Dad served in the State Assembly a few years before I was born and from there it seemed he always had something to do in Albany. What it was exactly I wasn't sure but I thought it had something to do with politics. He had numerous political appointments throughout my life. My favorite came when he was appointed the Project Director of the New York State Pavilion at the 64-65 Worlds Fair. You can still see the Towers in Flushing Meadow Park that were once part of the Philip Johnson project. I have great memories of time spent there. At some point I remember proudly showing off when I told a friend I had been to the fair 37 times.

I still have my father's campaign poster from his run for the Assembly. On it were words used to describe him such as "progressive" and a "friend to labor." Nothing particularly odd about that except that he was a Republican, and a Bronx Republican at that. I wonder what happened to those Republicans. They didn't much look like the ones in the Bush Administration.

Anyway I bring my father up to let you know I grew up in a political household. One from which I rebelled in various ways, but one in which I probably got my foundation for social work even while rebelling.

This brings me back to why I'm in Albany tonight. I was one of five people given a 2008 "Outstanding Recovery Volunteer" award from OASAS (the Office of Alcohol and Substance Abuse Services). I was able to speak for a few minutes and came to realize as I spoke, that my volunteerism probably has a great deal to do with that political household I so strongly rejected when I was growing up. I learned from my father that you sometimes need to do things you don't want to do, for the greater good. I learned that volunteering to work on behalf of others is a noble idea. I learned that you can get more from giving than from taking. And I learned that no mater how hard you try and how much of your heart you put into a mission, it doesn't always turn out the way you want it to. These are all valuable lessons for a social worker as well.

So I found myself in Albany a lot over the past few years. I've testified before a Senate committee and spoken with state representatives advocating for insurance parity. I became a founding board member of the new New York State Friends of Recovery (FOR-NY) as well, and I've been asked to speak at a few conferences regarding my family's journey into recovery.

And even though in the end our politics were quite different, I'm proud to be walking the same streets my father did. I think he would have been proud of me as well.

I was dressed in New York black slacks topped by a yellow jersey knit pullover and a black jacket. Behind me I dragged my latest "e-bags" purchase=a very large, black with touches of red, rolling backpack, I'd been dragging it all week with co-workers wondering if I was heading back to Albany. I'd smile a bit sheepishly, somewhat embarassed with the idea that what looked like a good size over-night bag was merely my latest back pack for school. I'd been through quite a few already in the previous two years. With each new one came a few hundred extra cubic inches. After all I'd been told that the DSM-IV TR was to be with me at all times. I wasn't quite sure why however and found myself imagining some wild eyed woman in the throws of psychosis sitting across from me on the #6 train shouting, pointing at my back pack and daring me to give her a diagnosis.

I unlocked my office door and was greated by the fresh lavender smell permeating the room. The "Yankee Candle" difuser, a good friend of mine had recently given me as a gift had been doing an excellent job of masking the stale, still, odor you find in Manhattan office buildings with windows that do not open. I parked, which really is what it feels like- pushing and pulling and steering- this large container of books, behind my office door. I glanced toward my desk and didn't see the red light on the phone indicating a message was waiting and so I decided to check and see if any emails of importance came in over night. I left the office door open and my supervisor greeted me from the entry. "So how does it feel to be a social work intern?" she questioned. I'd been waiting for that lightening to strike but it wasn't happening I explained. "Well maybe when you do your first progress note something will click." I smiled and she exited saying "See you in rounds."

She was right, of course. Supervisors are needed to be right. I facilitated a group of 2 patients opening with an ice breaking question, "when you were young, who was it that you admired most, outside your family?" Sixty minutes later the "group" ended and walking by the nurses station I reached over the counter to grab "Progress Note" form # PN7-S. It was not unfamiliar to me. In my office I proceeded to input my observations on the group. And there in the left hand column was the space prodding me to fill in "title." "Social Work Intern," I wrote. I stared at the words for a few seconds, sighed, smiled and shook my head left to right. I'd signed similar forms before. The "title" then was CASAC-T (Credentialed Alcoholism and Substance Abuse Counselor-Trainee). I'm hoping to be admitted to the December CASAC exam and be rid of the "trainee" designation at last. Six-thousand hours of work were required of me before being allowed to apply to take it. I was hoping my being awarded the "CASAC-Trainee of the Year," for New York State in 2007, would have given me some time off for good behavior from those Six-thousand hours, but no such luck. I forgot I was dealing with bureaucracy.

Anyway my mind was trying to determine which title had more meaning-Social Work Intern or CASAC-T. Funny, as I studied the words I realized I was feeling as though I was betraying the profession I'd become so devoted to. I was abandoning all those past school mates who shared my struggle through "Chemistry of Addiction," and countless ethical vignettes. I was turning my back on my professor who put me on the course to this very moment. And then I realize they can't take any of that away from me. I still get to put CASAC with or without the "T" after my name only now I get to add some letters. The CASAC will still shout my specialty as I embrace the broader perspective of a social worker. It's all good.

"It's weird the way my '70's' idea seems to have actually occurred." I said to my daughter as she came into the kitchen. "What's weird about it? You're smart, you're observant, you just happened to take note of things other people weren't looking at." "I guess you're right. Maybe I was just hoping I was wrong."

For weeks, maybe even months now, I kept telling people I was afraid the 70's were coming back. It started with the graffiti. The late 70's was probably the height of the graffiti movement (if that's what you call it). Everything was tagged. Buses, subway cars, apartment buildings, office buildings, schools, train stations, and every security grate that covered a mom and pop shop from Main Street to Crown Heights. Back in the day, the most infamous tag was "Taki 183." Goggle it, you'll find more than you wanted to know. Taki never did anything elaborate or remotely creative, he just seemed to be everywhere. And recently I began seeing it again--on highway concrete barriers, school walls, apartment building walls, overpasses, bridges, tunnels, etc. I took it as a sign something bad was happening.

Then I began to see more homeless. Suddenly they were under overpasses I'd driven by for years--a tent here, a large cardboard box there, a shopping cart stuffed with textiles and industrial strength black plastic bags. How does this seem to come out of no where.

It wasn't really no where. The housing market had been on the decline for months. We'd been warned or frightened that something called a "sub-prime mortgage," could lead to an economic crisis.

Somewhere in the mid-west I believe, were video images of people lining up to withdraw their money from a bank they believed was about to fail.

And then the "gas crisis." I'd lived through one before. Back in the 70's it was more about shortage than high prices but here it was happening again. Jimmy Carter was president and "the Bronx was burning." Well, at least the Bronx is no longer burning. But I'd love to see the "luxury tax," come back on "gas guzzling" vehicles. I'm glad there are no Iranian Hostages but I hate that President Reagan took credit for their release. If he, not Carter, had been president when they were taken, god knows what the outcome would have been.

Right before Carter, President Ford told New York to Drop Dead. At least artists and writers and college grads fresh from the mid-west, even social workers, could afford to live here. Of course along with affordable housing came unaffordable crime stats fueled by unemployment and cocaine.

Well as Bette Davis, in one of her best roles had to say, "tighten your seatbelts, it's going to be a bumpy ride."

The phone rang. I was in my office, on my computer hyper focusing on an individual note I was trying to finish up and put in the patient's chart. I was startled by the sudden ring and grabbed the receiver. "Hello, Deirdre Forbes, intake." The voice on the other end was female and trying to explain she was the wife of a former client of mine. It took but a moment to make the connection and when I did, I knew why she had called.

Bill (not his real name) was my first client when I came to the hospital. While I'd been hired to work in a new inpatient, co-occurring disorder unit I'd been kept busy with other assignments while the unit was still in Miller and Rollnick's third stage of change --Preparation. So I was assigned to work in the AOD (alcohol and other drug) out patient program. While covering their intake desk one day, I received a call from our liver clinic. The social worker on the other end of the phone was inquiring about making an appointment for an intake. She stated the patient was in need of a liver transplant and while he had told them he had given up drinking and joined AA months before, they still needed some concrete proof of 6 months sobriety before being accepted for a transplant. I was the next counselor up to do an intake so I arranged for him to come in the next day and meet with me.

He arrived on time in a dark, ill fitting suit, white shirt and tie. I later discovered he had lost a considerable amount of weight in recent months and this explained the oversized suit. He presented as the type of client we all hope for, eager, friendly, open and grateful. Apparently he was in need of a transplant for two reasons. His liver had become cirrhotic from both alcohol and hepatitis C. The Hep C was determined to have come from a tattoo he received while in the navy many years before, as he was never an IV drug user. On top of that he had just learned that he also had liver cancer--not unusual for an already damaged liver however.

Sure enough he became the ideal client. He had good attendance, he was compliant and he carried a positive message to all who would listen.

In the "Big Book" of Alcoholics Anonymous there's the story of one of the founders of AA and his "spiritual awakening." While he was in the hospital for the umpteenth time being detoxed, he described seeing a white light and suddenly feeling very different. Bill never told me he had a spiritual awakening but he certainly did awaken spiritually. He saw life as something to celebrate, friends as precious gifts, a spouse as a guide and companion and AA as the foundation of it all.

As weeks turned into months, Bill was getting more and more anxious about actually making it to the top of the transplant list. One day he came in and told me that the physicians' assistant suggested he look in other parts of the country for a shorter list and move there--at least until getting the transplant.

The transplant list has a complicated formula for who moves up. And while it is national in format if you are in a catchment area with fewer people waiting you can move up the list faster than in NYC where the list is long. So Bill and Lilly, his wife, (not her real name) became proactive and began calling other hospitals and centers to find out about possibly getting on their list and the odds of how long the wait might be. They finally decided Florida was his best shot. So they found a rental apartment near the Medical Center, moved in and after a test here and interview there, he was placed on their list and told it could be a 6 week wait--far better than the 3 to 6 month wait in NYC. Two weeks later he got the call they had a liver for him. I got the call from him shortly thereafter. He was very excited and very hopeful.

There were complications during the transplant but nothing I knew Bill couldn't overcome. He was doing everything the transplant team had told him to do. He thanked God, AA and just about everybody else who ever came into his life for helping him through the ordeal.

A couple of months later after healing he came back north and stayed at his home in PA. There he belonged to a motorcycle club. He proudly got back on his bike and went on a day trip with "his gang." When that didn't quite dare life enough to make him feel completely alive, he decided to try skydiving. He called me on his cell while driving back from the jump. He said he couldn't believe how fabulous it was. He'd love to do it again, but Lilly made him promise not to do so.

He went back down south for routine tests and was met with the words no one wants to hear. "The cancer is back." The prognosis was bleak. The doctors would do what they could--chemo, pain meds, and 6 months to live. He couldn't stand going through the chemo again and decided he preferred a better quality of life without it was what he wanted. He and Lilly sold their house in Queens and purchased a condo in Florida. Bill found a new AA home group and became an active member doing service. He and Lilly decided they would enjoy whatever time they had left and planned a trip to Australia and a cruise. I learned all this because Bill would call me. Every few months when a holiday came up such as Christmas, Thanksgiving or even Valentines Day, he would call. He'd tell me he was "doing great!" He'd tell me how blessed and grateful he was for each new day. He'd tell me about his adventures and future plans, like purchasing an RV to travel across the country. Never did he fail to sound positive, up beat, happy and full of life. Sometimes he'd mention the pain but the alternative he found to be worse--taking pain meds, which clouded his thoughts and slowed him down. Sometimes he would get my voice mail. I actually enjoyed that even more because it gave me the opportunity to keep not only the message, but also his joyful uplifting voice. I would keep it until another message came along to replace it. I never knew which message was going to be his last. The prognosis of 6 months came and went without incident. He promised to remain in touch.

Every time a major holiday would go by and I did not hear from him I would become disheartened, wondering if he was gone. And then just when I was sure he must be, another call came through and there he was on the other end of the line sounding as grateful as ever and embarrassingly, thanking me for all I did for him. When I would sound surprised to hear from him he'd have the retort, "No, it's me. I'm not dead yet!"

The last recorded message I have from him is from last Thanksgiving. I can't quite remember when I last spoke with him "live."

And then the call from Lilly, "I knew Bill would want you to know that he finally passed away on Sept. 18th. He talked about you all the time. He had a difficult last three months because the tumors had spread all over his body. He became paralyzed and really couldn't do much for himself. We had hospice come in at that point and they were wonderful. He passed away at our home in Pennsylvania. I'm pretty sure he told me that it was you he had shared the dream with in which he was dead but he was still running around the house like a maniac mowing the lawn and fixing and repairing whatever needed taking care of." "Yes, I remember that dream," I told Lilly. "He told me you thought it meant his spirit was always going to be around that house because the work was never going to be done. Well a couple of nights after the funeral I had a friend staying here with me who said she woke in the middle of the night having thought she heard someone or something outside. I told her about the dream and what you said. I think it really is his spirit out there."

I cried for a long time after that phone call. My emotions were all over. I was sad that someone like Bill was no longer walking the earth. I was sad he and his wife were never able to have children. He would have been a great Dad. I was sad for me that I wouldn't get those occasional calls anymore to put me in my place and make me
realize how grateful I am for all I have.

I still find it remarkable that he stayed connected to me for three years after leaving our clinic. The big lesson for me is the power of that therapeutic alliance. I don't think it was anything I did in particular that allowed for that to happen but I'm grateful I was able to give that to him and somehow help him through his last days. But I am even more grateful for what he gave me.

So thanks Bill. You'll be in my heart and mind and even my voice mail, for the rest of the time I walk the earth. Thanks for showing me how to die with dignity and truly live one day at a time.
-30-

I'm always overwhelmed at mid-terms. It's gotten better semester after semester in very small increments but so far every midterm I can look forward to becoming overwhelmed. This one is no exception. In clinical terms I'm somatically stressed.

Eight days ago I felt a headache coming on. Not your ordinary "take two asprins and call me in the morning" headache but the type I get maybe once a year at most. It runs from my temples around the back of my head and then down through my neck and shoulders. Almost nothing relieves it quickly. From what I read, a stress headache is pretty much your ordinary headache. But not this kind. It's not a migraine either though I don't think a migraine can be much if any worse. This is the type of headache you want to say "Would you kindly remove my head from my body and when it is done hurting you can give it back to me."

I finally got to the doctor on Friday who prescribed Celebrex and a therapeutic massage. Hopefully the Celebrex will take away the headache before it gives me a heart attack. So far the shoulders feel slightly better but yesterday I was dizzy all day. I'm pretty sure this all began while writing my midterm paper for HB III.

I went to a nearby public library with lovely views of the Hudson River as the only distraction. But I think of that as a de-stressing distraction. Five hours later I left the library about 1/2 way through the paper satisfied that the rest of it would flow easily. But then comes the second round of "OMG I think I'm doing this all wrong, I don't know where I'm going, it's going to be way too long, why don't i keep rereading directions before i take off in a wrong direction, I'll never get this done on time," and so on , and so on. The next morning the headache hit with a vengence and has been with me ever since. I guess that's why it's Sunday and I haven't begun to write my second mid-term paper due on Wednesday. Also, having this headache has kind of dulled the edges of my brain and how well I can focus and write is in question. On Thursday my unit chief (psychiatrist) told me I should sleep for a few days. If you can squeeze in an extra 24 hours into a 24 hour day I might be able to. Looks like I will have to take tomorrow off just to finish the paper and see if I can squeeze in a the massage my MD prescribed.

So I have to keep reminding myself "mid-term madness" will end and then there will be only one more to go through before, dare i say the word, graduation?!?

Oh, if you're wondering, finals don't freak me out as badly. I think the reason is having been graded on the mid-term, I have some knowledge as to what is expected for the final. At least that's what i tell myself

My 15-year-old, 15-pound beige and white feline named Gracie sits by the back door with her front legs crossed and a sun ray pouring over her back. She has no worries except for Ferris a 9 pound all black somewhat anti-social feline who attacks other cats and our pit bull just for the fun of the chase. But often Gracie manages a pre-emptive strike with a loud growl, a sharp hiss and a right hook filled with claws.

That pretty much sums up what I've been feeling with the financial crisis or as I've been calling it, Bush's Black Hole. There I am moving through my life sometimes concerned about what may lie on the other side of the door, when surprise the claws come out, the ground growls and everyone is walking around wondering if they have a job.

I was told I am one of the lucky ones. I was told this was great timing for doing an internship; they wouldn't dump an intern. Maybe, maybe not.

So when my supervisor asked me why I wasn't able to do the work assigned to me, the panic button went off in my chest. I knew I could do the work, that wasn't the problem, time was the problem. "But why, with a low census," the supervisor wondered. I explained it was difficult to do my practice internship when my policy internship was taking me away for more hours than it should be. If I'm there I can't do the work here.

Sometimes life is figuring out 1. You can't please all the people all the time and 2. well if I could figure out what that is, I guess i wouldn't be having this problem.

Stay tuned. Hopefully this gets sorted out and i don't have to feel pulled in so many directions or fearful I'm blowing my internship and my job. Anyone else going through this?

My social environment bothers me. It's why I first chose a career in journalism and a second career in social work.

Not everything in my social environment bothers me, but admittedly, where I see injustice, I am bothered.

I suppose that sounds a touch neurotic and it's not something I'm particularly proud of because I can drive everyone in my social environment crazy with an insatiable need to let everyone know about these injustices hoping that others will be as outraged as me and if they can't fix it, at least we can commiserate.

These aren't all big "I want to save the world" type of issues either. In fact it probably all began when I moved to my house which is one of 9, 19th century unattached town houses on a narrow dead end street. I was outraged to find strangers parking in "my space" right in front of my house. Not only that but they would just leave their car there for days, or weeks at a time. Maybe one of these days I'll tell you how I managed to "fix" that issue so that it bother's me less, though it still bother's me.

Anyway, I'm considering blogging about these issues as they come along as a means of "harm reduction," for me and those who I live with. If I share it here, maybe I won't bother everyone elsewhere. So I'll begin with a recent situation.

The Hot 97 FM car with the NYP plates
For those who don't know, NYP stands for New York Press. Back in the day I actually had a set. They were allocated to members of the press in order to avoid getting tickets if you happened on a news worthy scene (and I don't mean Gwyneth Paltrow pushing her baby Apple down the street) and couldn't find a "legal" space. There were also designated streets, primarily around news organizations such as The Daily News, City Hall, Police Plaza, CBS, etc. where parking was designated for those with NYP plates only. I was very proud when I got my "Press Plates". It proved I belonged to that special fellowship of news reporters and photographers in the biggest and best city in the world. So the other night when I was driving home from school heading toward the west side, I was outraged when a compact (thank god or there could have been worse problems) SUV pulled in front of me at a traffic light "wrapped" in advertising for the radio station "Hot 97 FM" and tagged with a New York Press license plate. What in god's name is a FM music station doing with press plates! OR could this be someone who is a legitimate member of the press and is picking up extra bucks for renting his car for advertising purposes. I wasn't sure which idea seemed more offensive to my sensibilities but I grabbed the pencil I keep in my side door and a paper bag which I found on the passenger seat and I scribbled down the license plate number just in case I could figure out how to "fix" this outrage.

As I drove up the West Side Highway I schemed how I would call up the "press authorities" and let them know what was going on, convinced they would strip this clown of her/his precious plates and fine him/her an appropriate big dollar amount.

Eventually on the ride up I got distracted from my cause as I was listening to NPR/WNYC and probably getting upset about some other awful world event. But the next morning as I got into my car to drive to work I noticed the paper bag on the passenger seat where I had written down the plate number. I grabbed it with conviction and marched back into my house and up to my husband who was at his desk writing his daily column and I said "Excuse me, I know you're busy but I want to know who I can talk to about the fact that this license plate (showing him the number) a New York Press license plate was found on a vehicle advertising HOT 97 FM and..." I suddenly stopped. I could hear what I was saying. My husband was looking up at me with a grin on his face. And I realized..."I'm crazy aren't I," I asked. "It's neurotic to carry around this much anger over a car in New York City, isn't it?" He started to laugh and shake his head.

And so, in the words of Rosanne Rosannadanna (for those of you old enough to know who she was)...Never mind.

Yesterday was the monthly class meeting for my Policy Practice internship. Dr. Marjorie Rock presented an overview on Community Organizing which is a class she'll be teaching next semester. I urge anyone with the slightest interest in advocacy and macro practice to take it. Unfortunately being an OYR student I will not be able to afford the opportunity as it is offered only in the daytime and I'll be working.

My guess is with a new US President whose skills as a Community Organizer, once derided by his opponents, helped get him elected, a practice focus in CO will suddenly become quite popular.

One of Dr. Rock's primary points was letting students know they actually had a good deal of power available to them in helping to make change within their agencies. As an OYR student there are times I wish I were strictly a student because it would afford me the opportunity to make suggestions for change without concern about job loss or retribution for daring to suggest the agency could do more or at least something different to make itself more responsive to it's clients needs. It's something to think about if you are applying to Social Work Schools with the idea of an OYR program.

It's also something to think about as a blogger. I have purposely not told anyone at work about my blog. I have also purposely not written anything which could be interpreted as negative about the place of my employment/internship just in case. So much for first amendment rights.

It's 4 in the morning. My house is quiet except for those odd noises that break the silence when everyone else is asleep. Maybe there are such things as ghosts who make sure the sounds of dripping water and the whir of white noise permeate the dark air.

I haven't been up all night, though sleep was disrupted a few times by other people noises, which don't usually disturb me. But I'm guessing my sleep won't be the best for some time to come.

As of December 31st my job will no longer exist. This is particularly distressing as an OYR student because it was part of my internship as well. I'm ambivalent about worrying. On the one hand I'm old enough to have gone through this sort of thing before (though not as an intern) and on the other hand I'm aware that being of a certain age, which gives me that wisdom, does not make everyone eager to hire me.

Today, Friday, I hope my head clears enough to ask the right questions. Admittedly I already blurted out "What about my internship, that could really &%#& up my life if I lose that as well?" The answer relieved some anxiety. Thank god I work for a large institution. I was told a deal is being worked on with my Policy/Practice program director to expand my internship with them. Keep your fingers crossed whoever may be lurking here.

Tune in for the next episode. I'm sure to report over the weekend. One such topic to be covered may be how am I supposed to write a final paper with all this nonsense spinning around my brain.

The gym should be opening soon. I think I'll head over there to work out some of this "stuff."

Since learning of its inevitable closing, keeping my mind focused and ever ready to work with patients on our inpatient unit has not been easy. One day I had to continually remind myself what day it was so I'd be in the right place at the right time. It didn't always work.

I missed classes this week. I only have classes on Wednesday evenings so at least I wasn't AWOL for too long, but still, that's not my usual behavior. Now I feel terribly guilty for not being there and concerned about what I missed. I feel foolish for giving in to my anxiety and depressed mood and "just not wanting to face" a roomful of classmates and an energized professor who would expect me to focus, take notes and participate. But I had already experienced being at a few meetings during the week. No matter how much I concentrtated on what the speaker said, I hadn't the foggiest idea what it actually was, though I nodded as if I did.

Friday I managed to get back some of my calm. I learned a number of people are working to find me a paid internship within the institution I currently work which would take me to May and graduation. Then I'll be looking for a job with the hundreds of other graduates on the lookout. But at least I will have had a cushion to work with.

It doesn't take away my disappointment with the unit closing however. The work we did was something I truly believed in. We did integrated treatment for co-occurring disorders. This was not parallel treatment but truly integrated treatment. Along with my own unit the out patient substance use disorder (SUD) clinic is closing at the same time. The Methadone clinic once run by this institution and where someone very close to me began to find recovery, closed over a year ago after about 30 years of operation. I'm not surprised by all of this really, just saddened. My experience has shown me that if something has to be cut it usually falls to whatever has to do with SUD. For all the talk of SUD being a disease or brain disorder I think most people, including health care professionals see it as a moral failing and therefore unworthy of extended outreach. Though even that idea seems to have a Dickensien quality to it. What if it were a moral failing. What if a lack of character caused people to fail at treatment or caused them to begin using and become addicted, why should we accept it as OK to "punish them" by making sure they never get recovery, never become a functioning, productive members of society? How does that help anyone or anything? And whose moral is it, anyway?

I hope you all enjoyed the week off from my "musings," I know I can overburden people with my monologues. But I'm back. And I'm back with a half-full glass and a half-empty glass. The half-full glass contains the saving of my paid internship until I graduate. I am told I will be working in the World Trade Center Program for those who worked on the clean-up after 9/11. I'll continue to do the policy piece of my internship as well which involves 4 or 5 interesting programs in varying capacities. The half-empty glass is the fact that this is a temp job and again when the internship ends so will my employment. But I'm one of those Pollyannaish believers that when one door closes another one opens. Whether there's horror or happiness behind it is another question but at least it opens.

None-the-less it has been quite difficult going to work without feeling defeated, depressed and anxious. I try to do some self-talk on the way up in the elevator like "the patient's still need you, you need to at least try and put out some positive enthusiasm for their sake." As I expressed in an earlier blog, I found that was impossible during the first week. I felt like I was in a state of shock. People would talk to me and I had no idea what they were saying. The following week I got angry and now I've accepted the inevitable with some positive hope for the future. I think I skipped a few Kubler-Ross stages but no mater how you slice it, our unique program for those with co-occurring disorders won't be there for those who need it most.

Some say everything happens for a reason. I believe that as well. But I also believe the reason is something we discover as we go through it or at some point down the road as opposed to being predetermined and imposed by some outside force. If we seek meaning we usually find it.

Deirdre

I walked into my massage therapist's office with a smile on my face. When Dawn, the therapist asked how I felt I said something like, "believe it or not I actually feel pretty good." She said I looked much brighter than when I'd walked in the last few times.

I met Dawn back in October. My stress was expressing itself somatically with miserable neck muscle and head aches. I couldn't relax because the pain was always there. Once before when I was feeling this badly I tried a chiropractor. I had a number of visits but I never felt better. I had recently been to my family physician who suggested I try out the new massage therapist down the street.
So when I finally couldn't take the pain anymore I decided to walk by just to see if I could get the name, hours and contact info. Turned out she was open and could take me for a 1/2 hour treatment. While I didn't feel enormously different when she was done. The next morning I did. She was called upon to make the same magic happen about 2 weeks later when the pain came back. After that I decided to try and keep a monthly schedule in order to keep the nasty, mood altering, work inhibiting, pain, away. No doubt psychotherapy relieves stress and anxiety over time but there's nothing like massage therapy to kick it off or boost the affect.

So what caused the change since last I visited Dawn? Certainly the relief of knowing my internship and at least temporary employment had been set in place helped. But also, complete were my final papers, a power point presentation for my policy internship and the 3 hour CASAC exam I'd been waiting (while working) 4 years to take. Tune back in, in six weeks, to see if I passed. Maybe now you can imagine, my angst at having to wait another 3 years after May to sit for another qualifying exam. Hopefully with all the hard work the LMSW Coalition is putting into it, the "C" issues will have been resolved in our favor and the 3 year road ahead won't seem like it's filled with bogs of quicksand.

Friday, the 19th, was my last day of work. After almost 4 years I ran my last group for the outpatient AOD (Alcohol and other drugs) clinic. 19 chairs with their backs against the institutional yellow walls were squeezed into the square space which usually held 12 to 15 at most. Since joining the staff, almost 4 years ago, we had hoped money would be found allowing for the purchase of new stacking chairs. Chairs which would be made of some material resistant to stains. As it was, most who used the chairs tried not to look before sitting down.

Shortly before the group was to start I was handed my yearly evaluation form to sign off on. I didn't bother to read it. I knew it was not going to be positive, though last year's was glowing. I know my performance was disappointing since learning they were closing the unit and I'd be out of a job/internship. I was disappointed they were unable to see the situation from my perspective. I was disappointed I was met with anger rather than empathy. I said I was sorry a number of times, for disappointing them with my behavior. The only defense I could give was my humanity. I also said I thought it unfair to judge all my work over the year based on the past number of weeks when I didn't perform my job above and beyond what was asked of me. They never said I didn't do my job, just that I didn't do it in the style they'd become accustomed to.

But needless to say, this interaction right before the last group was to begin, caused me to become somewhat emotional and tearful. So I grabbed the box of tissues from my desk and headed down the hall to the "group room," soon to be some mucky mucks new office space. I threw the box in the middle of the floor. I learned this protocol from my first supervisor. The clients defensively laughed and asked "Who's that for?" And I replied, "Me." I'd been through a scene like this once before. I had cried more than anyone in the place, I explained. I thought it was because I was new to the field back then; I really loved where I'd been working and the closing of the agency was quick and unexpected. Well I learned Friday (the 19th) that didn't have anything to do with it. I'm pretty certain I won the title for most tears once again. I hated the idea that a sorely needed outpatient program was closing down. I hated the idea that the clients had formed such strong alliances with those of us who worked there as well as their peers, that this was going to be very difficult for them and that it would be highly unusual if at least a few didn't wind up relapsing because of it. Though I pray that doesn't come to pass.

After the group I had to see my field supervisor to go over the 1/2 year evaluation for field learning. I wasn't looking forward to that, fearful it would be much the same about being disappointing. But we did manage to talk things out as I hoped we could and while I still think we have difficulty walking in each other's shoes, I'm grateful for the support she was able to give me.

Then I returned to my office, not realizing how bad the weather had become. I called an administrator to see if I could borrow a hand cart after hours if the gentlemen who were to help with the move had to leave at 5. I discovered they had left quite sometime before due to the weather conditions. So I thought why should I rush to pack if no one was moving into my office on Monday anyway, and decided I'd better just try to get home in one piece after the day I had and the weather outside, and so I did.

Oh I can be Pollyannaish here and acknowledge that endings are simply the start of something new and perhaps exciting and enlightening. But the fact that it was such a difficult ending saddens me. The fact that no one from upper management came and spoke to the outpatients. Oh, they were set up with other agencies to go to, but anyone who has ever had a therapist knows its not easy for whatever reason to change them when you're not expecting to.

I have two weeks off now. Thank god I didn't have to be at the job until the very bitter end (Dec. 31st). I have to practice a lot of self-care as well as a lot of housekeeping that hasn't been touched in a couple of years, thanks to school. My husband has been overgenerous with his help but there are certain things only I can do. I'll keep all those outpatient clients with me--I've internalized each one. I'm forever grateful for having had the honor to witness their recovery and have them in my life.

I waited a week to publish this blog. I wanted to be sure I wasn't saying anything i didn't really want to say in public. I'm satisfied it's ok.

So have a happy New Year everyone. 2009 should prove to be interesting.

It's the Dopamine, stupid-- to take a twist on an old presidential campaign sound byte. Happy New Year. Did you happen to "let go" more than you wanted to, with or without alcohol? Well according to a small study in the Journal of Neuroscience, those of us considered risk takers have brains which produce a preponderance of dopamine, the feel good neurotransmitter, whenever we take a risk.

The scientists hypothesis came from rodent studies which showed risky rats brains contained more dopamine than others. Each time they took more risk, more dopamine entered their brain reinforcing the risk taking behavior. The purpose of such research, it is believed, could help those with substance use disorders whose brains already set up for risky behavior, begin to use drugs flooding their brains with even more dopamine and the cycle of addiction and its dangerous, risky, deleterious behaviors begin.

Time magazine picked up on the report and suggests that those who are risk takers are at risk to become addicted to substances as well and therefore need treatment prior to their experimenting with drugs.

While this sounds like a noble effort, I do worry about "big brother," in the guise of medical science, stepping in to regulate behavior.

15 years ago I was at the school bus stop with my daughter when I overheard parents speaking about the concern they had about their child who was having trouble in school. She was having difficulty reading at the same level as the other children in her class and she was receiving extra help because of this "learning disability." I remember thinking to myself, why is it that we are always, as a society, so quick to make everyone the same. Will the day come when we live in a grey world of people who all behave and think the same way. Is this what we are striving for?

Last year. it was determined (by responses to a survey) that the happiest people in the world were found in Denmark. The suggested reason for this outcome was that Denmark had the most homogeneous population of those participating countries. So, maybe it is better that we strive to be the same. But I can't imagine a world without risk takers. If we all "played it safe," who would generate new social ideas. Who would fight fires, or go into space? Who would begin a new business, open a restaurant, volunteer for Doctor's without Borders, become social workers willing to work with populations others shun or fear? Will we only treat risk takers for whom their risky behavior interferes with their daily living? Who's to judge whether or not that is so?

Just because we can do it, or imagine it, doesn't mean we should.

I'll close with a quote from Lewis Thomas, which I found about 20 years ago and quite appropriate to this discussion:

"The capacity to blunder slightly is the real marvel of DNA. Without this special attribute we would still be anaerobic bacteria and there would be no music."

Happy New Year everybody.
Deirdre

Are we not all, with high hopes and great expectations for this new year and new administration? Can President Obama ever live up to this ideal, this heroic glory we as a nation have bestowed upon him? I believe so and believing so is more than half the battle. It's a time for positivity and keeping our outlook at what can be done, not the flip side --that which we can't do. Change doesn't come from the status quo. Change insists upon a willingness to take risk backed by a belief system which states whatever the outcome, we will thrive.

We know resilience is a sign of wellness and good mental health. How we handle challenge is a test of that resilience. With all the challenges President-elect Obama has faced throughout his life, never mind the past couple of years, he exudes resilience. Hopefully our nation and its individual citizens will be able to internalize that resilience and move forward as a positive force for good. The dream becomes reality.

Does the title for this blog entry sound familiar? President Obama said most of these words during his inauguration speech. Maybe for fear of copyright infringement he changed the last few slightly. Whatever the reason there's no doubt of their origin. It was the height of the depression and the Oscar winning musical Swing Time added a little positive inspiration to the souls of the suffering citizens of the US or at least gave them a diversion. I suggest you read the rest of the lyrics for a look at history repeating itself.

PICK YOURSELF UP
From the Film: Swing Time 1936
(Lyrics by: Dorothy Fields / Music by: Jerome Kern)
Fred Astaire & Ginger Rogers
lyricsplayground.com/alpha/songs/p/pickyourselfup.shtml>

For a fabulous, contemporary, live from Paris rendition by Diana Krall check out http://www.youtube.com/watch?v=vB04CFXMpHc

I thought this a fitting welcome back to the Spring semester and with some hard work and a little luck--my final one. I'll let you in on how it's going next week. But as a sneak preview just know that while last semester I lost my job and internship as an OYR student this semester is proving so interesting it may have all been worth it. As they say--when one door closes another opens. Good luck everyone...

2-8-09

Last Wednesday I traveled to Albany where Friends of Recovery-New York State (FOR-NY) was convening for a face-to-face board meeting. This was the first since September. I traveled by Amtrak up the Hudson with board President Richard Buckman, who happens to be a LCSW and CASAC. Richard and I have known each other since about 2002 when we met at a “Train the Trainer,” work group for those interested in organizing advocates around the state with the purpose of influencing policy change and eliminating stigma and discrimination in regard to substance use disorders. The late Ruth Maxwell, well known in addiction recovery circles for her work with families, individuals and advocacy, spearheaded the organizing. That was the beginning of my grass roots awakening.

We had a heady agenda to get through and less than 4 hours to do it. Board member Laura travels the furthest; she represents the far reaches of western New York. Mat traveled the least; he climbed one fight of stairs. We began pretty much on time despite our different distances and modes of transportation. Everything flowed smoothly until we got to item three, “Recovery Coach Academy,” which Betty had attended for 5 days. For a few minutes she waxed eloquent over the training. Apparently there was much experiential work done in order to gain insight into ones own relationship with recovery which she found particularly interesting. But there were also phrases used such as motivational interview and cognitive behavioral and other clinical terms one would not expect to find in a non-certified “coach.” I remember sitting there shaking my head the more and more she read. People began to jump in and ask questions referring to “others” who may have issues with such training being a threat to their jobs. Betty assured us that was not the intent but my feeling was, just because you call a car a cat, that doesn’t make it a cat. Just because that is not the intent of the training doesn’t mean it won’t happen.

I’ve had some experience with recovery coaches, or companions, or escorts or whatever the term of the moment seems to be and it’s never been good. The term “escorts” was my favorite given the sordid outcomes I observed. One group reported that they train all their “companions.” But who trains the trainers? The most obvious issue was their lack of boundaries. One tried to give financial advice and move into an empty office at the patient’s business. Another brought the patient home after an alcoholic binge in order to detox them. A young woman had to finally be asked to leave when she insisted on coming onto the unit with the patient and offering their own assessment of the situation. Another came provocatively dressed and another dressed like he came from a touch football game. This is not to imply what Betty was reporting on was the same type of training. But if it isn’t, what is their purpose in training?

According to their website:

“Most treatment programs deal only with the front-end of the problem: usually a brief stay and you're done. Other kinds of support, such as transportation, housing, job training, simply don't exist in most communities. There's rarely someone who is going to help you find a place to live or help you put your life back in working order. This is where CCAR comes in; helping to bridge the gap between treatment and rebuilt productive lives.” ccar.us/

Perhaps because I work in the metropolitan area, such a statement rings false. Social workers, CASACs and case managers all try to assist the patient with a good aftercare plan be that as minimal as seeing a psychiatrist once a month for medication to setting up an intensive outpatient treatment where the patient not only attends groups and sees an individual counselor or therapist but also is assisted in accessing vocational and educational job services as well as child care and assistance in obtaining housing and further medical care if needed.

So do I worry for those social work/case manager jobs when I hear about such training at CCAR? You bet I do! Do I think they have the same professional expertise after such training? Of course not! My real concern has to do with our state and federal agencies who, in particular, pay for many of these services through Medicaid funding. I fear utilizing such services affords them a cheap labor source which then devalues everyone’s work.

On the other hand, middle class families rarely have such supportive services.
Private insurance, in general, will pay only for acute medical treatment such as a 5-day detox and then the patient is back out there again. How many times have I heard patients say, oh, no, my insurance company gives me 28 days inpatient. And in order to protect this belief, they refuse to hear that even though the company says they will cover that much, it doesn’t mean they have to give it to you. If you are looking for your first inpatient treatment and you haven’t tried outpatient, most companies will not allow for it.

This being the case, Recovery Centers and Recovery Coaches may hold the key to helping peers continue in their recovery. But still I worry. I worry when government agencies are anxious to sponsor the start up funds for such places – places that rely on volunteer services to do the work of professionals. When you don’t need a license or certificate to operate, who conducts the oversight to make sure no harm is being done? No one. This is why sober housing or halfway houses or recovery homes or whatever the term of the moment is are found to be unsafe and undesirable. Lack of oversight can certainly ease the development of such centers, which can be a good thing, but looking at our current fiscal crisis and financial debacle we also understand how lack of oversight can collapse a “voluntary” system of recovery as well.

True, 12 step organizations have managed with a voluntary work force for over 60 years and can now be found in all corners of the globe successfully helping those with a myriad of issues. But the difference here is money. 12-step groups basically take a vow of poverty. Individual members can do as they please but as a group they take no funding from outside sources. Because of this they owe no allegiance to anyone and no one owns or owes them. Hard to comprehend in a capitalistic society but it’s obviously been working just fine.

I have no definitive answers to these issues I’ve raised. Perhaps the more we learn, brainstorm and tolerate others opinions the closer we’ll come to the “good-enough” answer. Perhaps the answer is far bigger than any of this. I’m old enough to remember when Communism imploded. I also remember thinking back then that Capitalism may not be far behind.

Happy Valentine's Day Everyone,
Here's a little light-hearted (pun intended) story for you.

On Monday's I get to drop by my Policy/Practice internship office around noon. I go after a staff meeting for one of the programs I'm working on. I don't have access to a computer at my other placement so I like to check in to see if anyone has emailed. I also needed to use the bathroom and as I entered and flipped the switch, nothing happened. I jiggled it this time but still nothing happened. "Hey, what's up with the light in the bathroom?" I asked, turning to no one in particular in the office. "The light bulb went out, Jerry already put in an order with building services. Just crack the door a little to let enough light in," I was informed by a fellow intern. "Ok if that's what you say," I replied and made use of the facilities.

The next day I was scheduled to work in the same office. I usually get in earlier than most and that day was no exception. A couple of hours later someone went to use the bathroom and shouted out the same question I had asked the day before. They got the same reply as well. "Is this some kind of special bulb?" I asked once again to no one in particular. "I don't think so," said a fellow intern. "Anyone got a flashlight so I can check it out?" Jerry in the office behind me called out that he had an order in with buildings to take care of it. I checked out the room anyway and found they were simple incandescent bulbs. Not even the energy saving curly florescent bulbs many people are switching to. "Well that's what I heard yesterday," I replied with a smirk. "If they don't come soon, I'll go out and buy some myself," said I. Then I went back to work. Shortly after I heard a staff member speaking to Jerry behind me asking if we had any petty cash. Jerry said he thought we did and inquired why this person wanted it. "I thought I'd go out and buy some light bulbs," was the reply. About 10 minutes later I hear Jerry's voice again, "Does anyone know where I can buy some light bulbs?" "Sure I said, You know the little everything store on the corner of 97th and Madison, they should have them." Then someone else asked him if he knew what wattage they were. He told them he'd check, and so he went back to the bathroom, unscrewed one and off he went. About 10 minutes later he returned and with bravado announced he'd found some bulbs and would put them in. For some reason another staff member followed him into the tiny bathroom and stood by the door as Jerry took to unscrewing the two bulbs behind the glass. "Ok, everybody," I loudly proclaimed. "Now we know how many social workers it takes to change a light bulb." A lot!

Have a great day everybody!

Could you come up with a title anymore magnetic than this for a psychoanalytic symposium? Well I couldn't. Especially given the time we are living in. But then again I had never been to a psychoanalytic symposium.

Here were smart, some even brilliant analysts presenting on a topic no tabloid or reality television show would turn down. And yet, it was excruciatingly boring.

The opening introduction was presented by a gentleman who utilized the podium as a physical support while in a monotone voice read, barely looking up to acknowledge there was an audience, for a good 20 to 25 minutes from a prepared speech. I don't believe he ever actually introduced the upcoming authors either; he was much to interested in presenting his own meanderings on the issue.

I read somewhere that in any kind of presentation, the speaker will lose his/her audience for a few seconds every 7 minutes or so, and that's even with a motivational speaker and fireworks. In the case of this gentleman I think he lost me for 7 minutes every few seconds.

Well, I guessed, he just must be some honorary, old coot who they let come out now and then to do this. Unfortunately I was very wrong.

According to my online dictionary, a "symposium," is first "a conference or meeting to discuss a particular subject." The second definition is a collection of essays or papers with numerous contributors. The third is, oddly enough, a drinking party full of convivial discussion after a banquet. If you can imagine the complete opposite of the third, that's what we had.

There was no discussion of the subject matter. There were six papers, not presented, but read, by their singular authors as if we were an audience of early 20th century upper class gentility enjoying the hospitality of Mr. and Mrs. Andrew Carnegie at their home not far from where the actual symposium took place. Admittedly one presenter did try to enliven the afternoon with film clips from the late 20th century film,"Wall Street" interspersed throughout her paper. And another did attempt a power point. It looked as if it might have been his first try at such as he only used 4 slides for his 1/2 hour read and each of them still showed the outline of "Title goes here," from the template given to follow.

Perhaps the next time a large group of analysts come together they can invite members of "Toastmasters," whose primary purpose is to support each others endeavors at learning to become better speakers and presenters at forums such as these.

But back to Mr. Carnegie. While the speakers poked fingers at the likes of former governor Andrew Spitzer, Enron's Ken Lay and the original Ponzi, who apparently failed miserably at the scheme which now bears his name, no doubt Mr. Carnegie would have enjoyed this topical presentation. He did not come from money but rather believed man should spend the first part of his life amassing wealth and the second part giving it away. In his tract "Wealth" http://tinyurl.com/ywyghb his devotion to capitalism never comes into question but his views on individual wealth would probably be considered sacrilegious, most especially by contemporary conservatives. He did believe in a certain redistribution of the wealth. He believed in an estate or "death tax" and a graduated, progressive one at that. He believed leaving vast sums of money to heirs was a burden to them. He believed leaving enough to keep them somewhat comfortable but not enough to make them lazy was what to strive for. What he most believed in was giving away vast sums during the earners lifetime. He acknowledged that it was the greater community which allowed him to amass his wealth and therefore deserved to share in it. His favorite recipients were libraries, education and science. He wanted to help elevate the poor in much the way of the proverb: give a man a fish and he'll eat for a day, teach him how to fish and he'll eat every day. Idealistic and perhaps and a bit narcissistic but worthy nonetheless.

Too bad there aren't more Carnegies to at least balance out the marauders of Madoffs.

Many things have been on my mind this week. Too many things. This is why I drove through a stop sign in my small town on my way to a meeting. As I pulled over to park the car for the meeting, I noticed flashing lights pulling up behind me. "What's this about," I wondered. An incredulous officer came to the window, "Didn't you see the stop sign back there?" "Yeah, are you trying to tell me I went through it," I asked? "You mean you didn't know you went through it" he responded? "Well, I guess my mind wasn't where my body was," was pretty much the only excuse I could come up with. By the time he handed me the summons he thanked me for being "so nice."

So where was my mind? The previous day I learned my daughter had flipped her car on the way to her internship. The car was totaled, she was bruised, but in one piece. I'm still trying to learn how not to carry around the WTC workers with PTSD who I meet with at my internship. Also sharing brain spaceI was my therapist who just learned his wife's cancer returned.

I always have the feeling (anxiety, perhaps?) I should be doing something else, somewhere else from where I am at the moment and try to remember to check my calendar at least 5 times a day to see if that's true.

I'm trying to learn if someone asks me to do something and I run out of time to do it, it's not because I'm "slow, stupid, ditzy, unqualified, irresponsible, disorganized, old, etc.," but rather I just didn't have enough time to complete it and didn't want to admit to such before hand for fear they'd think all those things I just mentioned.

I'm concerned about what's going to happen when I graduate, which now, 10 weeks away, looks like it will.

A number of us in group advisement were talking about really wanting a job but at the same time wanting a break. So we've been ashamedly putting off a full tilt search. We've all worked so hard over the past number of years to get where we are we think we deserve a month or more off, maybe? I know I haven't seen the back of my closet since 2005. But,"it's the economy, stupid."
Dare we test the fates?

And there's another portent of an absent mind. Will the stimulous package do what the President expects it to do? Will more non-profits fold due to poor investments with anti-social narcissists? Will health care become an oxymoron? And will funding for recovery from substance use and mental health disorder treatment and research fall to the bottom of everybody's priority list.

I'm an agnostic on this. Oh, me of little faith I wish I could think otherwise. I know it would help to keep me from going through stop signs.

But my brain got a little reprieve last night when my husband of 31 years (yes, we were chidren when we married) told me he posted some poems he'd written for me to his web site. "Excuse me?" My disbelief was showing.

In those fanciful, passionate, hormone flooded days of early lustful love we wrote. But the poetry was one sided. In one of those headdy love sick stanzas I remember asking if ever he would write the poem promised to me. So last night I crawled into my bed and under my down comforter with my trusty mac warming my lap and for a moment all those people living in my head went away. Instead my life partner's words rang true. It took 32 years but it came at the right moment. (Click the title to go to the entire poem and others.)

Poems for Deirdre

I think you thought

you were marrying a poet.

I did.

But I wasn’t a poet,

because I wanted my poems

to be perfect.

I walk around wondering what I didn't do, what I should be doing, where I should be doing it and what I'm doing it for. I check my day minder at least 2 times a day, check my blackberry to see if my message light is flashing and the calendar on my laptop as often as I can think of it. I wake up with a jolt thinking, OMG I forgot I have to go through all the articles on implementation and write a page on each while I've been focusing on trying to get to a WTC computer to input and print superbills and progress notes but the offices are already filled with other people who have patients to see. Is tonight the F2F meeting at OMH? Did I remind everyone I have to be in DC at the end of the month? I never did call back that job recruiter I've been playing phone tag with. And the dreams--very busy dreams. Why did I pick a fight with that jerk in the gym? That's not like me! Headaches never relieved, except at the gym when the jerks aren't around. Does anyone know when Easter is? Spring break, sure, all 3 1/2 hours of it on Thursday night. Is that Holy thursday? PTSD. She was walking out of the subway station when the body parts hit. Why didn't they tell us? All that paper survived. Remember? Floating paper against that piercing blue background? Of course there'd be parts. Is it Saint Patrick's day yet? Duncan turns 20 on St. Patrick's day even though he's Colombian. But the "real IRA" is back. More death, more body parts, more dreams, more papers--not floating but due--due when? Maybe it's April. Fools. Maybe I'm the fool. Fool me once. George W. Fool. Vicarious Trauma. Anyone gotta job? Got Job? Get job? Have job? Will travel. What about the license? Where do I apply? Did I already apply? 5-ll, 5-ll, 5-ll. 9-ll? No, 5-ll it's over. No more floating paper, floating people, floating dreams. It's 5-ll. No more 9-ll. It's 5-ll. Nothing more to prove? Everything to prove? 5-ll, 5-ll, Impending doom? Impending soon? I'm pending. How about you?

After last week's blog I met with my supervisor at the WTC program to discuss the secondary trauma I was experiencing. I realized afterward how fearful I was of letting her know I was having a problem "handling the patients." I mean how could I let her know I couldn't do my job? Of course once I did, I learned "Oh, we all went through that when we started here." She spoke to me about having to learn to contain the affect in the room and recognize that when we monitor (asking 100 +/- questions for the purpose of research ) we are not doing therapy and that it isn't particularly healthy for the client to let pour out his/her whole story and for me to hear it.

Immediately after that meeting I had a patient who began the session by drawing where he was and what he saw when the second plane hit. I knew right away I was going to have to find a way to gain control, keep the space safe and contain the affect he brought to the meeting. To my relief I was able to explain to him that we weren't there for therapy but that if he felt the need to say more about something specific when we finished with all the yes/no questions he would be welcomed to do so. Of course the struggle to keep him focused on yes/no answers continued throughout the interview but it grew less and less difficult. I was very proud of myself and very grateful to my supervisor.

Yesterday at the monthly Mentoring Meeting of the Westchester NASW I brougt it up again. A lot of good advice was exchanged from meditation, actually taking lunch and getting out, taking a break in between patients, stretching, doing a puzzle and perhaps listening to classical music on an Ipod. All good suggestions I hope I remember.

I was also reminded by my SSW advisor that hearing these difficult narratives is not the only difficulty I've been trying to handle. In my final semester I unexpectedly face having tp look for a new job; school will be completely over and what will that mean to my identity; the licensing exam and the application to take it are staring back at me from the not too distant future; we suddenly moved our offices from 98th and 5th to 102d and 1st, not exactly Siberia but the sense we are not really connected to the main campus and now take a shuttle bus to get from one building to another. I could go on with a litany of more big changes but it wouldn't get me anywhere and isn't all that interesting to those who aren't going through it. But it is odd to feel like we're winding down and yet on hightened alert.

To all those who said "three years will go by in a flash," phooey on you. They did not. It was an enormous amount of work going to school almost full time and working more than full time. It's why I am counting the days/weeks ahead. A few weeks off, if not longer, will be welcomed and deserved. While I graduate on 5-11
and I'm sending out my first batch of job applications tomorrow, I'm hoping I can hold off on actually having to take a job until the middle of June. I hope that's not too selfish a thought in this economy but I am trying to learn self-care.

I had to miss school this past Thursday night. I hoped my Advanced Policy professor would forgive me as my reason was very policy oriented. I was asked by Office of Alcoholism and Substance Abuse Services (OASAS) to participate as one of 2 representatives from New York State. My one hour flight going had a 2 hour delay and my return flight set for 8:20 took off at 10:45pm. But everything in between went well. It was an emotional few days for a variety of reasons. Below is something I posted to the website my husband and I have had for sometime but recently resurrected. It goes by the title of this blog entry.
Please visit and join the conversation at The Elephant on Main Street

As I write, I am in the vicinity of Washington DC (Rockville, MD to be exact) attending Families of Youth with Substance Use Addiction: A National Dialogue along with other parents and guardians (overwhelmingly women) from across the country. I don't think Hawaii is represented but Alaska is. Our Alaska mom, with angelic red hair, looks far too young to claim a 20 year old as her child. But we listen as she tells her story of generational alcohol addiction. We listen and applaud her strength as a single mom standing up to a system she has grown to know and not because she wants to. She wanted a stable life for her children. She lives in the same home for 20 years. Far different from the 28 schools in 16 states she experienced as an only child of a single mom who used alcohol and "adventure," as an answer to her creative energy or perhaps the damning demons which controlled her.

There are far too many moms here who have lost a child to addiction. There are far too many other's who have lost more than one child. One of the organizers of the conference, Shannon CrossBear of the Federation of Families, was born, raised and lived with her own family on the "rez," she told us her story...

I Grew up on a couple of reservatons. My tribe sits in Minn. Wisconsin Michigan and Ontario. I grew up in Minn and Ontario. We knew from day one about alcohol and other substances. You don’t grow up in a tribe and not know. We lived in log house we built ourselves. We lived 230 miles from the nearest gas station. But alcohol and drugs find their way everywhere. We had a dry community—all that meant was bootleggers made more money. (showing photo of family—the "children's table" at thanksgiving) There are 6 young people at that table. Some are still with us and some are not. One is in jail and probably will be for a very long time. One was pregnant at 15 as a reslt of drinking. One died by suicide, another has had two kidney replacements and the second one is failing. He's only 32. One died as a direct result of drinking. We sent him money to come home. He got to the bus but across the street was the liquor store. He still had the money. The pull of alcohol was too great. He died that night. That was this past November.

There were stories of mom's violating their own children (turning them into probation) with the hope that it would help get them clean. There 's the story of the California mom who worries we won't understand her as she speaks courageously through her Mexican accent. But we understand her all too well when she asks if there isn't somewhere she can move where her son, when released from prison, will be able to get a government loan to go to school and/or get a license to work, where the felony drug charge he is supposed to have served his time for, will not make it possible for him to start over.

These are some of the stories that brought all of us together for 2 days. These are the stories of women and men whose pain was turned into activism and advocacy. These are the stories of warrior mom's as one calls herself. And the battle seems endless but to do less is unthinkable....to be continued

And how does that make you feel?

In the moment, it makes me feel relieved. Three years is a long time to be working full throttle without a significant break. But May 1st it all comes to a grinding halt. Last week my emotions were all over the place and my mind was NEVER where my body was. I had a job offer. A good job offer in a place familiar to me because I once did an internship there. But it was my first interview! Don't get me wrong, it's exciting to be offered something so quickly into the job search but there's little voice gnawing at me saying "but what else was out there?" I think I sent applications to about a half dozen places. Some were delivered electronically other's by snail mail. I did hear from two other prospective employers right before I took the first offer. Both began with an offer of salary, concerned that it wouldn't be what I was looking for. The first offer was way under the mark, a salary I worked for 6 years ago even prior to becoming a CASAC-Trainee. The second was closer to the mark but still an easy number to turn down. While salary certainly isn't my only reason for taking a position, neither of these prospective employers were my ideal either. So I'll be working for a large non-university affiliated hospital. I'll be in a satellite Intensive Outpatient Program which is approximately a 15 minute commute from my home.

So I'm relieved. When I called and accepted the offer I was amazed how quickly all the turmoil, angst, and anxiety left my body. I could suddenly think again. My brain didn't hurt. Now all I had to worry about were my two final papers, my daily work/intern schedule and I was home free. So I'm writing this when I should be writing one of those papers.

By the way, there are discussions going on as to whether we will continue our blogs under the auspices of NYU or go out on our own, or close them down, if we choose. It's difficult to go on not having a sense of how many check in with my blog. If I'm writing for 3 or 4 people I best concentrate my efforts elsewhere. Let me know if you'd like me to continue...

I keep wondering why I sound so delighted to be out of a job, out of school, and out of Manhattan. I think the anxiety of the inevitable has something to do with it. Knowing I have another job waiting has something to do with it and not having more than two days off in a row since December has a lot to do with it!

While school is over, learning never is. Admittedly I wish I was 20 years, even 10 years younger.I would be exploring a doctoral track right now. But I see the doctorate as a 10 year process which would have me finish up just in time to collect medicare. Which I would most likely need after 10 years of intense work in a day job and 10 years of intense school work combined. Who knows how high levels of cortisol coursing through my veins would effect both physical and mental health!

Even committing to two years of institute study sounds profoundly exhausting, especially if I have to travel back down to Manhattan to do so.

One of my co-workers (an MPH) in the research dept. just announced she accepted an offer of 3 years of funding toward her Doctorate at NYU. She was so happy and excited. It's funny being in a research dept. People seem to come and go regularly and with great excitment, congratulations and encouragement. People on the clinical side seem to sneek out never to be heard from again.

My husband's desk at home (where he works) is a clutter of coiled wires and rectangular shaped objects that whirr and purr and flash colored lights not unlike sci-fi movies of the mid-to-late 20th century. I fully expect to come into his office one day and like the Christian idea of rapture, find him gone into some other dimension. Maybe I'm thinking this because we saw Star Trek last night but I don't think so. There was more face to face communication between and among people in that film than I find in my daily family life. None of the star trek characters seemed to be twittering or blogging or even phoning home. They were all in each other's faces, not always pleasant faces, but physically and mindfully present.

This morning I woke up to my husband explaining to me his "tweet dek." This is apparently some program that allows you to intantly note when someone has sent you a tweet or responded to a facebook posting. I imagine my husband is a bit unusual for a 56-year-old male in our present society. He keeps up with all things electronic that have to do with communication. We had our first "portable" computer in 1982 called a "K-comp." This was a hulk of a metal box which was nothing more than a word processor on steroids. Shortly afterward he worked for a company called "Prodigy," which attempted to deliver news by way of computer to a very small network of people in a particular area of New Jersey. We purchased our first apple in 1989 and our world hasn't been the same since. My 24-year-old daughter states that she never remembers a time when there wasn't a computer in our home. She has fond memories of playing "Manhole," a black and white "children's" program the purpose of which was to adventure off like Alice in Wonderland through rooms and towers and ships with a walrus and other odd creatures. None of us could get further than the ship wreck and still we wonder what was beyond that. Our son, a late bloomer when it comes to the spoken word, was an expert gamesmen with the Mario Brothers when he was a mere 32 months old.

But I digress. I'm writing this blog from a lovely rental retreat in the Catskills. All four of us have gathered here on vacation, fulfilling our promise to ourselves to always have at least one family vacation a year. It's my last before heading off to my new job as a newly ordained social worker. We trekked up Bellayre Mountain and had the trail to ourselves. We can sit on our deck and meditate on the mountain which stands before us. We can breathe air kept cleaner by fewer cars and more trees. But in the evening when we find ourselves indoors something else is inspired.

I bring board games wherever we go. I guess I have a fantasy as to what the perfect family looks like on vacation. Part of the fantasy involves engaging in board games with teasing and prodding and laughter a part of the process. We usually get to at least one night of such entertainment for which I'm always grateful. But usually our evenings center around the kitchen table each with his/her mac book front and center. Is this really any different than when we sat around the television occupied by mindless comedy presentations or the evening news? Yes and no. Yes because if we are all occupied by one idea we at least know there is a shared experience. The only thing shared when we each have our own computer is the table we're sitting at. Of course we each do look up from the screen now and then and share some discovery or discourse we've had with a friend we've never met other than on line.

Yesterday my husband informed us of a futurist who believes the day will come when human and machine will be joined as one even if we can't imagine it now other than in the current "Terminator-Salvation." I assured him I'd be part of the resistance.

It's our last day in the mountains. We'll return to Hasintgs at some point in the next 6 or 7 hours, though another week here would be fine by me.

My parents had a home in Washington County on the Vermont border for 30 years. We sold it in 2000, hours before my father passed away. We knew we'd miss it but we also knew we couldn't take care of it or make use of it the way my parents had. They purchased "the farm" the summer I graduated high school. It really was a dairy farm at the time and continued to operate as one for the next few years until Hazel's husband died and her son decided he really could no longer operate two farms at the same time.

There were two houses on the property when my parents first acquired it. There were three by the time we left. We moved into what was the tennant farmer's house. If it had been lived in recently the remains of the house looked as if they had been inhabited by indentured servants just scraping by. The entire structure was in disrepair and my parents spent the next year or more tying to convince the locally hired trades people to do what they'd been hired and paid to do.

With my mother's borderline voice reverberating in his head, "Bill, I told you they were nothing but a bunch of good for nothing yokels who just want to take us for everything we've got," my father would make the 8 hour round trip to check in on what was or was not being accomplished. Then again maybe he enjoyed getting away from the borderline voice for those few hours. Though, there was no doubt we were being taken as best we could be, for I believe at one point I heard my Dad say that 4 new windows cost us $10,000. But shortly after that he managed to locate some workers who actually did do the work for a fair wage and presented us with a lovely and liveable 5 bedroom 1 1/2 bath farm house which dated back to the 1830s. The farm land itself consisted of 530 acres of meadows and woods. On a clear day if you climbed to the top of the hill you could see the Adirondacks to the north, the Taconic range to the south and the Green Mountains to the East. And the cows grazing nearby on grass and alfalfa and what ever else dairy cows ate.

But today I stit on a large wooden deck afixed to what is known as a chalet, with three bedrooms, one bath and a "great room"-- one room which consits of the kitchen, dining and living areas. It's perfectly sized for minimal upkeep and maximum comfort. We learned that the house is located in an area which was originally developed for gays back in the 1970s. We learned this while visiting a friend who lives about 35 minutes west of here. Having never met the owner other than by email, it helped explain or confirm the choice of videos we found in his house. Barbara, Liza and Elaine Stritch lined the shelf along with Mrs. Doubfire and The Band Played On. Some years later the development had to open up to straight folk as well, when the houses began to change hands. Hopefully by that time there was less of a need to feel a segregated development was necessary. Hmmm I wonder if I unconsciously chose "Milk" from the video store for watching while here. No one in my family wanted to see it. They all thought it was going to be too sad. I wanted to see it at least for Sean Penn's performance. Too bad they couldn't find an openly gay actor qualified for the role. But then it probably wouldn't draw as many people like me to see it. I thought Penn was good given what he had to work with. It seemed like a low budget Halmark Hall of Fame movie to me however.

Anyway I have no desire to leave. I want to wake in the morning and have my senses experience what is here. I am relaxed. I am so relaxed I've managed to share my naked legs and arms with as many as 15 cluster flies at a time, without any detriment to my concentration. I'm not sure what it is they enjoy about my skin but they certainly keep busy. Maybe they're enjoying the novelty of a new experience just as I am.

I've been spending weeks now trying to determine how best to write about what I do and my thoughts about where I do it without finding myself on the unemployment line. This is tough stuff. I haven't named who I am working for but I can't say what I really want to say without worrying about it. I suppose I could keep telling you all about a friend of mine who once upon a time in a city far far away got a new job in an outpatient day rehab in New York State. Any other suggestions?

In the meantime I'm taking my licensing exam on Monday and trying to study. Wish me luck, I'll let you know how it goes.

The below article came from a site called getdegrees.com
The site seems to be an "advertorial" meaning the editorial content is there to promote the advertisers. In this case they all seem to be online universities like

University of Phoenix

Social Work Salaries

Career Center - by Get Degrees Staff

Social Work Salaries

Social work is a tough business. Social workers see what is broken in families and social systems. They work with people in difficult situations who are often stressed, unhealthy, and discouraged. If you are get satisfaction from helping others, are good at problem solving, and are emotionally mature, earning your degree in social work might be the perfect choice for your future in the field.

Social Work Degrees and Training

A career in social work requires academic preparation. Although it is possible to find work with an undergraduate degree in sociology or psychology, most positions require a social work degree (specifically, a master’s degree in social work). As of 2006, the Council on Social Work Education accredited 458 bachelor’s degree and 181 master’s degree programs.

Besides academic preparation, all states require some form of licensure, certification, or registration. Although these requirements vary from state to state, you should expect that you will need up to 3,000 of supervised field work to become licensed.

What Kinds of Jobs Are Available with a Degree in Social Work?

The U.S. Bureau of Labor Statistics (BLS) breaks social work into four categories: child, family, and school; medical and public health; mental health and substance abuse; and other. As of 2008, the mean annual wages for these categories ranged from the $39,630 (substance abuse) to $48,180 (other).

The top paying jobs are most often found in the public sector, working for the government (federal executive branch) or in education. Annual mean wages for social work positions in those fields were $65,490 and $56,530, respectively, according to the 2008 BLS salary reports. Private sector positions with insurance carriers had an annual mean wage of $55,590 in 2008. One of the highest paid positions for graduates of social work degree programs, in dentists’ offices, pays an annual mean wage of $111,480.

In a field like social work, the lines can blur between public and private sector because of grants and other public funding that might be paying the salaries of workers in a private company. Hospitals are a great, top-paying example, with general medical and surgical hospitals paying social workers an annual mean wage of $56,450, and psychiatric and substance abuse hospital salaries coming in at $54,170.

Although substance abuse social workers earn the lowest mean average wage, this category is projected to grow by an astounding 30 percent from 2006 to 2016, an increase that far surpasses the already healthy rate of 22 percent for all social work positions–a net gain of 37,000 workers. In terms of raw numbers of new jobs, the child, family, and school category comes out ahead, with an anticipated 54,000 new employees.

Where Should You Take Your New Degree?

Work is most plentiful in urban centers, but there is also more competition there. Across all four categories, the states that pay the best are: Connecticut, New Jersey, Rhode Island, Nevada, and Hawaii.
However, if you are especially interested in medical and public health social work, you might consider employment in California. Although there is a lower concentration of jobs available, the top five best paying metro area for this category are all in the Golden State: San Francisco Bay area, Madera, San Luis Obispo, Vallejo, and San Jose. Mean annual wages range between $63,680 and $65, 390, according to the 2008 BLS salary figures.

Of course, there are no guarantees in life, but if you are looking for a career in a field that has a better than average outlook for growth, you might want further to investigate social work.

Lorraine Watkins
Lorraine Watkins is a business writer and a regular contributor to business and education websites. She is a graduate of California State University, East Bay with an MA in English

Apparently babies need other people to learn. They take in more information by looking at another person face to face than by looking at that person on a big plasma TV screen," she said. "We are now trying to understand why the brain works this way, and what it means about us and our evolution."

The above is from a story on how humans best learn from other humans--in person not on screen. I happen to have a phone phobia. For years I've tried to overcome it to no avail. I would much rather get in my car and drive to a persons house to ask them a question than pick up a phone and call them. Obviously I'm ok with on line communication as well, but not the phone. I wonder when we're all at the point of using skype and embedded cameras in our computers will it be easier for me to use the "phone." Anyway this is an interesting story from Science Daily...

http://www.sciencedaily.com/releases/2009/07/090716141134.htm

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

About

My mother was a product of "The Great Depression." She suffered from much anxiety her whole life but perhaps none more than this. She often worried that any particular high priced (in her eyes) item would "send us all to the poorhouse." Not until graduate school did I learn there really was such a place.

With most of our laws here in the US based on the English system of governance, we can trace our welfare state roots back to the Elizabethan Poor Laws of 1601 when managing the poor was actually codified and "workhouses," (rather than poorhouses) were found in parishes all over England. The system then, as now, was punitive in nature and based on the belief that it was the the poor's own fault for being so. In my mind we can trace this belief back to the Christian notion of "original sin," and that humans are basically untrustworthy, unreliable and given the opportunity, a pack of thieves. So then as now, being poor was a full time job and the opportunity to change such status was/is minimal. In fact I dare say virtually impossible unless those of us charged with their care find ourselves taking liberties with the system we are pledged to be accountable to.

The only way I might be able to accomplish all the paper work I am obligated to complete within a week's time, would be to work 6 instead of the 5 days a week I am hired to. And that would be a week without having to do intakes, minimal games of phone tag and certainly not the last week of the month when all the 20 reports containing attendance stats, urine drug screens and behavioral updates are due on each patient to each agency they are connected to. These reports have their purpose--to catch a thief. Are they absent more than 2 days this month? Is the marijuana still showing up in his urine? Do they participate in group? Do they own the fact that their use had criminal consequences? No? Off with their heads! Take away their shelter, their allowance of $45.00 every two weeks, the food stamps and the medicaid. Then they'll understand!

I must have missed the course which explained these interventions.

They appear in our newspapers daily. They appear each night at the end of the major network's evening news. They appear as statistics on radio news programs and other media outlets. They tell us that another member of the US military lost their life in Iraq or Afganistan. Sometimes I turn away as the roll call comes up on the screen. Usually I turn the page in the paper without reading past the headline. But today something compelled me to read about Army Private Keiffer Wilhelm, 19 of Plymouth Ohio. Maybe his unusual name intrigued me. reminding me of the star of America's most torturous television series, "24." Maybe it was his age, a year younger than my only son who I just watched play Rugby for his college club team so alive and vital.

The short piece began by telling us that Private Wilhelm loved karaoke, surprising people with bear hugs and carrying on the family tradition of military service. We learned he was excited to be going places he'd never been before and seeing unusual sights. According to his mother he was "looking forward to going to Iraq." I was beginning to wonder if I'd ever be told how he died. But then it came, causing a sick flip to my stomach as I learned he committed suicide in Iraq the same day my only daughter turned 25.

The AP obituary didn't gloss over the death but noted that an investigation has led to charges "against four soldiers who the military says were mistreating some of the men in their platoon."

I'm still sitting with a queasy stomach--not wanting to imagine what "mistreatment by soldiers of men in their own platoon" could be.

I've known madness. I know of suicide. I know nothing of war and pray my children never will and no one elses children will find the pain so devastating that death by their own hand seems their only relief.

According to news sources, since the conflict began, 1,985 troops have died by suicide. This is nearly three times the number of all U.S. troops killed in Afghanistan within the same time period.

Continuing to allow our children to kill, be killed and kill themselves is surely "mistreatment" as well.

Below are 5 short "interviews" with Nora Volkow, Director of NIDA on 5 different topics. They are all on a website called Big Think, which in itself seems to be a very interesting site which brings this same type of interview to you from hundreds of diverse thinkers and experts in their fields. I thought you'd enjoy knowing about it...

When Loving Parents Raise Addicts | Nora Volkow | Big Think
Nora Volkow Absolutely Oh absolutely There's an enormous amount of evidence
about how important nurture is in terms of either protecting or making a
kid ...
http://bigthink.com/noravolkow/when-loving-parents-raise-addicts

Tricking Your Brain into Healthy Addictions | Nora Volkow | Big Think
Nora Volkow Yes indeed Unfortunately drugsagain it depends on the drug
obviously Not all of the drugs are the same In terms of how addictive they
are some ...
http://bigthink.com/noravolkow/tricking-your-brain-into-healthy-addictions

The Impossibility ofJust Say No | Nora Volkow | Big Think
Nora Volkow Many surprising findings have come across the studies that have
completely destroyed all of the hypotheses that we initiated with For
example ...
http://bigthink.com/noravolkow/the-impossibility-of-just-say-no

Why Diets Fail | Nora Volkow | Big Think
Nora Volkow Well again it's very difficult to diet A person wants to stop
smoking right They are addicted to smoking and it's not so hard to stop one
two ...
http://bigthink.com/noravolkow/why-diets-fail

The Unyielding Power of Dopamine | Nora Volkow | Big Think
Nora Volkow Dopamine is a chemical substance that serves to send messages
between two cells in the brain and that's we call neurotransmitters There
are many ...
http://bigthink.com/noravolkow/the-unyielding-power-of-dopamine

Addicts and other individuals with Axis II personality disorders see the world in terms of black & white. I sometimes think it's my primary job to help them find the gray areas and be comfortable with them. I watched a documentary today which won the Sundance Film Festival top award for documentaries called "Bigger, Stronger Faster." It's written and directed by Christopher Bell who along with his two brothers developed an obsession with body building, and steroids. Chris was the smallest of the three brothers and remained so as he was the only one who thought steroids was not the way to go. All three were overweight children, made fun of by their peers but they found with weight training they could mold themselves into something or someone else. They became people others respected. One gained fame on the football team. Another went into professional wrestling and Chris filmed them all.

A number of themes run through this remarkable doc but steroid use is the most prevalent. Chris Bell's evolution from a black & white thinker who believes that steroid use is both immoral and dangerous to one of grey ambivalence, reminds me of my own journey in terms of illicit drugs. It's a journey few dare take and I applaud Bell's willingness to seek out both sides of the issue in order to better contemplate the grey. It's the journey where libertarian/conservatives and liberals often cross paths. How much should the government interfere in our lives to protect us from perceived dangers to ourselves?

One of the most interesting segments of the film questioned how we decide what dangers or risky behaviors we are willing as a nation to allow. The interviewee pointed out that we take calculated risks for a variety of reasons every day which are no more dangerous than steroid use. We still permit people to drink alcohol and smoke tobacco with relative ease. We issue no buyer beware statement when it comes to the selling of what we term "supplements," much of which have no proven health value and to the contrary could be proven dangerous if studies were demanded. We are permitted to get into various vehicles on a daily basis and drive or are driven at speeds which put our lives or the lives of others in constant danger. We are permitted to ski the slopes of mountains which have seen their thousand broken bones and brain injuries and deaths. We are allowed to ride motor boats and larger water vehicles with no license or testing necessary; to say nothing of owning guns licensed or unlicensed and the lives they take each year. We eat genetically modified food with no long term studies as to safety or nutritional value. We go bungee jumping, ride ATVs and trek up Everest where accidents and deaths are not uncommon. So why draw the line at certain substances? Why allow amphetamine based drugs to be given to children so they can compete better with those whose attention is determined by other genetics and yet not call it a performing enhancing drug but rather "leveling the playing field? How do we know when the playing field is leveled and should it be? Or should we simply be more accepting of peoples learning styles and encourage them in what they do well (strengths based) as opposed to punishing them for what they fail at (weakness based)?

I don't have the answers. But if we don't ask the questions the solutions will be forever from our reach.

I had two of my charts scrutinized on Friday. They euphemistically call this a UR review (utilization review). Hey, maybe that's the correct word--is the clinician using the chart properly. Anyway, when the charts were returned to me the supervisor said something like, "you know you're 16 weeks behind in group notes in one chart and 14 in the the other." I just sort of looked at him and said "ok." He laughed (which he rarely does) and said "I'd be going crazy if I found that out." My response was, "piece of cake." Sure we've been granted a leeway of 2 weeks on group notes but if I try to keep up that closely then all the other priorities fall through and I've been told pretty much everything is more important. Of course none of this has anything to do with actual contact with the patient, which seems to be a recurring theme around here. Maybe I should just start looking at patients as if they ARE charts. See how my chart is progressing. What needs to be worked on? Hmmmm. I'll let you know how that works.

I'm exhausted. Every day I go to work and get beat up. I try my best to put on some type of protective armor/screen/ bullet proof vest in order to take on a lighthearted Muhammad Ali persona and "Fly like a butterfly, sting like a bee" and keep out of the vicarious trauma hole. But the aches and pains of battle are becoming more than I can peaceably handle. I don't really like who I'm becoming. There is no light air around me. I live surrounded by fog and smoke and cold and damp. I live in an atmosphere of deciept. The forces outside my agency wield so much power and control that at times I feel my voice is meaningless. What I have to say about a particular patient is unimportant. And god forbid the patient's words might be taken as truth. Addicts are liars, they don't know how to tell the truth. They wouldn't know the truth if it hit them in the face. 'Getting over' is all they are about. They are manipulative, thieving, exploitive individuals thinking only of themselves. So think about it. I'm only the social worker/therapist/case manager and I feel there's not much point in my getting up off the floor to fight the good fight one more time. Imagine what the individuals for whom these labels are supposed to fit, must feel. I try to shield them from the remarks my so called colleagues make. Everyday I go in remembering to be client centered and strength based only to be foiled by rumors and suspicions presented as facts by vengeful individuals tring to make themselves feel superior to someone else. I can only hope "this too shall pass," without losing lives in the battle. The War on Drugs has morphed into the war on addicts played out by former addicts who think nothing of acting out on even less defenseless individuals than they were in the early stages of recovery. If only prayer were a viable intervention.

"Off with their heads," she thought she heard him shout. Indeed he did in the secret language of directors who've lost their way. "We have to get them out of here. " These are the absent ones, the late ones, the tired ones, the ones without direction themselves when their own Queen was beheaded some weeks before and the pawns left to fend for themselves.

She did not fear beheading. It would be a relief. But how could she leave behind all the mad hatters. The bottle marked "Drink Me" would not serve her well either. She'd been down that rabbit hole before!

If she were to speak she was not sure she'd be understood as she herself understood little of the madness. But she was determined to try. She owed it to the hatters. She owed it to herself.