Did I mention OCD????

So, this post has little to do with the title. My therapist would say that I have Obsessive-Compulsive Tendencies, especially when I am anxious. I’d say the fact that I couldn’t just let that be until another post would perhaps suggest it’s more than a tendency. But, it’s for another day. Probably.

Today has been especially long. I have to talk a bit about my patients because it’s been about them all day, for the most part. I have one family where there are 4 little kids (under 7) who were taken by CPS due to abuse and then placed with relatives (who are now their foster parents) who had twins a month younger than the youngest of the other 4. At one time, I used to call them my 6 under 6, but then the oldest turned 7. The foster mom is pregnant, so it’s going to soon be 7 under 7. Can you even imagine? And, technically, only 4 are my patients. However, it’s never really been possible to separate them all out. The 4 actual patients are some of the most aggressive children I’ve ever seen. They are very angry, defiant, and oppositional. They hit, kick, throw things, trip people, pull hair, spit, and bite. And, I’ve had all those things done to me in that home, so it’s not just child on child aggression. There are other issues, too. The foster parents really want to adopt them. They have good hearts. But, they don’t always have the skills I’d like to see. I work most with the foster mom, and she has trouble understanding that these children are not necessarily “normal.” They have been through a lot, and I also suspect that there is some inherited mental illness that is already manifesting. It’s going to be a long and rocky road.

I spend about 4-5 hours at their house, weekly if possible. Once they are adopted, they will still get Medicaid, but they will switch to traditional Medicaid……meaning about $300 (at least) less PER WEEK! However, I know that with an infant and three two year olds that it’s not going to be possible for foster mom to get them all to “regular” i.e. in office therapy. I can’t imagine them having to sit in the waiting room while each child goes in for their own session. I try to work with the home structure and bounce between some individual to some family to some parent coaching and back again, as seems appropriate.

Play therapy can be exhausting. I have to be really engaged and actually play. Sometimes I let them lead so that they can tell me things in their own way. Children, especially young children, express themselves and process their feelings and thoughts best through play. Don’t get me wrong. This is one of my favorite things to do. It’s one of the things I really think about when I try to imagine ways to grow and change my career. I LIKE playing. I get extremely tired. Sometimes it’s heart-breaking. For example, today one of the little girls kept having all these intense conversations on the pretend phone. I know she’s mimicking what she’s heard. There are times to intervene, and there are times to just listen and let the child express what they need to express. Hard to judge which is which at times. Hearing what she was saying and even just hearing the tone was painful. It doesn’t take much to imagine what she’s seen and heard. She at times sounds just like a tape recorder with two sides of an argument going on and on.

And, yet, when I think about where I go next, how to create a career where I’m not always in financial crisis, the one thing I don’t really want to let go of completely is working with some of these same patients. I enjoy the really little ones, and sometimes I can really see progress if I can get to work with them young enough. Then there are the patients I’ve had for years and years, going through new things with each developmental phase as it converges with their history and their specific mental illness. I want to have at least a few of these difficult patients in my practice. I need, for my own sake, to do other things as well. And, I have to realize that doing those things might allow me to be able to work with at least a few patients like this.

Oh, so much to consider. Maybe not all today, though. It’s always in my head. How to grow my practice and/or business. How to get to do other things in my life, not just in my work life. How to get to do more creative “stuff” and spend more time with people other than patients. I don’t have the answers, and it rolls around in my head. Of course, then there’s the whole how not to be broke all the time.

Obviously, with my own health issues, both mental health and the fibro, I can’t do as much as I’d want anyway. I’m limited to some extent, and sometimes my work is all there is. I’ve even had my dogs help with therapy! I’d do it more if I could, but I can’t take them into a lot of homes cause they are HUGE, and not everyone wants them in their home. But, they are better at therapy than I am. Much better with kids. Really. It was a way to work well and to also have time with my beasties.

Then, I came home to tackle some of the paperwork that makes me so incredibly anxious. Oh, and back to the title, that triggers my OCD! WOOHOO!

How do I balance it all out? How do I make a difference, get to do some work I love, make a living, and have room in my life for all the other things I want? How do I do that when I hear and know these heartbreaking things in the lives of others? How do I do it when I myself am depressed, anxious, obsessive, in physical pain, and exhausted?

I don’t know. But, I am learning to say that’s for another day. I worry that I’ve said that too many times, I’m getting old, I’m running out of time! But, I’ve worried about that since I was 12. Seriously. My brain keeps spinning out those questions, and more to boot. But, maybe just for today I did enough.

I did therapy with a huge family with unbelievable issues and energy. I did two of the forms that stress me. I talked to a friend. I said hello to a few people on FB. Oh, and I put out water for wildlife in my yard. I didn’t give too much attention to the dogs, but I’ve been home for a lot today, so I was around for them.

And, if I don’t sleep in the tub (see last post), I’ll at least get to cuddle with my poor pups as we drift to sleep!

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~ by Janice Holladay on August 19, 2011.

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