For all I know, she plugged her nose and took a glorious swan dive right off that bridge. We crossed under it on the opposite side of the highway just seconds after she fell from above. My dad swerved our brown and orange Dodge station wagon off the side of the road, screeched to a stop, and jumped out to direct traffic around the action. I recall my mother turning around and telling the three of us children to ‘not look over there’ but something drew me to the scene. Like a moth to a flame I couldn’t help but focus my entire attention on this person. She lied in a contorted pose with a pool of blood collecting quickly around her. Passersby willing to help swarmed the area and promptly performed checks to see if, by chance, she survived the fall. Cars and trucks crept slowly past her as my dad frantically ushered them down the highway. The whole event seemed surreal, yet even as a seven year old child I remember over-analyzing the entirety of the situation. A person just jumped off a bridge-not accidentally, for fun, or as a victim of a crime-but to end their own life. “What was wrong with her?” I wondered. “Was life THAT bad?” In my juvenile mind, I began to think about her family life. “Where were her parents? Did she have children or siblings that would miss her? Were people mean to her? Was she upset about something?” My assessment skills were rudimentary, but my heart hurt for her.
After arriving home that evening, dad sat us down for a chat. He assured us that this woman simply had ‘special problems’ and that perhaps she suffered from cognitive delays. It was a great parental attempt at explaining suicide but ever since that day my mind has been churning over the mental health and ‘special problems’ of others. Perhaps this incident ignited my career in the helping profession or maybe I was just born to work with people. Was it part of a bigger plan that at such a young age I would experience the various emotions that accompany suicide and the ability to watch it happen simply put my destiny into motion?
If this story is already too much for you, go ahead and click the X in the top right of your screen now. You’ve been warned. I’d be lying if I said there aren’t times when I want to “click the X” on my choice to be a therapist. But the truth is, this is my job every.single.day. If it’s not stories of suicide, homicide, or psychosis, there are always the stories you hear from the mouths of five year olds about sodomy and sexual abuse. And as you carry those same children out the door of their abuser’s home with a bag packed for foster care, they are kicking and screaming cries of utter terror as if the separation from their ‘normal’ becomes too painful. Other very tragic stories litter my subconscious. People who spent ten minutes in the front yard of their home hosing the brains of their loved one off their clothing after witnessing suicide. Children who live without food, clothing, or regular bathing. Children forced to eat their own feces to ‘learn lessons’ about soiling oneself. Four year olds dropped off at state office with a bag of personal belongings, their social security card, birth certificate, and favorite Elmo tableware because parents chose drugs and alcohol over parenthood. Worse yet, the deaths of infants whose parents didn’t have the foresight to drop them off in a safe place. Their deaths will rattle and anger you. You will wonder what they felt in the last minutes of their lives-especially the violently murdered babies and young children who probably reached their small, trusting arms up to the very person who would snuff the breath out of their lungs.
I occasionally hear the ‘greenies’ (new students to the field of social work or therapy) say they chose this career because they “want to help people.’ I snicker inside because this helping field is not a profession you walk into casually or with hopes to help people. Their naivety and blindness are refreshing and like them, maybe blindly entering it was truly the best thing for me. Truthfully, had I known what I’d see, hear, and smell on a daily basis, I would have walked away from the beginning. And it is that thought that compels me to write the following.
Perhaps you are a recent college graduate armed with a psychology, sociology, or social work degree and very few career options. Or maybe you’re John Q. Public with limited understanding of the depravity of humanity. Perhaps you’re just nosey, or a long-time veteran of the helping field. Either way, hopefully this provides you a glimpse of my daily life in this profession. THIS is what you may need to consider before you accept your first helper’s position.
1). The helping profession is not about saving the masses. Most professionals in this field enter into it to walk alongside someone and rescue them from a bad place in an effort to elevate them onto higher ground. It sounds pretty. But on an average day, you won’t really ‘save’ many people. You end up being the ‘seed planter’ or ‘starfish thrower.’ Sometimes you’ll spend an entire day helping a person who turns around and runs back into the same situation. Other times, you’ll spend a whole work day on a client and you sleep better at night because they have somewhere comfortable and warm to sleep. And on rare occasions, you’ll perform one small action that will positively alter the course of a client’s life forever. This field will chew you up and spit you out if you are only in it to rescue every client or patient you come across…and you’ll burn out within the first year.
2). Get used to the grey…and I’m not just talking about the hairs that will grow in. I’m talking about thinking outside the box, using critical thinking skills and deductive reasoning. Some people really struggle with this concept because they think and behave in absolutes, or black and white. They believe a person or situation is ‘all bad’ OR ‘all good.’ Well, actually the helping profession is entirely subjective-every single day. Why? Because we deal with people and their lives, and we all know how both of those things change rather quickly. Grey zone thinking will become your best friend and it’s also a great skill to incorporate into your daily personal life. But if you struggle with wanting answers all the time, you may want to avoid this profession all together. At times you’ll have to leave things at a question and you’ll need to be comfortable with that.
3). Secondary trauma can become an unstoppable rebel force. Some call it vicarious trauma, but it simply means the trauma a professional in this field suffers from hearing, seeing, and performing the profession every day. There are days when my morning coffee has yet to digest and I’ve already heard stories about how one patient killed someone or how a grown man prefers to have intercourse with children. There are usually few, if any warning signs for one of those stories that will permanently alter your life. You think you’re just starting your day and one person, place, or event will completely derail your entire week. It eventually takes a toll. You’ll fight back tears one day and your eyes will gloss over the next. The vicarious trauma must find a way out or it bleeds into your personal life and creates more problems. If you are really considering this field, just remember there are going to be sights you cannot un-see and stories you can never un-hear. Find an appropriate outlet for them, make routine deposits of those stories, and do your best to let them go.
4). You’ll need to retreat to a safe place every evening. This means two things: find a partner that will listen to your daily drama, and ensure that your home is a sanctuary of peace. Truth is…you hear things that will make you want to run home and scrub your brain. It’s not that you can’t handle it. It’s that you just need that one person to talk about it with. Helpers know that nothing will make the trauma go away, but having just one person who will listen to the day’s stories is equitable to erasing the writing on a chalkboard so that it can take on more information the next day. Yeah, there may be some residual evidence lingering around, but the ability to discharge it onto one person makes a world of difference. Find just one person who will nod their head at your daily recap and say “wow, that sounds upsetting/intriguing/scary/fulfilling.” Secondly, make your home as stress-free as possible. Try to keep it organized, clean, and tidy. Indulge in the small things (bedding, pillows, candles, bath salts, etc.) that promote proper sleep hygiene and take warm showers/baths to settle your mind in the evening. Give yourself permission to invest in monthly massages, spa days, or individual therapy.
5). Self-care is a must. You know the typical rigamarole you hear on the airplane before you take off- “before you put an oxygen mask on your child, put one on yourself first.” As a parent, that almost seems counterintuitive. You innately want to save the life of a helpless individual before you would even consider saving your own. Those of us in the helping profession behave similarly. The vast majority of folks we serve are perceived as helpless in one way or another. We will stop at nothing to improve their lives, even if it means sacrificing our day off, time with children/family, or holidays. Working with people means that you run the chances of having to insert yourself into their lives 24/7. They will call you in crisis at 3:00am (yes, it’s happened to me), the police will call you to come help them, and patients can be so down on their luck a simple car ride across town helps them immensely. Helping them is okay, but be sure you practice good boundaries and proper self-care in order to prevent burnout. You must take time for yourself (yes, just you) to reconnect with what matters. Know your value and worth to this profession and don’t be afraid to take a day off here and there.
6). It’s not all sad. Sure we see and hear some very upsetting things-every day. There are times when I want to quit and go play with numbers all day instead. But then there are other days when I get the random email, text, or phone call from a patient saying the words, “you changed my life” or “our grandson is alive because of your persistence.” I’ve attended graduations, sporting events, and adoptions of clients/patients who may not have had those experiences without my involvement. Celebrate the happy times-they come few and far between!
7). Full moons will likely govern your professional life. We don’t really know what causes it, but wild things just seem to happen when there’s a full moon. Hospitals see more babies born, more psychiatric inpatient admissions, and a pervasive feeling of silliness endures. Don’t bother with trying to understand it. Learn to embrace it and plan to resist the urge to call in sick on the days following appearances of full moons in the night sky. Your coworkers will like you more.
8). Avoid working in the public sector. Had it not been for twelve long years working in state government social work, I’d have no experience under my belt. Most of those years were good-the perfect springboard for any career in the helping profession. However, if you insist upon shopping for a position in a local or state government job, you should know a few things. First, they are generally more interested in pushing paper than helping people. Second, workers who challenge the status quo are not welcomed there. Third, you’ll work for pennies on the dollar as compared to the private sector. Most often you’ll be underpaid, overworked, and underappreciated. I could go on and on about this, but I’ll leave it at that for now.
9). Working on holidays, weekends, overnights, and evenings is highly likely. Unfortunately, drama and trauma arise 24 hours a day, 7 days a week. We deal with people’s lives in a very intimate way and they need help in very desperate ways-at all hours of the day. Working in this field for me has meant leaving my house after opening Christmas presents with my kids to head into a hospital and remove someone’s baby from their custody. It’s also afforded me the opportunity to spend entire weekends second-guessing my decisions throughout the week before. I guess it could be easier said that in this profession, you are always working if you allow it to happen as such. Learn how to shut off your mind as soon as you leave the office and only work the hours for which you are paid.
10). Beware of compassion fatigue. Compassion fatigue has been referred to as the ‘cost for caring for others.’ It will probably look differently for every individual in this profession, but at some point (and probably on a monthly basis) you may begin to experience exhaustion with mental health issues. In his article prepared for workshops in the helping profession, Francoise Mathieu, M.Ed. (2007), says compassion fatigue is the result of “increasingly stressful work environments, heavy caseloads and dwindling resources, cynicism and negativity from coworkers, low job satisfaction and, for some, the risk of being physically assaulted by patients.” Believe me, I’ve been down every one of these roads. Eventually the constant exposure to these situations causes a “pronounced change in the helper’s ability to feel empathy for their patients, their loved ones and their coworkers” (Mathieu, 2007). In short, the energy you put into your job depletes the energy and resources you could be using on your family and friends. You’ll have emotionally exhausting days at work only to return home to experience emotional demands from those you love. You’ll feel like crying about the things you heard and saw that day, but the tears will not fall. Keep an eye out for compassion fatigue and take a break from work to tune back into the ones you care for.
So why do we do this work, you ask? There are those rare occasions when you’re reminded you have sacrificed higher income, time with loved ones, and notoriety for small moments here and there. You’ll know it when they happen and take special note of them. One of my most special ones happened in a hospice room one spring afternoon. My patient, a teenage boy unable to move his jaw due to large tumors on his face, had grown tired of fighting. He knew his time was coming, but was unable to verbally communicate his feelings about it. Over time, his ability to speak was taken from him and therapy with him turned into arm and hand massages. I would enter the room to find him sleeping and as I sat bedside, he would slightly crack an eyelid and use his limited strength to place his arm in my hands. I’d spend our hour together massaging his arm, fingers, and hands while telling jokes and soothing his fears about the afterlife. As his time grew closer, he would mumble words and I gradually came to understand what he meant. He asked for very few things and most often I’d return to his room with a cold bottle of Dr. Pepper or grape flavored Gatorade to syringe-feed him the beverages until he was satisfied. Shortly after he was given just a day or so to live, I could tell he was hovering in that transitional phase. He begged his parents to hold his hand and help him cross over into heaven, but they felt they were only capable of seeing him into this world, not out of it. I performed a routine visit with him and as I was situating his bedding and beverages, he loudly yelled to get my attention. With what little strength he still had, he mumbled what I believed to be an inaudible word and pointed to the top of my head. I didn’t understand. I’d never heard this word come from his mouth. I frowned and tried several variations of what I believed he said; he shook his head repeatedly until I asked ‘did you just say there’s a halo over my head?’ Relieved, he cracked a smile, nodded, and used his feeble index finger to draw a circle in the air above my head. I teased him about it, assured him that some have contrarily referred to me as the devil, and I just assumed he’d been doped up on pain killers and anxiolytics. Later, I asked his nurses what medications they’d given him to cause such wild hallucinations. Their response? “He’s had nothing today.” After hearing my patient’s mumblings were as close to lucid as he’d been in days (without the use of medication), it became very clear to me. The halo over my head was merely the extension of my help in the last moments of his life….perhaps because I walked into his vulnerable and feared moments when others walked out.
There are times when I look back at the faded State employee badge issued to me on 9/11/2000. The girl in the picture is fresh out of college with very few wrinkles about her face and a naïve, innocent smile. She hates the thought of transporting children in her new Mustang, and home visits to places with sticky floors and stained couches make her cringe. The suburban-raised girl knows so little about trauma, much less the vicarious trauma that sixteen years later she wears on her shoulder like an ever-growing, yet unshakable backpack full of bricks. Prior to being a social worker and therapist, she knew so little about what the helping profession would expose her to. She thought social services just meant helping people get their lives back on track. In a major way she was right, but more importantly and ironically, she was very wrong. Wrong because the helping profession has actually been more like an exposure to all things heinous. It has been listening to a mother recount her story of when she had to choose between which child to allow to die in order to save the other. It landed her in situations where she doubted if she would return home that evening. It’s been spending the last dollars in her wallet to ensure a family had food. It’s seeing pictures of dead children and babies with boot prints on their stomach and intentionally-severed tongues. It reminds her that there are grown men who prefer to have sexual relations with small children…and photograph it for the world to view. It showed her that a bullet hole in the side of a head won’t necessarily kill a person who wants to die.
Sure, the helping profession has cost me a great deal (including my innocence), but the payout has been worth it. I kiss my sons in a more meaningful way. I treasure the small moments together with loved ones. I don’t sweat the petty things, and I’ve been given this wonderful ability to see the world through the eyes of other people. It if won’t matter in a week, it rarely bothers me in the present. I judge nobody and know that every single person (regardless of economic status, gender, race, ethnicity, religion, etc.) has something to teach me. But the irony of this profession usually comes full circle over and over throughout my career. In the week before I quit working at the psychiatric hospital, I listened to a story from a patient who planned to jump off a bridge and end her life. It was one of the most common threats and plans for suicide I heard while working there. But what stopped her you ask? The patient said she worried about surviving the fall. In my heart I knew there were far worse things. Death being one of them; and a 7 year old little girl witnessing the incident being the other.