A Wide-Ranging Session

One client during my internship has grown into a really interesting case. Readers will remember him as the combative one. He has returned several times since that appointment, and his attitude has always been good. He enjoys lively conversation, but he’s never returned to the highly argumentative tone.

Today, he arrived and sat down and informed me he’d almost taken the bus to a town about two hours away. Taking this trip is his way of saying he wants to kill himself. He’s taken the trip many times in the past decade, but he’s thankfully never followed through. His routine there is always the same. He drinks rum on the bus ride and then continues to drink the first day there. He also smokes cigars that first day. He sleeps outdoors and awakens with the intention of killing himself the second day. Instead, he takes the two-hour bus ride back to the care home where he has a bed.

I knew about this habit of his, and I’ve known about his chronic suicidality since I first met him. My response to him this morning was to thank him for telling me about his plans. Then I said that I was glad he hadn’t gone on the trip, because it would have left me without a client and I would have been bored.

He quickly said, “That’s not a good enough reason for me not to go.”

I responded that I completely understood, but that I still didn’t want to be bored. He was really interested in my seemingly nonchalant answer.

My real answer was to then launch into continuing to fill out his WRAP folder. We approached the section entitled Crisis Plan, which requires a lot of writing by the client. They have to think thoroughly about how they want their care to be conducted in case they fall into crisis. My client mentioned simply that he didn’t want to do it. I agreed that we should stop since I’ve been trained that WRAP is self-directed. He did say he wasn’t ready to completely give up on the Plan. He wants a hook. He’s looking for something that will give him a lease on life.

I told him again of my own WRAP and how it changed my life. I went from having chronic negative self-talk to none. I talked about the dark times I’d seen, and I called them that: the dark times. I kept it general. Using “I” statements, I mentioned that since writing my WRAP, I had not relapsed into dark times, and I had not required a stay in the hospital. My WRAP has kept them at bay.

His reaction was to announce that dark times are the natural state of mankind, and they shouldn’t be fought. I thank him for telling me his ideas, and then I surprised him. I agreed with him. Dark times may be the natural state for many, but I don’t have to stay stuck there. I was careful to mention that I was speaking for me.

This client has a set of interesting ideas that he regularly says for all to hear. “Man is a primate.” “Man is alienated from life.” “Life is meaningless.” “God is dead.”

I surprised him again today. I agreed with him once more. I told him I thought it was indeed difficult for people to find an ultimate meaning in life. He smiled and said he had nothing to say in response. I continued with my story and how important WRAP was to helping me out of the dark times and into a state of serenity. That piqued his interest. I explained how the Daily Maintenance List kept me on an even keel so I wouldn’t fall back into a crisis.

“The whole meaning of WRAP is to keep us out of crisis,” I said.

He looked at me quizzically and muttered something about the meaninglessness of life.

I answered him by describing the meaning I find in a string of small things. I love my job. I love my family. I enjoy reading and writing for myself and others to read. Finally, I have a passion for theater. While I reserved my speech to “I” statements, I tried to steer the conversation to his enjoyments. He loves classical music and speaks about it with fervor.

Then I mentioned the word “pleasure,” and we started a tangential discussion of how a meaningless life could or couldn’t possibly have any. The talk was fascinating. We spoke about hedonism, and yes, we used that word. He’s a smart man and has read a good deal of philosophy. I threw Epicurus into the mix, and he was impressed when I mentioned that Epicurus was a champion of the middle path rather than what Epicurean philosophy has come to represent, namely hedonism. My client said he preferred a more stoical way.

We ended our time together with a talk about Shakespeare’s sonnets and specifically, the unknown lady mentioned therein. My client called Mozart and Beethoven eternal, and I said the lady of the sonnets was, too. Shakespeare even tells the lady she will be eternal in his words. My client appreciates the beauty of those words. He was surprised at me again that I seemed so enthusiastic about the Bard. For our session next week, I’m going to take a few of the sonnets for us to study, I think.

It was indeed a great session. I am blessed to know this man. He touches me with his candor. He honestly appears to be searching for something that he can’t or is afraid to grasp. I’m not so presumptuous to imagine I will help him find it, but I truly hope I can demonstrate that reaching out doesn’t have to be painful. A desire can sometimes lead to pleasant surprises.

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5 thoughts on “A Wide-Ranging Session

  1. Excellent post….this man is lucky to have crossed paths with you. The description of the session reveals that a spark has been lit and a difficult client is gradually engaging in his own recovery. Keep up the great work!

    John

    • I have the training I received to thank for a lot of that. I was coached to meet the client right where they are. I am not to impose my ideas of what they are supposed to do, say, or think. They set the pace, too. It really makes complete sense for my position.

      I’m not a clinician. I don’t diagnosis or prescribe anything. The most important thing I do is listen.

  2. Pingback: Overcoming my Fears | Winning with Bipolar

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