Sense-Making

I don't know why I haven't blogged lately. Maybe I got into a space in which I didn't want to think about my work all that much. A big part of that may have had to do with my caseload changing, so that I was working less with the manics and schizophrenics and more with the trauma patients. With the trauma patients, I'm much less likely to be able to take that "Gee whiz, aren't people fascinating" stance that made blogging sort of fun. Also, the stories are much harder to take: rather than the more mundane tragedy of bad luck resulting in some psychotic disorder, I was wading around in life stories that were -- are -- horrific. It's frequently observed that people who work with trauma survivors have to have some tolerance for the horrors that human beings can inflict on one another. We don't dig around much in patients' trauma histories on inpatient units all that much -- that tends to be more destabilizing -- but you can't avoid knowing about your patients' stories.

I think the steam went out of the blog around the time I got these two patients in particular. One had been abducted and assaulted a few years earlier by a group of men and was left tied to a doorknob for several days. By the time she had been discovered, her legs had become gangrenous and both had to be amputated below the knee. The other was a very sweet middle-aged woman who had been in an incestuous relationship with her father from prepubescence through adulthood, and was struggling with having decided to end all contact with him. What observation can I make about the universality of human experience with that kind of material? There's no poignance here.

Maybe I'm putting too much pressure on myself to be entertaining or have some point. Maybe it feels more exploitative and invasive to use these stories as material. Afterall, a decompensated schizophrenic has a really tough time hiding her illness, while a trauma survivor goes to extraordinary lengths to hide hers. Maybe I've taken on the survivor's coping strategy of protecting myself from the inevitable shocked and disgusted recoil from others when they hear the stories.

Don't feel sorry for me -- I love my work, and I have plenty of folks to whom I can turn when I need to dump this stuff. But I do admit to having higher aspirations for this space than merely dumping. And the coming-to-terms and sense-making processes are much more difficult with this population. So why wouldn't I want to just go home at the end of the day instead of spending another hour or two mulling it all over? As I wrote this last paragraph -- in fact this whole entry -- I had hoped some answer to that question would emerge. But it hasn't, so I'm going home.

Peace,

Madeline