Tuesday, August 10, 2010

Exposed

ShameImage by fabbriciuse via Flickr

I'd love to be able to explain why I haven't been writing any blog posts of late, but I'm not sure I could. It's not as if I haven't had things to say. I mean, I've got various notes in journals and on scraps of paper reminding me of thoughts I've had, issues I want to blog about. I've (mostly) accepted that I will write when I need or have to write. 


Today I'm feeling a need to write.


Yesterday morning I showed up for a session with a client I haven't been able to see for two weeks. There were some scheduling changes and then there were some scheduling conflicts, and that's the way it sometimes goes. 


Fine. 


I knew I had to be prepared for possible reactions to my absence. On the other hand, I wasn't sure how "real" I was to her as yet. C and I have only worked together since January. She seems to recognize me these days, but the relationship still feels fairly tenuous.


I found her at the other end of the cottage, and she smiled (which seemed like a pretty good start). She walked along with me and then pulled me toward the bathroom. I was hoping we wouldn't have a stripping issue, but her staff told me she might need to use the toilet. Okay then. 


Her staff accompanied her to the bathroom area, reminding C that she needed to be supervised (for a few reasons we needn't get into), and I waited in the empty day area where we'd be working. 


While I was waiting, K, one of the supervisors (who happens to be a former music therapist), came over to ask me how things were going with C. She was being nice, because I knew that it was code for "The staff are annoyed with you, because you 'let' C strip when she's in music therapy." To K's credit, she wanted to hear my take on the stripping. 


Apparently, I'm the only person who has this problem with C suddenly taking off her clothes (other than the afternoon shift).  


Great. 


I don't know exactly why C strips in music therapy. Maybe it's because I'm mostly new to her. Maybe it's because I only see her once a week (and even that can vary because of her schedule and mine) not every single day, and she doesn't know me that well. Maybe she's testing me. 


All I can say for sure is: I'm trying.  


So that was how I went in to the session.


C came on out of the bathroom with her staff person, and she was in good spirits, everything was going along, she picked up her giant beanbag to set it on her lap, sat on a comfortable couch, and we were off. 


She was vocal, I was reflecting, she was engaged, I was responding...all good things. She was bothered, for some reason, by a couple of binders sitting on the table, so I took those and put them in the next room, and we resumed our musical interaction.


Until...


C decided she needed to go to the refrigerator (there's a dorm sized fridge in the day area where we were working). Now, understand that: 


1)The last time we had dealt with the refrigerator, there was a lot of iced tea to be cleaned up. A LOT of iced tea. 

2) She has a very sensitive stomach, and I wasn't sure what she was safely allowed to have. 


3) It was 11 AM and not long before lunch when I knew she'd get something to drink anyway. 


4) I wanted her to focus on the session. Yes, that was my issue, but for that moment I decided it was a legitimate wish on my part.


Well. I asked her to wait until later, and that was when it all started to deteriorate. Rapidly. Suddenly, the jacket, pants, underwear, adult diaper, shirt and bra were on the floor. 


Crap!


I managed to get her into the bathroom area (and pick up the assorted clothing items) and then it just went from bad to worse. I was aggravated, C was freaking out, and it was argue, fight, fuss, refuse, be naked (not me), and consider becoming a hermit so I'd never have to deal with people again.


Finally, after about 10 minutes of achieving nothing I decided to ask for help.  


Her staff (the one who had helped her in the bathroom earlier) came in, and C set up a yell, but she got dressed.


Wonderful. 


I hung around in the bathroom for a while, trying to watch what her staff did to get her organized (wondering what I had done wrong, not thought of, why I went in to music therapy anyway). 


When they came out of the bathroom area (which is a big area, I must tell you, with a bunch of stalls, showers, a bathtub, and so forth), and C was dressed and calmer, I reminded C (and her staff) that I would see her in two weeks, and that I hoped we could find a way to have her stay dressed.


Her staff commented that "Oh, she'll be dressed when you get here. It's after that we're not sure about," which is code for "If you were a competent professional, my client would not be naked by the end of your session, would she?" 


"Thanks for your help."


I stewed about this for the entire rest of the day, feeling horrible and inadequate. 


And then I realized this morning that the thing that made me most angry about the situation yesterday was that I ended up acting from a place of anger and shame with regard to my reactions to the staff people and not from the perspective of a clinician. 


As such, I'm not only frustrated by the fact that the whole session went to hell suddenly, but I'm also bothered by the fact that I felt as if I allowed my feelings about staff's opinions about what I do/don't do/how I do it to get in the way of my being C's music therapist. 


Now, I'm sure that as soon as I settle myself down about all of this, I'll be able to use these new pieces of information I have (yes, also known as countertransference) in a more constructive way (you know...like, for one thing, using it to get a better understanding of what my client may be going through that she feels the only way she can communicate with me is by stripping).


Until then, I'm still annoyed and agitated about the whole thing. 








6 comments:

Kat Fulton said...

Hi Roia, It feels really good to read about your experiences as an MT on such a personal level. It's refreshing to read about such intimate details. We all go through similar issues in different ways, so thanks for helping us all relate to you, to the community, to our profession, to our clients.

Roia said...

Thanks, Kat. We do difficult work, and playing music with someone is a very intimate experience. I truly believe that we grow when we allow ourselves to experience the wrestling and agonizing in our work. Hopefully, as we're willing to deal with our own mistakes and frustrations, we set an example for our clients to do the same.

soundscapemusictherapy said...

Thank you so much for the honesty of your post. We need to talk about these things.

themtguy said...

That's tough...it's one of the problems of working in a setting where you are the outsider. Don't give up...I'm sure you'll figure something out!

By the way, thanks for your kind words on my blog. Good luck to you!
-Jesse

Lozzie Cap said...

My first thought about it was that the staff at the setting were projecting their own inadequacies onto you - as the relative newbie, as the outsider, that kind of thing. They all of them have had several occasions upon which they've had to deal with C's challenging behaviour, and perhaps they felt inadequate and frustrated and so had to try and find a way to make you feel that, too.

Does anyone know WHY C takes off her clothes? (I have a client who reputedly does this too, though I've not experienced it .. yet). The ironic thing is that by listening to C in the way you, as a music therapist, are UNIQUELY trained to do, you may well end up being the person who helps her to figure it all out.

(And then the support staff will REALLY hate your guts! *sigh*)

Feelin' for ya ... I wrote about the dilemmas of challenging behaviour recently on my own blog. It's a constant preoccupation.

L x

Roia said...

@themtguy Thanks for stopping by, Jesse. Actually, I hate to have to think of myself as an "outsider" when I've worked at this facility for 22 years! :-) The client is, however, relatively new to me.

But it's interesting that you use that word (and I think, Lozzie, you did too). No matter how long I have/will end up worked/working at the center, the reality is that I will always be perceived as an "outsider" to some of the direct support staff- largely, I think, because of my status as a "professional" who doesn't *have* to do the work of physically taking care of our clients.

@Lozzie I wouldn't be surprised if there was some major projection going on in there. I'm not sure why C strips. Part of it is definitely sensory related (in my opinion, she could really use some good OT intervention. When I'm not freaking out about house leaks (argh!) I'll have to sit still and sort the whole thing out.

I think, by the way, I recall reading about some challenging stuff in your blog (haven't had a minute to comment properly, but I sneak by to read). Thanks for roaming by and sending care.