Change And Inertia: Embarking On A New Adventure

6a00d8341d537753ef00e55133a7c08833-800wiI hate change, which I know is probably strange for me to say because during my therapy sessions I do a lot of what is called change talk, which is talking about and encouraging change. I generally consider myself to be an agent of change as I guide my clients through the stages of change, but I myself have always had issues with change. I don’t like it.

Some people love change and I always admire those people. They love new adventures, they adapt quickly, and never seem to get stuck in a rut or dead end job. They seem to just be wired differently and indeed, the ease to which people accept or don’t accept change is a personality trait known as the Openness trait and some people are naturally more open than others to change.

My fear of change over the years has cost me a lot. It has kept me at jobs I should have moved on from for far too long and in relationships I should have left for far too long. It has also kept me from experiencing many pleasures and probably some pains and failures, otherwise known as learning experiences and opportunities to grow.

I, like a lot of people, like being comfortable, playing it safe, even when that inertia isn’t all that great and sometimes downright unpleasant. There’s a popular quote by a late, great female therapist, I couldn’t find it or her name, but it basically says that we prefer the familiar negative to the potential unfamiliar positive, except of course she said it more beautifully.

And this tends to be true, at least for me and the majority of my clients who struggle to make changes in their thinking and interpersonal lives because they are afraid of what the new change will bring, good or bad, but they know exactly what the old thinking and behavior will continue to bring them, both good and bad. This is one of many reasons people resist change.

This is why I think I was so successful at helping people make changes they found difficult to make, because I understood their ambivalence towards change, their desire to both want to change and not want to change at the same time because I’ve experienced it so many times myself, even in ways that bordered being neurotic.

It’s easier to stay the same. Inertia is much easier than movement, especially when that movement has to be sustained, yet inertia robs us of so many experiences, opportunity and growth. A fellow therapist recently old me that if you are comfortable, then you are not growing. You should always be challenging yourself.

It’s that comfort zone I try to push my clients out of because sometimes you have to become a little uncomfortable to truly grow and realize your full potential and the same applies to me.

Some of you who follow my blog may know that the grant that pays for me to serve the students at the inner-city school I work at is coming to an end this Friday. The school has been working really hard to find funding to keep me and they may be close to working something out, but I couldn’t count on that to come through so reluctantly I started looking for another job.

Well an opportunity came up for me to apply for a job as a supervisor at the mental hospital I used to work at fresh out of grad school as a supervisor over the crisis unit I used to work at. I loved working in the mental hospital, I enjoyed dealing with people in various stages of a crisis from emotional and mental break downs to substance withdrawals.

This opportunity would force me to grow, push me out of my comfort zone, pay better and definitely be an upward climb in my professional career, so I applied for the job and got the news Friday that I got it. I should be excited right? But remember, I don’t like change and I do love working at the inner-city school I currently work at even though I potentially won’t be there next school year anyway because of funding.

One of my first students and myself.

I love working with the teenagers I work with, helping mold young lives and by taking this job at the mental hospital, I would miss that although in my private practice I would still see a very small number of teenagers. Although I would be taking a pay cut to stay at the school, potentially not have a job this year or next year AND still be stagnant career wise, I seriously thought about turning down the supervisor job to stay where I was comfortable, in a place that would require no effort (inertia) although I know I would love doing my job (compared to the unknown level of satisfaction of a new job).

I’ve had similar opportunities twice in the past two years to make more money and move up professionally and both times I turned it down to stay comfortable. Of course I said I did it because the kids need me, and while I felt like that was true, I also know that a large reason I stayed was fear of change.

Now however, I am pushing myself into change just as I talk to my clients about pushing themselves out of their comfort zones.

It’s with a heavy heart that I took this new job, something I should be extremely happy I got because the chances seemed so slim when I first applied and went through two interviews. After all, I have no real supervisor experience, but I have experience working in a crisis unit and my love and dedication to the mental health field and those who suffer from mental illness is unparalleled.

And it’s with a heavier heart that I have to tell the school tomorrow that I will not be returning for another school year. It’s a tough decision and one I made ultimately not out of where the money was, or where I felt most comfortable, but where I needed to be for both professional and personal growth.

I am pretty sure it won’t feel as rewarding and life changing as working with the high school students I work with, but I think it will allow me to serve people in another way while learning more about myself and the mental health system altogether.

My passion will always be teens and adolescences, and I’ll continue to write a lot about issues that effect that population, but I am sure that naturally I’ll write more and more about issues and situations I encounter working in the mental hospital.

So while I am still anxious and uncomfortable  I’m pushing myself towards this change, trying to welcome it and all of the new possibilities that come along with change. After all, how can I promote change in others if I am unwilling to go through the uncomfortableness of change myself?

Some Of My Frustrations With The Mental Health System And How It Fails Those It’s Supposed To Help

DGStory92211editAfter the tragedy at Sandy Hook Elementary School, there was a lot of talk about our broken mental health system. As a mental health counselor, I have worked in the mental health system since 2006 and could go on and on about why I think the mental health system fails many of those who need it the most.

It basically boils down to politics and money.

When I worked at the psychiatric hospital, I would see severely mentally ill people come in, but because they had no insurance, they were generally released back onto the streets within 24 hours without any medication or follow up appointments. At the same time, patients with insurance, regardless of the severity of their mental state at the time, were almost always hospitalized for at least 72 hours and released with medication, prescriptions, and/or follow up appointments.

Needless to say, the patients without insurance returned on a regular basis, to the point that I got to know them all pretty personally and could even predict when they would return. These clients were considered indigent clients or “regulars” as some of the hospital staff would call them.

They never got better, not necessarily because they didn’t want to, but many of them never really got the chance to get better.

Sure, many of them were homeless, some of them drug and alcohol abusers, and some even used the hospital like a hotel knowing that if they said the right words they would at least have a place to stay for several hours, but the large majority of them never really got the chance to get the help they needed because they didn’t have the money or insurance.

So, they would be back out on the street, most harmless, some committing petty crimes and a few were pretty scary as far as what they were capable of doing to an innocent person unaware that this person was in the midst of a psychological breakdown.

It was sad and frustrating which is one reason I left the psychiatric hospital and started working with juveniles, but even now I see how the system fails many people.

Now things are much more billing and money driven. They don’t care much about clients, giving quality therapy, making sure that counselors are well trained and given opportunities to stay well-trained and updated. All they care about is how many clients you can see and bill for in a day.

We are given three times as many clients as we can properly manage and give quality therapy to, but agencies don’t care about that because they are under pressure and in competition with other agencies and what’s called a “Managing Entity” that holds all the funds given to mental health and substance abuse facilities and can decide which facilities get and lose funding.

It’s frustrating and sometimes makes me want to quit my job because I can’t effectively do my job to the standard I feel like I’m obligated to by my own ethics and the ethics of the American Counseling Association.

On top of all that, my frustrations with the mental health system include a time when I had to have a young woman hospitalized after she had growing paranoia, anxiety and delusions that she was being controlled by other people who were raping her and turning her into a dog. She even crawled around on all fours and urinated on her mom’s carpet.

She was released from the hospital without any diagnosis and was only given a prescription for anxiety. This did not stop or even decrease her paranoia and delusions and I had to have her hospitalized again when her paranoia was so bad she started having thoughts of killing herself.

The reason I had her sent to the mental hospital the first time was because they had the resources and staff needed to truly help her better than I did working out of a school based program. Yet, they basically put a patch on a wound and sent her on her way.

In another situation I had a client stab himself in the neck during an argument with his girlfriend. Sure, this was impulsive and maybe he didn’t need to be hospitalized for an extended amount of time or given medication, but he didn’t even spend the night in the mental hospital before they released him without a diagnoses or any follow up.

If this same guy decides next time to stab his girlfriend in the neck, she may try to sue the hospital, or if she dies, her family may want to try to sue the hospital and everyone will be talking about how the mental health system failed her.

This reminds me of another aspect of working in the mental health hospital.

Almost twice weekly we would get handfuls of inmates being released from jail, inmates the jail didn’t feel were mentally stable enough to be released back onto the streets. Most of these inmates didn’t have any insurance so we would take them in and release them in the morning.

How scary and sad is that? The jail didn’t feel safe letting this inmates free to roam the streets, but they couldn’t legal hold them beyond their sentences, so they entrusted the psychiatric hospital to stabilize these inmates before releasing them, and all we did the majority of the time was give them a place to sleep and then let them out the next day.

In defense of the psychiatric hospital, a lot of it came down to funding and unfortunately, not much funding is given for those without insurance. We would have what were called indigent beds, beds paid for by the state for those without insurance, but there weren’t many and they didn’t pay as much as insurance beds did.

I believe most of the people who work in the mental health field, those who haven’t been tainted or sold their soul so that they can become program managers, directors and supervisors who are more concerned about funding and stats than actually quality of care, really do love and care so much for those who suffer from a mental illness that we go far and beyond what is expected of us and definitely far and beyond what we are paid to do.

Places I’ve worked typically don’t pay their therapists/counselors what they deserve. Those who are licensed could make more as program directors or supervisors who don’t see clients. Positions that once required masters degrees are starting to only require bachelors degrees so that agencies can lower the salary, which usually lowers the education, experience and dedication of those being hired for a lesser salary.

Quality of patient care is sure to suffer.

The mental health system is so broken and so politically and funding driven, that if things don’t change drastically and soon, I can only see much darker days ahead for all of us.