I am always reminded of the time I worked at the inpatient child/adolescent psychiatric hospital unit. I was a mental health associated and it's where I got my first hand experience in working with difficult situations. The unit had the joke of calling the kids the "worst of the worst". We had one girl come in who looked bad, smelled bad, had extremely bad acne and just was one of those patients that people tended to avoid because everything about her was "bad". I noticed her counselor spent very little time with her and gave her minimal attention, even walking through the halls. I thought that's probably what she deals with day to day outside of the hospital too.
One day I heard her in her room crying and I walked in and sat down next to her and asked her what was wrong. She said she hated her life, hated her body and everyone hates her. I told her I didn't hate her and I'm sure there are people that care about her reminding her of her family that brought her in. She said they were just worried she would kill herself and then they'd feel guilty but they don't really love her. I said to her you know what, you are a beautiful person, you care about others, you have compassion and to me that is the most beautiful thing a person can possess. Then I told her it was time for her to get ready for bed and I had to go, she said thank you and went to bed.
The rest of the week I was off so I didn't encounter her or witness any interactions with her but all the sudden I was standing at the nurse's station and this person comes up from behind me and gives me the biggest hug... I looked and it was her, I didn't see an ugly person, I didn't see severe acne, I didn't smell anything bad, what I did experience was a beautiful person smiling and giving me a big hug and she said thank you for making her so happy. It was time for her to leave with her family and she was glad she could say goodbye to me because I was nice to her, I said "you're worth it , remember that" and she said she would. The other workers looked at me like I was crazy...
That isn't the only time I encountered one of these "worst of the worst" kids. One girl came in with scabies, everyone was afraid of her including her counselor. No one wanted anything to do with her since scabies is spread easily through the skin. She was placed in quarantine and no one was allowed to go near her or her room and her counselor talked to her through the barricade of dressers, she was seen daily in there crying because of the isolation.
I couldn't take it, I went over there and moved the dressers, walked in her room over to where she was sitting on the floor in a corner crying and I sat down on the floor next to her and started talking to her. She was shy, quiet and scared. I told her I understand how scary it must be being away from everyone and in isolation and she said yes and she didn't know how she got scabies. The joke among the nurses was that she slept around everywhere it's no wonder she caught it. I said, well it's not the fact that she has it now but now we need to focus on her getting better and I enjoyed talking to her. She had finally stopped crying and it was time for me to leave but I visited her daily until the day she left, I never did contact scabies.
I also had the most difficult job I think a person could have, and that is spending an entire day with an autistic boy who didn't communicate except for tantrums and his parents learning to interact with him. This is where I dug down deep inside of me and pulled out the toughest skin I could because this boy was 10, he was nonverbal, did not make any eye contact, communicated through hitting himself or someone else and the goal was to spend the week with the family to help them behaviorally control him, show them basket holds and easy, safe restraints. I met the mother and the boy. I created this book that showed transitions, I did know from my training that transitions were the most difficult time for an autistic child. So the book showed pictures (drawn and magazine) of the typical transitions he would encounter that day. We spent time with the TV then mom took his hand to move him over to the blocks, which threw him into a tantrum.
This is where I intervened with mom to show him the book that showed the transition from TV to the blocks. So we tried it again and to her surprise she didn't even need to touch him she showed him the transition and he went right over to the blocks, we continued to do this throughout the day, from breakfast to lunch and he was even able to sit in group with the other kids without any incidents all day. At the end of the day when it was time for him to go home, this child who showed no emotion to anyone ran up look me in the eyes !!!!!!!! and gave me a hug and a big smile. Mom was also very thankful, they never came back they said after that day, they learned how to work with him and had minimal incidents. My heart was so warm after that.
The reason I am telling these stories of my first experiences in the field of mental health is first to remind myself to be patient with each client and to start where the client is but also as a reminder that what we think on the outside looking in isn't always what is going on, we need to look deeper into the world of the patient. These early experiences were my driving force to go back to school and become a counselor, I loved working with this population and felt I could be able to help better if I was a counselor. Each and every client taught me a lesson. Now after working in the field as a counselor for several years, I always can look back on my earlier patients and thank them for making me the compassionate counselor that I am. I hope each and every counselor who reads this remembers their triumphant moments too, it's what keeps us going in a field that is difficult.
Kimberly Beck is a counselor and a doctoral candidate with a special interest in Self-injury. Other interests are PTSD, trauma, and Borderline personality disorder