ACA Blog

Chris Allen
Jul 13, 2011

Day 4

Over breakfast, Jim and Fran discuss today’s schedule. Jim wonders aloud if he will be alone with Dave the entire time and Fran is kind of concerned about feeling like having to entertain Kamiah this evening. Jim reminds Fran that the V&B Staff cleans the cabin during the day, so “don’t get all stressed about what the place looks like”. “Easy for you to say” Fran shoots back. “Whatever Fran!” An uneasy tension remains with the couple throughout the morning. Both are inwardly angry with themselves for letting old arguments and patterns invade such a tranquil place.

Fran spends the remaining hour and a half of the morning taking a walk around the Ranch, while Jim relaxes with the morning’s paper. As Fran left the Cabin this morning for her walk, Jim wanted to go with her but stubbornness and anger kept him wanting to be with his wife.

1000 – 1200 Fran’s Meeting with Kamiah

While on her walk trying to forget the fight she had with her husband this morning, Fran nearly forgets about this morning’s meeting with Kamiah. She arrives at Kamiah’s office around 1005. Fran fears the worst because she is late. “What will Kamiah think? How could I have been so stupid?” The questions and doubts come in rapid fire succession. Her head begins to hurt. “Will she still want to come over tonight because I was late this morning?”

“Fran, great to see you this morning, and thanks for leaving me the picture you started yesterday. It must have taken some courage to leave that behind in my office. I saw the note you wrote about not being completed yet and that’s fine. There’s no deadline ya know.”

“I’m so sorry I’m la….” Kamiah doesn’t even let her finish the sentence. “No worries here. I was almost late myself because my 8 year old daughter decided to surprise my husband and me by doing dishes for the first time. We have a dishwasher in our cabin, and Kaia decided that normal dish soap would work. You can imagine the mess it made, but we all kind of laughed about it instead. We had a choice; we could have either become angry with Kaia or realized what was in her heart. We chose the heart! Besides, my husband is the one cleaning up the mess!”

Laughing now “Thanks I needed that today.” “No worries Fran.”
Note: Kamiah spends the next hour or so doing what counselors do. She does not discuss the picture during this first hour but instead will encourage Fran to complete it during the second hour of the session. Like before, Kamiah will leave the room to let Fran finish what she has started.

Kamiah was able to help Fran initially process some of the fears Fran had about Kamiah’s visit for dinner later in the day. Where did her fears come from? Why is she concerned about making the perfect first impression? What are the drawbacks of trying to be perfect?

Kamiah will share Fran’s goals at today’s staff meeting. Kamiah does no t have a “working diagnosis” at this point and is not pressured by other V&B Staff to provide one b/c insurance claim processing is not a factor. Kamiah is recognizing the potential need to refer Fran to the Staff Clinical Psychologist for further testing. She will also broach the subject at today’s staff meeting.

1000 – 1200 Jim Cleans Fish With Dave

“Jim grab a filet knife from that wall to your right will ya? I’ve got about 30 trout and 15 catfish to clean for a staff fish fry tonight because we have one of these things about once every month. Gives everyone a chance to spend time together and celebrate this month’s birthdays. Get’s busy around here and things like gutting fish are easy to forget.”

(The fish fry will happen at another location on the Ranch, away from the guests. The Staff lives in a secluded area away from where the guests live. They have their own cabins, the sizes dependent on the number of family members each Staff Member has. As I develop this living arrangement in future writings and concept sketches, I will attempt to create, convey, and describe an atmosphere where potential V&B Staff Members are cared for by each other, sharing in burdens and the natural trials experienced by members of the healing profession.)

Dave already knows that Jim likes to be in control of situations, so Dave decides to be more directive in nature.

“No problem, don’t think I’ve cleaned a fish in several years.”

The tone in Jim’s voice was submissive but Dave could detect a hint of irritation in Jim’s voice. Dave lets it pass but remembers to pass on his observations to Kamiah. Dave will be intentional about creating similar experiences for Jim during the course of just “fishing.” In fact, Dave will tailor his approach and relational style to the individual needs of his fishing partners.

“Well, you’re getting your chance today Jim. Thanks for helping me with this.”

There’s not much eye contact being made and there doesn’t need to be really. The two are already “in session.”

The two make small talk while they clean the trout and catfish. They casually discuss sports, fishing, hunting , and unsuccessfully try to figure out if they know any of the same people from the Army.

Towards the end of cleaning fish with Dave, Jim asks his first personally probing question of Dave. “How is it that a guy like you can know about a guy like me?”

Dave answers Jim back with the exact same question and a smile. They both share a laugh at this as they clean up the mess before them.

“I don’t know your story yet Jim, and you don’t know mine either. The world outside of the Army is the same way. People don’t know you yet.” Dave watches Jim as he processes what Dave just said, but his expressions do not yield much. They are hidden. Dave is not worried though because during future fishing trips in the weeks to come the group will start revealing more. Nature and the shared bonds that these men will experience while enjoying the lake will facilitate change and mutual understanding.

1:00pm Staff Meeting

As normal, the meeting begins with Counselors presenting their progress notes and recommendations for the guests they are caring for. Again, not every case is discussed, only the cases being recommended for additional Psychiatric and Psychological consultations. Guests in week 1, week 2, and week 3 are discussed in order. All Staff Members are expected to participate and share ideas. Depending on availability, Best Practices Members silently observe all V&B Staff Meetings.

Fran:

Kamiah indicates the following: “I had a two hour session with Fran this morning, and Abigail performed a facial treatment for her yesterday for an hour. As everyone knows, Abigail is out sick today and she asked me to pass along her observations. In my opinion, Fran meets the criteria for being diagnosed with a Somatization Disorder. A picture that she drew me of her life over the past couple of days is indicating that something awful happened in her childhood, but I haven’t been told what it yet. We haven’t fully explored her picture, and I plan on doing that in the next couple of days.”

Kamiah passes the picture around to the group so that they can provide feedback. Kamiah continues:

“Certain songs, songs from the early 60’s that Abigail played seemed to make Fran more tense, tense in her body. Abigail’s notes indicate that she inquired about Fran’s un-relaxed states during these songs, but Fran really didn’t have an explanation. She’s so creative, and this picture looks like a professional drew it, but in the middle is this tiny black spot. My intent is to focus on it during our individual sessions.”

“If there are no objections, I’d like to have Mel schedule a consult with Dr. Robinson and potential with Dr. Guilley. In the mean time, I’m going to start explore the picture more for material, explore body signal recognition and thought identification, and ask Mel to set Fran up in both our cooking group and relaxation training groups”

“Ok, I’ll schedule time to run a Schedule for Clinical Assessment in Neuropsychiatry (SCAN) Test to see how the scales come out.”

“No problem here” says Mel.

Jim:

“Dave, do you have any further insights on Jim” Kamiah asks. “No, nothing major really. I do think that one of Jim’s biggest problems is that he is probably scared of people outside of the Military, possibly throwing up walls to people before they have a chance to get to know him, people outside of his previous experiences in the Army. It’s just the vibe I get. With him wanting to find a job that he enjoys, I know that we will need to work on this pattern.”

“I’d also think it’s a good idea, if Kamiah has no objections of course, to have some career testing done for Jim. I also recommend that we introduce Kate to Jim at some point early next week. I’m not sure of what the best format for the meeting would be, but I think that the two could benefit in learning from each other.”

Kamiah: “Dave, I think that’s a good idea. Let’s get together later and figure out the best way.”

Dave: “Sweet, I think some boundary testing and how anger interplays needs to be explored too. I also agree from working with Jim that a goal we can lead him to consider is some ‘reality testing’”

Note: Kate is one of V&B Best Practices Volunteers. She has no military experience, and she is a Road Construction Forman from Portland, Oregon. Kate is in her late 30’s and has a large proportion of Veteran workers employed with her firm. Her firm requested that Kate visit the V&B in order to learn about Veterans and their issues. Kate does not know it yet, but her company plans on moving her soon to a position where she will serve in leadership management, recruitment, and retaining. Her duties will naturally require Kate to interact with a large number of former and retired Veterans.

1800 – 2000 Dinner at the Smith’s Cabin with Kamiah

After gathering the needed ingredients for the beef stew recipe Kamiah wants to try out from the Veranda’s kitchen and one of the V&B’s vegetable gardens, Kamiah arrives precisely at 1800. She drives one of the Ranch’s golf carts so that she can bring a large white easel and some markers with her from the office. Kamiah has three primary goals for the evening: have fun, further her relationship with Jim, and create a Genogram while the stew cooks. Genograms are basically family history diagrams that help both guests and Counselors identify patterns that may not be readily apparent to the guest. She knows that the ensuing discussion may take her until around 2100, but making visits like this is common practice for her at the Ranch. She also has a copy of tomorrow’s schedule that she will leave with the Smith’s once the evening is over. Kamiah also brings along her dog “Rufus.” There’s a pretty large storm brewing off to the west and Rufus gets terrified of lightening. Kamiah had called earlier to make sure if brining a dog to dinner was acceptable, and the Smith’s didn’t mind the extra guest. Besides, Jim and Fran are both big dog lovers and Kamiah figured that out early on.

“Hey , thanks for having me over and letting me bring Rufus. He’s such a wimp when it comes to big storms, and this one looks like it’s going to get pretty nasty.”

Fran and Kamiah begin shuttling things back and forth from the golf cart while Jim and Rufus instantly form a bond. “This is the most beautiful basset hound I’ve ever seen” remarks Jim. “Yeah, he was a stray that showed up on the Ranch about a year ago. I never liked dogs before, but I ended up getting along with him just like you are.”

With the Fran and Kamiah in the kitchen, Jim settles down in the living room with the dog. Kamiah and Fran are having such a great time talking in the kitchen, and Rufus begins to smell something more interesting in the kitchen. Pretty soon, Jim follows his nose too. He watches Fran and notices something he hasn’t witnessed in a long time, he notices how happy the woman he loves is. Fran is actually enjoying herself, completely unaware that she’s doing so. The scene makes Jim happy and Kamiah catches the smile on his face.

“What are you smiling about Jim? You think you’re going to be eating any of this stew? You better get in here and help your wife.” Kamiah’s Jamaican accent makes him laugh and instantly shatters any defenses he might have thrown up.

Jim moves next to Fran in the kitchen and starts cutting up some vegetables with her. The two instantly start telling stories about when they first were married. Jim would do the dishes as Fran would cook, “that way we could get the kids to bed early.” As the Smiths chat away in the kitchen, Kamiah excuses herself to go into the living room. The Smiths didn’t even seem to notice and neither did Rufus. He’s more concerned about scraps.

It’s starting to get a little chilly in the Smith’s cabin, so Kamiah lights a fire with the Smith’s permission. “It must be getting colder outside b/c I can hear small pellets of hail beginning to tap against the window pain. Gonna be a big storm.” She sets up her easel and takes out her markers. Kamiah enjoys doing genograms with couples and families b/c patterns become visible, addressable, and actionable.

With the roast in the pressure cooker, they have a little over an hour and a half before dinner is ready to draw a complete picture. Over dinner and a dessert of cherry cheesecake, the three will discuss what they’ve created together.

Highlights of Things Known:

Fran:

Has 3 sisters of which she is the oldest

Parents divorced when she was very young. Fran’s mom had multiple boyfriends and husbands over the years until Fran turned 18.

Father died over 20 years ago. Mother is still living and Fran is providing care for her on a daily basis due to her mother’s health.

She describes her relationships with two stepdads and some of her mother’s boyfriends as bad, but she doesn’t go into any details. She says that she can’t remember them.

She does indicate that when she met Jim, she loved him almost immediately b/c Jim is her “rock.”

She describes her relationships with her three children as good. She has solid relationships with her two oldest boys but wishes that she was closer to her daughter.

They also chart all of the deployments during the course of their marriage. When adding deployments, overseas assignments to places like Korea, and standard training missions, the time spent apart from each other during their 25 years of marriage was roughly 8 years.

Jim:

Has 5 brothers, of which Jim is # 3. All of which are still living and managing a large family owned farm in Iowa. Jim’s parents are both deceased.

Jim has good relationships with all of his brothers but was the only one that decided to leave the family farm to explore something else.

“Dad was hard on us but we needed it sometimes. I don’t think that I would have succeeded in the Army without him.”

Jim has always said that he has no regrets for leaving the family farm, giving up his “share” in it, but Fran is not so sure that this is true. “What’s done is done” Jim says.

In discussing the time away from Fran and his children, Jim has a tendency to minimize Fran’s opinion of these periods. All agree to varying extents that this seems to be a pattern.

Jim describes his daughter as “daddy’s girl.” Jim’s relationships with his sons are described by him as being “fine.”

Highlights of Things Learned by the Smiths:

Jim never knew or thought about the possibility of Fran being abused as a child, and Fran was only partially aware.

Fran always uses the term “rock” when describing Jim, but the term now seems to have a new meaning flourishing beneath the surface.

Jim acknowledged for the first time that maybe he’s been too dismissive of Fran’s feelings as they pertain to his being gone so much of their marriage on deployments.

Fran expresses a hint of jealousy about Jim’s “stable” past.

Primary patterns of relating have shown themselves during this exercise

There’s been a tendency for the men in Jim’s family to minimize concerns or problems over time, whether on “the farm” or in the Smiths’ marriage.

Jim also is able to indentify an underlying pattern of fearing situations that are new. “In the Army, you pretty much know what to expect, even when the most bizarre things happen b/c everyone is on basically the same sheet of music.”

For Fran, there’s always been an underlying need to “fix things” among the women in her family. She laughed about some of the same tendencies in her sister’s marriages, current and past.

After dessert and explaining tomorrow’s schedule, Fran, Jim, and Kamiah decide together on some of these jointly refined goals:

The impact of the Smith’s transition from the Army and how current patterns are causing problems.

How do Jim’s bursts of anger, fear of the unknown, and “rock” persona fit in with the Smith’s marriage and transition to civilian life? What’s the new reality?

It’s about 2230 and the night is coming to a close. Everyone is tired and “talked” out Jim says. “Well, it’s a good thing that you have the morning off to do something fun” reflects Kamiah. “Jim and I were talking in the kitchen earlier and think it would be fun to get up in the morning and help make breakfast at the Veranda. I heard from someone that we could just stop by if we wanted too. What do you think Kamiah?” “I’d be a good time. I hear last week that they actually had a food fight while making biscuits or something like that. Isabelle is crazy with the way she runs that kitchen. Good night and thanks for having me over. Rufus! Let’s go boy. There’s no more food to eat.”

Fran and Jim wave goodbye to Kamiah and have truly enjoyed the evening. The air is cool, crisp and clean, smelling like nature does after a great storm. The ranch is quiet and all that can be seen are the dimly lit cabins of other vacationers in the distance. The moon is rising from somewhere behind the trees and rolling hills of the ranch. Alone with their thoughts Fran asks “do you think we will be ok?” The question has never been asked by either of them amidst the many doubts lately. Jim turns to his wife, not saying anything, he just holds her. Jim doesn’t need to say anything at all, neither of them do.



Chris Allen is a counselor and an Army Officer just returning from Afghanistan. He is passionate about developing counseling practices that best address Veterans and their families. Blog comments are not representative of the Army or Department of Defense.


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