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May 14, 2018

A Lesson in Humor and Terror

As a graduate student, I would have told you that most of my knowledge and learning in my career would be the result of time spent with books, at professional conferences, and reading peer-reviewed journals. I am sure someone told me the truth; that most of my knowledge and education would come from my clients, but I wasn’t prepared to listen or to accept the vulnerability that comes with allowing another person enough access to yourself to bestow wisdom or insight.

But, when I look back on my albeit short career thus far, I find that that statement is true. I have learned more about the world and about myself, as a person and as a therapist, through my clients. Wedeling all those lessons into a single blog seems like a gargantuan task, so I will work on this as a series to allow myself to dedicate the proper attention to each lesson. Each lesson is a story. Humans are storytellers by nature, so I will convey these lessons through that medium, exactly how I learned them too. Please note that all potentially identifying information about the individuals in these stories has been altered or removed to ensure their rights. What remains is a story and a lesson.

HUMOR AND TERROR

We had planned the appointment for months. Rehearsing and roleplaying over and over the processes and procedures. She was ready and it seemed that nothing was left to chance. We were so wrong.

When the day arrived to go see her oral surgeon to get some teeth removed, we were prepared. As I drove her to the hospital, we reviewed her stress management and coping plan for the day. When that was done, we listened to her favorite music to help her relax. All according to plan.

But when we walked into the procedure room and saw the doctor, a tall skinny man with dark short shorn hair, I noticed her eyes widen and her breathing hitch and then increase in pace. The doctor was nice. He introduced himself and attempted to joke with her but her eyes remained fixed and on the verge of panic. When the doctor left the room to get supplies I spoke calmly to her, “you’re not here with me right now. What happened? You’ve been triggered?” That’s when we noticed the hitch in our plan.

“The doctor looks like Him” HE was her former abusive boyfriend and the doctor apparently brought back some memories of him and his years of pervasive abuse. While the doctor was out of the room we brought her anxiety back down through copious deep breathing and other exercises that helped her feel safe. Because she didn’t feel safe alone with the doctor, she requested I stay in the room. I was more than happy to oblige.

As the doctor prepared for the procedure he attempted to chat with her and, to her credit, she attempted to return the conversation. I could see in her eyes that she was still terrified despite our continued work on stress management. When the doctor left the room, I asked if she felt safe enough to continue or if we should reschedule with another doctor. She said no, that we would stay and get the procedure done despite how triggered she was.

The tide of the day changed in a flash. As the doctor was attempting to remove a tooth with significant damage to it, there was a loud “pop!” and then a “tink tink”. I realized immediately what had happened. Not only had the tooth broken under the pressure of his tools, a piece of the tooth was now residing in my work bag. I cringed and asked the doctor for some gloves and explained that the tooth was not going home with me. That’s when the tide changed; that’s when a wave of laughter flowed through the room and the earlier terror was replaced by mirth. Everyone was laughing at the absurdity of the situation; me, the doctor, and my client. We all enjoyed the moment.

I remember after this moment that the doctor briefly left the room. My client looked at me and beamed, “I’m no longer scared! He’s really nice!” Despite all of our efforts at therapeutic tools to assist in stress management, all it took was a shared moment of laughter and joy to break the spell of her post-traumatic stress induced terror.

To this day, if I find that traditional therapeutic tools aren’t working during a post-traumatic stress episode, I will resort to humor to help defuse the power of the moment. And, to this day, it hasn’t let me down.
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Brittany Lash is a counselor in Texas and is the director for the Professional Recovery Network (http://www.txprn.com) with the Texas Pharmacy Association. She has experience working in public mental health, mental health public policy, and in training first responders to work with individuals with mental illness.

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