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I haven't posted for a while.
My life seems to be going to hell in a handbasket. My new T or shrink...whatever she is, left today for a week of training.

I work with clients who are seriously mentally ill. One suicided this year.
I was unable to connect with another, had to discharge this person and who I heard is now doing poorly. Another became paranoid and angry and is taking a month off seeing me.....and this week another client fired me because I encouraged her to set goals....

Each of these situations is explainable and would have happened no matter which staff member was dealing with it....but my boss expects more of me. I'm supposed to have more successes with clients than the others who are not licensed. I also get paid more Frowner

SInce the suicide, I have been feeling unsure of myself and my skill, it really threw me for a loop.....my boss knows this ...losing a client was devastating.....I kept thinking "Why didn't I see it coming?". On Wednesday after I told my boss about the latest incident, she said, "If more of your clients decide to quit, we'll have to look at what you're doing". Her words stung. She knows me very well and knows how I work, that I'm compassionate and careful to the max.
I still have not recovered from my client's suicide (I spoke at the funeral) and these other incidents were bound to happen due to the degrees of mental illness.

I went home Wed night and cut for the first time in about 5 years. I can't take it anymore. I woke at 2 am, made myself stay in bed til 4 and then left town to drive to my therapists an hour away and waited til my 8am appt. She met with me and said the situation is toxic and told me to take 2 weeks off. I'm supposed to be taking it easy but my mind is telling me my boss thinks I'm (even partly) responsible for my client's death. I can't stand that thought. The client had a terrible life. She was on a trajectory to dying by her own hand and I couldn't stop it.

I'm beginning to trust my new T. She said to call her office #, she'll check her messages and return my calls during her week away. I feel like I'm going to vomit I'm so upset.

I called a realtor and he's coming to appraise my house in the morning. I want to leave this town and finish my degree next year in the city where my therapist lives.....I used to live there but moved here for the job. I have been here almost 2 1/2 years doing a job more stressful and demanding than I ever dreamed I'd do. I feel guilty and even wrong with my responses and reaction to this.

The very last thing I could stand would be to be responsible for causing any of my clients harm. I was in the system myself and hurt by professionals many times.....that is why I do this job, to try and make a difference and I work my butt off helping my clients. I'm good at what I do and have had amazing outcomes with some people assigned to me.

When my co-workers can't deal with a client, they refer him/her to me because I'm more specialized in trauma and stabilization. My clients are all Trauma, DID, BPD, Bipolar etc. They are the heaviest and have been in the system a long time. Of course I will have some bad outcomes.....but to not get support from my boss really blew me away. I just can't take it.
My mom is here and she is trying to support me and at the same time try to help me not lose my shirt financially. I already miss my therapist and she probably hasn't even left town yet. It's going to be hard getting through the next 2 weeks.
Oh, my boss called my house today. I was out and she left a message....said she will call again. I'm afraid to start talking to her in case I say too much....also afraid of getting a lousy reference if/when I get another job. I can't imagine going back to this workplace and facing the others as they now know I'm on a stress leave. I had another 2 week leave when my dad nearly died last year. Stress leaves are a sign of weakness - even though we should know better.

Thanks for listening to all of this. I am so thankful for my therapist right now, and this board where I can talk...whew, I'd never get through it alone.
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Hi Itshardtosay,
I'm so sorry, I can't imagine how difficult it is to deal with all this. But I will say this, I do NOT think you are responsible for that woman committing suicide. In the end, it was a decision that she made, not you, and it was her responsibility. You did everything you could to help her, but she made the choice to turn away and go another way. I can understand why you are struggling with guilt and second guessing yourself; I think anyone would be in your situation. Which is what makes your supervisor's lack of support and empathy even worse. Being in the profession, she should understand even better what you're going through. There is a part of me wondering if she is feeling guilty and trying to project it on to you. I would hate to see you stop helping all the people that you can because one person refused your help.

But in the meantime, you really need to take care of yourself. It is understandable that you need some time and even some space to deal with this. But I can understand you wanting to leave your job. That kind of lack of support by a boss can make a position very untenable, probably even more so in your field.

And I'm sorry about the cutting. It must be frustrating after not doing so for five years. But I do know that when we encounter really difficult stress (and I think this situation merits that description) we all have a tendency to fall back on our most deeply ingrained coping mechanisms. I know that you know how to handle your emotions and get the support that you need or you wouldn't have gone five years without cutting. So, it was nothing more than a slip and you are just as able to move past it.

Thank you for coming here and talking about how you feel and being so open about what you're going through. It is easy for me to forget that my T is a human, and has a life that is sometimes stress filled. You choose to do a very difficult, demanding job which demands you act in very sacrificial ways to help other people and I think that you deserve empathy and not condemnation when it doesn't all go right. Especially because you cannot control what you're patients choose to do. Please keep coming here and talking about it, you really don't have to be alone with this.

AG
Thanks for your replies and encouragement. When I am calm and think it through, I know I could not do any more for that client, it's just when I am triggered and fear blows up again...that is when the dysregulation takes over.

I talked to my boss and she is trying to be understanding. I don't think she realized how badly my client's suicide affected me. So I have 2 weeks off to get my right brain, body, and thoughts calmed again.
I guess I am more susceptible to a PTSD response since I suffered with that before....whatever it is, I am glad now to be planning a change and move. I hope to rent my place and move in July or August. I have been growing a stronger self in therapy for the past 5 years and now it is pretty amazing to be working my way through this job thing and rescue myself enough to be able to leave this job without shame, with a good reference, and with my head held high. THat is my goal.
Therapy can have pretty amazing results.....I am so different, so much stronger than the me who needed almost constant external regulation when I met my therapist in 2003. I've become a stronger determined to grow, survive, and thrive self....almost unrecognizable from the me back then. It's a very cool process.
HTS,
It sounds,(if writing can have sound), like you're feeling better. I think it's wonderful that you've made a decision to take care of yourself and move on. And it's great to have therapist that will support you especially when you're unsure of the supervision you are getting a work. I also work in mental health and have lost some wonderful people to mental illnesses and/or their life stressors. It is personally hard to live with at times, but I have to agree with AG, in the end a person is responsible for the choices they've made for themselves. I hope you continue to feel better.
Q
HTS,
How amazing that you can see the progress you are making/have made. I imagine a client's suicide would be the worst tragedy possible for a therapist, and it is so great you are being gentle with yourself, giving yourself some time to recover, and that you can see it was not your fault. You have some goals now, and it always helps to see them on paper Smiler
Take care, and keep us posted.

LTF
Thanks again for your responses.
I want you to know that my job differs from a therapist's job...I am a mental health case manager, an RN who helps people try to navigate the system, set goals and work on recovery. I teach stabilization skills particularly to trauma survivors...but I am not a psychotherapist. My belief is that psychotherapy can offer great opportunity to people especially if the therapist can connect in a R brain to R brain way with their clients. Suicide rarely happens if the therapist is attuned in this way...my job limits me in the support and therapy I can offer and that is part of this whole frustrating and devastating outcome.

Itshardtosay
Hi IHTS Smiler

I can't compare myself to the degree of health issues that you deal with in your career, but I had to leave my career because of similar reasons that you have recently had to deal with. It started as two weeks stress leave to get my head around what happened, it turned into 9 months leave and then having to leave permanently as I wasn't able to get past the fears involved. For me it's time for a career change Smiler It's not an easy thing to get over, especially if you (or if others make you feel) remotely responsible.

But like you I left knowing that I did a lot of good and helped a lot of people in my career. So I'm glad that you can see all that you did and leave your position with your head held high and without shame - there is certainly no reason to feel shame in doing all that you could for a client.

Good luck with your move and with the journey of change that you are about to embark on!!

Be well!

Holly
Hi Holly,

Thanks for your kind words. This is a hard time....I feel so stressed..was thinking I guess this is a PTSD type response. It is not going away, just tons of fear.
2 families are coming to look at my house to rent it tomorrow. I have spent nearly a year fixing it up and now I hope it doesn't get trashed. Some of my clients do that...but maybe I will get good tenants if I check references etc. I am worried that I'll cave into the wrong family if they seem pathetic enough. I am still paying off the $5000 I put into my bathroom.

Today I found a place to live in the town I want to move to. It will be sharing a house with another woman...hope it works out and sounds like a good enough fit. I can take my 2 cats with me Smiler

I could see this thing turning into a 9 month ordeal except if it does I will end up bankrupt.
I do have support, my mom was here for 4 days, my shrink is away but some friends have been talking with me. My biggest worry is dealing with work people. I want to just quit and never go back...but I will have to at least go back for my office stuff. I feel a bit guilty too. Memories of nasty happenings there with staff and clients keep flooding my mind, I cry at the least thing, am grouchy as in grizzly bear and can't sleep. guess that's reason enough not to go to work. Whatever.

I really wish I had listened to my body and mind earlier and found another job before Burn Out Frowner

Thanks for your reply.
Yesterday I had a garage sale. As I counted money, I looked in my wallet and found a parking token for the Dr's office lot where I took my client who suicided. Just like that, I lost it, bawled my head off shaking all over going over the last few days and weeks of her life in my head. I called my mom. I keep going over the details, thinking I missed it, I missed the clues she was giving me. I should have known.....I WAS her support, I liked her, like I like all my clients, I had connected with her, did so much for her and with her, held hope for her... but I obviously wasn't enough. I keep seeing her in ICU, realizing the extent of brain damage, then cremated in a small wooden box...the horror won't go away. It seems like it keeps happening it never stops for long and I wonder if I'll ever forget and be normal again. I can't sleep and keep very very busy. I am grouchy and impatient. During the time in ICU I'd call once or twice a day to get an update or visit then go home and take Gravol so I wouldn't vomit. I nearly lost my cookies in the grocery store after work, had to look around for a place to puke but in the pickle isle there wasn't much option....I held it till I got home.
I am saturated with work stuff, with what's been said, with all that's happened. I can't take another drop, and I know I can't go back and pick up a caseload.

My dr comes back to work tomorrow and I'll see her then or Tues. I rented my house for July 1 so at least it's protected against my potential loss of income, also found a place to stay in the town I want to live in. I guess I could go on long term sick leave. It doesn't look like I have any other choice with the hiring freezes on right now. I feel like toast.
Hi IHTS

I'm sorry I didn't see that you had responded to my last post here.

Like I said, my work experience wasn't nearly as traumatic as yours so I can't begin to even think of what to say other than it will get better in time. You sound like you're blaming yourself for what happened to your client. I'm going to say that your not a psychologist, a clinical social worker, or a psychiatrist ~ what makes you feel like you should have seen it coming when professionals in the field of mental health often don't even see something like this coming? This is obviously a reason that so many health practitioners don't allow themselves to emotionally connect to a patient. What makes things like this hard for us is that we often see these paople on a daily basis for months (or longer) at a time.

I'm so glad that you were able to rent your house out and find somewhere to live in the town you are moving to. It sounds like things are moving along well for you in that area, and hopefully your ability to be at peace with yourself will follow. Take your sick leave, we earn that time and you shouldn't feel badly about needing to use to heal ourselves!

Be well!

Holly
Hi Holly, I didn't see that you responded either until today. You might have read in other posts how things are progressing with me and this job thing.

I should have moved on from here a year or so ago....the thing I have learned from this whole thing is that next time I'll listen closer to what my body is telling me through the amount of stress and dysregulation I feel on a regular basis...I think if I'd listened I'd have worked harder to leave much sooner, probably before the suicide even happened. But I think I've learned something (the hard way).

I'm not sure if I'm blaming myself for the client's death or not, I'm still having a lot of flashbacks about it - and it's hard to tell which end is up. What I do know is that I'm ready to leave.

Karie

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