Not-So-Interpersonal Relations: Day to Day in Mental Health

I’ve said that I want to be a writer, professionally that is, and this blog is one of my efforts in that direction.  Of course, phrasing it that way indicates that I’m not there yet; I still need my day job.  (I wonder sometimes how much my day job needs ME…but that’s another issue completely.)  I have to admit, as day jobs go, they don’t get much more interesting than this!

I work in mental health.  That’s what I say to people when they ask; I like to be a little vague about it, it makes it sound a little more glamorous than it really is.  Some astute conversational partners will ask, “So, are you a (insert noun:  therapist, counselor, psychologist.  No, no, and no.)?”  Mostly they don’t ask.  I find that this line of work is intimidating to some people, especially if they don’t understand it (and let’s get the obvious joke out of the way:  Yes, sometimes that includes those of us who are IN this line of work).

The truth is, I’m a case manager.  That means that I deal with all the things NOT handled by the doctors, psychiatrists, therapists and counselors.  They deal with a patient’s two hours a week of therapy and appointments and medications; I deal with the other 166 hours.  I find housing when necessary; I make appointments and deal with medical records and referrals; I handle patients’ money and budgets.  I ensure that they have transportation; I provide emergency counseling services at odd times throughout the day and night; in short, I make sure they have everything they need in order to be able to function in the community, and most of all, to avoid going into the hospital.

I wear a lot of hats in this job.  Financial consultant.  Secretary (sometimes).  Impromptu therapist.  And sometimes, mediator.  Or maybe referee!  It’s a toss-up as to which word is better.  Tonight, “referee” was definitely the word of choice.  A simple little dispute between two of my…I don’t want to say “patients”; we usually use the words “client” or “consumer”…at any rate, a dispute turned into an argument, that came ridiculously close to a fistfight.  Two hours of intervention later, they finally settled…who am I kidding?  They’ll still be at each other’s throats if given the opportunity!

It’s a situation perfectly designed to cause fireworks.  Let me explain.  In my previous career in corrections, I learned that the reason inmates cause so much drama is that they are bored, mostly.  They have nothing but time on their hands, and they have nothing better to do with it than observe the people around them, find out what buttons those people have, and come up with ways to push those buttons.  Voila:  instant drama!  One of my two combatants from this evening is like that; she’s an initiator—and she’s very good at these things.  The other individual is a reactor; she rarely thinks, only reacts.  Further, she has so many buttons to push, she makes the cockpit of an airliner look simple.  When these two meet, an explosion is inevitable, like any scene in any Michael Bay movie (pick one, really, it won’t matter).

I promise, that will be my last awkward pop culture reference today.

There is one lesson to be had here, and it is one that, strangely, I find myself saying often lately, in a variety of situations.  The lesson is that dealing with other people depends entirely on you.  No one else is going to do it for you.  I spent the better part of an hour explaining to the second client, the reactor, that if the two of them were going to get along, it was up to her, because the other person had no reason to change—in fact, she likes it this way.  Put another way—one not original to me—you cannot control anyone else’s actions, only your own.  If you’re dealing with someone like my initiator, that person will not be interested in getting along—he or she will want drama.  So, every approach he or she makes will be an attempt to set the terms of how you will interact; and if you react in the way he or she expects, you’re giving up control of the situation to that person.  If you want to have any control at all over the interaction, you have to think before you react, and you have to avoid allowing that person to press your buttons.  This is the only thing you can control—but it is vital!  You need to control it, because you can’t control the other person.

Note what I’m not talking about here:  The actual mental illnesses suffered by these individuals.  Their illnesses are real, and severe, but fortunately, they are fairly well controlled right now.  That isn’t always the case; later, I’ll talk about what it’s like when things REALLY get out of hand.  Until then…let’s all get along!


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