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Tuesday, November 15, 2011

Major Breakthrough.

Wow. My head is still spinning from my experience today. Being new to the field, I haven't had too many "woah" experiences yet, but today...I woah'd.

I have a teenage client who has been with my agency for years. I'm actually her 4th therapist this year. Her parent's rights were terminated and her guardian isn't the most pleasant of creatures. I am not surprised she doesn't want to talk to anyone. Why should she trust adults?

I've been working with her for weeks and we have not moved past pleasantries, if you can call them that. I've tried everything I know to do, which might not be a whole lot, but at least I gave it my all. Lots of game playing to build rapport, lots of sitting in silence, lots of random questions, lots of validating, challenging, supporting. Nothing worked.

Until today.

I decided to try art therapy, since talking is clearly not on the agenda. It's a layered feelings activity that I facilitated it in a group setting during my internship. I provided her with a feelings sheet with different expressions and the feelings they represent. I gave her 6 sheets of paper, and asked her to draw these items:
  • A feeling you often show to others
  • A feeling you generally keep to yourself
  • A feeling you wish would go away and never return
  • A feeling you like to have
  • A feeling that you can live with but that challenges you
  • A feeling you rarely experience and wish you could have more of
She wasn't very invested in the activity, and drew some pretty basic faces. When I asked her to explain them all, she gave short answers and shrugged her shoulders a lot. One of her faces was confused, another lonely. I started to dig a little, to try and find out about her past experience that she still has not dealt with. She was hospitalized due to self-harm, but no one has been able to find out why. She has been closed-lipped for months and months. I brought up the incident and asked if she was feeling the same way now. As the one-sided conversation progressed, she began to cry, then she became really angry and stormed out.

I think my jaw was hanging low because she has never so much as laughed, much less show anger or sadness. And in a span of minutes! I let her leave, followed her outside. I validated her pain, determined if she was feeling suicidal, etc. She was angry but didn't leave the patio. She wouldn't look me in the eye or talk, but she didn't leave either. At one point she yelled "I'm sick of you people coming in and out of my life." When I tried to get her to open up about that, she was already gone (mentally speaking).

She asked to call her guardian, and I went to alert the school officer about her status, and left a message for her guardian. I immediately called my supervisor and asked for her suggestions, and she congratulated me on this breakthrough, even though the session ended pretty ugly. I often wonder if sexual abuse is a part of the equation. While it has never been brought up, her younger sister was abused, and the statistics show it's likely to happen to siblings. This is only a theory. I could be totally off.

Anywho, my head is still spinning. It may not seem like much, but I hit a chord.

Finally.

-SWS