I wrestled with presenting this story for two reasons:
1) I have not yet written the blog post I mentioned I would be posting.
and..
2) it’s all about boundaries AGAIN!
But then I had a growth moment and realized that if you’re working child and adolescent psych and there are no boundary issues with a patient, that child might not need to be there, or you should be very, very worried. In the wonderful course of bureaucratic events that I so love to complain about, Dr. Black and I have been, for the most part, unable to work together. This makes me sad, because I am unable to find out if she has refined her Coke Zero Bong Skills. Maybe next time we’re out to lunch, I’ll ask for an updated demonstration..
I digress.
In the wonderful world of sports here in CrazyTown, USA (I named it after myself 
)patients occasionally have to move from unit to unit based on psychiatric need. Dr. Black is now on what is supposed to be a relatively stable unit. Dr. Black had a patient, whom we will name Britney Shears, cut herself, and threaten suicide. I don’t think this was an isolated incident, so she was transferred to a more acute unit to stabilize her.
I do happen to serve this unit.
Now, in my massive amount of years of experience (shout out to Michelle Erfurt), I’ve developed the skill to identify potential problems on sight. When I walked on the unit the first time that Britney Shears was present, I knew that a firm boundary maintaining approach would be needed.
Man, I am SO SMART. People are like, CrazyMusicLady, how do you know these things? and I’m like, it’s like ESP man, you just know, and then they’re like Whoaaah and I’m like Whooah.
I digress again.
Britney Shears started by monopolizing activities by asking questions that she already knew the answer to. I played along until she interrupted a conversation I was having with the Charge Nurse. Then it was time to politely redirect.
Oh man. Tears welled up in Britney’s eyes and she left the group before it even started. She spoke to Dr. Aerobics (the psychiatrist on this unit), and told him that she has the same feelings for me as she does for Dr. Black (target number 7, I’m number 8), and that she thought I was mean to her and that she wants to kill herself.
After group, she asked to talk to me, and told me that she thought I was mean. I explained to her that it is my job as a therapist, to not only provide activities, but to also redirect behaviors. I wasn’t trying to be mean to her, I was just letting her know that interrupting conversations isn’t a good way to get my attention, which I knew was what she was trying to do.
Fast forward 5 days later.
Ms. CrazyMusicLady, can I talk to you? I give her 20 minutes.
She then tells me that she’s obsessed with me, not in a sexual way, but in an if she doesn’t have my attention she wants to hurt herself way. I told her that I knew, and you know what? Awesome therapy ensued.
Tomorrow is back to work. More work doing too many groups each day, doing individuals, doing major boundary work, doing wanting to pull my hair out.
I can’t wait for private practice. Then I might be able to write a song or two.
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