Day 3 of Homeopathy - Why it sucks when you're the "expert"

So, two different subjects, one post, because it all ties together. Subject one, suicide, subject two, Ignatia Amara. Let's begin with subject two.

So the homeopathic remedy my naturopath has me on is called Ignatia, and it's for grief and balancing emotions and stuff. It can make things worse before it makes things better. It's definitely made things worse, or at least psychosomatically so, I'm not sure. Nausea. Ick. Bleck. Nausea. And lack of appetite, but the nausea feels better when I eat. random. Lack of interest. Yup, I've got that. It goes along with the "lump" in my throat. Exhaustion, oh yeah. I've slept eight and a half hours two nights in a row and still been tired, despite my b12 shot on Monday. Hopefully things get better soon!

Subject 1, suicide. Without going into too much detail, there's this girl I know, younger than me, but still over 18, and she's quite depressed. I've been a non-professional support for her for four or five years now, and I know her quite well (far better then she knows me). Here's the thing though, right now she's quite suicidal from what I can ascertain and really not doing well. We both think she needs to go to hospital, but she is scared of going and keeps putting up barriers. I offered to take her tonight, but no go, barriers put up. So we're at a stand still.

Now here's the thing, if she was a client, instead of a friend, I could leave this at work. I could leave this in the client's hands, provide them with resources, write a safety plan, and I could go home. But as a friend, she has my cell phone number, and that's how we've been talking, text messages. It's harder for me to set aside, because I care about her a lot (not that I don't care about my clients and worry about them as well, but it's a different kind of relationship). But I'm stuck. She's not actively suicidal, or if she is, she's not telling me, so I really can't call the police. I've had to call the police for people before, and it's not fun, even when they're standing in front of you telling you that they're going to walk out the door and hang themselves, and they've got the rope already. The police would not be interested in this. I also don't have enough "evidence" to go to the magistrate and try and get a "form" so that she's forced to be assessed in hospital. I have given her all the crisis resources, I have been through safety planning with her, I've done all the "right" things, and now it's time to let go.

Here's how this all ties together though. Among other people who are friends with this person, I am "the expert". I'm not an expert in this at all, but I'm the one they all turn to when things aren't going well for this friend. There is no one else for me to call, they could call me, but that's where it stops. This friend has a counsellor, but I'm not in contact with them, because I'm not a professional in this case as I've told her many times. I'm not at my best right now, I'm really not. But there's no one to pass this responsibility off on. I just don't seem to have it in me to tell my suicidal friend with very little support, yeah, I'm feeling "off" today, can you feel like dieing another day? I have of course set some limits and boundaries, and I definitely took some me time for self care today where I completely ignored the phone, but it's still hard. I guess it's never going to be "easy" though, when a friend is feeling suicidal, no matter how good a place I'm in. I guess I'll see what tomorrow brings!

craaaaaay week

It is amazing to me, that one of my clients could ingest more than 200 pills, wind up at the hospital in an ambulance, be treated in emergency and be released with no admission, not even a follow up. The day before that they refused to admit her to psych. Who knows what the weekend will bring. Apparently she is safe because she swallowed her plan.

For the record, my whole week's been like this. I spent all of Thursday in tears. It's a long story. But every six months or so, I cry for an entire day. Unfortunately, that day, was Thursday. It sucked. But, it turned out really well. My supervisor and I had a great talk (after she freaked out at me in the hallway earlier that day). I'm calling in sick Monday for a planned mental health/self care day.

Also, Oliver Lockhart seems to think the litter box will attack him. It's a closed box, (with a lid) and he does his business with his head sticking out. After he burys it, he BOLTS down the hall to the living room like there's something chasing him. It is hilarious! Just thought I'd share :)

laughable

When I interviewed for my job at the work placement team (yay for new job) I really did NOT think I had done well.  I knew I had gotten some of the questions bang on, some of them half on, and only completely made up one answer (oh how I wished I'd actually done some research).  There was one question though, a very serious questions that I grinned and started laughing at...I thought it was definitely worth sharing, although I do realize that it is kind of morbid, and it shows me just how calloused my job has made me.  

So, the interviewer asked me to desribe a time when I'd intervened with someone who was suicidal.  Now, she wanted a professional answer of course, so I could use anything to do with my sister and her multiple issues (which reminds me of another post I want to make) but in my head I was thinking that I've dealt with enough suicidal people to think of something!  And that's when I started laughing, see this is what came to mind.  

A while back, I wrote about a man who tried to strangle himself in the drunk tank.  In this case, he was extremely drunk and high on an unknown substance(s).  Talking, as it often does in cases of intoxication, did me no good and right infront of me he took he shirt, wrapped it around his neck and began to pull tighter, and tighter and tighter.  I ran for a coworker and by the time we got back he was unconcious.  We opened the door and untied the knot.  When he realized he wasn't dead, he went nuts and it took six police officers to carry him out and take him to the hospital to get checked.  

But that's just one story, if it was just that, maybe I wouldn't have laughed.  When the police who apprehended him came back the officer looked at me and said "weren't you here last week when we took someone out who tried to kill themselves" and I had to ask "which one/which time".  Because it happens SO often.  I mean, people are really creative.  I've dealt with more then one hanging, more the one strangulation, attempted wrist/throat slashing, and of course, the good old bang head into wall until you pass out.  One of those ones fought the cops for a good long time begging them to just let him kill himself.  This was all I could think about.  All the lives I've potential saved with "suicide intervention", and I laughed, because I knew this was not at all what they were asking for, but it was all I could think of.  

Finally, I smiled, and said something like "I spend a lot of time with intoxicated people and their situations can be kind of exreme, let me tell you about a time I dealt with someone sober..." I based my answer on a client experience, but in truth, I just walked through the steps of a suicide intervention and ended with a likely outcome.  One of the reason I want this job, is so that I can have those experiences.  Right now, if someone's suicidal, once their sober, we pawn them off on the crisis team, we don't have the time to deal with them, I'm too busy watching out for the one in the cell beside them ripping his mat into ropes or watchign 71 other people in the shelter making sure they don't kill each other after a percieved sock theft.  

Suicide is not a laughing matter... just one of the reasons I got a new job.  

after the intervention

I've changed my mind about ASIST (Applied Suicide Intervention Skills Training). It is useful. I used it yesterday. And I was surprised...the method worked. I didn't think it would.

The problem with ASIST though is that it's suicide first aid. There's no aftercare, it's all about referral, which is fine. But when people already have community supports, then it's hard to refer them to community supports. I mean, you tell them to go see their therapist and follow up with that, but aside from that, there's not much you can do.

Part of ASIST is having them promise you to stay safe for a set amount of time of their choosing. If the person picks a week, that's great. When they pick one day, but don't have a therapist appointment for a week, that's harder. You talk to them after a day, they say another day, do you do it all week? The model would say so... how realistic is that though? Plus, you're supposed to go through the whole intervention again... that's really redundant. In this case, I just made another safety plan with the person and arranged another check in time as well as reassessed for risk. Thankfully there was a lower risk then the day before.

There is no easy answer in cases like these. There are always options (calling mobile crisis, getting a form two and having them forcibly assessed, calling 911, involving the persons other supports), but there are still no easy choices. How much do you put on yourself, how much do you transfer to others. Ultimately though, it's the persons life. Whatever happens, it will not be my fault (or at least I keep telling myself that).

second day

Despite the corny picture, the second day of my workshop went really well. I actually enjoyed the role playing we did, which is surprising in some ways because really, it's role playing. Worse then just role playing, it's "fish bowl" which is role playing in front of the entire group and then getting feedback. I've never really been a huge fan of it, however it is a really good learning and teaching tool. ASIST gives a really great framework for suicide intervention with "handy dandy" steps and diagrams to follow which makes it a lot easier and a less daunting task then one might think. On the whole, it was a good workshop, and I would recommend it.

all that emotional touchy feely stuff.

Today was the first day of my two day Applied Suicide Intervention Skills Training (ASIST) class. Basically, it's a $250 course so I can get the five letters that will let me get the job I eventually want (working in Mobile Crisis). I had a hard time sitting still long enough today. The course is 9-4 and even though there are lots of breaks, I found it hard. By the end I was swinging my legs and rocking back and forth. I did apologize to the facilitator because by the end I was feeling pretty rude. Bah. sitting.

Anyway, the course itself isn't as bad as I thought it would be, and I tried to go into it with an open mind. It's a little too personal for me though, and a friend of my father's is in it which is just really awkward. I don't quite feel like I can talk about my experiences or the experiences of my family as freely when he's in the room. But that's okay.

There really hasn't been a lot of new information, although I really like the way they write the model out. Tomorrow we get deeper into it as well, and so hopefully there will be some new content. It basically follows the six step crisis intervention model I use, with a couple variations which make it specific to suicide.

Something I really liked about the last suicide prevention workshop I did was their emphasis on how normal suicidal thoughts are, and how so many people have suicidal thoughts over the life time. This course really seems to focus on suicidal thoughts as a bad thing, when I do believe they can be a coping mechanism to get people through hard times. Sometimes knowing there's that way out is enough to keep someone going. Further, this course refuses to acknowledge the fact that there are some people who are going to die by suicide no matter what we do to intervene. And by we, I mean "systems" in general, not just "me" as a person. The other workshop was really good about that and I think it takes SO much of the pressure of the helper; whoever they may be.