accomplishments

I graduated from the University of South Carolina with a Master's in Social Work in May of 1996, but the education of a therapist/psychotherapist never ends. 

By the time I graduated of my graduation with a Master's in Social Worker (MSW), I had a job to start in an inpatient psychiatric hospital named Brynn Marr Psychiatric Hospital in Jacksonville, North Carolina.  

This seemed like a perfect opportunity because I had worked at "The Oaks" - psychiatric hospital - as an intern which I mentioned previously in earlier chapters. The Oaks like Brynn Marr were somewhat similar.  

I was hired with the title of "Therapist" on the adult unit. I was one of two therapists on the unit. Half the patients were assigned to me and the other half were assigned to the other therapist on the unit.   

What I mean by saying that I was assigned half the patients, was that I was responsible for all aspects of their care while they were in the hospital, and I was responsible for discharge planning, also known as case management. That doesn’t mean that I did the kinds of things that nurses, and psychiatrists do. I just meant that I was the primary point of contact.

The other therapist on the unit, Leslie, had a master’s in social work (MSW) like me and she was a Licensed Clinical Social Worker (LCSW). 

I had taken the clinical exam right away after graduation and applied for the certification/credentials/license of Licensed Clinical Social Worker – Provisional (LCSW-P). I did this at about the same time I was starting work at Brynn Marr as I had to first graduate from college with my master’s degree if I remember correctly. 

There was a substance abuse counselor as well, but he only offered group therapy sessions. It’s interesting how lived experience as an addict allows people to work as a counselor without the same educational requirements, i.e., a master’s degree. 

Our supervisor was more of an administrator than a therapist or counselor.  

There were several group therapy sessions every week that had to be run by either myself or the other therapist. We could provide individual therapy as well for each of the patients according to their needs, problems, interests, and diagnosis. I like the idea of a psychotherapist doing most of the therapy groups. 

I found that the patients loved to have the opportunity to receive individual therapy sessions with me. This was incredibly good for my self-esteem and my sense of competency. You know that you are doing something right if you are finding that patients want to spend time with you for therapy sessions.  

I did have a great deal of flexibility and freedom in offering or being available for therapy with patients. 

In terms of group therapy, I had learned techniques in my second year of graduate school. I had observed the skills and talents of Chris Hauge at The Oaks who I mentioned previously.

I had picked up a workbook that had a number of ideas and techniques for running therapy groups – some ice breakers – to supplement what I had already learned.

The only problem that I noticed was that the hospital wasn't able to provide therapy services to those who didn't have good insurance. This was a for-profit hospital, and I didn’t like the profit motive. 

As a social worker, I had been motivated by a desire to help those who are most financially vulnerable within society. So, the idea of not being able to treat those who don't have good insurance didn't sit so well with me.

Later in my career I would provide psychotherapy to individuals pro-bono. I NEVER wanted someone’s ability to pay to be a barrier to my services. 

You see this in so many settings. The only people who "get it" when you are needy and need help are those who have struggled and dealt with poverty or homelessness themselves. We feel an obligation to share whatever fortune comes our way or whatever might be helpful.

Let me give an example of what I mean about my own values. There was a patient named Victoria - whose real identity I cannot reveal. She was there for anorexia and complications related to that. It became clear that she did not qualify for any more Medicare inpatient hospital days and I was asked by my supervisor to just focus on a referral for her to get treatment elsewhere.  

This was my first job after graduation and so I didn't think of myself as necessarily an expert on eating disorders. However, if she wanted individual therapy with me, I wasn't going to deny her that. 

My supervisor also wanted her to attend group sessions every day while she was there. I guess the staff started to think she was "difficult." Whatever challenges she might present, that wasn't a factor in how a patient should be treated.  

She had said she felt that this was a hostile environment for her as a result of this. She had specifically asked that I be her therapist and not the woman therapist on the unit who was about my age but may have had a few more years experience than I did.  

At one point, this topic of the hostile environment on the unit came up when I was sitting down with my supervisor. I was sitting alone with my supervisor when he asked me, “do you think this is a hostile environment for Victoria?”

I answered, “Yes, I think this is a hostile and non-therapeutic environment for her.”

There was a point in the middle of the day when they were going to speak to her - the other therapist, perhaps the substance abuse counselor, the administrator (my supervisor). It seemed like they were ganging up on her. I made sure to be there to support her.  

I remember her listening and she seemed uncomfortable, and I felt it too. I had positioned myself so that I was at her side with her while the others spoke in a way that was confrontational, I felt.

To make clear where I stood, I said “I have discussed how I agree that this has become a hostile and non-therapeutic environment for you, Victoria.”

She was told that she needed to attend groups every day. She said, "fine, I'll go to Bruce's groups and that’s it!"

This may not have endeared me with the staff.

Of course, that made me feel good. I'm not saying that Victoria wasn't a challenge. It just felt good to hear that I had made such a positive impression on a patient. This wasn't the only such experience.  

In addition, it bothered me that my supervisor was seemingly implying that I could not provide therapy for Victoria because she needed to go to a place that specialized in eating disorders. It was clear that it was about the hospital getting paid and that disgusted me!

She wanted therapy and would come by my office or I would walk around the unit and she would approach me asking to meet with me.

They seemed to want to just get rid of her since they weren't going to get a great deal of money from her. The Master's level social worker that was also working on the unit seemed to have lost the passion that had inspired her to go into social work - that's how it seemed to me. That was confusing to me.  

There were some patients like Victoria who had Borderline Personality Disorder, which can be challenging for therapists. I know my co-worker, Leslie, used this term pejoratively and as their excuse for not being able to connect with and make progress with some patients.  

There is a great book that gives the reader a great way to understand borderline personality disorder - it's called "I Hate You, Don't Leave Me." Some people will vacillate between idealizing and hating a person.  

I believe this is a result of certain parenting styles.

At times I felt like I was walking on eggshells with Victoria. I felt challenged to demonstrate that I cared about her and was concerned for her welfare. Sometimes she would walk away angry and then come back or get up to go but then sit back down.  

I remember her storming out of the office saying "you are just like everyone else, you don't care... I can't stand you."  

Then the next day I saw her, and she approached me in the morning as if nothing happened. She just said, "can you meet with me for therapy?"

I answered, "yes, after group."  

She smiled and said, "I'll be there for your group, I'm not going to Leslie's groups."

"I know,” I answered with a smile of amusement, adding, “I’ll see you in a few minutes.

You just have to be thick-skinned and not take things like this personally.

As a sign of my dedication to helping others and my enjoyment, I want to describe an experience when I was working as hurricane Fran was about to come ashore. 

Lynn was much more afraid of hurricanes than I was. She was from California where they have earthquakes, and I would say that at least with a hurricane the earth doesn’t open up like it’s going to swallow you. We had debated which was worse a hurricane or an earthquake. To her, the waiting and suspense of knowing the hurricane is coming made it worse.

 Anyway, Hurricane Fran was due to make landfall on the Cape Fear River in Wilmington after 8 PM. 

I was sitting there talking to Victoria and the hour was a few minutes after 5:00 PM. I noticed a phone call coming in. Lynn had my direct extension.

“This is Lynn, I need to take this,” I said to Victoria. I must have mentioned Lynn. Chris Hauge, my mentor, had modeled self-disclosure as I mentioned earlier.

“Hello, this is Bruce,” I said not entirely sure yet who was calling.

“Hi,” I heard Lynn say followed by “what are you doing?”

“I’m working,” I said.

I could hear Victoria laugh as I said this. 

“You need to come home.” She said, “The roads are flooding and …” 

I listened to her concerns and said, “Okay, I will leave now.”

“Be careful, honey, I am worried,” She said adding “I have seen some of the roads. You might not be afraid of hurricanes as much as me, but you need to think about me.”

“I’m sorry,” I answered Lynn.

Victoria had been listening and she was understanding of the situation. I told her I would see her the next day if I was able to make it to work..

Success and Accomplishments

It was amazing to me that I was able to overcome the social anxiety that I had throughout most of my life. The only manifestation of this anxiety existed when I had to lead therapy groups. I needed to be able to meet the challenges and do what the job required.  

This was the career I had chosen, and I was determined to succeed. The sense of accomplishment that I felt in what I was doing - in being able to lead therapy groups - was rewarding and filled me with joy.  

I had come a long way in my journey over these past 12 years!       

I would feel a bit of anxiety when I had to run therapy groups, but I found a way to not let it show. I knew that I was talented and had a great deal to offer. This confidence in my competency made things easier for me. I also knew that if I wasn't doing a good job, the patients would have indicated this.

All eyes were on me during the groups, and I realized they were looking at me for guidance and treatment.  

People came to my therapy groups and seemed to be getting something out of it and they seemed to want to listen to me.  

There was something amazing about the realization of this. Like everything else happening in my life at this time, I didn't take anything for granted. I had a sense of awe whenever I reflected upon these things... and I did reflect upon everything that was happening.

I should say something about the setting... where I was working.

Brynn Marr Psychiatric Hospital was located near the Marine base at Camp Lejeune. Many of the patients were affiliated with the Marine base but not all, obviously.  

One might imagine that post-traumatic stress disorder (PTSD) was a common problem that patients were confronting when they were in the hospital since there are veterans and veteran families. Combat experience can cause PTSD, obviously.   

That being said, there were not that many veterans with PTSD that I treated. It could be that most veterans are men and it's harder for men to talk about traumatic experiences.  

I saw a large number of women who were patients at the hospital and most of them had no military or combat experience.  

I did work with one patient who reported that he thought he might have PTSD due to past combat experience and his fears and concerns were related to events that might have a basis in traumatic events and experiences during combat.  

As I listened to him, it became more and more obvious that he was actually suffering from a psychotic disorder. 

You have to keep your mind open and listen to others. You can't have pre-conceived notions such as assuming that a story that sounds like a traumatic combat memory is that. The location where Brynn Marr was located did not dictate how I thought about the experiences or patients. In other words, I didn't look for trauma disorders.  

Anyway, as I was saying above, I knew that I was good at what I do. I knew I was competent and talented. That's an amazing feeling. I had a tremendous amount of passion for helping others and I had a tremendous amount of compassion and empathy.  

Empathy is not something you tell yourself that you have, though. It is something that you have to demonstrate to others. I'm going to talk more about this in the next chapter.   

As I mentioned, Lynn and I couldn’t have a wedding because our combined income might make her ineligible for the insurance that would cover her treatment.

Okay, so this speaks to just how madly in love with Lynn I was. Anything happening to her was terrifying. I had asked her to marry me, given her a ring, and committed myself to her forever. But without a wedding or a “legal” marriage. 

We even tried going to the Catholic church to get married but without a marriage certificate and they would not allow that. The fact that we didn’t have a wedding didn’t change anything.

If you are thinking that I imagined getting married to someone else someday, the answer is NO! I had found the one for me! Lynn. So, my commitment to Lynn was forever.  

Let this all sink in for a moment. We were in a rush with time hoping that they find a cure for Cystic Fibrosis - a genetic illness - so that she would live past her fifties. That's what I needed!  

Treatment can cost several thousand dollars per year during good years. Even her mother could not afford that. 

What do I mean by a “bad year?” And what was it like in general, even during good years?

Occasionally, she would use an inhaler but that didn’t seem to happen very frequently. 

I drove her or we drove together to her clinic appointments in Chapel Hill. From Wilmington, that was a drive of over two hours. It happened for the most part only once a year. 

They would check her oxygen saturation… take X-rays to see the scarring and the buildup of mucus in her chest. 

Lynn was good about letting me sit in on every meeting, such as when she was taken to a room to be examined by first a nurse and then a doctor. 

Most of the time we were very lucky because she was so very healthy for someone with this very serious and debilitating disease. 

I might have turned away or left a room when they wanted to collect a mucus sample. Lynn understood that I had a weak stomach. 

Anyway, so much of this was becoming routine. Most of the time. 

I asked so many questions all the time. “What is that dark spot in her chest area that you described in the X-Ray? Is that mucus or scarring?”

The doctor would answer, “well, here is some excess mucus that needs to be cleared, and here is some scarring?”

“Wait how do we clear that mucus?” I asked.

“Have you learned how to do the tapping?” the doctor asked.

“Yes, we learned about that from the physical therapist.” I answered, adding a question “but it’s still worrisome?”

Then I asked, “What about that device that she is supposed to wear, is that better?” 

“Not necessarily,” the doctor answered. 

Then Lynn said, “it doesn’t clear it out for me, I can tell it’s still there.” Then she turned to me and said, “I told you about the problems and asked for your help the other day.”

I felt so guilty. “Oh, my God, Lynn, I am so sorry.” Adding, “it’s scary for me. I know you need me and I’m trying. I’m scared when you are not well. That makes me feel guilty because I should be there for you… but I get sad and scared about the meaning of these problems.”

I paused and added with tears running down my face, “I want a ‘normal life’ … and if anything happens to you… I just love you so much, you make me feel good and happy. I can’t imagine not having you with me.”

“I know sweetie, I have had more time to deal with this,” she said.

“Okay, so I still have a lot of questions,” I said. 

“Okay, ask away,” answered Lynn with a smile that said she knew I really cared.

Then turning to the doctor, I said, “so, how often and for how long should I do the tapping to clear up the mucus as it builds up?”

“Well, about 15 to 30 minutes at a time in the evening would be good,” answered the doctor. 

“And the scarring, that looks big, what…” I could barely get my words out I was so full of anxiety and sadness… trying hard to be strong for Lynn. 

It is SO MUCH easier to do this with clients or patients at a psych hospital. 

Dear reader, I hope that is somewhat intuitive but maybe I shouldn’t assume. I wasn’t in love with my clients or the patients I served. We weren’t sharing our lives together. They were not in love with me either. At least I hope not – that’s another issue for later.

Also, the big secret that I have been avoiding is that Cystic Fibrosis is a deadly disease! I could lose Lynn forever!

My blood runs cold when I think of this as it did at the time. It’s interesting how similar sensations can feel so different. When we were at the clinic discussing these matters, I could feel chills running through me… not the kind that I felt at the touch of Lynn’s hand or her lips on mine.

I was, for the most part, able to push these issues out of my mind and not think about the reality of it. But on these visits, we had to look at this darkness in our life. Scarring and mucus appeared as dark patches on the X-Ray of her lungs.

In answer to the question I posed about the scarring, the doctor said, “her lungs still have a capacity to breathe and get enough oxygen to function in many normal activities.”

During the visits, I would learn about how the scarring makes the lungs less elastic and that makes it harder for them to expand and get enough air to engage in certain activities that we take for granted… running, hiking, or walking long distances. And scars don’t heal.

So, even if they had a cure that doesn’t mean that everything would be fine.

When her health got worse…

There was a time in late 1996 when Lynn had to go into the hospital. Her lung functioning had gotten poorer or weaker and they wanted to put her on IV antibiotics in the hospital. 

The doctor had explained that they wanted to go after the infections in her lungs. They had to try some of the latest antibiotics that were thought to be more effective in people with Cystic Fibrosis (CF). They were always learning new things about the disease and people were living longer. 

It was scary for both of us. Waiting there in the lobby of the hospital I tried to stay positive and tell myself that things would be okay. 

Then she was brought to an inpatient unit that was used for treating individuals with CF. 

When Lynn asked me to get her something from downstairs – a drink and a candy bar – I was somewhat glad to have that opportunity. I was struggling to stay still. That’s how anxious I was. I had a strong urge to walk. I couldn’t sit still hardly. I was also sick to my stomach. That’s what happens when I am anxious or scared. I felt queasy or nauseous. 

I held her hand as they inserted the IV. I asked the nurse “what is that?” referring to the fluid that was being introduced into her IV. 

“This is just saline solution,” she answered… adding, “the doctor will give us an order to tell us which medications to give her.” 

I was sitting on the bed looking at Lynn. No words were spoken for a few moments.

“Do you want a book, or to play cards?” I asked, “or how can we pass the time?”

Lynn asked for a book by Anne McCaffery, one of her newest books that she had not read.

“I want to stay with you,” I said. 

“I understand,” she answered. “I am glad you are with me.”

“Me too.”

I added, “I can just be reading something too with you.”

“Okay, that sounds good.” 

“You can go meet my friend Carolyn,” she said. This was a friend who also had CF and she lived in Chapel Hill.

“Yes, we will see her when you get out too,” I said. “Before we go home.

Visiting hours don’t usually allow people to stay all night. That night I was in bed next to Lynn, on her left. She was asleep with my arm resting on her stomach or her chest. I just wanted to feel her breathing. We made sure the IV was out of the way.

I heard the door open, and I looked up to see a nurse checking in. She didn’t say anything. 

This finally ended and she came home. Our life went back to normal.

My tasks allowed me the opportunity to get to know others in a therapeutic setting. Recall that when a person is admitted to the hospital there is a short period of time during which the intake assessment for each department must be completed.  

Unlike during my first year when it seemed like they were making work for me to learn as a requirement for an internship, this was a setting where I was being asked to do something that was required by and for the hospital.  

This wasn't busywork. If I was asked to complete this, I was being counted on to do this. It was necessary and required. This made me feel so much more useful than during my first year where it was hard to see that I was making a difference. Also, as I said, Chris knew what I was learning from him and through my studies.

Instead of feeling bad about volunteering my knowledge, wisdom, and insights, I saw that what I was offering was valuable information to consider when evaluating what a patient was experiencing and perhaps how they could be helped. 

I had mentioned that during my first internship I had some doubts about my competency. I chalked up every "mistake" as a learning experience. 

Okay, so during the intake assessments we try to get a lot of information from a patient. Why they are in the hospital as they understand it... what has been going on in their lives... are they married? Do they have children? Can they describe their symptoms and problems? And so on.  

The ability to gather information from a person requires building rapport, creating trust, demonstrating empathy and compassion. The quality and nature of what you learn, what information you are able to gather, are a reflection of your skills and talents in this area. It’s also important to ask very open-ended questions as much as possible because the patient knows things that we don’t.

As you can see, I have come a long way from the young man who needed counseling to learn social skills, communication skills, and how to control my anxiety - social anxiety.

I constantly reflected upon how good I felt about having accomplished so much. Over a decade of hard work had been invested in getting me here where I am in my late 20s.  

It also seemed that when you do demonstrate respect for others, empathy, and concern, they want to talk about their experiences. That was my observation time and again. Chris recognized my growing talent and eagerness and let me start doing some brief therapy with patients. Because the patients were not in the hospital very long, the therapy had to be brief.  

Chris gave me some pointers as to what I might want to do when I sat down with a patient - what kinds of interventions might be helpful. I discussed what I had been learning in my classes and other studies. 

What might I do in a session with a patient? Well, if they are dealing with major depression, we could try Cognitive Behavioral techniques where we learn to challenge automatic thoughts that create negative emotions.

With trauma issues, deep relaxation techniques are very helpful in talking about a disturbing event. I would demonstrate or guide a person in the use of guided imagery and deep breathing to create relaxation. 

By that time, I was clearly demonstrating empathy and powerful listening skills. I received that kind of feedback from Chris when I turned in notes about my activities, but I also had that impression from the feedback that I received from the patients. I’m not saying they gave me a score on empathy and listening skills but there were so many times when I noticed how much people wanted to share their stories and feelings with me.

There were various opportunities when I was on the unit where patients had a chance to approach me and ask to talk about an issue that had come up in a group or from our earlier conversation when I did the intake assessment for example. Sometimes all I did was just listen with empathy. The experience of being in the hospital is not likely to be a pleasant experience. 

This kind of listening may not sound like a technique but in the psychological theories that were developed by Carl Rogers, unconditional positive regard and empathy are valuable tools.

I would tell them when I met with them for therapy that I was going to write up notes about what we discussed in therapy to see if it could be helpful to others who might be offering treatment for them. I instinctually felt that I could and would offer to let them tell me something and ask that it not be recorded in the notes.  

Gender issues were never relevant. I mean the fact that I was male was not a factor in a patient choosing to disclose any details about what they had experienced. Sometimes you might think that a woman might only talk to another woman about something traumatic, especially if they were victimized by a man.  

What probably intrigued me the most was the experiences that people with schizophrenia or psychotic disorders might be having. I thought that if I could demonstrate empathy, understanding, and compassion, and be able to help people struggling with these issues that would be something amazing. 

In seeking to help someone with a psychotic disorder, treatment might include active listening which means summarizing or rephrasing what someone just said to see if we can understand one another. That connection is so important. It’s sad but some people with schizophrenia will develop serious problems with communication and what they say might not make any sense. I believed I was making a difference by listening and trying to understand.

There is a great deal of research that demonstrates a genetic predisposition for various psychiatric disorders. However, it seems from my own experience that being confronted with major life stressors, even stressors that might not seem like traumatic events, and any person can develop a range of different symptoms – hopefully, that is temporary. 

I did file away the observation that so many people were coming to the survivor groups, even though trauma was not an issue that necessarily had an impact on why they were admitted to the hospital. 

Often Chris was present in the group sessions even when he allowed me to lead the group. I would talk about relaxation techniques as Chris had done. I would employ the kinds of guided imagery exercises that were used in the groups that Chris led, meaning, I invited them to follow along with my suggestions or guidance.

I know that I have covered a great deal here and may not have been overly specific when describing theories and techniques or what I specifically did. I'm not trying to give psychology or psychotherapy lessons, per se... but I will go into greater detail later in the book.  

My second internship would prove to be the most rewarding. All in all, during my second year of full-time graduate studies, I was feeling good about every aspect of my life. I was doing great in classes, in my internship, and at work.    

A master’s in social work is a two-year program and so the second year is our final year. As I was saying, during our second year, we take classes and work in a setting that closely matches our primary interest area for where we want to work upon graduation.  

An Epiphany - An Answer to a Question

I wanted to start with an insight that I had gained during a class that was titled "Abnormal Psychology." I touched on this a bit earlier, but I wanted to add a few things. Anyway, in this class, we studied and learned about the entire range of psychiatric disorders as they are described in the DSM-IV (the Diagnostic and Statistical Manual of Psychiatric Disorders, fourth edition).  

We used a big book that is used by psychiatrists and other mental health professionals to make a diagnosis.  

Anyway, when we started covering personality disorders, that's when I had an epiphany.

We were considering public figures as examples of people who may have a particular personality disorder. Some people on YouTube seem to walk on eggshells when it comes to speculating about the disorders of public figures. I don't think our professor was quite so worried about making an error in diagnosing someone. I suppose our professor wasn’t speaking to a large audience nor was he making a definitive diagnosis. 

I remember we discussed OJ Simpson as an example of someone with Narcissistic Personality Disorder. We were also encouraged to consider people we might know who might have a variety of different personality disorders. The thinking was that this would make things more clear and easier to understand.

There are some rules in the US that discourage diagnosing public figures. Those “rules” do not seem to be hard absolute rules. 

With regard to personality disorders, it’s not rocket science nor is it necessary that you sit down with someone to make a diagnosis. Another argument is that the person being diagnosed should be seeking treatment. Sometimes people are involuntarily committed to a psychiatric hospital and so they didn’t seek treatment or a diagnosis. 

Mental health professionals make observations, gather information from people other than the person being diagnosed.

Anyway, it was in this class when it hit me!

Narcissistic personality disorder (NPD) is the problem that my mother had. The questions that had racked my brain for decades finally had an answer or an explanation. I don't know if this diagnosis of the problems that Kathy Whealton had would have been helpful earlier but at least I had a sense of clarity as to what was wrong.  

In many ways my father, Bruce Sr. seemed to have the same condition. It wasn't so obvious with him though.  

It was obvious that my mother could not see things from a different point of view.

That is the difference that I noticed with my mother. She NEVER could come forward and say, "I am sorry for the way I acted... that was wrong."  

There is more to it than these observations. Both parents had a condescending and judgmental attitude toward others. Only certain "special" people could meet their high standards for being worthy of their attention. 

These are symptoms of NPD or characteristics of a narcissistic family. 

Anyway, I do not say these things with an angry heart. Nor is this an effort to make my parents look bad. This epiphany was an answer to a question I have been asking for the past 15 years or so. 

Getting back to the topic of second year graduate studies.

We had courses that covered a variety of techniques for group, individual, family, and couples therapy/counseling. I won’t give you an education here into a typical second-year graduate program in social work. While learning the “basics” we were also encouraged to learn more about certain theories, therapies, and techniques. This is not unlike the way that psychotherapists will specialize in the use of certain types of therapy that they do best. No one can know everything about every form of therapy. 

In graduate school, during our second year, we take classes that ask us to research different treatment techniques and therapies. For example, in one class I did a long paper on treatment options for people with dual diagnoses like a mental illness and a substance use disorder. I felt that the 12-step programs of Narcotics Anonymous (NA) and Alcoholics Anonymous (AA) had some limits and potential flaws.

My concern with NA/AA is that people get advice from others who have no specialized training. On top of that, I had noticed from the literature that these people will tell a person that the main and primary consideration is to avoid the addictive substance. That discounts a person’s overall suffering and pain.

So, I looked for recent scientific journal articles that presented research findings that might be relevant to this topic. I remember my paper was 30 pages long.

I was learning about a variety of treatment techniques and theories. 

My Internship at The Oaks

During this second year of my education, I did my internship at "The Oaks" psychiatric hospital under the guidance and supervision of Chris Hauge. Yes, he is the same Dr. Chris Hauge that I mentioned when speaking of my volunteer work at "The Oaks" in an earlier chapter.  

The doubts that I had during my first year, however infrequent they were, now were non-existent. I had no doubt that I had made all the right choices to get me here finally. Chris had worked in the field for decades, longer than anyone I ever knew, and he was very well respected. 

Chris was happy to have me do my internship there at "The Oaks" as we discussed previously. He saw my passion and drive to help others who were hurting, in distress, or having problems in life. He nurtured that hunger and drive giving me opportunities to do the things that I wanted to do... For example, it wasn't long before I had a chance to do some therapy with patients in the hospital.

I was participating in groups led by Chris - therapy groups.  

What I loved about the way Chris did the groups is that the "staff," psychiatric nurses, other interns, medical students, and others were expected to participate in the group. What I mean is that they were not there to just observe what others were doing.  

I'm going to have to be more specific to describe what I mean. Patients were in the hospital in most cases for no more than about two weeks. So, we had to figure out what could be accomplished in a brief period of time. Chris happened to be skilled in the use of experiential therapy techniques, which I will describe below.

Let's consider some examples. In a relaxation group, we might talk about natural ways to relax and deal with anxiety. In a survivor's group, we would start with deep breathing for relaxation and then Chris would guide us into a guided visualization exercise with our eyes closed. As an example, we might visualize a younger version of ourselves sitting in a chair in front of us.

It was really powerful and amazing. As the name implies, a survivors’ group was for those who experienced abuse and/or trauma. This younger version of ourselves was our wounded inner child... or it could be a younger version of ourselves when we were younger adults. 

Technically, it’s important to note that we were younger a month ago and if something traumatic happened at that time, we would say that we were psychologically wounded. We could also call this wounded inner part of ourselves an “ego state.” It’s almost as if a part of our “self” is frozen in time. Our task is to help a person move past the experience and find closure.  

The use of self-disclosure was also encouraged by Chris. That means that the staff or a group leader will share personal details about themselves. To me, it seemed that this would encourage or make it easier for patients to open up as well.

Think about it. You are a patient in the hospital, maybe there against your will if you were committed involuntarily. For whatever reason, you decide to go to the group to see what is happening, and maybe in the back of your mind, you are thinking that you were hurt at some time in the past and it still bothers you.  

As long as you don't have to talk about it, you will come. You enter the room with chairs that are in a circular formation with an opening in the middle. You are invited to close your eyes and take a few deep breaths. Everyone closes their eyes including those wearing a staff badge/id. So, you feel safe, and something happens.  

What happens? Well, this is called experiential therapy and experiential is a word that is easy enough for the patients to understand because it means what the name says. This is about creating an experience. It's non-directive in the sense that no one is telling you what to focus on or making suggestions about what did or did not happen that was meaningful to you.  

I was able to observe that the therapy did have positive effects on patients during the sessions. This was evidence from the direct feedback from patients during the group therapy sessions and by observing their facial “affect” – displayed emotions.

What was intriguing for me was that people who were in the hospital with a wide range of different diagnoses seemed to be coming to the survivors’ groups and working through past trauma and abuse. The idea that mental illness is only caused by chemical imbalances that occur just because of some genetic predisposition alone must be questioned.  

At the very least, some stressors in life seem to be able to create symptoms that one finds in various disorders.

I began graduate studies at the University of South Carolina in September of 1993 as a part-time student for the first year. This was prior to Lynn and I getting engaged and then moving in with each other.

With my past experience mainly as a volunteer working with the social work team at a psychiatric hospital in Georgia, I was able to get letters of recommendation that were necessary to get into graduate school.

As I think of this, I worry about how I am portraying Lynn. She wasn’t a housewife, homemaker, or anything like that. I didn’t come home and say “honey, I worked all day can you cook me dinner?” She wasn’t living through me and my successes.

As I mentioned previously, she had to keep her income below a certain level to qualify for health insurance to maintain her health and stay alive. That meant limiting her work hours. She did some office-type work and used her proofreading skills. Of course, she had her pottery as well.

She wasn’t sitting at home watching TV while I worked, went to school, and did my internships.

Anyway, after gaining admission to the school in the fall of 1993, I found out that there were a few classes I could take part-time through distance learning. Instead of traveling over three hours to Columbia, South Carolina, I only had to travel to the campus in Conway, South Carolina which was about an hour and a half away. 

This allowed me to continue to get experience working directly with people in the human services field. 

Going part-time wasn’t a “real” college experience. I sat in a room by myself in the evenings. Sure, we could pick up a phone and interact a bit, but it was nowhere near as rewarding as full-time studies with other students in the same room. 

Full-Time Graduate Studies in Social Work

I began full-time graduate studies in the fall semester of 1994.

This was still, obviously, at the University of South Carolina but now I was going to Columbia, South Carolina. This was a three-hour drive from Wilmington, North Carolina. I would drive down on Wednesday and stay in one of the dorm rooms. I would then check out the next day and go to class on Thursday.  

Three back-to-back classes, that were just under three hours long. Hardly a break between classes.  

On Monday and Tuesday, I had my internship. An internship isn't paid work. So, I had to borrow money to cover living expenses, books, travel, and other expenses.    

The Stafford Loans are designed to cover a scenario just like this. During the summer between what would be the first year of my studies and the second, I was able to pick up extra hours working as a paraprofessional.  

Anyway, this was like night and day from my earlier days in college when I had been so shy and quiet. I suppose I was anxious to share my thoughts, speak in class, participate, ask questions and learn as much as possible. That is what I was doing.

I was psyched. This was happening for real! My dreams, my goals, were coming true. 

During the first year, you study both macro and micro-level social work practices. Some colleges call this direct and indirect services.  

Macro-level social work addresses issues that can be looked at from the level of a community, an organization, an agency, or government. So, we learned about the history of social welfare in the United States. Of key importance among the programs that stand out or the periods in history are the FDR years and the "New Deal."  

In terms of macro-level work, we were expected to do a "needs assessment" for a community where you are living. Through my work, I had identified a low-income community that was partially in the historic district of Wilmington not far from the Cape Fear River. I had also been going to a gym in that area. It was a boxing gym, but I wasn’t a boxer. I just went to work out. It wasn’t far from one of my internship placements. 

That area contained a great deal of public housing which is by definition set aside for the poorest individuals and families. Demographically, it was also predominately populated by African Americans.  

While this was macro-level social work, I did get a chance to develop relationships with “community leaders” and similar folks who knew the area and could share information with me.  

With this information, we were tasked with writing a paper that describes the area and the needs that exist in the community. We were also encouraged to present photographs that illustrate important aspects of the community and their needs.

During the second year, we focus on our choice of either micro-level or macro-level social work. Micro-level social work is about providing direct services to individuals, couples, families, and groups.

I remember the theories that guided micro-level (direct) social work practice more than those ideas or principles that define macro-level social work because my specialization was in direct (micro-level) social work. This is what therapists/psychotherapists may do. We provide direct services (treatment/therapy) to individuals, couples, families, and groups.  

There is a range of different pioneers, psychologists, and psychiatrists that have provided the therapies, theories, and techniques that professionals use. I will describe this later in the book.

First Year Internships

Finally, in considering this first year, I want to talk about my internships.  

During the first year, we are expected to work in a setting that is distinct from the setting where we would like to work during our second and final year internship. The second-year internship is intended to be a reflection of the setting where we would like to work primarily in our career upon graduation.

For me, as indicated previously, I intended to work at The Oaks with Chris Hauge, DSW (my mentor). This kind of psychiatric setting has been the kind of setting where things have been the most rewarding and interesting to me.  

During the first semester of my first-year internship, I worked on the children's unit at the mental health center for New Hanover County in Wilmington.  

Things didn't go as well as I would have liked. It was discouraging. This was the first time when I felt like I didn't have the necessary direction and guidance to be successful. I didn't want to be in a setting where I was uncertain about what to do and feeling lost.  

I was a bit hard on myself and expected that I should have figured out what to do. Often, work with children will involve "play therapy" which is harder than it seems. I had no training yet in working with children and I wasn’t getting guidance from my supervisor or others.

I was torn between unreasonable expectations and doubts that I couldn’t just figure things out. I didn’t think they wanted me to come in and just “play” with kids. I suppose it took me some time to get comfortable with the realization that this wasn’t a good match for me. If this wasn’t a job or an internship, it would be great spending time with kids.

You might recall that I had been like a big brother to a girl who was the child of a couple that was friends with my parents. That was so much fun, with laughter, and just hanging out with her. I was the same way with my relatives who had younger children when I was growing up. Often, I was the one who entertained the kids while the grownups socialized.

Doing an internship working with children felt so different to me than spending time with children outside a treatment setting. So far.              

During the second semester, I was placed at the same organization but in two different departments. In the mornings and early afternoons, I worked at a day treatment program for individuals with chronic and persistent mental illnesses. In the afternoon, I worked with the homeless program that was staffed by the mental health center.  

Some of the time I was able to participate and get to know those who came to the day shelter for the homeless. It was interesting because there were classes that covered mental health issues and the format was something like a support group/therapy group.  

I remember seeing in the morning at the day program for individuals with chronic and persistent mental illnesses, some of the same folks that were residents at Sherwood Village where I worked on the weekends.  

Anyway, that need to prove myself didn't go over so well in one instance. I somehow spoke out of turn and corrected someone accidentally about something from the DSM – the Diagnostic and Statistical Manual of Mental Disorders. I was trying to demonstrate my knowledge, but I was not in a classroom setting. So, my supervisor corrected me after that.  

It was disturbing to me that I was having some troubles during the internship placements that I had. Only occasionally did I feel like I was doing something useful and important. I guess I also still had things to learn in terms of social skills. 

Mainly, I felt discouraged. I had switched out of the children's unit/department and given two placements with two other departments. The reason for me to be placed in two departments was to allow me to get the hours required. I don’t remember all the little criticisms my supervisor had done to correct me, but it made me feel discouraged and sad. I had so wanted everything to go right.

My supervisor during that second semester once asked me if I was really had the potential to work in social work. That was the first and only time I have heard that in my career/life. If a job didn’t go well in the future, it was not for reasons related to my skills as a social worker.

The afternoon placement went okay in terms of my interactions with the staff and my responsibilities. It just seemed that I wasn't needed as much as I wanted to be needed. There seemed to be limited opportunities for me to do things.  

I did develop a "street sheet" that would be useful for the homeless in Wilmington. I used our computer at home and the bus maps. Various resources were marked on the map on one side and on the other side there were descriptions of the various resources and services.  

An Unrecognized Foreshadowing…

Years later when my life had become a living nightmare, I would be given that same "street sheet" I had developed… a time when I was homeless and alone.

However, at this time, I had no knowledge of what was coming years later.

Anyway, during this first year, and similarly during the second year, as you can see, I had a very busy schedule.    

Monday and Tuesday I did my internship, then I slept late on Wednesday and drove down to Columbia South Carolina, stayed overnight in the dorms, and went to class on Thursday. Then on Friday evening through Sunday evening, I worked at Sherwood Village.  

On top of that, I had papers and homework, of course. I was extremely motivated to prove myself. Part of me was trying to prove my competency to myself. Self-doubt is very troublesome.  

Despite some challenges and doubts, this was a very rewarding experience and overall, I loved where I was in my journey. I especially loved what I was learning in my classes and I loved the work that I did at Sherwood Village.  

That job didn't require my attention during the entire 48-hour shift. So, I was able to bring my books from classes with me and read. Sundays were especially slow days so I could catch up on my reading.  

There was one other job that was very rewarding and fun. I worked the weekend shift at Sherwood Village, an Independent Supportive Living Apartment Complex. There were roughly 30 apartments that housed 30 individuals.  

I was on-call with a beeper for a 48-hour shift from Friday at 6 PM until Sunday at 6 PM. It was a supportive independent living facility in the sense that everyone lived independently but someone was on staff 24 hours per day 7 days per week. This was a place for persons with severe and persistent mental illness. It was called Sherwood Village.

By now I was a graduate student with so many other responsibilities and things going on in my life – a life with Lynn.

I was responsible for transporting the residents to the movies or other similar events. They had a van for me to transport the tenants. I didn't go with them to the movies most times because tenants that chose not to go on an outing might need my services.  

I was allowed to go home with the pager that any of the residents could call if they needed me.  

It was a great job, and I was well-liked by everyone. I stayed on with this position until I got my master’s degree and could move up into a more professional level position.  

It was fun to get to know all the residents. They said they liked me better than the staff member who worked from Sunday at 6 PM through Friday at 6 PM. So, that felt good to know.  

The only activity that I had to do as someone who is "in charge" was to do some inspections of the apartment - mainly that was inspecting the A/C filters and other things like that. Obviously, there were some things that are important to promote a person's overall health that I had to oversee.  

They knew I had a job to do for the landlord and the managers that maintain the apartments. I obviously had to make sure people were okay, but it wasn't like in a hospital unit where someone might come by every few hours. Most tenants were relatively high functioning, so they weren't going to wander away and disappear.  

They had their own cars in some cases and there was no curfew or anything like that.  

It was extremely rewarding because I NEVER had an issue with any of the tenants not liking me.

This would be a common theme in my career overall where the greatest challenge was with paperwork/charting, bureaucracies, staff expectations, and in my role as a member of the staff. 

During this entire decade and into 2000, I NEVER had negative feedback or opinions expressed by anyone I served or helped – with clients, patients, or tenants everything went so smoothly. 

The job was awesome overall. I mean I was getting to know these people and feel like I was part of a family. I considered them part of my family in a way. I mean I liked everyone there. One or two residents were distant and didn't talk much but most everyone was great to know.  

I didn’t think the staff for whom I was working had too many rules. I was on my own for most of the entire weekend and for most weekends. The only people contacting me were tenants/residents.  

I could visit them inside their apartments. Obviously, that could be problematic with female tenants, but it never became an issue. If there was more than one person in the apartment, I didn't feel too concerned about spending some time in any of the tenant's apartments. Sometimes there were emergencies, and that required spending extended time with a particular tenant who was in a crisis situation.  

These crises rarely happened. I do remember one woman having a seizure and I was on the phone with EMS. I had to return to Sherwood Village because I had gone home with the pager when I got the message to call the tenant's phone number.  

Residents of Sherwood Village had disorders such as schizophrenia, Major Depression, Bipolar Disorders, and so on. These disorders were characterized as severe and persistent mental illnesses. That is likely a designation that is necessary to obtain funding.  

I obviously was made aware of the diagnoses of each resident. I also had to know what medications they were taking, physical problems, and other important information. This was all on file in the office. I was given a couch in the dayroom or I could sleep on the couch in the office if I needed more privacy at night.  

I ran the tenant meetings which were held about once a month. Most of the tenants came for the meeting that was held in the dayroom which was a place where people could visit during most hours such as 9 AM to 9 PM. I could certainly spend additional time with tenants in that room if they needed to talk to someone.

Hopefully, you can imagine why this job was awesome for me. And why they all felt like my family.  

It also is important to note how comfortable I felt running the tenant/resident meetings. Unlike reading my poetry to a group, this was more like directing a group event.

Yes, I felt so comfortable interacting with everyone as the person that everyone turned to for help whatever their problems were. I was starting my graduate studies during this time period, so I had been learning other skills in college (graduate school) to help me in counseling individuals in need and how to run group sessions.  

I wasn't actually doing therapy yet but some of what we do as therapists is to listen to others with empathy. To help people feel safe. To be someone who others turn to for help and support.  

We also had a Christmas party on the weekend when I was there. It was so nice. I felt needed and important.  

It felt so right. I mean I was doing a great job, and I could tell that I was. I could tell that I was someone that people felt very comfortable talking to. 

I also know that I was more liked than the young woman who worked there during the week.  

I also have no doubt that both the men and the women felt more comfortable talking to me about anything than they did talking to Donita, who worked during the weekdays. I knew that people there were glad to see me arrive on Friday - they told me.  

What people most want, and I can speak from experience is someone who truly listens and demonstrates empathy. Notice that I said, "demonstrates empathy."  You cannot just feel comfortable believing you have empathy for another person and their situation. People will let you know how they feel when you are working with them or they will be distant, closed off, or reserved as they had been with Donita.

It seems like common sense that people won't be coming to you or repeatedly seeking your help and support if you are not demonstrating empathy. People here were coming to me to discuss everything that concerned them. 

I felt a powerful connection.

Donita seemed to be held out as a role model for me by my supervisor at least until he started talking to the tenants about me.  

The tenants on the other hand did complain to me about Donita’s "attitude." She wasn't approachable, I was told. It wasn't anything that was serious enough for them to complain, for the most part.   

It's important to note that some people in a situation like this do not feel empowered to complain. Having a chronic and persistent mental illness carries with it some stigma and it doesn't lend itself to creating feelings of self-esteem and self-confidence. Low self-esteem can go hand-in-hand with various psychiatric illnesses.  

That being said, I know I made a difference and the tenants at Sherwood Village didn't want me to leave when I had to move on with my career and take on more professional opportunities. That was happening as I completed my graduate training.          

Unfortunately, due to confidentiality, I could not ask them for letters of recommendation for any job outside the mental health center/clinic. I did have complete confidence that each of the tenants, when and if asked about my performance had nothing but good things to say.  

In the next chapter, I will begin to discuss the next stages in my education. More specifically, I am going to discuss my graduate studies at the University of South Carolina in the Department of Social Work. 

Prior to starting graduate school, there were limits as to what I could do in the field. I was not able to work as a mental health professional yet. However, there are jobs where one can work as a para-professional.  

I found opportunities to do work with clients who have developmental disabilities as well as in some cases, mental illness and/or physical conditions/disabilities. There has been some overlap between the fields.  

The Mental Health Center in New Hanover County was also the Center for Developmental Disabilities.  

With my job ending at Corning, I had to find other work. I had been spending all my time with Lynn and my self-esteem had grown tremendously as a result of that relationship and as a result of the experience, my time with Celta before that, and my various experiences as a volunteer in the psychiatric field.

I'm not saying there were not struggles, worries, or uncertainty. Had my mental health not improved from where it was before I moved to Wilmington, I might have been more panicky about the job ending after six months.  

Instead, I just looked for opportunities and bounced ideas off Lynn. It was very helpful to have someone who could hold me in her body... someone I could cuddle up next to whenever I was anxious or fearful. Plus, she was very practical, as I described earlier, so I felt confident that I could find answers and solutions to meet the challenges I was facing, whatever they might be. 

As I was saying, I needed to find employment after the job at Corning ended. I had worked as a technical writer and had saved up a great deal of money in just six months. Since the job was contracted through an employment agency in Augusta, Georgia, the salary was paid as per diem – similar to when a company pays you for going to a conference. This way most of it was not taxed at all!   

Eventually, I found a job with an agency that treats individuals with developmental disorders such as autism, and various levels of mental retardation. The latter is measured by results on IQ tests when a person scores at least two standard deviations below normal - which is an IQ of 70 or less.  

I started working with a client who had autism and some degree of mental retardation. I met him at the day program that existed in Wilmington and which was affiliated with the Southeastern Center for Mental Health/Developmental Disorders/Substances Abuse Services. Adults would come for several hours to the facility where they would be taught various skills for coping in the environment.  

The guy I was working with was very big, about twice my size, and he could not speak as a result of his condition or disorders – that is commonly the case for individuals with autism. He used sign language. So, I had a chance to learn sign language. It was so very important to be able to sign various words to communicate with him. 

I had goals and things that I was supposed to do with him every day. One such goal might be to accompany him for walks around the area. Obviously, I had to make sure he didn’t run out into traffic so I mainly walked on the sidewalk closest to the street to ensure that this would not happen. 

He also had a problem with repetitive behaviors where he would swing his arms and risk injuring himself. This is troublesome because I was afraid that he would hurt himself. No one spelled out what exactly I should do when this happened. 

 There was at least one other individual there who was a client of the same company and I worked with him as well. 

I knew that case managers had developed the goals which were put into a treatment plan that I was responsible for implementing. I also knew that case managers are usually social workers – not typically social workers with an MSW (master’s in social work).

I wondered if I was helping these people. I knew I was helping their families, but I wasn’t getting direct feedback from the clients I was serving.

Jumping Ahead To When Lynn And I Were Living Together…

The relationship with Lynn was growing, I was beginning graduate school and working several jobs. 

In late 1994, Lynn and I moved into a nice neighborhood in northern Wilmington, and one of the clients with whom I was assigned to work lived in that neighborhood. I worked with him through the Southeastern Center for Mental Health/Developmental Disabilities and Substance Abuse Services and with a company with whom they contracted.

This client’s name was James. 

I worked with James both in the community and at his home. James lived in a home that was staffed 24/7 – all the time every day. Unlike a “group home,” he lived in a home where the rent was paid by the state as were the staff and other services that he received. 

I had been “networking” with employees of the Southeastern Center for Mental Health/Developmental Disabilities/Substance Abuse Services as well as agencies with which they contracted for direct-care services to clients. I worked at group homes and in the community including at the Day treatment center as I described earlier in this chapter.

While James had his own residential placement, I was also working at other residential locations where individuals with a mental illness and/or developmental disability were staffed 24/7 365 days per year. A “shift” at these residential locations was 8 hours straight and you had to bring a meal with you or eat food that was available for staff because sometimes you were alone on duty. 

James was unique and that’s why he had to be placed by himself instead of with others at a “group” home. He had Cerebral Palsy, Intermittent Explosive Disorder, and an Intellectual Disability. I can’t give his last name for confidentiality purposes.

"Intermittent explosive disorder" is just what it sounds like.

I had to learn how professionals in the field restrain a client who might get combative. In all my years of experience that only has been an issue in cases in which a person has a developmental disability like autism or some form of mental retardation and a mental illness. 

Unfortunately, when you combine intellectual disabilities, problematic or limited social skills, and certain psychiatric conditions, there is a potential for aggression. 

A foreshadowing of things to come…

As an aside, it is possible to be hurt by someone with a mental illness without the mental illness causing a person to hurt you. I would learn that many years later, when things happened.

I started working with James shortly after Lynn and I moved into our home on Brucemont Dr. This would be OUR home for years after this.

Getting back to working with James…

Our goals with James were to help him to fit into the community and to go places within the community. This could include the library, restaurants, the park, the beach, shopping, and maybe the movies among other things. 

At least, I knew that these were goals that James desired. The challenge was to teach him socially appropriate behaviors, so we didn't get thrown out of places where we went.  

Indeed, that was a challenge. He was the opposite of shy. He would approach anyone and everyone and start talking to them as well as a great deal of touching – potentially sexually inappropriate, hugging and putting his arm around people. Everyone. And he was loud. So, everywhere we went he knew people and he would hug them or otherwise touch them. 

James loved to see Lynn when I took him by the house where we were living. As it turned out his residence was less than a quarter-mile from where we lived.

I didn't leave James alone with Lynn because he might get inappropriate. I am sure he saw me as more than just a staff person giving him directions about how to act appropriately in a particular setting. He saw me as someone who would protect Lynn from ANYTHING that bothered her. 

I did get approval from Lynn and confirmation that she was comfortable with me bringing James there. 

I didn't disabuse James of the notion that I would treat him the same way I would treat anyone who dared to do anything Lynn didn’t want them to do. He would struggle to keep his urges in check… moving to touch Lynn on the shoulder and then start to invade her personal space. Lynn would put up her arms and say “James!”

I wasn’t far away, obviously. Instantly, I looked up and James would look at me. Then James would say “uh, oh, he’s mad now” with an uncomfortable, low rumbling laugh. 

I’d say, “Okay, we are leaving now.”

Lynn would say “he’s okay, right James?”

“Well, we need to go anyway,” would be my response because he had to learn. I was a bit uncomfortable whenever he did these things but not everyone was as forthcoming and understanding as Lynn.

Then Lynn would say “when will you be home, honey?” and Lynn would give me a kiss, unaware of what kind of reaction this was eliciting in James. I knew from his low rumbling laughter. 

He wanted another hug or something. So, I would turn and guide him out the door before he or Lynn knew what was happening.

In the last chapter, I was discussing the primary accomplishment of my life - building a family with Lynn. As husband and wife, we were a family.  

Prior to that, during college, I had spent five years trying to overcome my shyness which manifested as social anxiety and a lack of social and communication skills. To even meet Lynn and to express my interest in her required skills that I did not have previously.  

As I described in earlier chapters of this book, engineering wasn’t even close to being a good choice. In high school, though, they didn't give us any psychological tests, aptitude tests, nor did a guidance counselor sit down with us and help us figure out what career might be a good match for us.

Because of the benefits that psychology offered me in making radical changes for the better in my life, I wanted to bring those same benefits to others who might be struggling in life. If it could transform a guy who was paralyzed with or by shyness into a person who would choose social work, then imagine the possibilities.  

Having realized just how rewarding it had been to work with the social work team at Georgia Regional Hospital, a psychiatric hospital, I was looking for a similar opportunity when I moved to Wilmington in 1992. I had arrived for a 6-month contract at Corning as a technical writer as I had indicated previously.

Wilmington had just the right opportunity at "The Oaks" which was part of "New Hanover Regional Medical Center."  The Oaks was a psychiatric hospital. It was a locked unit because many people are there under involuntary commitment orders.  

When I approached “The Oaks” I was introduced to Chris Hauge, DSW, LCSW. DSW is for Doctor of Social Work and LCSW is for Licensed Clinical Social Worker. Most people with an LCSW have a master’s in social work (MSW) as that is typically considered a “terminal degree” – the furthest one needs to go in in one’s education to work as a psychiatric social worker. Usually, a person will get a DSW so they can teach at the university level.

Anyway, I volunteered to work a few hours every week. I also explained to Chris my long-term goals and my journey up to this point. Chris would end up being a mentor of mine. He supervised me during my second internship about 3 years later. He also helped me get started in private practice even later in my career. In other words, he knew me quite well and he was very instrumental in my success.

His style was also very refreshing.  Chris encouraged the use of self-disclosure by the staff at the Oaks when they were interacting with patients and he modeled that. This is not very common in the field. Many mental health professionals are very guarded about disclosing personal details, their own experiences. There is a risk that some clients or patients will use some personal information to make us feel bad or to get under our skin.

As another example of what I found unique about Chris was that in his groups he encouraged the staff to be very genuine and to share their own honest feelings. Imagine a client or patient is feeling very down about themselves and feeling worthless. Now imagine that with what little time you’ve spent with a person it occurs to you that you can think of at least one positive thing that you like about the person as a fellow human being. To even get to this point might seem impossible to some mental health professionals.

I actually had such an experience not long ago in 2020. I was talking to a psychiatric nurse at the University of North Carolina at one of their clinics. It was awkward for her as she stated that it would not be proper for her to tell me if she felt there was anything positive that she recognized about me or in me. The question and the interaction were rather uncomfortable for both of us. But really, does it need to be? If such a question was posed to me, I’d have offered some positive feedback before I put that much thought into the matter.

To think that you can’t offer any positive feedback to a client is strange to me.

As a social work volunteer at The Oaks, I was assigned to complete an intake assessment, not unlike the ones I had done at Georgia Regional Hospital.

There are some interesting things that I wanted to add about the intake assessment. This was the case when I was a volunteer at Georgia Regional Hospital as well. Chris encouraged me to make a diagnosis of the patients and to do so without looking at what the psychiatrist had listed as a diagnosis. I’ll explain what it means to make a diagnosis later in this book. 

The point is that the information that you gather is used to make a diagnosis. Patients were not given a battery of psychological tests (or any psychological test for that matter) in most cases. I could see how I was gathering more extensive information than what the psychiatrist had available previously. 

I got the sense that the clinical social workers like Chris were providing crucial information that would inform the treatment plan while they are in the hospital – outpatient settings are like that as well.

Later, while I was working at a public mental health center after getting my degree, it seemed, in that particular setting, that the doctors were less receptive to considering the additional information that I offered or to read or listen to my explanation for why my diagnosis might be different. I was never chastised for offering my own diagnosis into the chart, but they seemed less receptive than the psychiatrists here (I am using doctor and psychiatrist interchangeably). 

I was not even an intern yet and had not started my formal training but the information I was gathering seemed valuable to the entire staff. 

Anyway, I would come in and meet Chris. We would sit down, and he had a list of new patients. He would say that we have to finish a certain number of intake assessments that day – there was a requirement to complete them within a certain period of time after admission. So, Chris would say, “I will do the assessment on these people, and could you meet with these others.”

I was given a key to an office somewhere that I could use to meet with and gather information from a patient. 

It’s important to note that this was not “busy work.” These intake assessments had to be completed in a certain period of time, as I just said. I felt like I was doing something important.

I had an opportunity to sit in on various group sessions as well. I told Chris that I wanted to do my second internship at The Oaks, and he agreed to that plan.

I learned even more under the supervision of Chris than I had as a volunteer in a similar situation previously.

I continued to grow in my social and communication skills. 

I felt the contentment that goes along with continuing knowledge that I was on the right path in life.

I had been intrigued by the ways that mental illness took a toll on the lives of others. If I could apply those same skills to help others, that would be something. To heal others afflicted with debilitating disorders or to help them cope and find joy in life would be the most appropriate career direction for me. The relationships I was forming even before I graduated from Georgia Tech were so powerful and meaningful to me! 

Everyone has different preferences and things that motivate them. I had found what mattered to me and what kind of activities I wanted to perform on the job. You might say that these were activities that I NEEDED to do if life was going to be meaningful.  

This was about helping others and working with others. That’s what mattered to me.  

I mention all this to make it clear that having made one mistake regarding my education and career direction, I didn’t want to make another.

In retrospect, as I write these words decades later, I know that I had made the right decisions back then. I had been on the right path and doing everything right.

The worldwide web was still fairly new in the 90s. Lynn and I were both interested in poetry, and I had the idea of publishing a poetry magazine on the web. This was in 1995.

I  had a goal of becoming a psychiatric social worker and I was learning a great deal about psychiatric issues at this time. I will describe this in greater detail later.

Anyway, we were thinking of a title and I thought of a term that I heard in the psychiatric field – word salad. The definition from dictionary.com is as follows: incoherent speech consisting of both real and imaginary words, lacking comprehensive meaning, and occurring in advanced schizophrenic states.

I had remarked that at one time, years ago, I had struggled to make sense of poetry… like when I was growing up. I once had the impression that poetry was hard to understand. Maybe I just had bad teachers.

This seemed like a good name that we both liked. So, we called the magazine “Word Salad” or “Word Salad Poetry Magazine.” I got a domain name online and started creating a static website. This was prior to WordPress and so I had to work with Microsoft Word or perhaps WordPerfect (yeah, back then both programs were equally popular). 

I would then create a list of pages for each poem with links on the main page which would serve as a table of contents. 

Lynn let me do this part. 

I also did what was required to try to get submissions. Back then, newsgroups were very popular, and your internet service provider included a list of newsgroups that you could subscribe to. It is similar to a forum today, but they were more open and not controlled by any particular owner… meaning there weren’t strict rules about what you could post. 

Consider something like this today. We might join groups on Facebook, but someone is an owner and creator of the group or there are a small group of administrators for the group. Unsolicited requests for submissions posted to a group might get you kicked off for sending spam. 

Newsgroups were not like that and you could find appropriate groups where you could find creative people who are writers and poets. That’s what I did.

Poetry submissions started coming into our email account for the magazine. 

Keep in mind that at the time this idea of an online magazine was very new as well. That is no longer the case.

We decided to publish four times every year. Around the time when we were getting ready to publish an edition, I first asked Lynn to sit down in front of the computer and see what she thought of some of the poems we were getting – which ones did we want to publish?

She said she wanted me to print out all the poems that I got. I did that and she started creating piles for rejects, those we might want to publish and those she or we liked. She might show me ones she liked right away along with the ones that were in the “maybe” stack or I would look later… sometimes I would start off indicating which ones I liked. 

This was really taking off and it was amazing. 

At one point, we got an interview with Ben Steelman who is a reporter with the Wilmington Star-News. He sat down together with him outside near his office in town. It was memorable. 

We got some submissions from our friends as well. 

A similar process occurred when Lynn would edit/proofread my papers for graduate school. She would ask me to print out the paper and she would go about marking up typos or other stupid mistakes I would make in my writing. It’s strange how easy it is to make all these errors even if I was a much better writer than might be indicated by some early drafts of my papers.

In the next chapter, we will go back in time. I will pick up the story of my career journey. That journey might have started in the 80s when I decided I was going to go into social work, but it took off in 92. That just happens to be the same time when I met Lynn.

It was the best of times, a period of great success and accomplishments. 

This section of my book covers building a family as an adult. Beginning in April of 1992, I would move out on my own leaving the life I had living with my parents. You will notice that the "problems" that I had described when I was living with my parents and dealing with grief will almost magically disappear. The environment in which I was living with my parents had become very toxic. 

In this section, I am writing stories that read like a love story when taken together. When I speak of starting a family, I mean sharing my life with another person, eventually as husband and wife. So, this is about falling in love. I had dated a little but no one other than Celta played a role in my history. There was a moment when we almost kissed – do you remember what I described?

I suppose some it can be confusing. Nothing “sexual” happened. That being said, I never held hands with my male friends, or cuddled with them, or stared into their eyes, felt the need to repeatedly tell them “I love you.” You get the idea. 

The book overall is about my interest in building connections – social connections. For me, this is a form of self-actualization!

It's important to note that the same efforts involved in overcoming shyness in order to be able to find someone to love were helpful in my career journey. So, this section is a very important part of my overall autobiographical story. It offers a background for the other later chapters of the book.  

While these chapters within this section can stand alone in part, the best way to understand everything and appreciate the love story here is to have read every chapter that has come before these next chapters in this section of the book.  

For a brief moment, before I moved out on my own, I worried about my own mental health and whether my "problems" would have an impact on my career plans. That was where things were left at the end of the last section. Never again would I wonder about this. Clearly, the environment where I was living with my parents had been extremely toxic. That narcissistic household would be left behind and replaced with brighter days.       

At this same time in my history, I would embark on my career goals and dreams. I am going to describe that aspect of my life in Section Three where I will have to back up in time to cover that aspect of my life.  

Regarding shyness, I would say that I was a "shy person in recovery." I made up that term and you will come upon this later in this section of the book. I use that phrase to indicate that I had accomplished so much with regard to overcoming the paralyzing effects of shyness, but it has been an enduring aspect of my life story.  

Cystic Fibrosis and My Life with Lynn Denise Krupey

It's also important to note that the girl of my dreams, the love of my life, the one person I would fall madly and passionately, totally and completely, in love with, had a chronic illness called Cystic Fibrosis. I will discuss that later in this section of the book including the implications this had on our life together.  

The Role of Religion as A Toxic Influence

For the longest time, I was still a believer in religious ideas – the ones I had been exposed to growing up. God, spirituality, heaven, and sin of course. We can’t leave that out. I would come to feel such great shame for things I said to Lynn when we were living together. She would ask if I regretted the things, we did. I would answer “no, of course, not.” I knew we had an incredible relationship, and we were committed to each other forever, we had an incredible connection.

Everything we did was so right!

Being an atheist like I am now, would have been easier. I can be philosophical without looking for supernatural answers.

Lynn was always open- minded and curious… practical but curious. I’ll explain the practical part. By curious, I mean she listened to our friend Jean as he discussed and applied to the tarot. Her mother went to someplace on Sundays that didn’t preach any particular faith or religious dogma.  

Where the Story Begins and Where it Leads

 I pick up the story when I turn twenty-six and move to Wilmington, North Carolina - my home. Things are much different than when I arrived in Atlanta Georgia for college. It's true that I didn't know anyone in Wilmington when I first move there. However, I am not paralyzed by shyness and social anxiety – I had developed social skills as well.   

The experience of being in love was more amazing than I had imagined. I could not have known what it is like to be in love until it happened. I suppose no one does... but no one tried to convey the happiness and serenity that comes from being loved and being in love.

Please join me... this promises to be exciting.