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career development

Chapter 25: Pursuit of Career Dreams – Psychiatric Social Work

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.  

I was preparing to be a social worker even when I was studying engineering at a school that didn’t even offer a major in social work. I just didn’t know at first that I was preparing to be a clinical social worker or a psychotherapist.

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.

Chapter 2: Going to College 

As I packed my bags for college, the weight of leaving everything familiar behind weighed heavily on me. I felt a sense of dread in my chest as I thought about leaving behind the only family I truly connected with - my aunt and cousins. But what choice did I have? My high school offered no guidance or insight into potential careers, leaving me to blindly choose my path.

The idea of engineering seemed like a safe choice, but deep down I had no idea what it truly entailed. Yet, when acceptance letters from prestigious engineering programs arrived in the mail, I got the impression from my father that Georgia Tech was the most renowned among them all. UConn had an engineering program but I got the impression probably from my father, an engineer, that it was insignificant in comparison.

Perhaps, part of me believed that I could earn their respect and pride.

My parents always preached about the impact of every decision, but little could anyone know just how transformative my life at Georgia Tech would be.

As my parents drove away from Georgia Tech in Atlanta, Georgia, leaving me behind in the unfamiliar campus, I realized that I felt free from their presence - both physically and emotionally. My parents had been indifferent, limiting contact, but what little contact I had made me always want to get away.

My mother’s explosive anger had been hard to predict. That had forced me to climb tall trees for the freedom of being hidden or I had hiked or hung out in the woods if I was not with friends.

What I missed now were my cousins, Barbara, Dan, the younger cousins, my aunt, my aunt’s daughters (my first cousins).

When I first came to Georgia Tech and started to engage in the orientation progress, I became radically aware of my loneliness. It’s not like I had left behind close friends. There was Paul. But he had moved away and we had not being hanging out like in the past.

Somehow the loneliness was oppressive. Frightening. Was it because I couldn’t hide in the woods?

I had an inner dialogue of thoughts, trying to make sense of things, trying to figure out what I was feeling. This inner dialogue was forced upon me. I was curious to figure out what I was feeling or experiencing.

With what I know now, I could say that I had been engaging in dissociation. I was detaching from thoughts and feelings. I couldn’t figure out what had prompted the sudden reflection and examination of my thoughts and feelings.

I wrestled with the fact that I had been alone quite often. It was partially true that I didn’t have the comfortable escape into the woods. College would be much more complicated and challenging than high school.

Right? Yes, Georgia Tech accepted only the best of the best from high schools across the US. It was easier for residents of Georgia to get into Georgia Tech but staying and graduating was another matter.

I needed to have some connections. People I could talk to. Plus, I was an adult now. If I wanted a normal life with my own family, I needed others.

Why had I been more aware of not being able to find anything to say to others during orientation? Wasn’t I used to that?

After the thoughts about how people must have thought I was weird during the orientation rafting adventure, I had similar thoughts about how weird I was walking alone through the quiet dorm. This wasn’t a big spread out neighborhood like where I grew up in a town with people spread out. People were right outside hanging out together.

People hung out together naturally, or so it seemed, at the end of the day when the scheduled activities ended. What if someone came back into the door or walked downstairs to the empty TV room and other empty activity rooms. What would they think of me, the weirdo, all alone?

Ironically, it was good that I felt so uncomfortable. This would push me to join a fraternity and to seek counseling.

I didn’t have to look far, I immediately sought help at the Counseling and Career Planning Center.

I had a sense of purpose and determination. The urge was inescapable. I had been comfortable being alone in the past. But now, I was determined to change that.

However, it took enormous courage for me to make that first step towards counseling. I didn’t believe I deserved or needed help - a belief instilled in me by my family who constantly shamed and scapegoated me. The counselor gave me the MMPI test to assess my mental health and it revealed a distorted result due to my upbringing.

I had always been made to feel like there was something wrong with me, so if the test showed no abnormalities, I would have dismissed my own struggles as insignificant compared to those with "real" problems seeking help and I projected my own beliefs onto this psychologist that I was just getting to know.

I moved from one engineering program to another as I learned more about each of the different engineering majors and then landed in electrical engineering, with a specialization in computer engineering and a minor in psychology.

While I did remain in counseling with the same psychologist for the full five years, it didn’t take long before I noticed radical changes in my ability to communicate, connect with others, make friends.

I had joined a fraternity thinking that this would help me fit in with a group and create opportunities to make friends - connections.

Nearly a year and a half into my program at Georgia Tech, I was walking with David, deep in conversation with a friend who lived in the room across from mine. We talked about our future goals and aspirations, and he revealed a hidden desire to work in restaurant management. Though he had been told that an engineering degree from Georgia Tech was more prestigious, his heart longed for something else.

As we continued to talk, I suddenly had an epiphany dawning on me like a beam of light. In a moment of clarity, I asked him a simple yet profound question: "Do you truly want to do engineering for the rest of your life?" It was the first time I had actively thought about choosing a career based on personal passion and fulfillment rather than societal expectations or financial stability.

Through this conversation, I came to realize that our professions and occupations didn't have to be just a means to an end. They could bring us joy and fulfillment on their own. My friend's response showed me that he wasn't truly happy with his career in engineering. He made the courageous choice to leave Georgia Tech and chase his dream of managing restaurants. This experience taught me that it's possible to be in the "wrong" job or career if it doesn't bring you satisfaction and purpose in your daily work life.

Halfway through my engineering program, after having come a very long way in developing social skills, learning to communicate, building self-esteem, and in overcoming my social anxiety, I told my psychologist/counselor (I would have that same psychologist for the entire five years at the University), that I didn’t think I was in the right field.

Growing up, my father had told me that childhood was the best time of our lives because we had none of the stressors he faced. So, I had no idea that one could enjoy what one was learning and what one would do in their career. Why had this never occurred to me that the actual activities that people do on their job could be enjoyable and could be matched to our interests.

So, my counselor gave me a career interest inventory. This matches one’s interests with those in various fields. This considers how one might enjoy spending their time, the activities that we find or might find interesting.

I scored highest with careers in two themed areas: first Social careers, and the second highest theme area based on my scores was Creative. Engineering, I noticed was grouped in “Realistic” themed careers, which made sense. The “design” aspect of engineering was not reflected in the actual tasks of an engineer.

The experience of therapy while attending university was both transformative and eye-opening for me. The psychology courses I took only deepened my fascination with the human mind and behavior. I was amazed at how much understanding psychology had provided during my sessions with my psychologist, and I felt a strong desire to use this knowledge and my empathetic nature to assist others.

My passion for social work went beyond just the academic aspect. It aligned perfectly with my personal values and desire to help those in need. Growing up in Atlanta, I couldn't ignore the poverty and homelessness that plagued our city, and I saw social workers as the ones making real change in these communities. It was more than just a career choice, it was my calling.

But I was already deep into my studies and changing my major or transferring schools seemed impossible. My parents were funding my education and switching to an English degree, while enticing for my love of creativity, would extend the time and cost of my education which my parents did not support. Plus, I knew a Master's in Social Work could be pursued with any undergraduate degree. I felt torn between following my heart and sticking with what was practical.

The improvements I made were massive. I was becoming an extrovert in many ways. Yet I hadn’t been able to find a girlfriend, just like everyone else seemed to effortlessly do. But instead, I had only been on two ambiguous dates with young women, unsure if they were even “dates.”

The most profound transformation I experienced at Georgia Tech was not through engineering or academic success. It was clawing my way out of paralyzing social anxiety and building essential social skills. Though some may argue I still suffered from selective mutism, unable to speak in large groups like classrooms, and I only had two “dates” - if that is what they were. This perpetuated the notion that everyone had someone more important in their lives than I was.

The lingering feeling of inadequacy haunted me and made me feel that I would never be good enough - good enough to be the first choice for someone. I still felt like it was true what my parents had said about my cousins, that they had their own lives - lives that were more important than what I could offer.

I also discovered a profound capacity for empathy. I would have to learn to control that. During the last year that my best friend was at Georgia Tech (a friend that graduated before I did) he had mononucleosis (aka mono). Towards the end of the quarter, I started developing the symptoms of mono. I was certain of this and just laid down to sleep on the couch in our room. I woke up a few hours later and I was symptom free.

I had developed an empathic reaction and taken on the symptoms that my friend had been experiencing throughout the quarter.

I didn’t have a job upon graduation, and I thought it was understood that I was going to go to graduate school for social work. My father had said that he understood that engineering was not a good match for me. I imagined that he would have understood that it would be very unlikely that I would get a job as an engineer upon graduation but their support in paying for my undergraduate education was helpful.

I didn’t expect my parents to pay for graduate school but they had a large home with a free room upstairs, and I didn’t eat too much. I somehow had not fully appreciated how toxic my family was.