Saturday, October 17, 2020

I Am Glad You Are Here


I am glad you are here.

Those are the words I say to every new client at the treatment facility where I work. When they are in one of the groups I facilitate, I offer them the opportunity to introduce themselves. I ask them if they want to share some of their story. "Do you want to say what brought you here?" I ask gently. It's up to the client to answer. They can talk if they want, or not. 

Sometimes clients have never been to treatment before. Often you don't even have to ask what their treatment history is. They look at the floor as if they are afraid to catch someone's eye. That's usually the tell. What brought them into treatment? "I'd rather not talk about it," new clients will often say.

I don't care if they share their life story or if they feel too shy to speak a single word. When I first meet a client, there one thing I want them to know and one thing I make sure to say: 

I am glad you are here.

Last week the facility where I work found out that one of our clients died. He was 24 years old, and he'd been murdered. He is not the first client I have worked with whose life has prematurely ended. I've even had other clients who've been murdered. Still, any time we find out we have lost someone, all of the staff I work with are shaken up. 

For me, whether I want to or not, the first thing I do is search my memory. When was the last time I saw this client? What did I say to them? What did they say to me? Could I have said something more? Should I have listened more intently?

It's a short lived contemplation. Addiction is a disease that kills. I work in a field where clients will be lost. I could say a lot about the failing of mental health and addiction treatment in this country, but I'll save that for another post. What I know personally is that we can't save every client we work with. So much of the saving involves healing hearts and dismantling shame. This is the hard work required of those who are suffering from addiction, alcoholism, and mental illness. Most cannot do this alone, they need support. And those of us who are trying to help cannot succeed unless our clients are open, honest, and willing to do that hard work. 

On my end, I believe the first step is to let a client know that I believe in them. I believe in their capacity for recovery. I believe in their ability to heal. I believe that they are entitled to lay down their shame and instead move forward with the compassionate act of self forgiving. Sometimes I tell clients who seem to feel partciularly unworthy of recovery: You have a life waiting for you. It's yours. You get to claim it any time.

And then, as a clinician I have to take a step back and wait for a client to find the courage to take their own first step. Sometimes they are able to do that, sometimes not.

In my own efforts at recovery, I meet with others who remind me to say prayers. Often we pray for 'the addict who is still suffering'. Just as often we will also pray for those who will lose their life to addiction today.

Sometimes people die from mental illness. Sometimes they die from addiction or alcoholism. And it's heartbreaking, but without better treatment modalities, some days the best we can do is to say a prayer for those who will die.

When I thought about the client we recently lost, I couldn't remember the specifics of the last time I'd worked with him. I am not sure what I did or didn't do. But there is no formula for what might have been missed. At present, we just don't know who is going to walk out the doors of our facility and into the life that is waiting for them, or who is going to lose their life to the very thing that brought them in.

Mental illness and addiction will steal away a person's sense of belonging and therefore their sense of hope too. I don't know the specifics of what happened to our client, and I don't know what his mindset was in the days or hours leading up to his death.

I can't remember the last words I said to him, but I am confident in what words were among my first. I can only hope that even if it were just for a brief moment, he took in what I tried to tell him. It is the thing I want every person strugging with addiction, alcoholism, and mental illness, to know. I say it because it is true. We are not alone. And so to every peer who stands beside me fighting this same good fight - know this: 

I am glad you are here.