HSIOW

(Holy shit, it's only Wednesday.)

Could the week go by any slower? It sucks having an off-day on Monday, because then Wednesdays feel like Tuesdays.

When I start my new group in my DBT program, I'll be doing 5 days worth of DBT services. Tuesday - group 1; Wednesday - no DBT; Thursday - individuals for grp 2; Friday - individuals for group 2; Monday - group 2; Tuesday - individuals for grp 1; Wednesday - individuals for group 1; no DBT until the following Tuesday ... lather, rinse, repeat.

Now, the reason we are doing it this way is because the second group was supposed to be on Thursday, but my co-facilitator already had a group later in the day, and "just couldn't see doing two groups in one day." But it's okay for me to do 5 days worth of program material? I took it to my supervisor, who said, "Nope, she can't do two groups in one day." And that was that.

Now, also consider this: DBT warrants that the participants have telephonic access to their therapist after-hours. I have 8 people per group ... 16 people will have access to me via a DMH-provided cell phone that remains on from 5p-8:30a (weekdays) and 24 hrs (weekends).

DBT, to give you a little background, stands for Dialectical Behavioral Therapy. It's a very solid therapeutic approach to dealing with individuals diagnosed with Borderline Personality Disorder. The characteristics of a Borderline diagnosis are usually that the individuals have pervasive mood swings, which are often accompanied by alternates between idealization and devaluation (otherwise known as the "I love you/I hate you" dichotomy ... that's what I call it); they often have serious abandonment issues, and will often engage in frantic attempts to avoid real or perceived abandonment (incl. sabotaging their own relationships, sometimes by testing the limits of those that they perceive to care about them); and ... my particular favorite, and the one that keeps my ulcers well fed ... they can also be quite self-damaging (e.g. overdosing, self-mutilating by cutting or burning), and often express parasuicidal ideation ("I'll kill myself if you don't see me for a session a day early" is one of my favorites) which lands them in frequent hospitalizations.

Comparing my group to the other groups in the clinic is like straight-up apples vs. oranges territory. Hell, no, 'cause at least those are fruit. It's like comparing apples to bicycles. Two of my folks have clocked more inpatient stays than my two colleagues' groups combined (22 clients). These are the people who will be expected to exert the insight sufficient enough to contact me BEFORE a crisis hits. (And yes, I've been called as late as 3am more than once.)

And why do I do this? For more money? (If that's it, I ain't seen it yet.) For experience toward my Ph.D? (My current paperwork expectations keep me from even fathoming the concept of doing more paperwork after I leave the clinic.) For professional pride? (You forget, I'm looking for another job at the local state university.) Personal pride, surely? (You know, there is a certain untouchable feeling that comes with dealing with the most difficult clients in the whole clinic, but that only lasts until after the next disruption.)

Had to vent. I'm basically treading blog water until Friday, which will start a new run of some cool shit on here, I hope. Did anyone peep the new look to "that other site?" I did that shit.