When I first met her, straight out of graduate school in my first job, I was terrified. My fear coming from a place of inadequacy and lack of knowledge. Sure, my school had prepared me for psychosis in the purest sense of the DSM; but it had not prepared me for the reality of it. The depth of emotion that filled a room when someone living with Schizoaffective Disorder was scared of working with a new case worker. The jarring whirlwind of flight of ideas or word salad. Everything was new, for both me and my client. Looking back on it and exploring it in supervision, I saw that we had both been sitting in the same place of anxiety in the same room, but expressing it in different ways. We both felt powerless and out of control. I often wonder if I’d been in a better space clinically if I would have done anything differently, if I would not have defaulted to humor as my go-to technique for releasing tension. In one of the few moments she slipped back into the room, into her body, to face me I made a joke with her and she laughed. Okay. Laugh isn’t the right word. She cackled, a full hearted and open cackle. That’s when I knew we would get on famously. To this day, she still crosses my mind and I wonder how she is.

But working with her was a challenge in patience and clinical skill; balancing the line between directive styles and reality testing. She taught me how to communicate most effectively with a person experiencing psychosis; which was her baseline. She lived with it daily. On good days, she knew what it was and reality tested beautifully; her insight something to behold. On her ‘bad’ days, the days her symptoms were more intrusive, she remained fearful of demons, of turning into a cat, and her clarity disappeared. On these days, I relied on her quick wit and my calming core to shred the darkness from the room; to give her psychic space to breathe.

One of the most beautiful moments I remember from this time of my life was with her. Every time I think of it, it makes me smile and brings up in me a feeling of joy and gratitude for a small moment in time.

It was a typical Wednesday and by 11AM I was walking from my parked car to the group home where she lived. My first stop was always the medication logs and the staff, to see their impressions of how she was doing, what she needed, and overall medication “compliance” (I hate that word). My second stop was always her room. I made my way down the hall, hearing music in the dining room. This was common as the staff liked to keep a local jazz station playing for the residents during the day. Her room was empty save her roommate, who occupied the chair in the corner of the room like a hawk. I said hello, noted the rows of small stuffed animals that graced my client’s bed and moved on to find her. As I rounded the corner to the dining area I saw her, dancing her heart out. She didn’t see me at first, her eyes were closed, arms in the air, swaying to the music. This was the first time I’d seen her simply BE, enjoying life and not being led by her symptoms. The music brought her pure joy and she expressed it openly in that moment. When she finally saw me I smiled and “danced” (if you can call it that) a little bit with her. She beamed at me.

I learned to love human moments like this. Moments when the barrier between psychology and humanity blurred and my clients and I could be people together; could experience part of the journey together without the inherent power dynamic getting in the way. In times when I feel the weight of clinical judgement, risks, liabilities, needs, traumas weighing on me, I remind myself of human moments like this. That is typically when I look a client in the eyes, put on a silly song, and have them dance a bit to get out the negative energy and just enjoy the moment. At first most clients are wary. But the second they start to laugh at how badly I dance or at the choice of song, I see the negative energy beginning to float away, the power dynamic shift a bit, and humanity settle in. Some of my best sessions have been interrupted by song and dance; musical therapy. Some clients came to expect it, even ask for it in moments when they felt the world weighing them down. I am grateful for every human moment like this that I am able to have with clients and all of it started in the small dining room of a group home with a woman I’d once feared; and for that I am eternally grateful.
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Brittany Lash is a counselor in Texas and is the director for the Professional Recovery Network (http://www.txprn.com) with the Texas Pharmacy Association. She has experience working in public mental health, mental health public policy, and in training first responders to work with individuals with mental illness.