Thomas would yell whilst making a fast break down court towards the opposing teams basket “Outlet, outlet, outlet.” Thomas was the loud, outspoken, fast talking, mathematician, the unbelievable dribbler and phenomenal shooter. As a shooting guard he handled himself exceptionally on court.
I have mentioned my adoration of Basketball and of the Alienist in other posts. With the Alienist the appeal has been it’s willingness to display patterns in manageable saccades that introduce difficult and strange and new ideas, that turn stomachs and minds and at times both.
A thought struck as I near the end of the 1st book of Caleb Carr’s The Alienist. The idea of the outlet. The shedding of psychological material in a safe and secure way that offers regeneration. Think a reptile it’s skin, a cat or dog their summer/ winter coats, a London Plane it’s outer bark. At page 516 the case is as good as over. The shudder of the character John Moore, recognised as letting the horror and level of mind torture he has gone through to pass. He shares the events of the night with his friend and police commissioner Theodore Roosevelt.
Shake it off
The recognition is in acknowledging that a case has run its course to an eventual end. How many of us in helping professions conduct a full case analysis or case review to determine learning. With the intent to successfully shake the case off? Every client we work with is unique and has patterns that can be recognisable. Then there are those clients that surpass our understanding. That leave us questioning our training our experience, our knowledge, inviting doubt, questioning suggestions from supervisors both internal and external.
How often then do we review with the aim of release and then cleanse? Psychological Burrs are sticky and can unduly influence a helpers work. The journeying with another on the path to better health is one that tests both the professional and the person being worked with. We enter a play that has a number of factors that interact and can determine the outcome of treatment.
If the play happens to move along desired paths then we congratulate the client for their success. When working amongst a group of other professionals we also commend the team about the decisions and choices we all took part in playing with recovery.
Were the play to be difficult and lengthy and not follow the desired path, we make alternative plans and develop contingencies that may develop a successful outcome for the work. This is where the heart of the matter often sits. Perhaps the client is initially enthused with the idea of what the work with you will deliver. Then a number of road bumps happen and they become aware that continuing with the work will arouse long held fears. Forgetting the intention to move towards better health. Here the skill of the therapist is key as well as the resilience and trust of the client. Where a good working alliance is built this road block can be understood and moved past respectively.
Were things to get stuck and not progress we then enter another phase of the work – that of figuring out the why of the holding pattern and where the blockage could lie? The tricky thing about road blocks is that they are almost imperceptible. They reveal themselves in the client’s away times, or in the quiet moments in a session. For me they appear as questions or slivers of insights that may be occurring for the person sitting opposite. I have grown to trust these slim chance offerings as hidden openings. Using tools like art, paths, stones, the wind, changing seasons, dreams, woodland tableau’s something gets worked loose and we begin investing time to what has been unearthed. These moments are when the magic happens.
Shudder to Outlet
With all three patterns the shudder should occur. Shudder to reorganise thinking, shudder to congratulate, shudder to stay awake and to find other ways in which to grow move and shape treatment.
Here the outletting of the pressured thinking, the complex conversations, the layered concentrated empathy and compressed and extended compassion need to be passed. To allow space, to breathe freely, to re-energise and replenish to connect with our purpose, our why. This then is an aspect of self-care. We who care for others can be less concerned with our own wants needs and mental well-being sometimes at great cost! Placing all of our focus on those that we support. Care starts with us first. Selfish? Possibly.
Whilst on an airplane or on a ferry the flight attendants and shipping crew advise to fit in emergencies – breathing masks and life jackets first to ourselves and then to others. The idea: look after self first, then we are able to look after others.
Outletting can be achieved through a range of actions and behaviours. The main aim is to let go of the psychological weights being carried from one day in to another or from one interaction in to another. Supervision is a great way to get loose from the psychological work. Once a month or twice a month may not be enough. We can become susceptible to compassion fatigue, empathy impasse or burn out/singe outs. That may be ameliorated with a daily check in and an outletting of all that could be a trigger, an up setter, an applecart turn-overer, with the aim of finding a piece of tranquillity. To rediscover and reconnect to our why. Returning to the play with those being helped with renewed energy.