A Precarious Alliance

It is different every time I leave work. Even though my work is in a psychiatric hospital, my time there can go smoothly and is often pleasant and enjoyable. I can leave feeling satisfied that I did what I was supposed to do. Sometimes I will mainly have enjoyed the camaraderie with my co-workers. Other times I may be physically tired from being on my feet too long or my brain may remain hyped up for a few hours as if it still wants to perform in high gear. Sometimes I will feel disturbed over situations. This morning I have been processing a few of those situations. Confidentiality is a big deal in a psych facility and prevents me from being specific. You would think we deal with government secrets instead of hurt people, but I understand. Nobody wants their "dirty laundry" spread all around, and some individuals deal with shame. But suffice it to say, there were some difficulties this weekend. There is an interplay between staff and patients. It is called a brief therapeutic alliance or some such thing. Still patients can become out of control through memories of past experiences, psychotic thought processes or other mental distress. And sometimes staff people make mistakes in judgment. Three of the don'ts I have learned in the past twenty-some years are 1) don't put more into the therapy than the patient, 2) don't get into power struggles with a mentally ill person, and 3) don't provoke a redneck. The second two together can create an explosive environment.