June 1st, 2010

Getting to know you

The woman glided into the room on tiptoes, trepidation and confidence contending for control of her gait, her tortured smile reflecting some inner struggle about which we knew almost nothing. She had just arrived at the hospital and was meeting the team of mental health professionals who would provide her care during her stay. She made for the nearest chair, the one next to me and extended her hand in greeting. “Pleased to meet you,” she said, “I’m mildly depressed.” This is not the way people usually introduce themselves and say hello, not even in a mental hospital. I asked her name and gave her mine, together with my title and role as the unit psychologist. This brief exchange with its implied question about how people get to know one another has become emblematic of my first month in a new work site.

The change from one job or setting to another brings about a heightened perception, a sharpening of the senses and a more mindful way of being that can be un-settling and uncomfortable. Remember when you first learned to drive, how much effort you expended in checking every possible line of sight for oncoming vehicles and how you made and followed a mental list of every action required for the simplest maneuver? With time and experience, driving became an automatic sequence of behaviors, so much so that it sometimes seems as if your car drives itself to the places you routinely go while your mind busies itself with other things. Now, in many ways, this is a positive development that improves your efficiency, leaves you free to multi-task or simply to unwind and relax during your commute. But efficiency has its costs, not the least of which are an increased susceptibility to distraction and the chance that bad driving habits can creep in undetected while you are following another agenda. Moreover, these episodes of automatic behavior stand in contradiction to the ideal of mindfulness that we psychologists have been so keen to promote in recent years.

When it comes to enhancing mindfulness, there is nothing like change and novelty. So, instead of chafing at the awkwardness of being a newcomer to the hospital, I am learning to appreciate my increased mindfulness before it slips away into the mist of routine and unchallenged assumptions. Armed with these new habits of thinking, I embrace the challenge of getting to know my patients, my colleagues and the building where I work.

For example, I have learned to discard the assumption that the main elevator stops on all eight floors of the building. It never stops on floors two or five. To get to either one of these destinations you have to take a different elevator, use the stairs or travel to the floor above or below your goal and climb up or down one flight. Getting to know the building means learning which corridors permit free passage and for how far and when you have to use your key. You quickly learn that you can enter almost any stairwell without the door locking behind you and, when you’ve chosen the wrong one, that you can always get yourself to the main exit as long as you remember to travel with your ID badge and your key. You learn that the rooms on the North side of the building are always freezing cold, except when they are boiling hot and, in your struggle to regulate the temperature, you learn some things about your colleagues, old and new.

Three therapists, one psychologist and two social workers, walk into a frigid room and immediately fall into a conversation about which extreme of temperature is easier to endure. Those who prefer the cold reminisce about growing up in cold climates with insufficient indoor heating while the devotee of heat shakes her head in disbelief. Enter a new colleague, an occupational therapist, who at least by profession, is a person dedicated to the ideals of personal initiative and adaptive behavior. It’s freezing in here, she says, and promptly closes the windows. Though we know better than to apply the characteristics of a class, in this case, profession, to its individual members, sometimes doing so makes for a good start. Or, as it did on that morning, a good laugh.

Getting to know my patients mindfully, I look, listen and try to understand in a more deliberate way and, when I do, nothing I see or hear is ordinary. A man struggling to control his violent impulses tells us soberly what he has learned in the hospital: “I cannot lay a hand, just one inch of hand and I’m gone.” His own words and quaint manner of speech mark him as not just another person with anger management issues, but as a true individual, an original who defies classification. When our new patient introduced herself as “mildly depressed,” she was either trying to speak the language of this strange country she is visiting or telling us that her life has become circumscribed and defined by her mental illness. But through the new eyes and ears given to us by change, it is always so much more than that.

Alan Bodnar, Ph.D. is a psychologist at Worcester State Hospital and a consultant in the field of leadership development.

By Alan Bodnar Ph.D.

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