A Day in the Life of a "Foreign" Psychotherapist

A DAY IN THE LIFE OF A "FOREIGN" PSYCHOTHERAPIST

BY DEBBIE ALMOCERA

I’ve been working in the mental health field for over 15 years now, and sadly, I have yet to meet a patient who does not look surprised when they meet me for the first time. More than half of them don’t hesitate to ask me if I’m Chinese, nor would they hesitate to ask for the “Chinese lady” when coming in for their next appointment. But of course, that’s the least of my concern when it comes to my job.

There is not a single dull moment in my work day. The field of mental health offers a variety of exhilarating experiences, colossal disappointments, and priceless humorous encounters with patients presenting different realities. I have learned painfully to disassociate myself from the chaos and turmoil in front me, by reminding myself that I am not responsible for other people’s wrong decisions, and that by me being there does not mean they would stop making the wrong decisions.

People often mistake sadness for depression. Sadness is within the range of human emotions. If you never feel sad, chances are, you’re an alien. Just because you’re very sad, does not make you depressed, especially if there’s a reason for your sadness. Depression is an illness, a dysfunction of the brain’s biochemistry. It has physical symptoms – tiredness, fatigue, lack of energy, and lack of interest in things that you used to enjoy doing.

It is not uncommon for patients to cry in my office. They express their frustration, confusion, and their lack of confidence in dealing with their own problems. Sometimes they demand answers from me, or expect me to solve their problems. I tell them I don’t know the answers, and I can’t solve their problems, and they cry even more. If they stay long enough in therapy, they would soon realize they had the answers all along. They simply refuse to acknowledge them for various reasons. For the most part, it is their own fear of having to deal with change in their lives. Change is never easy. But doing the same thing over and over again, and expecting a different result, is insanity. And they wonder why they’re sad.

Patients with Bipolar disorders can be very frustrating, if you allow them to get to you. I raise my protective shield higher when working with them. You never know when the mood changes and you could get caught in the middle. It is important to remind them to get help not only when depressed, but also when they start to see the world in rainbow-colored glasses, and they’re having so much fun they’re neither eating nor sleeping.

I enjoy working with patients with disorganized Schizophrenia, because they’re usually in a good mood, they just don’t know it. I often wonder what kinds of thoughts they really have, aside from the tangential and disorganized speech they are giving me. I ask them how they are doing, and they say “it would be better if it rains”. I ask “and why is that?”, and they say “it’s good for China”. Somehow I have a feeling my ethnicity influenced that train of thought. Then they would ramble on and on without a care in the world if they are ever understood. As far as they are concerned, they make perfect sense and you are the idiot. When they get paranoid however, it’s a different story. You might not get a single word out. And I keep my distance. In case the FBI is watching me too.

These are the people I see every day. By the end of the day, you learn to appreciate what you have, including what’s left of your own sanity.

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Debbie Almocera is a licensed therapist working in the behavioral medicine department of one of the largest hospitals in St. Louis, Missouri. For her, there has not been a more fulfilling and rewarding career than the one she has now. She can be reached at dholderle@yahoo.com