CYP 4953

Journal # 1

This past Friday was my Orientation at Fellowship House. When I got out of the car, the first thing I did was walk up to the first office I saw, since I had no idea in what building the orientation was to be held. When I entered that office, I saw a man, sitting down quietly. In my mind I started wondering if he was one of the members of Fellowship with a particular mental disorder. I really could not tell by his physical aspect, since he seemed pretty normal, however, I just kept on wondering. Then another person came out of this office where I was still waiting. He was a thin tall man. He started walking down this little narrow hall. I noticed he was walking a bit strangely. His hair was somewhat messy. His eyes were looking just about everywhere, like if they could not stay focused on one particular object. He came out of the door, and he said "hello." The sound of this voice was "scratchy," perhaps a better word to describe it would be phlegmatic. Again I began thinking about all the things and people that I am to encounter when I start working there. I began feeling a bit disconcerted, however, I said "hello" back to him, and watched him as he walked in this sort of funny manner, out the building. Finally I was attended by a person at the front desk and directed to another building called the "Annex."

I got to the Annex. The girl at the front desk was on the phone. I looked around to see if I could ask someone else where the Orientation for the FIU students was to be held. I saw one of my classmates, therefore I asked her. She told me that we had to wait for a little while. Just as I was about to sit, an elderly woman approached the seat, so I stepped out of the chair and stood beside my classmate. Since I only have a vague idea of what to expect when encountering these persons with these psychological disorders, I could not help but to meticulously observe and sometimes even stare at the people around me. I believe things are definitely different in practice than what they are in theory. Definitely I have read about mental disorders, in this particular case depression and schizophrenia, however, I have never been exposed to such social reality. I have never done social work with this type of particular community. This was particularly what I did this past Friday at orientation, lots of observation, and the most that I could. Therefore, I observed the elderly woman who was sitting down. She seemed as if she had no expression on her face, the commissures of her lips where deeply marked downwards on her face and motionlessly she stared at the floor. She would not take her eyesight away from it. However, there was one particularity in her eyes, they seemed lifeless. She reminded me of someone very dear to me, and I cannot put a word to the feeling I got at that moment, I do not know if it was sadness, or maybe compassion. She was later help out of the chair.

Later on a man came, and sat down on the very same chair. I really did not pay much attention to this man, this time. However, something caught my sight again and most specially my hearing. Out of somewhere, came this erratic man, with a really loud tone of voice, and a Hispanic accent I believe was from Cuba. He started talking to the man on the chair, and he had this really loud tone of voice, and he was moving around gesturing all these expressions. He was talking really fast and switching from one topic to the other. It was kind of hard to follow the conversation, because there was no particular line of thought in his conversation. My observation was some minutes later interrupted, since we were taken to a conference room for orientation.

In Orientation we were explained the formalities of the job, as well as given a general overview of what Fellowship House is, its contribution to society, the ways they help the ill persons who attend Fellowship, and regulations and rules that we are to follow. I felt overwhelmed during the orientation, since the supervisor was giving us so much information on what we have to do during the internship, the workshops, the project, etc. I just want to do a good job, and when I finish I want to leave feeling good about myself of having helped out in whichever way is needed of me. I cannot deny that I am in more than one way nervous, because this is the first time that I will be having a close encounter with mentally ill persons. However, we were already warned not to be affectionate with the members. It was good we were told this, because it sets the standard, however, I do not want to be "cold". I guess I just want to be of good help being how and who I am, and I hope I am able to do that.

 

 Journal #2

This week, was my first week working at Fellowship House. The first day I felt a little apprehensive, which I thought was pretty normal, since one always tends to get a tad nervous of the unknown. However I knew I was not alone, since the staff and the coordinators were there to help us. As the day of work commenced my other two classmates and I were taken to "Town Meeting." Here, we were introduced to the members. They were all very welcoming. I could tell they were very eager to get to know us, since after Town Meeting, as we walked outside the building, they would follow us, making one question after another.

After Town Meeting was over, we were directed to our workshops to start our activities with the group members. The activity of the first day was the "Getting to Know You" activity. Therefore, I told the members a little bit about myself, and later they each told me whatever they thought was a relevant aspect about themselves. Some of the members seemed to be quite reserved, while others were very open, willing to say more than what time allowed them. During that allotted time, what I mostly did was observe how they expressed themselves, their gestures, communication skills, etc. Some of the members seemed so normal, that I remember thinking, "this person looks so normal, that I could never tell that he has a problem, if he were not here;" these were the "highly functional members" as they call them in Fellowship. With other members, however, it was particularly difficult to understand their speech, and they seemed to loose concentration quite easily, digressing from one topic to another; these were the "low functioning" members of the group.

Later on, coffee time ended the activity. At this moment, I got to converse and get know a bit more of some of the members that would approach me, letting me in on more about themselves. Two of the members, which whom I was able to speak to the most, told me the two things, that have stayed echoing in my mind during these days. The first thing one of these members told me was: "I got sick because I was not able to control my nerves." I have dwelled upon this quite a lot, perhaps trying to find a more profound, reflective meaning as well as trying to grasp as much learning as I can from these words. I know from the different psychology classes that I have taken that many of these illnesses have biological root, as well as a psycho- social origin. Biologically, we may have a predisposition to suffer from a particular illness. Socially, a particular event, perhaps mostly stressful events, may trigger a mental illness. Psychologically, the inability to analyze one's self and emotions, in a particular situation, may contribute to the suffering and deterioration of the psyche. Therefore, what I was able to learn and get out of this, was that when one is going through a rough time, or is facing a situation that is triggering a particular emotion such as being irate, or extremely anxious, etc, one should take a moment to analyze one's interior state and the surrounding situation. By doing this a person may find that things are dealt with better by finding more adaptive techniques or approaches and breaking rigid patterns that may be putting in danger or aggravating an already sensible psychological state. Based on this, I come to believe that the power to stay sane is in one's self.

Another member, as he was narrating to me the story of his childhood, said to me: "loneliness is a dangerous thing." These words made me remember the words from one of my professors. I remember he told me that there was a difference between loneliness and solitude. He told me that loneliness triggers sadness and depression, and a feeling of being empty inside. On the other hand, he explained to me that solitude, was the dialogue that we has with one's own self, that brings about self knowledge, self understanding and self contentment. With all this in mind, I come to realize once again, that one should not depend on other for one's well being. Certainly, we are social beings, and we need human contact, but one should not develop a dependency on others to feel that we are well.

Particularly, I have chosen to write about these two things since they remind me the importance of analyzing one self to be in control and well. Other than that, I can only say that as the days are passing by, I am learning how to better deal with these persons, and it is definitely an experience from which I can learn by just listening to what these persons have to say.

 

 Journal # 3 :

 

 

This week was my second week working at Fellowship. In these two weeks, I can say that today was specially a good day. By this I am not saying that the other days have been bad. However, today was the first time I was able direct the group members by myself, without needing the coordinator's help. Having kept the members focused and concentrated for thirty minutes in the activity made me feel very satisfied and proud of myself. I kept on thinking - after the group activity was over - "I did it!" All these days, whether on group therapy or group activities, it has been so difficult to keep the members focused and interested, that at times I have felt frustrated. At times, I even think that they are like kids, who get rapidly bored or distracted, and they are not able to stay put in one place or keep their attention on one thing. However, when things have not turned out well, I tried not to be so hard on myself, since I know these persons are not "normal," and they probably do not have the same attention capability for example, in contrast with someone who is not mentally ill. Nonetheless, I wish I could leave everyday after doing my hours in Fellowship, as I did today.

Even though today's activity was quite simple, I did notice something that I had not been aware of before: these persons are extremely concrete. Specifically, the activity we were doing today was "pictionary." I notice that when the members had to draw a particular object, they had no problem sketching it. However, when they had to depict a situation or event in a drawing, they were not able to do it, unless they were told exactly what to draw. This observation was reaffirmed later on the afternoon during a meeting we - the interns - had with Ms. Dougery.

During our meeting with Ms. D., we discussed our doubts and feelings toward the members and the situations that occur in the different groups. I was glad to know that I was not the only one who gets annoyed every now and then with the members. Ms. D. explained to us, that she sometimes too, she gets annoyed by some of the patients since some of them constantly repeat and come to you saying the same thing over and over again. In a way, it eased my "guilt."

 

I constantly wonder how the brain, especially of a schizophrenic, works. As strange as it may sound what I am about to write, sometimes I have even wondered how would it be like, to have the mind of a schizophrenic just for one day, and then after that come back to being my normal self again. The only reason that I have had this thought is because I wish I could truly understand how the mind of a schizophrenic works. Many times I believe that there is so much more to things and situations and in this case this to this particular illness, that I wish I could wholly understand it. Perhaps that way I could know why is it that some of them just repeat things over and over, and what are these sensory "things" they claim to "perceive."

I will definitely be learning more about this illness in the case study that we have to present to Ms. Dougery. I am looking forward to that, because I will be able to get further insight. I have picked the member on whom I will be doing the case study. He is a high functioning schizophrenic member, according to his diagnosis. I am constantly surprised to know how these members know about the fact that they are ill. However, I wonder if they know exactly what they have. This is one of the things I will find out in the assessment I will be making for the case study.

On the mean time, I am trying to ask and learn as much as I can. I believe also that I am getting better in the way I am handling the situation with the members and how I direct myself to them. I believe it is just a matter of getting used to the whole situation. Surely, I will be getting better at it each day.

 

Journal # 4

 

This week at Fellowship House has been quite interesting and perhaps a little bit tiring as well, but definitely interesting. This week I did my case study assessment on one of the members from the Hispanic-I workshop. I have to say that I felt a bit uneasy since I was going to be asking this person some "delicate" questions regarding his mental disorder. I guess I was, to some extent, insecure that my approach would not be right one. Obviously since my goal was to get as much information as possible, I did not want the member to feel uncomfortable with me and with the way I had structured the questions. However, today during our meeting with J., without her knowing that I already had done the case study assessment, she gave us some pin pointers on how to structure our questions; I was glad to know I had done it the "right way", that is, ask a close ended question first, followed by an open ended question concerning the same situation as the close ended question, thus allowing us to further delve into a particular aspect of the person. Nonetheless, it all went well.

Definitely, the case study was the most relevant aspect surrounding my work experience at Fellowship during this week. Initially, when I asked for the member's consent for interviewing him, my offer was rejected immediately. The member told me that he was not ready to answer questions regarding his past, since he had gone through some difficult and hurtful experiences, and he did not wanted to look back and reminisce on those experiences. However, when he said this, he had no idea of the type of questions that I wanted to ask him, so I told him "give me a chance to explain to you and give you an example of the type of inquiries that I will be asking you." After explaining to him that I just wanted him to tell me a little bit of why he was attending Fellowship, and that sort of thing, he acceded; I felt relieved, I really wanted to do my case study on him, and I did.

This Wednesday, I sat down with John - that is the member's name - and I did my assessment. I followed the format that J. gave us, so I started by asking him some questions regarding demographics: age, occupation, residential status, etc. After that small segment of questions came the section of questions I was edgy about, that is, the issues enveloping his mental illness. I was crossing my fingers that he would be really open with me, and he was; I was really surprised and happy of course, because in a way I felt that he answered my questions because I inspired a condition of trust between him and I.

While he was talking to me, I did a lot of observation, which is common of me. I noticed that when he was comfortable talking about a specific issue, he would look at me directly in the eyes. I noticed that he felt really at ease talking to me about his mental illness, and his symptoms, and the medications that he is taking. However, when I asked him about his family and how they help him and support him, in regards to his condition, he would avoid looking at me, and he would answer really quickly, without letting me in on too many details. I guess that I struck a cord of pain in him and he did not want to talk too much about the subject. I completely respected that, and whatever doubt I was left with, I asked my supervisor.

It was definitely interesting getting to know some more about John's mental disorder, which is schizophrenia. It was amazing the insight he made regarding his illness; he knows that the voices that he hears and the people he feels are surrounding him and looking at him (paranoia symptom), are all in his mind, as he said to me.

I have to say, that a lot of energy - maybe emotional energy - but definitely energy, is required from my behalf in listening to these persons, not only in the case study assessment but also in group therapy. That is maybe why I come home sometimes feeling somewhat tired, because a lot is invested in working with these people. However, I feel it is worthwhile, because I am learning and I am becoming sentient of a social reality that I was not aware of before this course.

 

Journal # 5

 

 

This week at Fellowship went well, like every other week. Actually, there has not been a week where I can say things went badly, because they have not. The only thing that I can say is that I have become aware of some changes within me and with the patients - specifically the way I react to them now, as well as the way the react towards me. I can now say that I am no longer uncomfortable being by myself and being myself with the members. At the beginning I was pretty terrified at the idea of staying alone, guiding the workshop, if Julia was not there. Particularly, this week there was an emergency with one of the members. I. - one of the members from the Hispanic I workshop where I am working at - fell flat on her face because she did not take her walker. She had a pretty bad cut on her jaw so Julia had to go with her to take of the situation. Exactly when this happened it was time for the group activity with the members. Julia asked me if I wanted Nelson - another person of the staff from PSR - to be with me so that I would not be alone with the members. Immediately, I said "no;" I really did not even think about it. I directed the group activity by myself, and while I was at it, I noticed that I felt comfortable and confident; I was not uptight, in contrast to how I felt the first days and perhaps the first two weeks or so. Unfortunately, this change within me has been quite slow. It has not been if not by almost the end of this course, that I am now getting adjusted to the environment in Fellowship House, and better accustomed to the social dealing or treatment with the members. Nonetheless, as the aphorism says, "better late than never."

In regards to the members, they now respond much better to me when I am in charge of directing group activity or therapy. I actually know that they are now habituated to my presence. This I know because they let me know that. Some of the members come up and ask me how much longer I will be working in Fellowship. Obviously, I tell them, and then I ask them why they question me about that; they say that they have now become used to my presence. They explain to me that it is hard for them to become habituated to other people who are evidently unknown to them. In another case, another one of the members, when it was time for him to leave, said goodbye to me, and then came back and peeped into the room and asked me "are you coming back tomorrow?" and I said "no, I cannot come tomorrow, I have a class trip tomorrow" I really do not know what word would be the exact one to adjectivally describe his facial expression, but I know I saw a particular air of disappointment in his face. Julia then told me "oh, you just crushed him" and I said to her "don't say that, you're going to make me feel bad." In a way I felt bad, but on the other hand not really. In a way, I was thriving for this, to reach this point where there is a good rapport between the members and I. Perhaps I wanted them to see in me, what they see in Julia, who is someone they trust and they can approach her with confidence to talk to her about whatever is concerning them. Trustingly, I can say that this is the type of affinity I believe I have come to attain with the members. There is in me, a little bit of this feeling of success that makes me feel good.

Other than what I have written so far, I can say that they are looking forward to the picnic that we are taking them to, this week. They are all excited about it, especially about the food, so today - June 13th- I went to the supermarket and bought them a bunch of really good stuff that I am sure they are going to like. I believe the picnic will do some good to them, I do believe it is necessary that they have their time of social recreation outside the facilities of Fellowship and outside there homes, where they have told me they spend the majority of their time. In part, I guess this accounts why the majority of the members during group therapy express constant feelings of loneliness and depression. Hopefully they will a breather with the picnic and distract their minds from their monotonous routines.

 

 

Journal # 6

 

My days at Fellowship House are coming to an end. One more week of work, and after that, the experience will conclude. I am not sure if I will miss it or not; I still have mixed feelings about it. Sometimes, like right now that I find myself writing my journal, and I have to reminisce on the experiences of this week, I definitely feel that I will miss being there with the members. At other times, however, I feel the exact same opposite. I do not think I will not be missing group therapy, which was quite an experience for me you see. During all these weeks that I was there, I really could not manage not to feel affected in some way, by the feelings and stories that these people told during therapy. I remember feeling at times that I did not want to be there in therapy, because I, myself, began identifying with some of the feelings that came out to light during therapy. I guess I just was not able to desensitize my emotions during this experience, although I did try everyday, but it is just my personality, and I cannot change that. At other times I felt that I was not suited to listen to their problems, because at moments I just thought "I have my own problems to deal with." I guess, in a way, they are my own unresolved problems within me, and for sure, that does not allow someone to be in the best shape to give therapy. I guess I now come to better understand the words of one of my professors in Guatemala, who use to say to me, that for someone to be a good psychologist and therapist, one has to first try to tackle and solve one's own problems. Nonetheless, the experience was insightful for me, because, I came to realize that I am not suited for a job in the mental health field, because of all of this that I just mentioned.

There were some good things, however, that I did accomplish during my internship at Fellowship. Some feelings that I was able to overcome, like for instance, at the beginning when I started working there, I felt uneasy or just plain weird, in being around these individuals, which the majority have acquired a peculiar physical aspect, due to the illness and the meds, etc. However, after some weeks of working there, I just became neutral to that sight, and just that allowed me to become better in managing group activities, and in a way also getting them to habituate to my presence. That was actually a good thing that I achieved. I guess that at the beginning, due to my uneasiness in being around them, the members perceived that, and as it is normal, responded to that and perhaps they felt exactly the same way with me. Perhaps, they saw me as someone just alien who was invading their space, and to them I had no business being there, or telling them to stay quite when they were talking too much during group activities, or whatnot. With this, I came to perhaps discover that these individuals have developed an acuteness in their senses - perhaps due to their mental illness - and they are able to perceive subtleties in others that the majority of us who are "normal" do not perceive in others or just simply ignore or do not become bothered by it, as for instance, the uneasiness in me that I mention above.

On a final note of the internship, I cannot finish this journal without saying a thing or two about the picnic, which was my internship project. It went really well, the members were really happy. They walked around the park, they talked, and danced, and ate a lot, since there was a lot of food, which took quite an amount of hours to do, but was well worthwhile. They were actually stimulated simply by just being around nature and in the outside. I was actually able to tell that they were stimulated, because they were talking a lot. One of the members, when we got back to Fellowship House, was on a roll, he was just, talking, and talking, which was great because I guess the picnic cheered them up, and that was one of the purposes of the picnic.

That is pretty much what I have to say for this journal. The experience was great for me, because I was able to further get some more insight into my own self and feelings, and I believe that if there is one thing important in life, is to get to know one's own self. For the members, I have to say that I really feel for them and their troubled minds, it must be extremely hard for them to live day to day with their psychological condition. Finally, I have to say, that I really admire and respect the work of all those who go into this field, because their passion to help others who are so troubled, in my belief, is of a true altruist.

 

 

 

 

 

 

 

Journal (5th Week)

Journal (5th Week)

            After five weeks of work at the hospital everything looks pretty common and normal, my feelings this week are that even though my presence there is part of my learning experience I don’t perceive it that way now, it has become a routine and nothing impress me that much, I guess that is because now I understand that mentally ill patients express the same patterns (or symptoms), and that is not a “weird, intriguing and mysterious state of mind” as I was used to say before.  Those symptoms are shared characteristics among all the patients within every particular disorder; I guess I have my feet on earth now.

Last week the size of the group reduced dramatically, there are only two patients left, which has help us to get closer to them and has help them to trust us a little bit more.  During a group therapy session, all patients expressed their feelings about acceptance, it was a great topic for them, and they all participated and uncovered their feelings.  After the group, one lady, whom I will call “J”, went to her room and started crying, we called the group to take them for a walk and “J” didn’t want to go.  After her friends insisted she decided to come to the park.  On our way to the park she told me if she could talk to me, of course I said yes, and she began to tell me why she felt depress.  The group had reminded her of her past and so many things that she considers wrong.  “J” had an abortion when she was 18 years old, she didn’t tell the father, and when he knew he was really mad at her and left her.  “J” feels guilty about her past and what she has done.  We talk about not feeling guilty but responsible for the things we’ve done, and

especially we talked about living the present.  The past is unchangeable, but your present can be manageable and make our feelings and thought work in favor of our present.

            Among all the things “J” and I talked, she mentioned an incident that is related to the research process going on at the Hospital.  During the same group session, one of the patients said that he was HIV positive, which scared “J”.  She told me in the same conversation, that he had sex with another guy from the Segal study at the hospital, and that she was afraid that that guy, who had already left, was HIV positive.  I don’t know if that is true or not, or if it is part of her delusions.  For me, it was shocking to see how many difficulties and challenges researchers have to go through when experimenting with people, it is so much care that has to be given to the subjects.  Another ethic question comes to my mind, how far should researchers go to control subjects’ behavior in a study, and how close should they look to these people’s behaviors in order to get accurate results in any type of research involving human beings?

I would like to share also, my feelings and ideas about the recreation room.  I had never think of recreation as a good therapy to mentally ill patients.  When I went for the first time to the “rec room” as they call it, I had this great sensation that it was the different, colorful, and entertaining place that gives hope to these patients.  It is great to see how productive (artistically) they can be at this place.  It is awesome to see how a person that cannot stop shaking his legs and rubbing his hands, go to this place and spend half an hour and sits calm, and paint a pot, or ceramic; the feeling to see this people working their minds and though toward constructive and positive behaviors fills me with hope, and gives me the idea that not everything is lost, something inside them can is working toward getting out of the trap of their minds.

It was a great week for me, but as I mentioned before it was disappointing to see how my perceptions of these disorders and these people have changed to a more systematic and medical point of view, I guess that is the only way to work and prevent that my own feelings hurt myself.