TW: Violence/Suicide

Being a therapist is a difficult role to define. In some ways, you speak in metaphor because speaking to human experience can be better understood in symbolic rather than literal terms because of the intangible nature of human experience. You can bear witness to someone's experience. Your ego can be used to provide a protective environment in which your client can explore, emulating the holding environment that a loving parent provides their child. You can be an informed facilitator, providing the kind of knowledge and power that provide someone with the tools to enact the change process in their own life. Your job might be to allow enough care for someone to follow their own path to change. You can pursue humanistic ends to promote self-actualization, often in an uncaring and oppressive realty.It's a role with a measure of power that works best when you take your own ego out of the relationship. You are important but you are always secondary to the work that your client is doing.

The role becomes palpably confusing when you confront the real human costs of despair. It can feel like the world tilts slightly off its axis and because of the constraints of your own role, you have to remain silent, cut off from normal human experiences of grief and mourning.

I can't go into the details and tell you all that I experienced and heard and thought during this past couple of months but it does bring up another metaphor, one that I only talk about with other clinicians because I feel like they can really understand without judgment.

I spent a lot of time doing home visits. Walking into unknown situations in unfamiliar neighborhoods to help people who often viewed me with a deep level of ambivalence. Most of the time it was either mundane or you had the warm feelings of real connection, like you really made a vital difference. It sounds terribly silly but in the moments that you make a profound connection and feel the emotion in the room, it's like kismet. It's like falling in love. It's strong, it's real, it's humane and gives life meaning.

But there are more unsure spaces. There are dangers. I can tell you the obvious ones. I knew a colleague raped by their clients while their coworkers were in nearby offices. I worked with someone who intervene with a long time client and was stabbed repeatedly. A former clinician (who left before I started at one of my jobs) was murdered by her client. I've never been physically assaulted, save one near miss and a few indecent exposures. I've been lucky. But I walk around knowing that there is some reasonable danger. You have to have a level of audacity to be a social workervand maintain your humanity in an unsure situation. You have to be aware that these are risks but that physically, like emotionally, you are willing to go where others might not, all armed with the hope that every situation can improve and a universal positive regard for all of your clients.

So it's always sad when you confront real despair. Everyone who works as a clinician for any reasonable period of time will work with someone who commits suicide. I can't give details. I'm a silent witness in a role that only works because I don't betray confidences. The intimacy is possible because of the trust and privacy that the role entails.But not too long ago, someone I treated killed themselves and I am left with sadness and disappointment. There is always a sliver of wondering if somehow I backed away, I said the wrong thing, I misjudged. And for that person, I was their final disappointment.

I'm pretty strong. I understand I don't have the power to determine what someone does with their life. I've probably seen at least 2000 people in total as a clinician. I have context. I have confidence. But like any clinician, there is always that thread of doubt.