Saturday, March 25, 2017

The one you hate

The one you hate

"There she was in my group, 40 minutes late but a week early for our scheduled appointment. Group days are always hectic but I fit her into my schedule thirty minutes before lunch because we had a few things to go over before she met with the team doctor and she had  to keep her last scheduled appointment. She hijacked the group immediately giving her peers unasked for advice and complaining about her roommates in treatment until I cut her off and dismissed the group. One on one she complained for 40 minutes about the incompetent care she was receiving adding it was not necessarily my incompetence she was referring to while clearly sending the message that it was. I know this game well so when I was satisfied I had given her a fair say I redirected the conversation to her goal and trying to break them down to manageable objectives. she parried by switching the topic and refusing to commit to any course of action. I confirmed the date of her doctor's appointment and that I would provide transportation before she left.  A week later she didn't answer my calls, didn't show up at the agreed upon meeting place and missed the appointment then showed up the next day at my office angry that she was making no progress."

In close to five years working in the the recovery field most recently as the substance abuse specialist on a community mental health team I am happy about the direction of my life. I wake up in the morning tired but I don't dread going to work, I look forward to it. My favorite part of my job is the face time with clients and as a rule the more I get the less tired I am at the end of the day. But every now and then a client comes in that makes me dread the upcoming appointment and I even wish they wouldn't show up. Sometimes it's because they are negative, sometimes they are just plain mean, and it's hard to see if I'm doing any good at all. At past jobs I had the reputation of being able to manage the "difficult" clients. I'm not certain that reputation has followed me to my current position where the people we work with are often struggling with profound mental illness and the percentage of "difficult" clients is much higher. I can honestly say that while sometimes I do dread an upcoming appointment with a client I have managed not to hate any of my clients. I'm no saint but I've found a few things to keep these challenges from getting me down.

While it's okay to blow off steam it's not okay to be openly disdainful of a client. Even if it's just among friends and colleagues 

A client can be so frustrating that you need to give voice to the complaints burning in your gut to a supervisor or trusted colleague but don't let it go on for too long. Nobody gets paid to do an easy job, a miner doesn't get anywhere by complaining about the stone and I don't get anywhere complaining about the symptoms of disorders who's very existence provided me with employment. While Goodwill Hunting moments of tears and hugs do happen from time to time most of the time change takes hard work an a lot of time for us and even more for the clients.

See past the symptoms to the pain.

The people I work with are suffering. Often the pain isn't physical (though sometimes it is) and it's hard to see. Isn't that what the unpleasant behavior is for, to hide the fact that they are suffering, vulnerable? The behaviors are frustrating to me but to the client they are isolating and as bad as it is to suffer it's worse to suffer alone. When I can see the clients pain my judgement of their symptoms melts away. It can be a powerful experience when this happens and the client can sense it too. When judgment is replaced with acceptance suspicion turns to trust. It can make all the efforts leading up to it worthwhile.

Just because it's hard to see doesn't mean your not doing any good.

I don't believe that some people "just aren't ready to change." At least not the ones who have managed to come to my office.  They may not be ready to change in the way I want them to, they may not understand what is required to change, I may not have what they need to change, but it's not because they don't want or just aren't ready to change. I strongly believe that if a client is truly getting nothing from our contact they will ask for another counselor or stop coming altogether. It might be that my office is the only safe place for them to be unpleasant or at least the only place they don't feel judged for being that way.


Suspending judgment in the face of a barrage of insults and attacks on your competency and character takes energy, if you don't have any you won't be able to do it. Use those vacation days, sick days if you have to, illness doesn't have to come from a virus. I found I need to see a therapist and do so no less than once per month. Our jobs are difficult, sometimes even dangerous and we need to be at our best to do it right. If you find yourself in this field you care about people. Remember you are people.


  1. For the one or ones that try your patience it is such a shame. It is really scary too Ken. What if (and I am sure it has happened to people you work with or know) get just the jack of being treated badly. Even if it is just by the "one".

    The way some people deal with pain is blame and anger "I want to speak to the manager" "this isn't good enough". I know I have been there. To think I could have risked being an attributing factor for a health care worker, addiction support / recovery worker eventually leaving their job... by simply being chipped away at is a terrifying thought.

    It is not a job you would do for the money and it is a shame that humans react in different ways to pain. It is so cool that you see it for what it is and would be even better if somehow that can be communicated to someone like your "patient".

    One of my bloggers said to me in the beginning of my sober journey that attitude "I want to talk to the manager" was so common with her and it was because she was out of control of her own life. I TOTALLY had a penny-drop moment and have never looked back.

    If I ever am rude or start blaming, I immediately recognise that something in my life is out of control and apologse and start again.

    Hard for you :(
    Michelle xx

  2. Very well said. It's that lack of control, that fear and hopelessness, that bring out such behavior. It can be difficult to remember that in the moment. In the "bring me the manager " moment the best thing to do is get the manager. Try to hear the client, let them know you hear them and be honest about your ability to meet whatever needs they express. Sometimes being heard is all they really need.

  3. Hi Ken!
    I wish I had these words of wisdom when I was teaching my little ones and struggling with the "hard ones". I would get so mad at myself that I wasn't helping them, and yet not understanding some of the changes were happening at a pace I didn't understand, or at a level I didn't understand.
    I know when I am upset, so often I just need to be heard. So true.


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