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A Shared Team Approach Is 1st Option

We met Mason, a retired nurse practitioner for his first counseling therapy session. His friend, Christian, called to initiate help for his friend. Mason arrived alone. He looked to be physically drained. As Mason began to unfold a vision of helplessness and hopelessness, he conveyed a clear statement of having no suicidal thoughts. He referenced family of origin, siblings, his own children and grandchildren and friends/acquaintances who might be aware of his plight. A common theme representing all groups was him not wanting to burden them. Socially, he reportedly liked sports, which he shared with a friend occasionally. I convinced Mason, a medical practitioner, to sign a release to speak with his PCP. A shared team approach was a good first step in helping Mason. I needed to assess for any medical problems that contribute to his depressed state. Appearance can be deceiving as the saying teaches us. Lastly, Mason wasn’t interested in his wife’s active participation in his treatment. I’ll save that one for later.

Welcome, Mason. Thank you for coming to this appointment. How do you feel? Oh, by the way, your PCP called me. We’ve not yet connected. I plan to call her later. Is that all right? “Yes, Sir. How do I feel? Miserable .. .I feel miserable. I feel no energy. I’d like to go for a walk. I can’t muster the motivation. I used to enjoy walking. I can’t remember the last time I walked for pleasure.” Mason, I’m wondering, if you don’t mind me asking you, did you and your wife talk about your first session? “No, not really.” Silence followed. “Nah, she was busy when I got home last week. I put on a ballgame. We spoke little after that. You know, my baseball team lost. When they win, I get a little pick-me-up. Guess it’s not meant to be.”

Mason, did you speak with your friend, Christian? “Yes, he called me twice in fact. I waited until the ballgame was over. Maybe I can invite him for the next session. Do you think I need to continue coming?” Yes, I do, Mason. You’re depressed. You state that you’re not suicidal. Are you now Mason? “No, I’m not. I just don’t seem to care; to give a s—.” Do you know that you are depressed? “I guess; it’s fairly obvious. I feel like a trapped animal in a cage with no hope for long-term survival.” Mason, that sentiment can be easily misinterpreted. Can you kindly clarify this picture for me?

“Okay. I’m not suicidal; however, sometimes death sounds appealing.” I held the silence and heard my heart beating. Are you interested in seeking an avenue out of your plight? “Gee, I don’t know what that might even look like, sir. Sounds good but is it realistic for me? I hurt real bad.” What hurts real bad, Mason? “Feelings like a lifeless being that no one can help.” Mason, are you open to receive help? Christian made an offering that you accepted. Now you are here. I know you have strengths. There certainly are positive qualities about you. Right now you can’t see clearly given a fog that’s enveloped you. Will you allow for some sunshine to bum off some of that fog, Mason?

Mason took one, two, three deep breaths. He began to laugh. What’s going on here right now Mason? “I had a flash of a most difficult patient I served \Vay back when.” Please say more, Mason. “The patient was a man who presented in my office with a panic attack. He thought he was having a heart attack. His pulse was rapid, his heart was racing, and his blood pressure was high. I called in a colleague. She looked at him and requested he take one breath. Hesitantly and painfully, he complied. She asked him to repeat and to go deeper. I remember that he shook his head. Then she took her own deep breath. I followed suit. She and I continued for a while. Then my patient did it. He took a deep breath, then another, then another. Suddenly he burst into tears like he was out of control.” Mason, are you blocking some deep-seeded emotion and spirit?

Mason repeated his repetitive deep breaths. I joined him with deep breathing exercises. He looked at me and cried and cried like Mount Vesuvius erupted. I offered Mason a gentle hug. He grabbed me violently and held me in close. “Please don’t let go.” Five minutes later, we gradually dis-embraced. I looked into the eyes of a man with a deep vein of emotion. I could only imagine a colony of emotion all tied together. Perhaps Mason’s breaths untangled the bonds just a little. I saw a lengthy treatment ahead for Mason, if he approved.

Still, I wondered silently about his love life. Did he want his wife to come in? Was she interested? Hate to ask. This represents a large question that might need an answer.

The fact that Mason spoke little of his wife, were there problems? Did they support each other in their golden years? 1 know nothing of her. 1 think the pace of treatment was dictated by Mason. Took much too soon. 1 didn’t want to overwhelm him any more than his current state.

Mason, how do you feel? “I don’t know. Maybe a little less confined.” I’d like to see you again soon. “Sounds all right to me. Maybe I’ll ask Christian to come.” Let there be peace on earth and let it begin with me.

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