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We met Antonio in the first vignette. He had been experiencing agitation and his girlfriend, Antonia, urged him to seek counseling. Working in the health field and being familiar with lots of local people, he chose to seek treatment further away. He Googled and found me. Due to his tight work schedule, we chose Saturday to meet. He had a "blow-up" recently.
He wanted to meet me before discussing Antonia's participation in possible future sessions. I asked him to provide a picture of what his agitation looked like. Antonio felt initially "embarrassed." He'd never had mental health counseling. He has a story to tell. Intuitively, I made allowances for what might be a build-up of years of emotion.
Was Antonio ready at session one to face the nuance? The analogy of a chapter book offered Antonio a choice to offer chapter one, not the entire book, so-to-speak. Did he or could Antonia pinpoint an experience that set the proverbial wheel in motion?
Antonio pointed to age nine.
"My life took a turn for the worst. I felt like I was struck by a bolt of lightning."
Before he might open up, I explained the concept of privacy and confidentiality. Additionally, I explained my professional 'duty-to-warn' as it's called if Antonio referenced any self-destructive, destructive crime or abuse. He was certainly affected, and I needed to allow Antonio to move at his own pace. I needed to gauge how much he might open up to and an immediate effect on him. We want clients to relate their story; however, when telling their story, especially when weighted down emotionally, this experience can be trying. Allowing for small bits to emerge can be helpful, healthy, yet risky.
Antonio's body went into convulsions and was shaking. Tough to watch, tougher for Antonio to experience. I reminded myself what a health practitioner once told me. The body holds onto memories. It's like a storage unit. Antonio's remarkable body movements carried arguably a powerful message. Something occurred at age 9 or 10. Now at age 26, I could only surmise how much he'd built up. He then cried and that morphed into laughter, both unsettling. His outburst lasted for several minutes. He gradually regained some composure. He was surprised at his experience, which "wiped me out." A race runner, he'd experienced a different kind of 'exhaustion.'
He "...felt different feelings." They included by his report: anger, sadness, shame, and confusion. He then added that during his bodily shakes, he'd had 'a vision.' He saw a man "touching me inappropriately." He recalled the man telling Antonio "Not to say anything to anybody." He wanted to leave. I assessed him for any immediate danger to drive home right then. We made another appointment. He wanted to sit for a while in his car and "listen to music. That will sooth me." I fervently requested that he call me when he returned home, as well as the next day. I asked him, additionally, to maintain contact.
A call from Antonio came from his car after he calmed down sufficiently and confidently drive home. He called later from home before resting in bed. He called the next day to report being shaken by the experience. He said he rested enough to go to work on Monday. He texted me for a couple of days that he had recovered enough to temper his emotions. He'd see me on Saturday.
I got to work early. I sipped my tea. No call from Antonio plus...he was 10 minutes late. He did, in fact, arrive alone.
"Sorry I'm late. I stopped for coffee. The line was busy."
How are you, Antonio?
"I feel tense. I don't feel destructive or anything like that. I toughed it out at work. I struggled to sleep. I figure that might be normal for now. Hope it get's better. I don't seem to have much of an appetite. I do need coffee. I found that my intake has increased. I had to get through the week of work. I do want to say that what I experienced last Saturday was hellish. Antonia and I talked that night until she fell asleep. I couldn't sleep. I had more to say. She's a real good listener. She let me talk and share. All day Sunday, we went for a drive. She drove and I chilled out. We talked very little, only briefly when we pulled over to a rest stop. I did tell her how rough the session went and how my body went berserk. She did not judge me. I asked her if it was okay to let me come alone today. I didn't check with you."
That's your decision, Antonio. There's ample time to decide when you want Antonia to join us. Just to remind you, though you opened up tremendously, you can dictate going forward your own pace. If you need more than once a week, be it in person or by phone, this is your story to unfold.
"I get it. I don't think I'm ready for another explosion today. Is that how treatment can go?"
Certainly. I'm your support. I can guide you. You decide what's in your own best interest.
"Thanks. Is there something I can do today that will help me, yet be not so explosive?"
Yes, Antonio. Here's some paper and a pen. Take your time. For your session, jot down your goals for treatment. This is for you. It can be modified, if you want, to add or delete. This isn't academics. This is utilizing a tool that can be visual and a reminder. At any time, any day, you can be obliged to write as much as feels fine to you. Any ideas you have for goals can be simple. For example, you mentioned sleep, which commonly is affected by what you begin to describe. You might consider an attainable goal when it refers to sleep; whatever you realize that improves your overall health and well-being.
The last 15 to 20 minutes of the session, Antonio wrote, drank coffee, and took a restroom break. With his consent, I made a copy of what he started. We agreed to meet next Saturday.
Let there be peace on earth and let it begin with me.
Marshall Greenstein holds a master's degree in marriage and family counseling and is a licensed marriage and family counselor and a licensed mental health counselor in New York state. He has regular office hours at 415 E. Sixth St., Jamestown, and can be reached at 484-7756. For more information or to suggest topics, email editorial@post-journal.com.