My first real job was as a rehabilitation counselor on a substance abuse unit. I was totally green. I knew little about addiction treatment. And I was working with some really tough people, and I mean both the patients and the staff. One of my responsibilities was being case manager and primary therapist to several clients.
I was assigned to work with Chick. Although he was young, in his mid-thirties, he had become a severe alcoholic. The unit adminstrators must have figured I couldn't hurt Chick, and maybe I might help him. In other words, they had nothing to lose by assigning him to me. Chick was a Viet Nam veteran. He had been badly shot up during the war. As a result, he was partially paralyzed on his right side. He walked with a limp, had little control of his right hand and only minimal movement of his right arm. Chick had come from an upper middle class family. He had been somewhat pampered in his early life. Before the war he had been an artist. Now, because he was right handed, he was told he had to give up art. His early life had left him unprepared for war, much less the debilitating injuries which he now faced. Alcohol drowned the lost artist.
We worked together for only two months I think we really enjoyed each other. He was extremely likeable and very funny. I'm sure he thought I was naive. From his viewpoint, he was right. My experience in life could certainly never measure up to what he experienced in battle. But therapy wasn’t going to take away the damage.
He used to joke with me about my being young and unathletic. This used to get under my skin, even though I knew that it was his projection of his poor motor skills. In an effort to get under my skin, one day, during session, he challenged me to arm wrestle him. I accepted. It took me a while, but I pinned him. Then I had a thought, and I challenged him to a rematch using his other arm, the right, weakened side. First, he refused. He accused me of taking advantage of him. Then, being a good sport, he agreed. Despite his poor coordination, he gave it a good effort before I again pinned him.
After I released his hand, he sat back and stared off into space for a minute. Then, for the first time, he began talking about the paralysis. I can almost remember his words verbatim. He remembered waking up in the hospital bed in Nam. He was badly injured but minimally sedated. For the next few days, he was not allowed to move, he remained in bed with nothing to do but think. The nurse offered to help him write his family. Finally, he dictated a letter to his brother describing what had happened. He described his arm and leg. When he started to describe his hand, he broke down into tears. As I watched him now, I could see that he was beginning to tear. Then, as quickly as he had begun the discussion, he tried to change the subject. I responded, "Don't think about your body." This comment forced him to think of his body for several more seconds. Then, it slipped away again. “Chick, don’t think about your body.” Once more I returned him to thinking about his body, by telling him not to think of it. Then, the moment was lost. My third attempt failed to take him back there. I hoped that sharing this pain would be beneficial. I felt good about the session. At least for those moments, I had helped him connect with his pain. I had no idea the effect this would have on Chick.
That night, Chick eloped from the hospital. He snuck out after hours and went into town. He proceeded to get roaring drunk and the police were called to contain him. When the police arrived, he broke a beer bottle and attempted to assault one of them with it. In restraining him. they broke his left arm. The next morning I again found Chick on the locked detox unit with his left arm in a sling. He now had both arms incapacitated.
For several days, Chick proceeded to tell everyone, "See what happens when you work with Boylin." Of course. I responded, "Yes, I am reponsible for your drinking, getting you arrested and having your arm broken." I tried to deny feeling any responsiblity, but I did have some guilt. However, a funny thing happened. For the remainder of the time I knew Chick, which was over eight months, he didn’t drink. He was on the road to recovery. He landed a job and was discharged from the hospital. He stayed on this course as long as I knew him.
I’ll never know exactly what happened. I think I understand it. But it is difficult to explain and difficult to teach. It can’t be learned by copying. A therapist has to be able to go inside and find their direction. They have to be able to trust themselves and what is emerging within them.
