Hello everyone. Hopefully you enjoyed last week’s post! This is a continuation on that case.

If you didn’t read it, you can find part one below!

As always, the names and other identifying information has been changed.


My experiences in community mental health have led to a lot of emotions. I’ve felt sadness, empathy, frustration, anger and more (sometimes within the same hour). One of the most important takeaways from my work, however, has been personal growth. Peter was the first client that helped me grow both, professionally and personally.

After a few sessions together, we were developing a pattern and rapport. Sometimes I’d meet him at his house (I had grown accustomed to Not-Joe and the disaster site they shared), sometimes he’d be MIA. I would then have to track him down. Some days, he’d be at the office driving the staff crazy, wearing some sort of brace, smelling up the place while telling them all about how he broke his knee or some other limb and/or appendage. At one point, he told everyone he broke his back and had a heart attack! (he never broke his back, nor had a heart attack). This was still early in our relationship, though, and I was still becoming frustrated. But I was also becoming familiar with his behaviors and thought processes. I would open discussions on maintaining our appointments, to which he would reply by telling me “You work for me!” I didn’t take it personally. I was picking up on things at this juncture and learned that responding in kind to these would never get me anywhere. His discussions of surviving injuries were simply ploys to get some positive attention. He yearned for some sort of love or care- he didn’t know what it was like to receive such a thing.

“Be water my friend.” Bruce Lee

Why the corny quote about Bruce Lee? Because it fits perfectly into many areas of life, including working with the severely mentally ill. If I go into a session with a client holding expectations and rigidity, it will be a terrible ordeal- for both of us. This was the first lesson I learned with Peter. When he missed appointments, I didn’t try to force him to meet me how I wanted him to; I learned to meet him how HE needed me to. Sure, when I went into the office to find him, I would be frustrated. Sure, I would also become angry when he told me I was his personal employee. But, I also would feel empathy when I learned how he was being treated everywhere he went; he was a pariah, even at home. His parents abused him as a child. His earliest memory of this was an attempted drowning in the bathtub when he was six years old. He was mistreated his entire life, and learned to live in that space. He was comfortable in poor relationships because they were all he knew.

His roommate(s) often took advantage of him. I would witness them coercing him to use his money for their gains, pay for everyone’s food, and more. Why did he do it? He was getting the attention he never got. Spending all his money, or being taken advantage of was still better than being beaten. He didn’t think he deserved better.

One day, I noticed him struggling more than usual. He was genuinely sad. Peter hid his emotions well, he’d learned to use anger and posturing as defense mechanisms. But he was experiencing some delusions and more intense symptoms. He didn’t refill his medication because he didn’t have the money to pay the one dollar copay- his roommate convinced him to “lend” him the rest of his money to buy beer. He ran out medications some days prior, and he became increasingly confused. His thoughts were convoluted and clouded- I could see the wheels turning too much for someone as intelligent as he was. We had a long session- I spent over five hours with him that day. Finally, after exhausting every avenue, I decided no human being’s life should be so damaged over $1. That evening, I took him to his pharmacy, and paid the copay- even though it was strongly discouraged to pay for any client’s expenses. On the way home, he cried. I didn’t speak, letting him maintain some sort of pride. When we stopped at his house, he thanked me and smiled. It was the first time I felt genuine care for him. Walking up to the front door, he turned around and walked back. I rolled down my window. He leaned in, smiling.

“We should go to CiCi’s pizza tomorrow.”

Even water has limits.