Colleen Beardstroker wakes at 7am for her yoga class. She has found that starting out her day with a relaxing activity helps alleviate the stress and anxiety associated with her job. Also, the dopamine released during her workout gives her a boost.
By 8am, she is ready to start her workday at a behavioral health non-profit clinic where she is the clinical psychologist manager. Nancy, one of her fellow psychologists, walks into Colleen’s office and sinks into the couch.
"What’s wrong?" Colleen asks. "Bad day? It's only 8:15."
"I know," Nancy says. "I have an especially difficult patient coming in this morning. He keeps going off the antidepressant drugs his psychiatrist prescribes him as soon as he feels the slightest bit better. It's really depressing."
Many people see a psychologist and psychiatrist at once. Because psychologists can't prescribe antidepressants, they may be referred to a psychiatrist to obtain proper medication while continuing to go into therapy.
"That's pretty normal. I mean, one in ten people take antidepressants. Not everyone experiences any benefits. What is he depressed about?"
"Global warming. He wants to be able to cook a burrito by laying it on the sidewalk once in his lifetime. He's upset with people's efforts to save the ozone. You may see him in the hallway sometimes. He's the one wearing the "Ozone Shmozone" t-shirt."
Nancy just started interning for the non-profit as part of the requirements for her doctoral degree. During her internship, Nancy sees patients, attends training classes, conducts group meetings, participates in stsff research projects, and writes patient assessments. She also complains on an almost daily basis to Colleen, who feels that Nancy may be just neurotic enough to make it as a psychologist.
"Let's chat more about your assessment of the patient at the end of the day," Colleen suggests as she looks down at her watch. Nancy mumbles an "okay" and shuffles out of the office.
Colleen's first patient is a woman named Gabrielle. Gabrielle has been seeing Colleen for three months, ever since she left an abusive marriage. The mission statement of the non-profit states that the clinic strives to empower people so that they can live independently. Gabrielle is making a go of it after moving out of the woman's shelter. Their clients include women getting out of abusive situations, children coping with stress, and those who moderate mental illnesses.
Colleen and Gabrielle chat for a few minutes about her progress finding a job.
"Sometimes I feel like people are looking at me like they know what I've been through," Gabrielle says.
"How do you feel when you think about looking for a job?" Colleen asks.
"My stomach is all in knots," Gabrielle says.
Colleen scribbles away on her notepad. After every session with a patient, she writes case notes, which document what transpired in the hour-long session. In addition, case notes provide a clear outline of the services provided by the clinical psychologist to the patient. Psychologists must be able to identify the mental needs of the patient and what they can do to facilitate these needs being met. Unlike psychiatrists, they can't just give up and prescribe a bunch of meds. (It should be noted that psychiatrists, while they are able to, shouldn’t prescribe meds willy-nilly. They've got some pretty stringent responsibilities of their own.)
Colleen asks Gabrielle to think of some methods she can use to help cope with feelings of anxiety. Gabrielle lists some meditative methods that she recently learned in a group session. Colleen agrees that closing her eyes and breathing slowly in and out while listening to soothing music is a good idea, but feels her alternate method of driving her Ford F-150 through the wall of her ex-boyfriend’s house may be slightly less productive. After the hour is up, Colleen says good-bye to Gabrielle and writes up her notes.
At noon, Colleen has a meeting with her colleagues. They discuss patient assessments and treatment plans. When the meeting concludes, Colleen signs off on her colleague’s clinical reports. She takes a quick lunch break at the park adjacent to the clinic.
Because of her busy days, Colleen savors the brief quiet times she has during which she is able to unwind. She remembers her days working at a private practice. While she had a busy schedule of seeing patients, she had much less responsibility. Even though her current job is stressful, Colleen feels like she now makes a difference to many more people’s lives. The interns that she trains go on to become licensed psychologists who will go on to train other interns. Under her supervision, clinical psychologists are able to discuss different treatment options and conduct their own research that can help other people suffering with mental illnesses. Plus she is now much closer to a Pinkberry.
The rest of Colleen's afternoon consists of supervising interns' patient sessions to provide feedback and support.
She steps into her office to see a patient who is overcoming friggatriskaidekaphobia (the fear of Friday the 13th).
"Hi, Michael. How do you feel today, it being Friday the 13th? You’ve come a long way."
Michael shifts uncomfortably in his seat, "Yeah, I hadn't noticed."
"Are we feeling a little abnegation about today?" Colleen asks.
"Oh yeah. Big time abby negatively. This is the first time in ten years I've been out on a day like this. I know that millions of people suffer from this, but it doesn't make me feel any better."
"Our minds associate events to different things. You've associated your mother leaving with this date and now you believe that it is unlucky or unsafe for you.”
Michael bolts up from his chair. He walks quickly past Colleen and goes to the window. "Did you see that? I think I saw an owl in the window. There's a black cat near my car. What is this?" he says while pointing to a ladder leaning against the wall.
"I was changing a light bulb," Colleen says while busily writing in her notes.
"This is a set-up by Friday the 13th. You are in on this. I'm getting out of here while I still have a bit of luck," Michael says, racing out the door.
"Michael, next appointment we need to talk about your paranoid delusions."
Meow. Ahem. Roar.
She hears him yell, "See you next Friday!"
By the end of the workday, she is pretty worn out. On the way to her car, Colleen sees a patient who she used to counsel when she first started working for the clinic. Denise had a troubled childhood bouncing from foster home to foster home. Her chaotic past left her with severe anxiety problems. Colleen worked with her for a year before Denise set out on her own three years ago, determined never to set foot in a foster home again. Nor did she ever want to patronize a Foster's Freeze. The association would simply be too painful.
"Hey Denise, how's it going?" Colleen asks.
"Hi, Dr. Gist. I'm great. You will never believe what I'm doing right now. I'm here to apply for an internship! I've been in school the last couple of years getting my psychology undergraduate degree."
"Wow, I'm so happy for you! Psychology, huh? What are you, a mental case?” Ordinarily, Colleen would never employ such terminology, but she and Denise could always joke around like that.
Denise laughs. "This place allowed me to really turn my life around, and you are part of that, so thank you," Denise says.
Colleen and Denise talk about the program for a few minutes. As Colleen pulls out of the parking lot, she thinks of the transformation that Denise was able to make. She completely forgets about her own fatigue and stress for the time being. At least until she ends up behind a guy going 15 mph under the speed limit on a one-lane street.