One of the things I think MSPP doesn't do enough is tell their students how hard goodbyes are. There is no feeling quite like saying goodbye to a client, after forming a firm, positive relationship with them. This is especially true when the goodbye is unexpected. We all know that our Practicum and Internship has an end point. The relationships we form with our clients are very temporary, even moreso sometimes than the ones we'll make when we go to work after our degrees.
My goodbye today was nothing I was ready for emotionally. Even after working in various psychiatric hospitals for the past two years, where hellos and goodbyes are only weeks apart, nothing could prepare me for the emotionally draining experience of losing one of my kids to circumstance. I suppose the first real goodbye is always the hardest, but a part of me wishes I knew how this would go down before hand.
Olivia (name changed, obviously) was one of my tougher clients. As an 18-year-old young woman, diagnosed with Reactive Attachment and Borderline Personality Disorder, she was always hard to get to know. She used to look at me skeptically during those first sessions. They were quiet, made up of small talk and student-bashing, talks about all the kids she hated and why F. L. Chamberlain school sucked. As our conversations evolved, so did our relationship. I'd take her from class and walk, in cold silence, until something in her rose up. We talked about her family, her adoption, and deeper conversations about her friendships and what they meant to her.
This change was so rewarding. She was a client I was nervous about working with, but despite her intensity and somewhat over average angst, we respected one another. She told me during one session that I had a weird way of peering inside of her and drawing things out. She had this smirk as she said it, as though it pleased her that someone could get that deep and wasn't scared.
But today she left.
For so many reasons that are wrong, Olivia decided, a month before she gained her credits to graduate, that she was going to leave. Chamberlain wasn't "challenging" enough. The school was "a joke." And there is that man she's dating now...
I sat across the table from her and just watched this young girl try to defend herself against the school district, against Chamberlain, against her mother, all who knew this girl was tenacious as ever and wasn't going to change her mind. Her argument was full of curses and "whatever"s, adolescent coping skills to beat the better logic of adults.
"Whatever. I don't care. I'm not f'ing staying here," she said. People talked. I just watched her, noticing how she'd changed the color of her hair since I saw her last, how she struggled to walk in the 4" heels her "boyfriend" bought her, and how very young she looked.
The meeting ended at the obvious impasse. No, she wasn't staying. Yes, the school district would send Chamberlain the appropriate paperwork for her dismissal. Yes, the meeting was over. She got up to leave.
"Shouldn't you say goodbye to Ashley, seeing as you haven't yet?" my supervisor asked her.
Olivia and I regarded one another, but she couldn't look me in the eye. I recall her telling me once, don't take offense if I don't look at you when we're talking. It's not meant to be rude. There was so much insight in that moment, back then. But now it just seemed void. She held out her arms and said a generic goodbye, something so bland I can't remember. And this girl, only 18, felt so tiny in my arms as we hugged. I couldn't think of a single thing to say.
"Don't make me worry about you. Be good, okay?"
I still don't think this was the right thing to say. But what do you say to a girl who makes another impulsive decision in a line of impulsive decisions? What do you say to someone who's whole line of defense is "whatever"? What's the "right" thing to say when your the relationship you spent five months building is suddenly severed, just like that?
She said, "Okay."
And then she was gone.
I'll probably never see her again.
I'll tell you what my reaction was: I wanted to cry. I felt a pain so real that it settled in the bottom of my throat and tingled like a million bees stinging my lungs. I had not expected this. Not any of it. With all the talk of her leaving for this "boyfriend," and all the maybe-could-be's, I didn't think I'd see her walk out that door.
I thought I was going to be the one leaving.
They don't train you for this. In reality, I don't think they can. How can someone train you for the heartbreak of losing a client, who chooses a poor path for her future? This is no bad breakup. It's not a solumn "see you later" to a friend who is moving away. It's different. It's hard in a different way.
You could say I learned something. You could say, I'm going to have this experience hundreds of times in a career full of built relationships destined, ultimately, to end. But this first time, (and maybe a hundred times after this, too) changed me as a clinician. I think, in training, we often reap the benefits of positive, maybe even stressful, relationships with our clients. We learn to cope with being loved and hated, with successes and failures. Less often we cope with the feeling of having a client leave us, before we're ready to leave them.
"Man's feelings are always purest and most glowing in the hour of meeting and goodbye." - Jean Paul Richter