Tuesday, December 14, 2010

I am an excuse

I still take a few hours away from tossing the sleeping child around to keep my practice going.  It is the holiday season, and who would want to miss hearing about all of the family dramas that occur this time of year when families gather to rip open old scars, and bleed out of old wounds.

But before I get into tales of toppling Xmas tress and inter-familial lust, I want to comment on a phenomenon that has been rapidly increasing:  that is how people and agencies use me as an excuse.  I find that in the last two years I have been writing more letters for people than ever before.  Having a psychiatric diagnosis, or being in therapy, can open doors to more services, or close doors to scary places.

I write letters to probation officers, to tell them that their wards are benefiting form "Anger Management." I also write letters to the court  for people who don't feel they can serve on a jury. Panic attacks or PTSD, will certainly free you from that civic responsibility.

I write letters to allow undergraduates to return after a semester of bad judgement -- drinking, fighting, stalking, missing classes, leaving classes, not finishing assignments.  These lapses can all be forgiven if you have ADD, depression, panic attacks, a substance abuse problem, an anger problem, or just "problems."

I write letters to get people out of work, and then get them back into work, using pretty much the same letters I use for people going to school.

With the terrible job situation, more people are applying for disability, because really, there are no jobs that many marginally adjusted people can cope with these days.  Car mechanics, laborers, and other semi-skilled or unskilled work has become mush more complex and much less available than even fifteen years ago.  Machines can do most of what people had once earned $12 to $18 an hour to do.

In many ways these schools, agencies, institutions and individuals are all just passing on the responsibility to me.  No one wants to make a decision about who is just not acceptable, or who can be re-classified as "unable" and therefore reap some kind of benefit.  I don't really get to make that decision, I get to be the cover for it.

Usually, I make a concerted effort to give as accurate and descriptive a summary of what the person's strengths and weaknesses are.  With that, the person receiving the letter has to decide what is acceptable.
Often, I feel that I have to make a strong case for someone whose difficulties are real, but may not be obvious, since psychological problems are not as visible as shattered knees.

But really, these are philosophical issues involving the question of "free will," although no one wants to acknowledge that.  I am being asked to determine if this person "can't" do something, or if they simply "won't" do it.  Will they be able to do so later, or will they never get there?  Could they do this last year, so why can't they do it now, or could they never do it and they need help?

These are very complex, and the judgements are based on very subjective evidence.  The definition of terms, the clarifications of circumstances, the delineation of expectations, and the understanding of capabilities all come into this determination.

Most of the letters consist of about three to five sentences.

I try very hard not to let people take advantage of me, but then again, someone who puts in that much time and effort to fool their therapist probably has a problem.

2 comments:

Forsythia said...

I don't envy you that task.

Lena said...

Wow, how do you do that in 3-5 sentences?