The most
difficult factor faced in clinical work is creating deep connections with
individuals over time, only to carefully terminate those relationships, and
hope that the therapeutic work has a positive influence on the individual client
(and hopefully the therapist as well). I have become all too familiar with the
various forms of ‘boundaries’ in therapy, and the flexibility of such
boundaries, depending on the therapist and his or her clinical judgment. Most therapists would admit that they have worked with an individual (whether
formally as a client or informally) who made a significant emotional impact on
them. Personally, these emotional connections are gifts to me; a reward from the
work that I do, the essence of my motivation to practice psychotherapy.
Four years
into volunteering on a suicide prevention hotline for the elderly, I made an
incredibly (and delightfully) unlikely connection: Lina. Lina is an
unbelievably strong and brave soul; stronger than most people that I’ve met…
her chronological age is likely always mistaken or misperceived to mean that
she may be young and naïve, but her wisdom constantly surprises me. As a
13-year-old girl battling cancer most of her life, there has never been a
flavor of bitterness in any of her words. Our relationship initially began while
she was seeking services for a counseling crisis hotline. From the confines of
her isolation unit in a children’s hospital hundreds of miles away, her only comfort
was her few select visitors, family members, doctors, a plethora of nurses, and
her iPad.
We initially
talked one night when she called the crisis counseling hotline in search of
social support or just someone to talk to as she struggled to fall asleep. Her
mother had found many resources for her, as Lina is bound to her isolation unit
in a hospital, unable to be around anyone because of the fragility of her
immune system. Her condition is so severe with recurring cancer, that she
cannot be around anyone else or have anyone visit her unless they are suited in
a sterile gown. From the confines of that isolated unit, she found a phone
number, and I happened to be on the other end. The tenet of the crisis hotline
for the elderly, which she had called that evening, has a rule about our
clients meeting the minimum age requirement of 65 years or older to talk to a
counselor. Lina is clearly 50 years younger and technically could not be served
as a client through our hotline. Her mother and she expressed frustration in
this; here was this great resource for her daughter who has no social support
and who routinely only talks to the number of nurses who draw her blood from
the moment she wakes. I had to do something. I couldn’t just let her hang up.
As I spoke to
my supervisor, we concluded that it would not be appropriate for me to talk to Lina outside the frame of my counseling shifts, and that the best we
could do is allow her permission to call the hotline solely during my twice-a-week
shifts. Lina was ecstatic; she instantly lit up over the phone when hearing
that we would be able to continue our conversations. She always reminded me
that her body was in less chronic pain towards the end of the evening; I always
knew she would be the last caller of my shift. In a way, I began to routinely
look forward to speaking to her as a way to culminate my day. She would always
tell me which nurses were there, and why she appreciated (or
did not appreciate) their attitude and approach to patient care.
This little
girl and I had so many parallels between our lives, despite our 14-year
difference in age. She was Middle Eastern, held many traditional cultural
values that I identified with, practiced and loved ice skating (my sister’s
main hobby), and grew up in the same Southern California neighborhood that I
had. Some days, Lina would be able to hear frustration or exhaustion in my
voice; she was so incredibly perceptive, more so than many adults that I’ve
come across. These brief interactions with Lina reminded me of the childlike
innocence that we all have within us. She helped me channel mine; when we’d be
on the phone, I’d forget about my loads of graduate work and just tune into our
light-hearted and playful conversations. At times, however, our
conversations would become grim, yet real. She would often engage me in
conversations about ‘if it would hurt’ to die, and ‘why’ God would enable
children to endure such painful diseases such as cancer. I became emotionally
invested in our ‘relationship’, to say the least.
3.24.2013—————————————-Most
of the way through writing this article, Lina’s mother contacted me to inform
me that Lina had lost her battle with cancer. I couldn’t believe what I was
reading in her written message. I froze up before I could finish the paragraph;
this couldn’t be. I had just talked to her the night before. I checked the call
log, and she had contacted me close to 11pm, about six hours before she would
enter Heaven’s gates. I only had one prominent emotion: Gratitude.
I thanked Lina’s
mom for giving me permission to be part of her daughter’s life, and that I
would be pleased to help her find resources to help her throughout her grieving
process. By default, my emotions as a therapist had to take a backseat. I
didn’t even know if it was appropriate for me to feel as intensely as I did
about her loss, but I just surrendered to my emotions and allowed them to flow
over me like I was a rock anchored in a flooding riverbed. It has barely been three
weeks, and I remain in loose contact with Lina’s mother. She left me with a few
pieces of heartfelt information; first, she had disclosed to me that she was
pregnant! She mentioned that Lina always wanted her parents to birth another
child, whether or not she lived to experience their sibling relationship. Her
mother pointed out that in nine months, when her child will be born, she hopes
that Lina’s soul will live on through this baby. This sent chills down my body.
Second, apparently Lina had talked much about me to her parents, expressing how
thankful she was for making a connection with me and for having me to talk to.
While praying with her parents one night, she had thanked God for blessing her
with our relationship. This sent a wave of warmth all over my body that soothed
my chills.
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