There are some things they don't prepare you for in grad school as you study to become a therapist:

1) How to prevent a man, who is strung out on drugs, from hurting his girlfriend or their baby or the girlfriend's kids

2)Knowing how to duck and cover, when a client flings a table in your general direction during a group therapy session.

3) Learning a safe way to stop a schizophrenic teenage boy from choking himself.

4)How to conduct yourself as a professional when an angry teenage client comes after you with a fire extinguisher.

5)What to do in case a client grabs you by the hair and won't let go.

Yep. Those things all happened to me. And by some act of god--neither the people or I were hurt during these situations. At least physically.  Mentally and emotionally---situations like this take their toll.

What always intrigues me, is what happens to my mind when I'm faced with these situations. I don't know if it's adrenaline but I become a lot braver (or dumber--you decide) than I ordinarily am. I'll jump in and break up the fight, restrain the self injurious teenage boy, calm the scared kids who are listening to their mother's drug crazed boyfriend break down the door.

Then comes the emotional aftermath...but WASP girl that I am: it's all internalized. I get stomache pains, migraines, neck aches. Archipelagos of pimples show up on my cheeks and chin. My eyes get blood shot, my lips get chapped, I begin to stare blankly at things.

Once, the morning after an especially harrowing shift on Ward 10 (when all hell broke loose and the clients all began fighting with one another), a co-worker looked at me with pity and said, "Wow, you look like you're all 'cracked out'!"

I didn't know how to respond to that comment. My knee jerk instinct (which I swallowed back) was to tell my co-worker to "F$#% Off!"  At that moment, I was simply happy that no clients or staff had been seriously injured the night before AND that I had a mega large Starbucks Latte in my hand. Plus--I was pretty sure that particular co-worker had never seen someone on a crack bender. Nevertheless, it's hard to maintain professionalism when you both look and feel like a dog's breakfast. 

However, that's part of the gig--to remain calm as others fall to pieces around you. Then, when the dust has settled...and the clients/their families are calm, you crawl back to your home/the comfort of your family/friends/pets and...what? Think, process, cry, drink, read, talk to your spouse/significant other/family members? The answer is different for every therapist.

We're taught to maintain professional distance from our clients. "Boundaries" is how it's described in therapy educational literature. And I do, but I'm also human. There have been situations that rattle me:

1) Watching as a 10 year old client sobs and tells me his stepdad physically abused him. Then listening to this same child's bio-mom swear up and down that her son is lying about the abuse, is "crazy", and should be committed to a psych. ward.

2) Sitting with a terminally ill client as she is wracked with waves of pain in her hospital bed.

3) Helplessly watching a teenage client in the first stages of a psychotic break...

And although, yes I automatically internalize negative emotions...I'm also practicing what I preach--finding outlets for my grief, anger, frustration. I wonder if it will get any easier and I won't get so upset by certain cases. Although...I don't think it's good to remove my emotions completely from situations. Maybe one day I'll find the perfect balance. Until then...I'll muddle through.