learning curves


This is a long post, so first the short version. In the last year: I started working full time and am adjusting to that. I’m glad to be working towards my MFT licensure, but uncomfortable about how it pushes my relationships and other projects onto the back burner. My marriage gets better and better, despite this. The company I work for goes out of business so I get part of the summer off, and I get the exact same job (family therapist for US Marines & their families) with a new company.

And for the year ahead: I plan to continue this work, taking good care of myself, dance with Reanna every night, as promised to my friend, Tilke, in her “How to be a Real Artist” workshop, get in best shape in 5 years, and learn how to treat myself and Reanna really really well while working full time.

October: I started my year out at Farm & Wilderness, VT, staffing and teaching a really fun psychology project at Not Back to School Camp. As is traditional, I got really sick, but this time it was from a waitress in Rutland, not someone at NBTSC. I recuperated while visiting Ethan & Susannah, also in Vermont. Back in Joshua Tree, I started working out again (SERIOUS style), planted my first winter garden, fixed some electrical and plumbing problems in my trailer, and started setting up a private practice. In the process of hiring a supervisor, I found out that in California, unlike in Oregon, I cannot do my internship in a private practice. So I started looking for work in a local clinic.

Looking out over Woodward Reservoir from my cabin at Farm & Wilderness

Ethan, cataloging NBTSC lost & found in his library

The famous Quodlibetarian tub

Reanna

Reanna at Playa Del Rey

Ollie, a year ago

Ollie & Pap

Gabe, Damian & Maya on the Hwy 62 Art Tour

Trailer at sunset, looking south

November: I move into a new computer, archive my years of audio journal entries, and learn Sketchup while applying for and getting a job at Morongo Basin Mental Health: providing free, confidential therapy for US Marines, veterans, and their families. In what would become a series of small-town coincidences, a high school friend I hadn’t seen in decades worked there, saw my name on the interview list and sat in on my interview, interjecting stuff like, “Oh, yeah, good answer!” Nice way to interview. The manager of the military program assured me that the our contract was solid for at least two years. That’s about how long I need to get my hours for licensure, so the job sounded good–no chance of having to ditch my clients like I had to in grad school! I spent the rest of the month getting in as much time with Reanna and my family before starting full time work.

Rainbow over the Bartlet Mts

Maya & Ollie in hammock

Ollie helps Nana Honey cook

Me & Reanna

December:  My 93 year old Grandpa Bob gets really sick, and I get really sick taking care of him. I was pretty sure he was going to die. He had pneumonia and had to go on antibiotics for the first time in his life. It took me weeks to fully recover. He eventually recovered, too, but I’m not sure he’ll ever fully recover. He’s been on antibiotics off and on ever since and is progressively less mobile. It’s got me thinking a lot about dying–how I can support the people I love when they start having a hard time taking care of themselves, and how I want to die when my time comes.

I start at MBMH, reading 40 hours a week of protocols. I have Christmas with family in Joshua Tree. My brother Damian starts a weekly evening with family, listening to an integral Christianity lecture and meditation that turns out to be a presentation of integral theory to Christians, rather than Christianity to integral thinkers, but valuable nonetheless.

Reanna & Christina, Xmas

Reanna & Maya, Xmas

Ely, Christina, Pap, Ben, Rebeca, Xmas

Gabe, Ely, Ollie, Christina, Xmas

Reanna, ukulele, heater

Ollie, bundled up

January: I get my first paid vacation ever–one week off, fully paid by MBMH. Weird, pretty nice. I write my first attempt at a comprehensive political statement. Reanna and I start a three-month experiment with a strict “paleo” diet, which mostly means we cut out sugar and grains from our diet. The theory is that human adaptation to grains and refined anything is shallow at best. I also start cooking Mexican food (the paleo-friendly recipes) from Rick Bayless’ Authentic Mexican. I love it. And Reanna loves eating it. I start learning to play Reanna’s ukulele. I play and sing “Amazing Grace” most nights for a month. Fun!

I’m working full time, which I’ve never done. It’s not my favorite schedule. I had to let go of most of my projects. I started building a solar batch water heater in the fall, for example, that is still not finished. The schedule has simplified my life quite a bit. Work all day, spend the evening with Reanna. I gained more respect for my friends who’ve been working full time for decades and still manage to write some music or read books. I’m ramping into a caseload, though, and am seeing seven clients a week by the end of the month.

My endurance training is going great by this point. Mid month I got my heart rate up to 179 bpm without hurting myself. Very exciting.

Smiley and Gallant visit

Reanna in our clean, cold kitchen

Dinner’s almost ready. (Photo by Reanna.)

Grandpa Bob turns 94

Me in therapist costume, with Ollie. (Photo by Reanna.)

February: Full time work continues. I get trained in the Trauma Resiliency Model, which I find very cool and useful. I re-up the trademark on Abandon Ship. I feel sad that I can’t write music with my brothers right now, but have plenty of optimistic plans to do so… Reanna starts designing our future house, another exciting project that I have to watch from the sidelines. I love watching her get super deep into a topic like this, though. She is now the resident expert in passive-solar-optimized-very-small-house design. We start car shopping, too. We need to be independently mobile in Joshua Tree.

Trench. Hose feeding trailer finally to be buried.

Reanna & treehouse near the Mexican border

Ollie, Damian

March: I’m up to 16 clients at MBMH and I’m fighting for mastery of the intense paperwork load. The clinical work is going great. My supervisor is good, I am fully engaged by my clients, and I get to see a good variety of folks–kids, adults, families, couples. The paperwork is fairly unpleasant, though. Mental health providers that get government funding spend a huge amount of time and energy creating and maintaining a paper trail for their work. These clinics get paid based on the work they claim to have done and then various agencies can audit their files and take that money back if a box wasn’t checked or a T wasn’t crossed. I spend my first very late day at work in March, trying to catch up on paperwork. Reanna is not happy.

Highlights: A great lecture by Bruce Perry, planting my first spring/summer garden, endurance training going great (I work out during my lunches at MBMH), meeting the Transition Joshua Tree folks. And Reanna. Reanna is wonderful.

Lowlights: My truck fails smog and I begin what becomes an expensive debacle trying to get it to pass.  I start having sync problems with my Mac that I am still dealing with as I write. I start working on our taxes on weekends. Reanna is Canadian and that makes our taxes super complicated and somehow even though we hired a professional we ended up owing big fines.

Abandon Ship cover art, for the TM folks. Art by Tilke.

Damian & Ollie in old billy goat pen, future garden

Me, just having sunk the garden beds. (Photo by Reanna)

Reanna planting pepper starts

Ollie

Ollie & Reanna take the trash out

Ollie & Reanna rest in the hammock

April: I find out that Morongo Basin Mental Health has decided to go out of business after more than 40 years, at the end of June. That’s quite a shock and less for me than for the many decade-plus employees I work with. At home, our three months of paleo is up and I feel fine, as I have on just about every diet I’ve tried, but it clearly had not solved any of the problems we’d been tracking for the experiment. And I am sick in bed for a week for a third time this year. Reanna’s parents arrive for a month long visit. I don’t get to see them as much as I’d like, but we get in some fun events (like the Morongo Basin Conservation Association’s “Desertwise Landscape Tour” and Transition Joshua Tree’s Water Catchment Workshop), good talks, good swimming.  I get trained in sand-tray therapy by my supervisor, Richard Gray, which I find quite useful.

Reanna preps cholla buds for dinner

Family dinner at Damian & Maya’s (Damian with Bugzooka)

Doug & Kathryn up San Jacinto

May: We get a great little car, a gift from Reanna’s parents. It gets 38 mpg unless we use the AC.  At work, emotions are high and rumors are flying around. I try to avoid it as much as possible. My coworkers are mostly looking for work with great intensity. I decide that I will chill instead, concentrate on my clients, and do what I can to get my job back with whatever company picks up the military contract in the summer.  Meanwhile,  something is eating my garden. My weekends and after work time is often spent critter-proofing.

The highlight of the month by far is meeting my new nephew, Julian.

Julian in sling

Ollie in work gloves

First scorpion of a scorpion-rich year

June: I’m at 21 clients at the beginning of my last month at MBMH. The management has had me continue taking new clients but I’m starting to get nervous about it. It’s starting to look like my clients will have a significant lapse in services, and it pisses me off. I write people in charge at the county and local journalists but no-one can say how long it will take to get the military program back up and running. I know I’m fine. I can look forward to a full season working at NBTSC if things go badly. It sucks, though, that my clients are just getting dumped. It’s screwed up. I just have to set them up as best I can for the lapse and do the tons of paperwork to close their charts. Meanwhile, my co-worker, Jackie, introduces me to Candy Crush, which starts sucking up the cracks in my schedule.

Highlights: Jonathan & Ayako’s wedding in Idaho. Motorcycle safety class with Reanna. And being married to Reanna, of course.

Living room pano: Ely, Christina, Julian, Ben, Rebeca visit

Ben & Julian

North end pano from on top of Reanna’s sewing RV

Ayako & Jonathan, getting married

July: I’m unemployed again, but within two weeks I get interviewed by Pacific Clinics, the company who got the military contract that I’d been working for at MBMH. It looks like I’ll get the job based on the reputation I’d made for myself in that position. That feels good! It means I’ll miss most of NBTSC this year, too, for the first time in 14 years.

Reanna leaves for OR to do prep work for NBTSC and I delete Candy Crush from my phone so I can get some things done: install AC in our trailer, create an outside pantry, build a greywater cistern, make a front step for the trailer, get my motorcycle license, and a few other things. Satisfying. Then I fly up to OR to work the Camp Latgawa session of NBTSC.

Reanna hangs our laundry while I goof off with the camera

Cistern in progress

Julian & me

August: Finish at NBTSC (wonderful, as usual), and spend a few short days in Eugene at an NBTSC leadership summit, then back to Joshua Tree for my last week of unemployment. I completed some last-minute landscaping and plumbing projects, built a dry toilet and installed a weather station, then started training at Pacific Clinics in Arcadia.

At the end of August, Reanna got back from her travels, and we started shutting down all lights and electronics at 8pm and just hanging out until going to bed. This was lovely. We usually laid in the hammock outside, talking and looking at stars. The desert summer evenings are really, really nice. Especially with Reanna.

My advisee group, NBTSC Camp Latgawa

Ely & Julian before dinner

Reanna & Ollie, downtown Joshua Tree

September: I start making contact with clients and by the end of the month I’m back up to 7 clients. This is exciting, and it’s nice to be working with some of my old co-workers from MBMH, and the new crew at Pacific Clinics is an entertaining bunch. Working full time again limits what I can do in terms of projects, but I manage to put a new roof on the old goat pen/the new outside pantry, go visit Quail Springs permaculture farm, and start building a new composter with my 2-year-old nephew, Ollie.

At the end of the month, I have my first birthday at home in many years. Usually I’m at camp. It’s nice. My family threw me a little party and I’m glad to be here, even though I miss my people at Farm & Wilderness.

Yes, Ollie wants to help build the composter!

Rain Event, 29 Palms

With Reanna & ocotillo, on my 42nd birthday.

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It has been four years of sitting in hundreds of hours of lectures, reading thousands of pages of theory and research, writing hundreds of pages, and seeing clients for hundreds of hours. It has been long weeks, late nights, steep learning curves, and lots and lots of thinking. It is amazing how much learning you can do in four years of 60-80 hour weeks!  In 2009 I finished a Bachelor of Science degree in psychology, with a research assistant position in Sara Hodges’ social cognition lab, a practicum position at a residential treatment facility for teenage sex offenders, an honors thesis entitled “Differentiating the Effects of Social and Personal Power,” and a GPA of 4.23. Yesterday I graduated with a Master of Education degree, Couples and Family Therapy specialization, 455 client-contact hours at the Center for Family Therapy and Looking Glass Counseling Services, one term as a counselor for the University of Oregon Crisis Line, four terms volunteering for the UO Men’s Center, a GPA of 4.19, and a “Pass With Distinction” on my final Formal Client Presentation. It has been a wonderful, exhilarating, exhausting four years.

It has also taken a bit of a toll on my health, but the major loss was in community. If you do not live in Eugene and we have not made a point of a regular visit, I probably have not spoken or even written to you much, if anything, since 2007. For that I sincerely apologize. It is not how I prefer to live but I could not seem to do this any other way. Know that I miss you. Let’s reconnect. Call me up, write, send me your unfinished song, your idea for a book, something to read and talk about. Let’s go for a walk, go swimming, have lunch, see a show. I am looking forward to it.

Couples & Family Therapy 2011 Cohort

Me & My Dad, June 14, 2011

At 8 o’clock tomorrow morning, I am taking my first round of comprehensive exams for my couples and family therapy program. The purpose is to make sure we understand all of the theory we’ve been learning before we start seeing clients. If I don’t pass, I will be given another chance at it in the summer–I won’t be able to see clients this summer, but I could start in the fall.  I feel good about it. I am ready.

We will be graded Pass, Fail, or Pass With Distinction. I expect to get a Pass. I know the material quite well, but we’re supposed to write 3-4 single spaced pages on each of three questions, all in five hours. With citations. That’s a lot of typing. I’ve done three dry runs through the test, and the most I’ve been able to type, even with my outlines in front of me, is 7 1/2 pages, total. I’m not a fast typist, and I still have to think some about what I’m going to write. I’m fine with a “Pass.” Part of my learning curve is learning how to stop at “good enough.”

We’re allowed to bring food, drinks, ipods, and our reference lists with the references in any order. (I’ll paste in my list below). I’m also bringing my own keyboard (Microsoft Natural Keyboard Elite) and mouse (Logitech TrackMan Wheel). Five hours of fast typing–I need to be comfortable! I’d like to bring my chair, too (Herman Miller Aeron), but it’s difficult to bike with.

Tonight I’m treating myself to some food someone else made and getting into bed early.

Here are the questions. I’ve had them since December. Below them is my reference list. Wish me luck!

Question 1

Describe in detail systems theory, contrasting it with modernism (aka positivism). Be sure to include central concepts of both epistemologies and explain them fully. Also detail the main concepts of communication theory, and the connections between communication theory and system theory. Describe a family problem in detail using a specific model of family therapy (Structural, Strategic, Solution Focused, Experiential, EFT, Bowen) to describe the relevant associated concepts to understand the situation. What are the model specific concepts you will use to understand the family? How will it direct your treatment? What interventions might you utilize to help this family? Why are these interventions systemic? How will you evaluate outcomes based on this model of therapy? How will the common factors research influence your view of intervention with this family?

Question 2

Research ethics includes principles of social justice and dictates competence at each of the following levels: a) conducting research, b) consuming research, and c) utilizing the research literature.

Describe the key social justice considerations when conducting research, when evaluating the merits of a research study, and when utilizing research data as a clinician. In your response include notions of consent, validity, and the characteristics of a well-constructed qualitative and quantitative research designs. Finally, specifically describe how you will incorporate your knowledge of research and its relationship to social justice while a clinician at the CFT.

Question 3

Please describe a process for how you will develop a systemic diagnosis and treatment plan for the client system depicted in the vignette below. Carefully describe how your diagnostic impression and treatment plan are informed by your knowledge of (1) diversity, (2) empirically validated treatments, (3) relational ethics, (4) the diagnostic and statistical manual and (5) CFT theoretical frameworks (systems and communications theories). Finally, based on the vignette below, talk about your treatment approach and how it is informed by the five areas mentioned above. Clearly articulate your systemic diagnosis and treatment plan for this client system.

Kelly (39) and Kris (26) presented for couples therapy. The couple reports they have been together for about two years and are very serious about their future together. Kris reports they have “problems understanding each other. We just can’t communicate.” Kelly agrees and reports it’s been that way for several months. Every time they try to talk with each other about their problems they don’t get along and often engage in escalating verbal arguments. The arguments often lead to Kelly leaving the house very upset and not coming home until the next day. Each partner is hoping for it to get better and want to engage in ongoing couples therapy. Kris reports feeling down and “out of sorts” most of the time and has had difficulty in getting out of bed and making it to work on time the past few months; however, is able to have some good days feeling happy and energetic. After the third session, Kelly discloses to you over the phone that he is thinking of engaging in a sexual relationship with another partner but doesn’t want to bring it up in therapy yet, and doesn’t want you to, either. He states that he feels having another partner will help the relationship because he will “be able to get my needs met.” He further reports to you that they both occasionally seek out partners outside the relationship and feel an open relationship works for them, though made the decision years ago to just not talk about it when it is happening.

Comps References

Becvar, D. S. & Becvar, R. J. (2006). Family therapy: Systemic integration. Boston, MA: Pearson.

Burbatti, G. L. & Formenti, L. (1988). The Milan approach to family therapy. Northvale, NJ: Jason Aronson.

Fisch, R., Weakland, J. H., & Segal, L. (1982). The tactics of change: Doing therapy briefly. San Francisco, CA: Jossey-Bass.

Gehart, D. (2010). Mastering competencies in family therapy: A practical approach to theories and clinical case documentation. Belmont, CA: Brooks/Cole.

Haley, J. (1993). Jay Haley on Milton H. Erickson. New York, NY: Brunner Mazel.

Madanes, C. (1991). Strategic family therapy. In A. S. Gurman & D. P. Kniskern (Eds.) Handbook of family therapy (pp. 396-416). Madison, WI: Routledge.

Nichols, M. P. & Schwartz, R. C. (2008). Family therapy: Concepts and methods. Boston, MA: Pearson.

Sandberg, J. G., Johnson, L. N., Dermer, S. B., Gfeller-Strouts, L. L., Seibold, J. M., Stringer-Seibold, T. A., Hutchings, Andrews, J. B., & Miller, R. B (1997). Demonstrated efficacy of models of marriage and family therapy: An update of Gurman, Kniskern, and Pinsof’s chart. The American Journal of Family Therapy, 25(2). 121-137.

Sprenkle, D. H. & Blow, A. J. (2004). Common factors and our sacred models. Journal of Marital and Family Therapy, 30(2), 113-126.

Watzlavick, P., Bavelas, J. B., & Jackson, D. D. (1967). Pragmatics of human communication: A study of interactional patterns, pathologies, and paradoxes. New York, NY: Norton.

Sells, S. P., Smith, T. E., & Newfield, S. N. (1996). A clinical science for the humanities: Ethnographies in family therapy. In S. Moon & D. Sprenkle (Eds.), Research Methods in Family Therapy (pp. 25-63). New York: Guilford.

National Institutes of Health (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. URL http://ohsr.od.nih.gov/guidelines/belmont.html

National Institutes of Health (2010). The Nuremberg code: Directives for human experimentation. URL http://ohsr.od.nih.gov/guidelines/nuremberg.html

Sue, S. (1999). Science, ethnicity and bias: Where have we gone wrong? American Psychologist 54(12), 1070-1077.

Freire, P. (1970). Pedagogy of the oppressed. New York, NY: Continuum.

Aronson, E., Ellsworth, P. C., Carlsmith, J. M., & Gonzales, M. H. (1989). Methods of Research in Social Psychology. Columbus, OH: McGraw-Hill.

Creswell, J. W. (2009). Research design: Qualitative, quantitative, and mixed methods approaches. Los Angeles, CA: Sage.

Corey, G., Corey, M.S., & Callanan, P. (2011). Issues and ethics in the helping professions (8th Ed.) Belmont, CA: Brooks/Cole Cengage Learning.

Fisch, R., Weakland, H., & Segal, L. (1982). The tactics of change. San Fransisco: Jossey-Bass.

American Psychological Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed.-TR). Washington, DC: American Psychchological Association.

Bettinger, M. (2006). Polyamory and gay men: A family systems approach. In J. J. Bigner (Ed) An introduction to GLBT family studies (pp. 161-181). New York, NY: Haworth.

LaSala, M. C. (2001). Monogamous or not: Understanding and counseling gay male couples.

Families in Society, 82(6), 605-611.

Ballet is such a weird, cool system of moving! It’s so deep in Euro-American culture it’s difficult to see at first just how bizarre it is, all floaty and lilty and superhumanly graceful, even during those acts of incredible athleticism. I love how much attention we pay to our feet, the subtleties of articulation, how they move against the floor, exactly how they lift. I’ve been walking around in a constant foot meditation for the last few weeks. I love how wildly unintuitive it is, the toe-pointing, the isolation of the leg and arm motions, and especially how the arms move—all elegance and flair, which I have been avoiding for decades. I love how much my balance has improved. I’m reconnecting with the classical piano music, or whatever it is—I know ‘classical’ means something very specific to those in the know. I’m starting to see dancing when I listen to my Mozart piano sonatas while studying.

I’m still a bit cringe-y at the prancing and leaping, but less so now, and I imagine the better I get at it, the less cringe-y I’ll be.

11 years worth

11 years worth

I have started this blog inspired by my friend of just over a decade, Jeannie Lee. I’ve been waving her away about it for years because of the time commitment: learning curves and then continuing to post. I’d already stopped writing in my precious journals in favor of a voice recorder because of how much time it took. I already have plenty of ways to keep myself a little too busy: university, learning to dance, making money, reading, writing music, keeping up with friends and family…. Jeannie’s rebuttal was that I could put as little time as I felt like into the project, which is true, of course, but not usually how I operate.

I think two things tipped me. One is that I’ve been thinking a lot about how difficult it is for me to write well, and that it’s because of how difficult it is for me to think clearly. But good, clear thinking is important to me. I decided I could stand to nudge my daily activities in that direction. Another push was from my new friend, Reanna, who told me she liked the little rants I’d put up on my (feeble) myspace page. She’s smart and a writer and I have a crush on her, so that convinced me to make better friends with the part of myself that says things. Plus, the few writings and images she has up online give a sense of her personality and life that mine do not. I’m jealous.

NME 32, 33 & 34

NME 32, 33 & 34

So here it is, starting September 29, 2008, the first day of my 38th year. I’m calling it Nathen’s Miraculous Escape after a zine that I made for a while about my year, each year, for Christmas presents. (I stole the name from the title my dad gave to the film of my brother Ely’s birth: Ely’s Miraculous Escape.) I hope this blog will serve the same purpose as the zine—make it easier for you to stay connected with me during the times (most of the time, actually) that I’m working on projects and neglecting the loved ones in my life who I don’t see every day.

I’m excited about this project. I always get a creative rush around this time because I always spend a lot of time brainstorming about my new year, clarifying my goals and visions. This year’s creative rush has been bigger than usual, though. The last several days I’ve woken up after only a few hours of sleep and lain awake until morning, thinking about how to organize this page, how I can include all of my inspirations. Normally I’m not a big fan of insomnia, but this has been fun. I hope you enjoy it.

Love,

Nathen