Saturday, July 7, 2018

Chapter 5: The Coldest Heart


“The Coldest Heart” offered a great deal of helpful insight into Leon’s sociopathy. Reading the vivid and horrifying description of his crime followed by the details of his relatively normal family and childhood at first left me confused and consequently with certainty that Leon was fully responsible for his actions. I felt angry and disgusted, possibly the same way Perry did in his first interview with Leon. However, his decision to remain neutral, listen intently, and eventually meet with Leon’s brother and parents left me feeling impressed and with greater certainty that something was behind the brutal murder of the two adolescent girls.

A common theme in The Boy Who was Raised as a Dog is Perry’s innate drive to complete a thorough assessment of each of the children he works with. This assessment is consistently tailored to clients’ needs (and therefore looks different in each case), is driven by a desire to understand, and typically involves strategically gathering invaluable information from a child’s caregivers within the context of a focused, compassionate conversation. Assessment has always seemed like a nebulous, complex, and at times impossible task to tackle for me, but Perry’s approach leaves me with hope and has helped me plant small seeds of confidence within myself around this task. There sometimes seems to be no single uniform way to accomplish anything in this field, which is a large part of why I’m drawn to social work. It inspires creativity and greater compassion and asks us to constantly adapt and evolve.

Reading about Leon’s mother’s “routine” after moving to the city and giving birth to Leon left me with a feeling of deep sadness. I considered what it may have felt like to live in the dark, alone, detached, and trying to learn how to self-soothe at such an infantile stage. Leon had to adapt in such a terrifying way, in such a terrifying emptiness, that it left parts of his brain withered, underdeveloped, and unable to function properly. “So that’s an important piece of info,” I consistently think to myself as we read about the various possible causes of why the children in these chapters respond and behave the way they do. Furthermore, Leon’s history of being placed in “reformatory” environments to help him learn how to cope with stressors and interact positively with peers and adults only pushed him further down a path that was quickly leading to sociopathy.

I thought of the young, impressionable children I worked with at an RTC as a mental health technician. These children had histories of trauma, were incapable of living at home with their families for various reasons, and often entered the RTC with a specific diagnosis or comorbid diagnoses. After only a few weeks, I witnessed them “pick up on” the behaviors and response patterns of their peers on the unit and integrate these into their own patterns of interacting and responding to events and stimuli. It was certainly a systemic issue, and an intense and heartbreaking process to observe and attempt to intervene in: every young patient on the unit deserved and needed consistency, and in larger part, peers who could model appropriate behavior, who could interact with them in healthier ways, and who could simultaneously learn something from them. While intervening as a technician by attending interdisciplinary team meetings, integrating the advice offered to me by various hospital clinicians and nurses, and helping individual patients resolve interpersonal conflicts were short-term solutions to this pervasive issue, I still don’t have adequate answers to this problem. I hope to be a part of the solution, however, and know that improved community care, parent and teacher education, and developing my own skills as an aspiring clinician are steps in the right direction. I would love to hear your thoughts on this, fellow bloggers.

2 comments:

  1. it really is amazing how wonderful Perry does assessment of his clients, and is able to look beyond the face value of these children. I'm sure that some of this is hindsight and it more than likely didn't occur as smoothly in the moment, but it does illustrate that health care workers need to always spend some time to understand their clients, rather than leaping to conclusions quickly. I know that for my work with adults, sometimes I feel that I wish that I had more time to get to know the client before jumping into the therapy. Unfortunately, often there are major time constraints due to insurance or limited sessions (which is a whole different soapbox rant). But no matter what, I think that showing that each person has their own story to tell and that we as social workers need to hear them is a lesson that we can all use!

    ReplyDelete
  2. The assessment process in working with clients is incredibly important in gathering information about the presenting problems and the client’s history. Perry does a fantastic job of assessing, but I feel like many social service and healthcare agencies treat the assessment process with boredom and hurry. In a lot of places, assessments are completed by having clients or clinicians fill out specific assessment tools so there can be measurable, quantifiable data to then re-assess later in treatment. I love assessments that are also qualitative and based on clinical interviews and meetings with families. Unfortunately, in many cases, the limited amount of time clinicians have with clients limits them from completing really thorough assessments like Perry’s.

    You point out how Leon’s history of being placed in “reformatory” environments only made things worse, which I found really interesting about his case. Research does show that peers learn from other peers, so if Leon is surrounded by children that are like him and have trouble regulating emotions and behaviors, his situation is reinforced. I wonder what would have been a better path for him, and would the family have even been able to use those resources? Your experience of working at an RTC gives you firsthand experience of the systemic issues of working with traumatized children. If we can’t put all the children under one roof, what should we do? People need positive role models and influencers in their life, and these children just don’t have enough of that. I have no answers to that problem, but understanding the systemic problems in intervening with cases like Leon’s is really important.

    ReplyDelete