An Open Letter: Welcoming the Intern to the World of Clinical Social Work

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When I started this blog, I primarily wanted the focus to be on poetry with some short essays or just thoughts. As I was preparing a good-bye letter to our intern this year throughout the week, I thought about the importance of words. I thought about how sometimes I gain insight from quotes in article or interviews. I also do in letters. Sometimes journalistic stories are works of art. I’ve said before, I consider myself a ‘storyteller,’ who has a deep love of words and how they describe the human experience. As I was writing the letter to my intern, it was describing a lot of what I’ve learned in my years as a clinical social worker. It’s a story in some ways, and so, as a ‘storyteller,’ I’m going to share that story with you today. It’s purely observational. If nothing else, it’s my perspective on being a clinical social worker. So, here it is.

Dear Intern,

First of all, congratulations! You have made it through school, completed internships (including one here), and even landed yourself a job before graduation. It’s impressive, and you need to step back, congratulate yourself, soak in the moment. I often feel we spend our lives (great portions of them; typically Act 1) pursuing these milestones. We move from one thing to the next and then we finally get to the finish line and we don’t stop and really pause, reflecting on the fact that we have just spent a quarter of our lives to get to this one moment. I’ve read account after account of people who never stopped and gave themselves credit where credit is due, so please (if nothing else) pause and enjoy this moment, celebrate it, you’ve worked really hard to get here. You deserve celebration.

So let me be the first person to say, “Welcome to the club!” It’s a small, selective club in the population. It sort of has to be, to accept the challenges, the lack of pay, the thanklessness I’m sure you’ve seen are all part of the club. Social work is a unique profession and an exclusive club. You will learn this quickly, if you have not already. It’s time to get used to the fact that no is going to have a clue as to what you actually do. There are days, I, myself, think, “Someday in a different time and place in society, people are going to question if this was really a job?”

As a social worker, your grandmother will tell people, ‘he does what Dr. Phil does,’ (that is how my grandma used to describe my career). Other people just assume you are this overworked, tired individual with the intent to take away people’s kids. Other people picture you as some sort of savior to the mentally ill and impoverished and will tell you repeatedly, “I could never do THAT job.” Then, there’s the group that you will learn to lie to on planes and at weddings. The people you have to lie to about what you do because the second you spill it, “That’s fascinating, let me ask you about my nephew who never can sit still and..,” there goes the peaceful plane ride you were hoping to catch some sleep on and ‘not be a social worker.’  If you use any of the other titles you will probably wear as a ‘clinical social worker,’ (psychotherapist, therapist, mental health counselor/provider) be prepared for people thinking your can prescribe them lots of interesting drugs (we can’t prescribe drugs) or the inevitable, “I am fascinated with psychology. I wanted to major in that, which is either prompted by a rant on their own psychological beliefs. Do they like Jung or Freud? Most therapists don’t really think of them much past their licensure exam. The other half will want to know stories. They will ask questions about ‘sociopaths,’ (not a current diagnosis) or bring up someone they know or have dated that they ‘feel should be evaluated.’

For all the people who do not understand what you do, there are some who do. I’ve literally had dates leave when I told them. I also get, ‘Great, I totally need a shrink.’ I, personally, never thought my friends would catch on or family, but they have. I get calls about breakups, the scares of ‘abnormal child behavior,’ from family and friends. The calls from friends who are dating someone new and their sister needs drug rehab. The concerns about a brother’s friend just back from down range, who’s not himself. Due to the many hats social workers play, you do sort of become a wealth of knowledge. You will be questioned on medications, power of attorneys, education plans, and many bizarre things. I dropped my badge once on the way to work and my neighbor picked it up. My title during that job was psychotherapist. She must have saw this and every day when I got home she’d yell from her apartment, “Doctor…Doctor.. I have a question about childbirth.” The number of times you will and can explain to someone, “I’m not a doctor,” is insane when you consider how many clients will just keep calling you doctor after countless discussions on how we are not doctors. Eventually, with some people, you just have to allow it.

For all the misconceptions, I can tell you what this profession has come to mean to me. It means learning to dismiss judgement and have open conversations about really messy stuff. You will learn to sit with things in a way you never have. You will come to know all sides of a story. I remember the first time I was told I was going to a prison to sit with a woman who murdered her three children. I was scared. I would say (somewhat for safety) and a lot because I knew it was going to test me. I was going to have to have honest, open dialogue with this woman about murdering her children. I went and I came out a different person. Social work will transform you, like that. Be ready, everything you thought you knew about your life and your beliefs is going to change. Our perspectives and values shape how we hear and live. The profession of social work requires fluidity and flexibility in those values and boundaries unlike any profession. There is no one who is able to exist in this profession without finding themselves in an existential crisis now and then. Point being, great social workers have and need great therapists.

The list of topics you will learn to talk openly about includes: trauma, infidelity, addiction, suicide, homicide, rape, abuse, mental illness, poverty, sexual deviance, racism, aging, illness, finances, religion, gender and sexuality issues, criminal activity, military combat, and every hot topic and/or topics you are told never to discuss at a bar, etc. Your job is to be judgement free (or to learn to keep those judgements under wraps). I often say being a great clinician is ‘being a great actor.’ You will master the trade of holding a poker face. That list is enormous! Listing them feels huge and living them is something beyond.

I remember the first suicide, a sobering reminder you are in the business of life and death. I remember the first homicide and how broken I was. Every night I went home and turned on the news and there was story after story about this person, who I knew differently than what was portrayed in all those stories. “Was our time together all just a lie, or did I know this person in a way the world never was able to?” I grappled with that constantly. The news was everywhere, and I couldn’t turn to my wife and say, “Hey, shut that off, it’s my client.” I had to sit and listen to those reports. Each time asking myself, “Where did I fail here? What could I have done differently?” They are huge questions and I was alone with them. 

There will be times when you are literally made speechless, in a job where words are your tools. What do you say when a twenty year old, healthy, smart guy collapses on you sobbing and whimpers, “I was just too fucking young to see what I saw in war, to do what I did?’ I remember sitting with a woman who was being picked up from the hospital to be taken to jail for the rest of her life. She would never know the freedoms of the world again. We sat for two hours as I held her hand and tried to assure her ‘things were going to be ok.’ Being a social worker is having to explain to a mother that she will never have her healthy 19 year old son back after a psychotic break and being present with her as she grieves. It’s trying to be supportive when you’re angry because the client you’ve invested hours into helping them obtain sobriety, washes all that work down with vodka one Tuesday. It’s being told you’re not doing enough to parent someone else’s child, when they refuse to follow through with every tool you give them. It’s listening to them berate you and having five minutes to get yourself together because the next person who walks in the door will bring something unexpected and needs all of your attention. 

There will be days when you will have had a breakup or lost just returned from work after losing a friend or family member and (it always seems) that day everyone you see will be talking about that one thing you are trying your hardest to take your mind off of to be present at work. You give a part of yourself to the world. You have to think about every action you take now, not only as how it’s going to affect you, but also how it’s going to affect your clients. You have to choose your words very carefully knowing people see you as an expert. When you speak, they are absorbing your words. They are reading your body language, your attempts at small talk, everything. In their minds, you are ‘evaluating them,’ and every move you make (sometimes even the involuntary ones) are being read into and called into question. 

When I was going to school to be a teacher, I had a professor say, “In this profession, most days you will walk out of the office feeling like you failed. Then, there’s the rare day when you will walk out feeling on top of the world.’ This is social work. It means, nights questioning your wording of things, did you miss something, each day being hopeful but not ruling out a crisis. You stop finding it strange when people talk to themselves or tell you stories about how messages are being sent through the TV. You expect people not to shower and just prepare by wearing a scent under your nose. You, yourself, will have a whole new set of boundaries. There will come a time when you just forget the world you live in is not ‘the real world.’ You will be out with friends or be at a wedding being introduced to someone new and find yourself asking questions that are ’normal’ questions to ask, except they’re not normal ‘unless you are assessing someone and in the privacy of your office. The looks on their face will let you know, your lives have blended. You will catch the blending in your own speech at times. When you’re asking a family member ’to be mindful, to stay present, to sit with something..” 

You will spend your days with people who have endured more than you can imagine by the age of six, and you will be thirty, forty, sixty. The people you spend your days with often will not thank you. They often will not like you. They sometimes will downright hate you for simply trying to help them. Most days, you will just know that they are profoundly suffering and will have to wait for them to come to a place where they can see you want nothing more than to be there for them.

I often say, as a social worker, you hold the world’s secrets. You begin to know the world in a much different way. Every story has two sides and you begin to see this. It will cause beliefs you’ve held your whole life to crash down. You will probably change more than your clients. They will give you some of the most powerful lessons in life. It’s important to remember as you join this selective club that someone deems you worthy enough to show up for them, to speak for them when they cannot, to be a part of their journey with all its ups and downs.

For all the hard things, there is also the joy. Sometimes those joyful moments might seem incredibly small to the rest of the world, but you know hard it was for that person who was abused to take a shower. You get to be the person they can’t wait to tell that they went outside or to a movie with a friend after months of isolation. You get to sit with a family as they lose a loved one and hear them make sense of how impactful the person’s life they are about to lose, was. You get to see the kid nobody could work with transform, when they are taken out of an abusive home and put in a safe place where they are loved. 

I don’t know if asked, “Would you ever choose to be a social worker again,” if I’d say ‘yes.”  However, when I think about what else I would do, I can’t think of anything that has the elements I love about being a social worker in it. This profession has changed me. There’s no doubt. I might be more introverted. I’ve learned to choose words very carefully (and I was a writer before this); however, I’ve also learned to listen and observe. Most of the time, it’s not what is being said, but what is physically happening in a room. Your instrument is yourself, so you have to take care of you. 

Your clients will give you life lessons you never dreamed. They will teach you more about life and yourself than you ever expect. Often, I watch them and think, “Damn, they are brave. I could never say that in a group or be that vulnerable.’ They constantly push you to a greater version of you.

I’ve had the joy of numerous interns and I love them. I’ve learned from all of them. There’s a famous quote from a poet I love, Adrienne Rich, where she says in an interview something to the effect of, “You must never stop looking for your teachers.’ I’ve lived by that quote for years. I believe we are not accidents in each other’s lives but teachers. 

I have enjoyed learning from you. You have a natural charm, ability to build rapport with others. You bring a youthful, hopeful approach to a profession that continuously needs this. I am deeply sad to see you go. You brought new humor, someone to sing pop hits with to the kids, a youthfulness, playfulness, and kindness to our unit. We gained a friend and a new colleague in you. I have no doubt you will make a great social worker. You made it seem effortless from the start, and that’s not something you see all the time.

So,  officially, welcome to the club! I think you’ll find it’s messy; however, it’s in our messes that we often find things we forgot we had. We find parts of ourselves we might have misplaced and find joy and pride in discovering a new way to work through the clutter and messiness of life, creating many new paths to discover. One thing is for sure, social work never stops offering social workers new paths of insight. I can’t think of many professions that offer this benefit daily. I can’t wait to hear and watch how your journey unfolds.

We’re here whenever you need us!



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