Kamis, 17 Oktober 2013

Trust Too Little, Trust Too Much?

The quiet woman I wrote about is still coming to see me. When we met last week, she smiled and laughed a couple of times. But she still is very guarded. I can help her with housing, but right now, she won't sign any forms. And there are mountain of forms that go with obtaining housing for a person with a disability. But, she has said that with time, she may be able to tell me more. She saw one of our psychiatrists last week -- when he asked about symptoms, she said she couldn't tell him about them. She clarified and told him "I'm not saying I don't have them." She indicated that she might be able to talk to him in time.

So last week when I saw another homeless woman for an assessment, I got to thinking about trust.

This woman was much younger -- only 28. She has been homeless for 10 years, and for several has been living in a tent with her cats. She has gotten very little in the way of mental health services. She does not have disability benefits, has worked very little, and has no insurance. She described a lifetime of chaos--drug addicted parents, school failure, sexual abuse, head injury, domestic violence, substance abuse. She was very free with what she told me. And she clearly has significant mental health issues, to the point of being disabled. She also came across as smart -- she said she likes to read novels. She told me she has a temper, and even when she wanted to take medicines, she wouldn't remember to. What I see are emotion regulation issues, and problems with executive function -- her ability to plan, organize and make good decisions. She is eager to engage in services to help her find housing, as long as she can bring her cats. She signed a bunch of forms, and we'll start moving along in the process.

This is a woman who was failed by multiple systems for years -- her problems clearly go back to childhood, yet she described no formal services in her early years.

I thought of the contrast in these two women's ability to trust. One who is very slow to trust; and one who may trust too much, too quickly. I'm a trustworthy person, but someone who connects so easily and discloses everything so quickly can be vulnerable out in the world. If we can't trust, we can't connect; if we trust too much, we can be taken advantage of.

But I am hopeful for both of them. They are engaging in services and developing a relationship with me. I hope to use the trust we develop and what I know to help them navigate the system and help them both find homes.

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