Mr. Rhodes* began sobbing in front of me as we sat in “the box,” a small common room at the jail where I volunteer as a social worker. I can use the box for individual therapy sessions, but two of its walls contain floor-to-ceiling windows leaving my clients with very little privacy. Although his peers could see him, Mr. Rhodes was unashamed of his tears.
I first met Mr. Rhodes when he approached me in the hallway after a session of the anger management class I teach at the jail. He explained that he had felt rage ever since he was a kid and did not know how to handle it. When we met one week later, he disclosed that he had been incarcerated for 12 years. He had recently been released from prison but had acquired new charges and was facing a 90-year sentence.
Mr. Rhodes’ sister died of an allergic reaction while he was incarcerated, and he was unable to attend her funeral or say his goodbyes. I asked him to write her a letter, specifically focusing on the anger he felt. One week later, we met again in the box. He was about to hand me his notebook but I requested he read his letter aloud.
“You always believed in me, Jess,” he began. “You were always there for me, even when I was locked up. I am angry that I could not be there for you. I wasted time in prison when I could have spent that time with you. You were such a wonderful person. Why were you taken, and not me?”
Working with people like Mr. Rhodes is one of my favorite parts of the week. I feel honored to witness some of their most vulnerable moments and be there for them as they work past those moments. What also compels me to spend my Saturdays at the jail is my own loss.
On Nov. 18, 2010, one week after I turned 18, I came home from school to find my brother Sam, dead by suicide. His lifeless, slightly green body was hanging from a rafter in our basement. He was my only sibling.
In college I experienced flashbacks, nightmares, hypervigilance, irritability, suicidal ideations and an overwhelming sense of worthlessness. After an inpatient psychiatric hospitalization around the one-year anniversary of Sam’s death, I decided on April 12, 2012, to end my own life. I took bottles of Cymbalta and Wellbutrin as I looked at myself in my dorm-room mirror. The next thing I remembered was waking up in the hospital. I’d had four seizures from the overdose, which resulted in my being in a coma and on a ventilator for five days.
I would like to say that I got better after that incident. But I continued to struggle for years, ranging from additional suicide attempts and hospitalizations to intensive outpatient programs and twice-weekly appointments with my therapist. Still, I was able to graduate college with a bachelors in psychology and get into a graduate program for clinical social work.
Throughout my studies, my time in inpatient psychiatric units stuck with me. For instance, since I’d been a college student when I was being treated at the hospital, I did not have to sit with “the crazy people,” as one nurse put it to me. I had a recliner, away from the woman shouting all night that she was on fire.
As my mental health improved over the years, I began to recognize these experiences for what they were: White and middle-class privilege. That’s not to say it was easy for my family to pay tens of thousands of dollars for a 35-day residential psychiatric program. But I had support that some of my peers—many of them homeless—lacked. Today, I see myself in many of my incarcerated clients, except I received treatment instead of punishment for my mental health symptoms.
In social work when a client says something that elicits a memory or emotion within the practitioner, we call this “countertransference.” When I think of countertransference, I imagine a bathroom faucet that controls all my pain and allows me to stay fully present for my client. When that faucet turns ever slightly, a drop of my anguish enters my heart. Rather than dwelling on my own pain, I use that anguish to connect with my clients as they continue to talk about a traumatic event.
For example, when Mr. Rhodes described the anger and guilt he felt about his sister’s death, I used countertransference to be present for him. I did not use that opportunity to tell him that I had lost my own brother or that I’ve had many moments when I feel immense guilt for his suicide. Nor did I say to myself, Oh, these emotions that Mr. Rhodes is experiencing remind me of when Sam died.
If I focus on my own experiences while in a session then I fail as a therapist because it takes away the purpose of counseling. I am there for my clients, not the jail system or additional experience to put on my resume.
Another major part of my work is avoiding bias. I channel my pain into empathy, regardless of why my clients are in jail. I don’t even look up what they’re charged with because, like it or not, we all have biases. Often those biases are very subtle. As accepting as I think I am, I do not want to risk tarnishing the therapeutic alliance by coming in with preconceived notions about the crimes my clients may or may not have committed. They get enough of that from society and the jail.
Due to COVID-19 I have been restricted from entering the jail since March. It has been hard not going every Saturday. I have multiple clients there that I have worked with for months, if not for over a year at this point. I worry that the jail is not providing them access to mental health therapy or groups. But mostly, I miss seeing them.
And in a way, my work at the jail allows me to honor Sam. My brother felt utterly alone; I want my clients to know that someone cares about them. They deserve a clinician who is empathetic, present and authentic, despite their incarceration. Everyone does.
*Mr. Rhodes’ name has been changed to protect his privacy.
Lizzie Fatseas is a clinical social worker at Central State Hospital in Petersburg, Virginia. She works with clients who are seriously mentally ill and have intellectual disabilities, autism, dementia or are medically fragile.
