Expectations

Expectations.. they can be a powerful tool for setting boundaries and priorities and for establishing predictability and structure. However, expectations can also be limiting, exhausting and a formula for letdown.

I recently began a personal journey of reflecting on the impacts of expectations in my own life. The high level of entrenchment and consistency of these little gems in my life has increased both my tolerance and my pursuit of them. For many years expectations have guided my perception of personal relationships, professional performance and activities of daily living. I have conditioned myself to always raise the bar on expectations of myself (regardless of rationality) and thereby my expectations of interactions with others.However, too much of even a good thing can lead to pathology. And while, in many cases expectations are healthy and beneficial tools, I recently identified my use of many them as sole indicators of the 'success' and 'value' of interpersonal interactions and individual achievements - a dangerous and narrow ridge to tread.

These self-imposed and automatically assessed standards have served as a litmus test of my functioning for many years. The truth is, when all is going according to expectation, it seems all is right with the world - relationships seem to deepen and thrive, colleagues, supervisors and clients comment on exceedingly 'professional' performance, even self-talk reflects a tone of accomplishment. Yet, the effects of these encouragers are fleeting and within minutes to hours I am reflecting on ways that I have fallen short of fully delivering on said expectations.

In most areas of my life I can trace the primary cause of my distress and frustrations back to unmet, unaccomplished expectations. While sifting through the emotions associated with these 'discouragements' in my life I realized that the source of my hurt, frustration or disappointment with any given life situation is highly correlated with the lack of 'perfect' attainment. What had once served as a general guide to provide protective boundaries had become the sole rubric for perceived success in many areas of my life. In many cases these expectations have become a rigid, restrictive, tunnel-vision approach for the way things 'should be' as opposed to one of many alternatives to how they 'could be'.

So, beginning with the most emotionally exhausted relationship in my life, and working my way out, I have resolved to (1) acknowledge my expectations, (2) identify the feeling I associate with that particular expectation and what I believe I will feel if it is met, (3) identify the belief I have about that specific expectation and why it is important to me, (4) consider whether the association between the expectation and belief is appropriate, (5) communicate what I am desiring from the other person (or if professionally oriented, discuss my intentions with a supervisor), (6) brainstorm a go-forward plan with others involved and (7) permit myself to begin to let go of the habit of tying emotionality to expectations and focus on the beliefs that direct them.

My first reflection using this model - (1) I 'expect' the process of deconstructing my 'expectations as a rubric' approach will be a challenging but fruitful process. (2) I am both excited and anxious to experience growth in this area and (3) I believe that being open to changing the way I view the world is imperative in my development as a professional and individual. I also believe that change is neither easy nor immediate. (4) The association between personal development and changing the way I view expectations is an appropriate fit and (5) I desire that my supervisors, peers and family members be open to dialogue with me as I being to process expectations and their impacts on my relationships and performance. (6) Outwardly discussing expectations, requesting support and accountability from others in speaking up in the event that they feel any type of resistance or disappointment coming from me (due to expectations), journaling about any frustrations or disappointment and assigning feelings and beliefs with them are ways I can go-forward with this plan. (7) As I continue through this day, this week, this month and so on, I will give myself permission to awkwardly work through this process while reminding myself that what has taken a lifetime to develop will take a great deal of time to adjust.

One clumsy step toward the person I want to become is worth more than a full on sprint down the path that leads me to the orderly world of straight-edge expectations.. even if I do seem to be very comfortable there!

An Exterior Thought

I wonder what it is that makes us spend to much time judging ourselves before the mirror. I don't have the same thoughts about others around me, in fact, I cannot remember the last time I carefully inspected the way back pockets were arranged on another's pants, where someones belt buckle seemed to bulge under their shirt or how another's sleeves revealed or covered her ever so womanly arms.

I see women out and about dressed to the nines - 3-inch heels, seven designer jeans, a flowy forever 21 top.. all the numbers one might expect to add up to a perfect 10 and yet, what do I notice about this women after I get past her impeccable exterior? That she avoids the glances of others either because her chin is held to high or here eyes are cast to the ground, that she doesn't joyfully chat with all the people around her but rather seems to be on the defensive against unwanted attention, and she doesn't smile - how is it that in the midst of a perfect image she can be perfectly unhappy with herself or those around her?

So if those who go before me, those with the perfect body shape and clothing to match don't seem settled in their skin, what makes me think that that, as an ultimate goal would hold different results for me? Rather, I think it is yet another phantom source of gratification which distracts me from where I should be looking first - within.

I remember, one of my favorite guys in high school was light-hearted, always fun to be around, kind, thoughtful and carrying 150 more pounds than any of the varsity football players. He had a huge personality and a large exterior to match.. Yet, I never seemed phased by his exterior, in fact, I found it to be both disarming and welcoming at the same time. That same guy has worked hard to drop the extra 150 pounds and then some, but I can only pray that he didn't lose that incredible personality that he carried so well.

I am inspired by those who see where they are in life and regardless of circumstance find humor, courage and above all joy. I want to seek out those sources within my own life.. I want to own them and carry them well, regardless of the hand bag I'm toting and how well my shoes may or may not match it.

Counselor, Know Thyself

"Update blog" has been a checklist item haunting me for months. With little excuse for the delay, I return to writing, encouraged by a semester of new thought and processing and excited about the future that lies ahead.

I've completed 12-hours of masters counseling coursework and, with little prior experience to speak of, I found myself reeling from the new perspectives and thought processes that began to seep into my awareness. My newly-discovered understanding of what a therapeutic relationship looks like and what goes on in the mind of the counselor has led to a major transition in my perspective and in addition to growing in understanding, the last 4 months have been a time of:

• Stabilization: I have not lived in the same place for more than 4 consecutive weeks at a time for almost 4 years. Reclaiming routine, building new relationships and nesting in my new place have been wonderfully enjoyable! My room is now a sanctuary where I read, sleep and study with a renewed sense of appreciation for familiarity.


• Exploration: I have had the opportunity to investigate different counseling theories, trying them on to see if they fit my personal perspectives and character. I have also had the opportunity to attend workshops on various expressive arts therapies and dreamwork therapy.


• Culination (aka - taking a stab at the culinary arts): I find myself moving to basic foods, losing a taste for preservatives and artificial additives and returning to natural, organic nutrition. This past year I was excited to celebrate giving up red meat, chocolate and fried foods. My primary motivation was discipline, making choices to better care for my body and be creative with my diet. While I am a little late out of the gate in 2011, I am starting up again with this regimen!


• Deepening: I have had the opportunity to set aside some time throughout this past semester to contemplate my current state - spiritually and relationally. I was thankful to be able to steal away for a few days in January to take myself on a little mini-retreat with the Lord, I returned refreshed and grounded with an intense desire to just sit with the Lord - without petitions, without requests, but just spend time thanking him and learning more about his beautiful heart for us. In addition, I am becoming more involved with other Christian students through a graduate as well as undergraduate group, I am excited to see where this adventure takes me this year!


• Dating: Phil and I celebrated our 1 year date-a-versary this past January 30th and I enjoyed him surprising me by re-enacting several moments from our first meeting one another as well as the dates leading up to our decision to pursue exclusive dating and deepening in our relationship. We look forward to what this coming year will bring.

Classes started off mid-January and I have loaded my schedule with 15-hours of graduate work. The reading is fairly involved and I find myself spending most of my days cuddled up with a good diversity in counseling or ethical and legal issues text, sipping hot tea and considering the implications of this education on my future career.

My cohort has heard on more than one occasion, that 'you must go through the counseling process yourself before you can counsel others'. With that, I completed 10 course-required, counseling sessions as a client. While I entered into those sessions without any major life issues in mind to discuss, I completed my sessions with a deeper understanding of myself, my perceptions, my personal biases and what I would consider to be the footnotes to the story I tell myself about the world around me. Wow!

I not only enjoyed the process but seem to catch myself continuing the process even on my own. When exchanges happen between people around me, I find myself looking for the meaning and the emotion behind the words they are saying. I watch more carefully for nonverbal inflections, pauses and moments of struggle, I listen.. truly listen more carefully than ever before and I am continuously surprised by what I hear even in the silence.

Onward into semester 2! May my posts be shorter and more frequent in the future!

Back to School

After my summer courses ended in California, I took a few days to road-trip back to Dallas, stopping to adventure with my sister, Kristal, in Phoenix for a few days then to west Texas to visit my good friend Mitch and his family. Kristal and her friends introduced me to the world of 4-wheeling and shooting. Who knew that jacked up Land Rovers could do such crazy climbing over nearly vertical boulder terrain in the dessert?? Well.. now I know..

After just over a week back in Dallas, I'm prepping for a move this Friday, up to UNT in Denton for my graduate coursework in Clinical Mental Health. I'm excited about my new roommate (she's awesome!) and the opportunity to apply some of my novice interior design skills to the new place! It will be fun to live amidst the college and young professional population again.

Already I'm finding myself challenged and intrigued by the material we are covering in class. On day 1, my professor said, 'we are reflective helpers.. we must first process the information we are learning and only after we have reconciled it with the way we live can we apply it in a client setting' (paraphrased). Needless to say, I've been doing a load of processing already and it's only been a week of coursework. Suddenly I'm asking a whole slew of questions of myself that I don't remember asking before - why exactly do you feel that way, what led up to that type of thinking, how does this dictate your actions?.. this is, what we are in one of my courses referring to as, the language 'Shrinkish'.

I'm taking a 12 hour graduate course load, which, currently looks like about 36 hours of studying and 12 hours of classwork each week. I feel a little slow on the uptake given that I've been out of academia for almost 4 years now, but I'm encouraged by the energy and enthusiasm of our professors. This will certainly be a cool semester!!

Graduation: Way to Play W-EMT Crew!

After 4-weeks of intensive coursework and testing, our class took the National Registry EMT exam. For many, the certification would not directly impact their career or next steps in life, but for all, the education gained would be readily put to use given the need and opportunity. I'm so proud of all of my peers, a group of strangers that met less than a month prior, who shared sleeping, bathroom, training and classroom quarters all nestled within the same economically sized building, shared nights on the ridgetop watching meteor showers, breakfast lunch and dinner at the same tables, adventurous days in Yosemite conquering mountains and domes for that matter, afternoons practicing patient assessments on one another and evenings studying new course material in small ad hoc groups. For a month we did life together, got to know one another, encouraged, challenged and studied one another - I could not have picked a finer group of peers and instructors to grow with. Congrats Midpines 08/10 WEMT crew!!

Reality Check #3 - MVI Scenario Meet Real Life

I believe, beyond a shadow of a doubt, that the NOLS Wilderness Medicine Institute W-EMT course prepares students for real life emergencies. The scenario-based teaching continuously placed each of my classmates in a high energy, stressful situation that demanded performance. Through this learning approach, I was provided with the opportunity to rotate through virtually every role there is in an emergency situation - with the exception of bystander.. I gained experience as a 1-on-1 patient caretaker, an operations gear chief, incident commander, patient manager and actual patient. I was given the opportunity to see a trauma event unfold through the eyes of every vantage point on the ground and that experience has proven invaluable.

At the end of the 3rd week, we performed our final scenario - the Motor Vehicle Incident (MVI). At this point in the game, each of my peers and now friends in the class were fairly seasoned at seeing something quasi-disturbing then taking a breath and getting into the weeds of it. In addition, we had all become expert patients, so staying in role seemed no longer difficult for those who were 'experiencing the trauma'. This made the scenario that much more real for each of the rescuers.

In this scenario, 1/3
of the class was removed
then the remaining 2/3's were split into two small teams which would each be performing a different rescue. After a short period of prep time for the teams to identify leadership and roles, we were set loose on a scene which we had no prior information about. Trodding out of the classroom with backboards and oxygen tanks in tow, we walked out the door and directly into the middle of our scenario - two cars, a truck t-boned by an SUV and a pedestrian pinned between them. No one flinched - we just went to work.

In just over 30 minutes we had all 4 of the passengers and the 1 pedestrian extracted. All passengers were removed from the cars using spinal precautions and were back-boarded and transport ready. The patients were tagged based on level of critically and were whisked away accordingly. Faced with challenging and cumbersome interior car compartments and patient positioning, various levels of consciousness and types of injuries - we just did what we had be taught. The completion of the scenario was somewhat bitter-sweet. It was our final scenario, our last time to work with one another as a team of medical professionals in training.

And yet.. it wasn't more that 24-hours later that I found myself surreally thrown back into that scenario, except the patients weren't my friends 'playing a role' and the components of the incident weren't props strategically arranged for dramatic affect.

7:00am: I started the morning with an ambulance crew out of a small town about an hour from our hostel. My shift was 7am to 7pm and would fulfill the professional EMT ride-along component of my coursework. The paramedic showed me the ropes when I arrived - the rig and all the various equipment it held and the house where employees relaxed between calls, she also introduced me to the EMT on the rig. We visited for about 15-minutes, chatting about the possible slowness of the day (I had made sure to bring my textbook so that I could study for my upcoming finals, sure that the day would provide ample time for such a thing).

7:30am: We received our first call of the day.. and hit the ground running. Call after call we were responding to all different types of medical emergencies. I quickly realized that while there were variants that changed with each call - type of emergency, age and gender of the patient, location and duration of time spent with the patient - there were two constants.. (1) the patient and family member's need for affirmation and encouragement and (2) the fact that the medical providers were in the best position to provide it.

So, call after call, I found myself perfectly positioned to speak peace and calmness into situations, validating the family member's decision to call us, encouraging an elderly man to take deep breaths and focus, handing off tattered medical cards from the patient's wife to the paramedic, toting the bag that would monitor a drug addict's irregular and weak heartbeat, soaking down towels with water to wipe blood from the hands and legs of a woman paralyzed with weakness. This is the side of emergency medical response that we don't really hear about.. the side that brings a medical provider into the very intimate details and setting of some of the most traumatic moments of a person's life.

5:04 pm: After a long day of calls we stopped to refuel the rig then were headed back to the station. I overheard some chatter on the radio about an MVI in a town about 25 minutes away. 'We're too far..' the paramedic said, 'there is another rig closer that will respond'. I began thinking about what the dispatcher had said, the location announced was 7 miles from where my class was staying and was the largest town nearby. The closer ambulance rig reported back, they were on another call. The dispatcher came back and requested that we respond to the incident. The dispatcher also clarified the location of the incident while we were in route, it was less than 1/2 of a mile from the hostel my class was staying at. Head on collision, multiple patients, two trucks and a motorcycle.. In the blur that was the drive to the site, I remembered doing three things: praying that none of the patients were my classmates, putting on two layers of gloves, and going through the basic patient assessment process in my head.

I am convinced that the scenario approach works.. from the moment we arrived on scene, I began processing everything I saw as if it were another scenario. While we were not the first on scene, I started from the beginning, noting the environment, how many patients I could see, where they were located, what might have happened to each and what their status appeared to be. I have snapshots of various parts of the experience burned in my mind now - a motorcyclist's boot empty and upright in the middle of the road, crisp white sheets in comparison to the torn figures they partially covered, a patient's mom climbing into our ambulance for a few precious moments, the helicopter medic's focus as he spoke to a patient prior to transferring her into the medi-flight, a classmate's face when we returned to the site to pick up another patient, staring in the eyes of one of our patients helping her fight unconsciousness, holding a girl's hand, how very quite things seemed..

There were a number of firemen and police officers on site already and a throng of bystanders from the community - undoubtedly shocked by the incident. And then.. there I was, finding myself to be strangely calm and rational given the circumstances, seeing clearly, moving methodically, and doing exactly what I was trained to do - I was completely someone else in those moments..

I could say it 100 times and still struggle to believe it.. but I wasn't phased, I walked right into the situation and got to work, doing exactly what I had been taught and yet, learning all along the way..

Reality Check #2: Trauma Center Emergency Room

Friday, August 6th marked the mid-point of my EMT course. That night one of my roommates, Charis, and I drove out to a major California trauma center for the 11pm - 7am emergency room shift. We were blown away by what we witnessed..

Over an 8-hour period we saw 4 patients with various gunshot wounds, 1 patient with blunt trauma to the head with a possibility of a subdural arachnoid hemorrhage (bleeding between the brain and its protective layer that stores cerebral spinal fluid), a multiple stab victim and various other traumas. We stood in the trauma pods and watched medical professionals assessing and treating conditions we've only read about. Seeing real people going through this type of triage and trauma process was quite an education.

As we drove back after virtually no sleep for 2 days, I reflected on the fragility of life. I will not be able to see the ER the same again.

This week holds more coursework, tests, scenarios and studying. I'm thankful for continued opportunities to see the grace of God in the midst of my coursework and medical rotations. Asking for strength and retention this week.