Autumn in the Shallow Valley

A shallow  valley

in the northeast,

bushy lemon corn shocks

dissolve into deep gold

missing the moiety

of themselves only four weeks later.

Faint gray fog

whispering above corn fields 

and retention ponds,

protecting them from

the bitter cold

soon to come.

Scarcely any fields

turned for the winter,

by months end, predominately all will be prepared

for winter frost and snow.

Everything within sight

stained white and immoble.

The annual cycle continues:

Late spring frost in mid-May,

planting crops in early June

for harvest by mid-August

into September.

The sumac has started its slow burn.

The shallow valley in the north east

continues this ritual

into eternity.

How I Spent My Summer Vacation

This is the last night of my summer vacation. I start a new, full time, outpatient therapist job tomorrow, Monday, 08/10/2026. The last day I worked was 02/20/2026 which is A LOT of time. So here's what I did.

I was unemployed for a total of 22 weeks, that's roughly 110 workdays Monday through Friday. I applied for at least 84 jobs. I say "at least" because unemployment requires four work searchs per week and there were weeks when I applied for more, but only reported the required four. Unemployment doesn't give you extra credit if you apply for more.

I had 14 in-person or final virtual interviews. At one agency I had 4 interviews and still didn't get hired. Living in Green Bay, the farthest I traveled for an interview was Oshkosh in early May. I really liked the Clinical Director and Clinical Supervisor I met with on a Monday and as the Supervisor was walking me out, she said, "You'll be hearing good things from us by Friday." Surprisingly I received the following email on Thursday, keep in mind this is all within the same week:

Hi Kristine,

Thank you again for your interest in the MH position and for taking the time to speak with us throughout the interview process. We were very impressed with your experience, professionalism, and the qualities you would bring to the role.

Unfortunately, in the short time between our last communication and reconnecting with candidates today, [company name] underwent some restructuring at another location. As part of an effort to support and retain current staff, the decision was made to fill the MH position with an existing employee. Because of this unexpected change, we are no longer able to move forward with the position as originally planned.

Please know this decision is not a reflection of you as a candidate. You were among our top candidates, and we truly believe you would be a valuable addition to any team. We sincerely appreciate the time and interest you invested with us throughout the process.

With your permission, we would love to keep your information on file should circumstances change or another opportunity become available in the future. We would be grateful for the opportunity to reconnect if the need arises.

So that was a kick in the teeth. My second in-person interview was in Green Bay in mid-March. After the interview on Monday, the Lead Clinician walked me through the office and introducted me to other staff and gave me a benefits folder to take with me. I was told the "next steps" (I could happily live the rest of my life without ever hearing that phrase again) would be receiving an email by Friday with "next step" in the interview process. Surprisingly, I received this email on Wednesday:

Dear Kristine,

Thank you for taking the time to interview for the Substance Use Therapist (Psychotherapist) position.

At this time, we have decided to move forward with other candidates that better fit our organization/department needs.

We encourage you to keep an eye out for new jobs as we are continually growing, and we wish you the best of luck in your job search.   

Sincerely,

Human Resources

I have no idea what in the hell happened in those 48 hours but wowzers that stung. I wish I had learned this lesson sooner than I did, but by the end of May I had been looking for work for 3 months and after every interview which would be used by the agency to make their final decision, I was so psyched because in my mind, I nailed the interview, I was clear and concise answering their questions, and I made a good impression given my experience and variety of clients I've worked with. This was going to be "the one".

I had to scale my expectations WAAAAAY back. I developed a "meh" attitude. Of course I gave it my all in every phone call, virtual or in-person interview, but I couldn't maintain any expectations that "this was finally the one" because it hurt too much. Every email with "We've decided to persue other candidates who more closely match...." or any variations on that theme, came to mean I sucked. I sucked as a therapist, I sucked as an interviewee, I sucked as an employee, and eventually, I sucked as a human being. 

"Meh" became safe. "Meh" became comfortable. I could settle with "meh." My brain really liked "meh" so that infiltrated my self-talk, my view of myself, and my behavior. At the start of this job search I wanted to keep my sleep/wake routine and I did until "meh" took over. I was staying up until 11pm, getting up roughly 12 hours later; even if I was awake, I would lay in bed and watch You Tube shorts for hours. I played the one online game I play laying in bed, awake, but "meh", what was going to getting out of bed accomplish? 

I'm no longer in that space. Yes, being offered and accepting a great job helped, but during those 22 weeks I still had to keep my head above water. There were endless weeks when I could barely do that. I cried hard and often. I could only do that if I was in the bathroom with the fan on to drown out my sobbing or if I was sitting outside. For whatever reason, I still cry at times 3-4 days a week, but it's less intense and no longer includes the "I suck" message. I've kept seeing my shrink and am med compliant. I have ketamine therapy every two weeks. I use a vagal nerve stimulator which amazingly helps with emotional regulation.  

I spent last week, August 3rd through the 7th, in a 5-day intensive EMDR basic training for clinicians. My peers were great, the trainer was great and I knew her from previously working together, and I got to get the hell out of the house to simply talk with other people. Besides the vagal nerve stimulation to help me remain emotionally regulated, I've learned that I am such a social person, I need other people to feel fulfilled as a person. I need to be cognitively challenged (yes, that's total therapy jargon, but Rog and Shirl didn't pay $40,000 for graduate school for me to not use the jargon). 

I have started the same work routine tonight: I chose my clothes and jewelry for tomorrow, I have timed out when I will go to bed, when I'll wake up tomorrow and have taken into account my commute time.

I'm ready for this!! Let's rock 'n roll.  

Lifelong Friendships Are Real

My father stood at the foot of his lifelong friend and fellow veterans coffin, waiting silently for him to be lowered into a final place of rest, within view of my parent's headstone, straightening his 78 year old spine as best he could and saluting for 45 minutes before Butch, my dad's best friend since middle school in Shawano, was lowered into the semi-frozen earth.

Butch graduated from Shawano High School three years before my dad; they were on the school's baseball team with another student who was actively recruited by the Cincinnati Reds, but graduated from UW-Whitewater and joined Price Waterhouse in Milwaukee with my dad instead.

Dad has a solid group of "guy friends" from Shawano, together they deer hunted, goose hunted, and flew into remote Canada for a week of fishing each summer.

I too have strong friendships from junior high and high school. I have attended services for few of their parents (which is a blessing), yet I wonder who will attend when it's my mother or father services are held for.

Untitled

Every day,

            dark

Every thought,

            dark

Every feeling, 

            dark.

            No energy                                                                                                         motivation

                   movement from my bed.

    
                  

Every distraction,                        

            dark

Every ask,

            dark

Every look,

            dark.

            No joy

                  potential

                  movement in my brain.

Every touch,

            burning

Every question,

            ignored

Every demand,

            pointless.

            No interest

                  color

                  hope.

I Quit my Fucking Job and Couldn't be Happier

Yes, it's true: I quit my job (technically not until Monday 02/23/26) and I couldn't be happier!!

I have been told ad nauseum to never quit a job unless you had another one lined up, but in this case, my job was creating so much stress, distress, and overall decreased satisfaction in my life that I had to get out of there before I became a patient there.

UHC/Optum/Sherman Counseling closed all of the outpatient agencies in the state effective 12/08/25 and I got another job at a free standing psychiatric hospital which is a level of care I had no experience working in. The salary they offered made my jaw drop and I immediately accepted.

Here's the deal with inpatient psych care from my humble experience:

There is no "typical" day

The only tasks scheduled are daily groups with the expectation of facilitating and documenting two groups per day 

Any given day at a hospital can include 4-19 admissions; multiple AMA (against medical advice) discharges, involuntary admissions with virtual court which can lead to 90-day orders for patients to remain admitted until the staff psychiatrist deems a patient no longer a harm to themself and/or others with court ordered meds which will be administered by a shot in your ass if you won't take them orally

Severely psychotic patients who will scream for hours on end something like "HELP ME!! SOMEONE HELP ME!! HELP ME!!" And it's not because they are receiving substandard care, it's because they have lost touch with reality and will be given PRN Haldol, Benadryl or possibly Thorazine by a shot in the ass to get them to calm the fuck down and sleep for between 8-10 hours

There are patients such as the one described above who cannot benefit from the inpatient level of care provided and are transferred to one of the state psychiatric hospitals - Winnebago Mental Health Institute outside of Oshkosh or Mendota State Hospital in Madison.

New admissions must have their psychosocial assessment and Treatment Plan with therapy goals completed and routed to the assigned staff psychiatrist, nursing staff, and assigned case manager within 72 hours from admission

If you complete a patient's "intake" as outlined above that patient becomes part of your caseload with the expectation of meeting with them every other day for general updates which you are expected to provide in every morning's Treatment Team meeting with staff psychiatrists, other inpatient therapists, case managers, recreation therapists, nursing staff, and utilization review staff who will tell you what the patient's last covered day by insurance is at that point and that they need a "criteria" note to indicate that the patient needs additional time at this level of care which will be part of the documentation submitted to the insurance company to gain approval for additional days at the inpatient level of care

Patients admitted for alcohol or other substance use detox have an average length of stay of 3-5 days. What beneficial therapy they are going to receive in that amount of time is beyond me.

Mental health patient have an average length of stay between 7-10 days. As primarily an outpatient therapist, what coping skills or insight into what led to their admission they can gain in that short time again baffles me

I am clearly meant to be an outpatient therapist. I want to connect with my patients, establish clear goals and work toward them with my patients, and if we get off track, I want to steer them back on the path of reaching their goals. I cannot do the work for them, however I will provide all of my training, knowledge, and experience to walk that path with them and support them during times of crisis and times of success.

That's who I am. 

                                                           😱                                                                                             

 

So This is Christmas...

This is a lyric from the song "Happy Christmas (War is Over)" that sadly strikes me as very relevant this particular holiday season:

And so this is Christmas

For weak and for strong

For rich and the poor ones

The world is so wrong

I've heard this song as often as any other and they all sort of mesh together at some point, but for this blog I read all of the lyrics and realized this is really an anti-war anthem more than a traditional Christmas carol. Regardless, it's the "The world is so wrong" line that grabbed me.

Without doubt there are many things "wrong" in our world, but as the political pendulum swings as it always does, I want to post what I wrote on the back of our photo Christmas cards this year.

I feel I've been pretty open about my mental health and work struggles this year, but I don't want to believe that the world is so wrong. Has it been my best year ever? No, but honestly I struggle to remember an entire year that didn't include disappointment, loss, or pain. Sure, maybe when I was six or seven years old the world seemed stable and consistent, but I know for sure that the Christmas of 1976 was unsettling because that was the first Christmas with my youngest sibling, my brother who's six years younger than I am. Being the oldest of the Porath clan, I've heard stories about how I pouted when my younger sister was born and the world didn't revolve around just me anymore. 

So I'm pretty sure there has always been disappointment, loss, or pain in any given year. When you're a little kid these setbacks are age-appropriate, at least I hope they are for others reading this. At age 54, the disappointment, loss, and pain feel SO MUCH MORE intense than the tantrums I threw when I was six and naturally so. If I still threw tantrums at this age, that would be really fucking weird. 

Bringing this all together, I'm trying to say that life is not fair, shit happens, and as we mature, the unfairness and shit mature with us. At age seven I wasn't worried about car insurance, now at age fifty-four, sometimes I am. I came to terms with the birth of my siblings decades ago, love them to death and am thrilled they are a part of my life. 

My intent for 2026 is to manage the challenges that will undoubtedly happen, not make mountains out of mole-hills, and reach out for help when I need it. 2025 showed me how much I need to lean on others which I have fought against so hard I burned out. I was a pile of smoking embers as summer waned but I got  help and I need to keep up that momentum. That will help me find peace, joy, and to take better care of myself (I have a terrible habit of working harder than my patients and that has stopped since I started my new job as an inpatient therapist at a free standing psych hospital).

I will close with this lyric from the same song I've been yammering about:

And so this is Christmas
I hope you have fun
The near and the dear one
The old and the young

The Bittersweet Goodbye is Real

Since I came back to work part time on 11/05/2025, I've been working knowing that at the far end my last day seeing clients would be Tuesday 12/02/2025 and staff (me and another LCP) would spend 3 days discharging clients, counting up IT and office equipment, finally locking the doors on Friday 12/05/25.

Last week I emailed all of my clients who haven't scheduled to see me from 11/06/25 to 12/02/25, checking if they wanted to schedule another couple of sessions or if they wanted me to discharge and close their file, which is the option the vast majority of clients took. So I spend a good amount of time last week discharging them and closing files.

Each client discharge brought to mind the awkwardness of their Intake session, "ah-ha" moments I was privileged to witness in sessions, and memories of tragedies shared and successes achieved. I teared up as I looked over most of the names on my client list. I wish I could take dozens of them with me, but I can't. I'm moving into a position that's not focused on outpatient therapy.

For me the good news is that I've already found a full time position at a local 74 bed inpatient hospital, completing Intake assessments, treatment planning, and discharge planning for both mental health and detox patients, in addition to providing individual, family and group sessions, and floating over to offer PHP and IOP 1:1 sessions, processing and psychoeducational groups. 

My last day at my current gig is Monday 12/01/25. My new gig starts 12/15/25. I've never taken any time off between job changes, but given my own mental health struggles, the objectively fucked-up way the termination of my current position has been handled, and my need for time to process all of it, I feel entitled to have ten days off between,

Whenever I get a new client I go into Facebook and try to locate them and block them. When working at a prison, this was literally for my own safety.  With middle school and high school kids this was purely for privacy boundaries and I've continued that practice for many years since. I'm well aware of the Wisconsin Department of  Health Services and best practices of not contacting or accepting contact from former clients for at least two years after the end of the professional relationship. Two years is a long time to be motivated to search for someone and start social contact with them, which is the point of that limitation. As much as I care about my clients now, in two years will they even be interested in any contact from me, and me from them?

I hope I've offered the best care I could to my clients. I want all of them to succeed, whatever that looks like for them, and if I played any role in that coming to fruition, I am humbled, I hope I've made a difference. I hope I've compassionately prompted change.

I continue to and always will hope....