Playing Injured

After the debacle with A.J. I decided, in an act of pure superstition, to switch over from Connect Four to Uno as the play therapy game of choice. Although it can be a faster-paced game, it allows for easy therapeutic conversation. Especially when shuffling, as the deck is much larger than the standard 52-card pile, thus allowing me to ask lots of questions and impart plenty of words of wisdom to today’s youth between hands.
Many clinicians schedule clients at the top of every hour. They are seen for 45-50 minutes, with the remainder of the hour dedicated to notes. I prefer to schedule people every 45 minutes, completing notes at a later time. The pros of this philosophy are a shorter work day and a positive therapeutic rhythm, as once I start talking with people I don’t really need any down time. On the negative side, I’m bound to my schedule, lest I make clients wait should I be even one minute over time.
After completing a very productive session with a young woman suffering from assertiveness issues, I realize that Jack, a 14 year-old boy struggling with sleep issues following his parents’ divorce, was my next appointment. Jack is an avid Uno player and seems to truly enjoy coming to sessions. Although he can be quite sensitive, he is a great kid who I love working with. A young and very intelligent man who wants to be a doctor. Only a freshman, he takes many classes with seniors because of his advanced I.Q.


Recognizing that I am running a few minutes late, I start to walk toward the waiting room. At the same time, I reach back for the Uno deck … Everything goes white. A sharp pain shoots up my lower back up to my shoulders. I can almost feel my eyes gloss over with a white sheen. I had this pain once before, about 9 months ago and it was excruciating.
I collapse to the floor of my office and I know that my SI Joint is out of place. The last time this happened was in the grocery store as I bent over to pick up a big of chips before a Jets playoff game. Then it took about three weeks to heal and my chiropractor, Dr. G., told me that the pain could come back at any time. But since all of us are prone to selective hearing, I only recall him saying “don’t worry, you’ll never have any pain again, whether it be physical, emotional, or spiritual. Here, have a lollipop.”
I’m on the floor, flailing frantically in a pathetic attempt to massage my back muscles. The pain. Could any writer describe it? Melville? Tolstoy? James Frey at the dentist? None are worthy of this moment. Until you experience your flesh burning beneath your skin, you are living in ignorance.
My eyes open and I see that I am now ten minutes late. Jack must be wondering where I am. Dr. G told me that if I can do some basic stretching – laying on my back and pulling my knees toward my chest – it could help release some of the pressure. I gently lift up my legs and move them close to my face. Although it’s amazingly painful, I’m able to do it. Dr. G. said to hold the pose for one minute, but after about 30 seconds, my legs give out and fall to the floor. I reach up and grab the desk pushing down on it as hard as I can until I’m standing. Strangely, this type of injury feels much worse sitting or laying and so once I’m on my feet, the pain is bearable. I can feel the throbbing, but it’s not making me cry, which is what I usually do when I’m in physical pain.
I walk out to the waiting room to find a somewhat confused and irritated Jack. I apologize to Mrs. Jack, a mid-30’s soccer mom, who stares at me wondering why I’m tilted slightly to the left. “Come on in, Buddy,” I say to Jack, “sorry to keep you waiting.”
“Jack, I hurt my back recently, and it’s a little hard for me to sit on the floor and play cards. Do you mind if we use the table and I stand? You’ll have to shuffle if that’s okay?”
Therapist Rule: Children do well with consistency and structure. Only break rule when necessary.
“Just sit on the floor like always! It can’t be that bad.”
Apparently children do not appreciate a bad back the way adults do.
“I’d really like to, but I can’t. Let’s just play the way I suggested and we’ll talk about mom and dad.”
Jack lets out an annoyed “Hmmph. Fine,” and starts to shuffle. Picking up cards, I can feel the nerves screaming in my back.
Therapist Rule: Within reason, children do better in therapy if they see you as mentally strong and in control. Thus, I don’t ask Jack to pick up the cards for me but this game can’t continue for much longer.
“Tell me about your time with dad this weekend.”
“Fine.”
Therapist Rule: Open-ended questions are the interrogative method of choice, and if you have a solid relationship with a child, don’t be afraid to push a bit.
“That’s great, but tell me about it.”
“Well, we went to dinner with Dad’s new girlfriend. Olive Garden. Then we played Halo.”
“You and Dad?”
“No, me and Angie.”
“That’s Dad’s new girlfriend?”
“Yeah, she’s awesome. She bought me candy and got me a bunch of flash drives from the Audio/Visual Department at school.”
“Oh, so she works at a school?”
“No, that’s the school she goes to. ________ High, like me. Angie graduates in a few months. It just sucks because we have a few classes together, so next year she won’t be there.”
Right then, as I’m reaching for my 3rd Draw Four in a row and trying to process the fact that Jack’s dad is dating one of his son’s classmates, the pain shoots up and down my back and I can’t hold back a somewhat girlish and shrill scream.
“What’s wrong? You don’t approve of Angie?”
“No no, it’s not that. It’s my back.”
“Liar! You hate Angie! Mommmm!”
In true Déjà vu spirit, Jack runs out of the office and I walk into the waiting room mentally preparing for another speech from an upset parent.
“Jack ran into the bathroom. He told you about Angie, huh?” says Mrs. Jack.
“Yes, it was just a case of bad timing. I hurt my back, and winced at the moment he revealed that she was, um, younger than what one would traditionally expect.”
“That’s fine. Are you okay?”
“I’ve been better,” I confess. “Are you okay with your son spending time with Angie?”
Therapist Rule: Always find out parental reactions to new and important people in a child’s life.
“She’s an 18 year old slut, if you want the truth. But she adores Jack, and can’t spend enough of Mr. Jack’s money. So that makes me happy.”
“I don’t want to imply that there’s anything wrong with it, but I’d like to spend some time with Jack discussing non-traditional relationships and how it impacts him, if that’s alright with you.”
“That would be great. I don’t think you want to start that right now, though. He’s very protective of Angie and I think you really upset him.”
“I know,” I say, sadly. “I’ve been doing that quite a bit lately for some reason.”
“Next week, then?” asks Mrs. Jack.
“Absolutely,” I say with a forced and pained smile.
Closing the door behind her, I hear Jack come out of the bathroom. “He hates Angie!” he yells. “I’m not going back, ever! No. More. Doctor. Rob!”
Considering my string of bad luck with the young ones, maybe I should convert my practice to adults only. They seem to be the only clients I can hold onto anyway. Although I really hope Jack comes back next week.

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17 Responses to “Playing Injured”

  1. zach says:

    what an intentionally cutesie and misleading title for a story

  2. Liz says:

    forgive my ignorance.. but I can’t help but wonder, how can child of Jack’s age, and the IQ you mentioned, be unaware of back pain, or of being polite to others who mention they are in pain? but then, I’m not a parent, nor am I a child anymore, and though I remember understanding back pain, and having a better reaction toward it, long before freshmen age, I suppose things have changed.

  3. someone intelligent says:

    I agree with liz. Personally, seeing you say something like “I’d prefer to stand because I can’t really sit right now”, would lead me to believe, you either have hemmroids or some sort of other pain, in which case I’d prefer to give you the benefit of the doubt if you say your reaction to anything is a result of physical pain.

  4. Wayland says:

    Geez bro. Get that back taken care of : ( You take enough care of people and deserve a little for youself, don’t you think?

  5. Eli says:

    To answer Liz:
    Intellectual IQ and social/emotional IQ (if the term can be used that way) do not necessarily correlate. In fact, I would say that often times children with a high IQ possess a lower social/emotional IQ than average.
    Moreover, I distinctly recall thinking when I was around that age that back pain really couldn’t be as bad as everyone said it was. I mean, your average kid of that age has only ever hurt him/herself in an activity of some sort and it is rarely the back that gets hurt. Therefore it is difficult to understand how horribly debilitating it is to have something go wrong with your back. I know I never appreciated it until I twisted me neck last year and couldn’t move it properly for a few days.

  6. MB says:

    I’m 19 and I still don’t appreciate my parents’ back pain or any other pains they mention. Surely it can’t be that bad? I know it probably is, but to be honest I cannot fathom this.

  7. steve joe says:

    I remember when I was 18 and made fun of my friends back pains. About 5 years later I pulled my lower back, which from what I hear is much less painful than the upper back or SI joint. One of the first things I did was call my friend to apologize.
    Kids have no appreciation for back pains.

  8. Ken says:

    I’m 19, and I understand the whole back pain issue fairly well. When I was 14 I compression fractured 3 vertebrae in the thoracic region while snowboarding. I constantly pop my back now when I stretch, and if it doesn’t pop it starts to ache something mean. Other times if it pops too low, it’ll send shooting pains up my back.
    Back pain ain’t no laughing matter, that’s for sure.

  9. Alex says:

    it seems like all your readers have back pain

  10. Brodie says:

    I too was acquainted with back pain at a younger age. I, playing center on my JV football team, managed to tear my latissimus dorsi in an upward angle from the spine. Surgery, six weeks of hell and eight years later I still occasionally get hit with an odd and painful burning sensation (around a 6 on the pain scale) in the upper corner of the tear.

  11. liars, all of you says:

    back pain is a myth grow up

  12. killians says:

    He’s what, 14 years old? Seriously, I was immature at that age too, but the last time I remember acting like that was when I was seven.

  13. hotspur says:

    To killians: I had a similar reaction to the immaturity of the kid… but then I realized: when I was 14, I wasn’t in therapy and my Dad wasn’t dating a senior in my high school. Possibly I would not have developed the same kind of equanimity…
    Also, right into my 20s, I had no sympathy for back pain, shin splints, asthma, migraines, or any other condition that I never had and therefore viewed as 100% BS.

  14. LOL. I’m catching up on “Jack”, so pardon my tardiness to comment.
    With the prevalence for blended families, it isn’t surprising that you’ll find interesting dynamics, but this is definitely not common. I once worked with someone who’s father dated her friends….it was an odd dynamic to say the least.

  15. AliceJ says:

    If my therapist had back pain then I’d rather he went to his doctor for sympathy, not to me! Why didn’t you just cancel the session?

  16. ep Thorn says:

    There are two locations people seem to commonly have pain in that are particularly debilitating… teeth and back. Anyone who’s ever been kept wide-awake by a major toothache or back problem knows how bad the pain can be, even to the point of being intractable unless you happen to have some opiates around.
    I did something bad to my back when I was 19 and have been paying for it ever since. Now 25 I have once or twice a year- sometimes more depending on behavior- where my mid-back flares up for half a week with stabbing, acute pain. Hydrocodone/APAP 5/500 is the only thing that seems to help, but most reasonable doctors wouldn’t proscribe an opiate for such a condition, fearing drug-seeking patients. Makes me wonder how long that bottle from my wisdom teeth removal will last…
    In any case, I know I didn’t understand back pain at the age of 15 the same way I do at 25… I’m sure he’ll get it eventually.

  17. sandy,phd says:

    Believe it or not, I’ve got SI Joint problems, too. Fortunately my back has never “gone out” while I’m at work. Yikes, that would be tough. Several times tennis playing has brought mine on, or something ridiculous like leaning over to pick something up off the floor.
    These back problems are a hazard of our profession. I once read that sitting in one position for 45 minutes or longer can cause a decrease in blood flow. 45 minutes. Sound like a familliar length of time? My sessions almost always run longer. But I do try to move around, find an excuse to get up at least once during the session. And on a good day (or while recovering from recent injury) I do stretches in between clients. And I have a round of gentle yoga stretches that help keep me flexible.