Prior to starting graduate school, there were limits as to what I could do in the field. I was not able to work as a mental health professional yet. However, there are jobs where one can work as a para-professional.

I found opportunities to do work with clients who have developmental disabilities as well as in some cases, mental illness and/or physical conditions/disabilities. There has been some overlap between the fields.

The Mental Health Center in New Hanover County was also the Center for Developmental Disabilities.

With my job ending at Corning, I had to find other work. I had been spending all my time with Lynn and my self-esteem had grown tremendously as a result of that relationship and as a result of the experience, my time with Celta before that, and my various experiences as a volunteer in the psychiatric field.

I'm not saying there were not struggles, worries, or uncertainty. Had my mental health not improved from where it was before I moved to Wilmington, I might have been more panicky about the job ending after six months.

Instead, I just looked for opportunities and bounced ideas off Lynn. It was very helpful to have someone who could hold me in her body... someone I could cuddle up next to whenever I was anxious or fearful. Plus, she was very practical, as I described earlier, so I felt confident that I could find answers and solutions to meet the challenges I was facing, whatever they might be.

As I was saying, I needed to find employment after the job at Corning ended. I had worked as a technical writer and had saved up a great deal of money in just six months. Since the job was contracted through an employment agency in Augusta, Georgia, the salary was paid as per diem – similar to when a company pays you for going to a conference. This way most of it was not taxed at all!

Eventually, I found a job with an agency that treats individuals with developmental disorders such as autism, and various levels of mental retardation. The latter is measured by results on IQ tests when a person scores at least two standard deviations below normal - which is an IQ of 70 or less.

I started working with a client who had autism and some degree of mental retardation. I met him at the day program that existed in Wilmington and which was affiliated with the Southeastern Center for Mental Health/Developmental Disorders/Substances Abuse Services. Adults would come for several hours to the facility where they would be taught various skills for coping in the environment.

The guy I was working with was very big, about twice my size, and he could not speak as a result of his condition or disorders – that is commonly the case for individuals with autism. He used sign language. So, I had a chance to learn sign language. It was so very important to be able to sign various words to communicate with him.

I had goals and things that I was supposed to do with him every day. One such goal might be to accompany him for walks around the area. Obviously, I had to make sure he didn't run out into traffic so I mainly walked on the sidewalk closest to the street to ensure that this would not happen.

He also had a problem with repetitive behaviors where he would swing his arms and risk injuring himself. This is troublesome because I was afraid that he would hurt himself. No one spelled out what exactly I should do when this happened.

There was at least one other individual there who was a client of the same company and I worked with him as well.

I knew that case managers had developed the goals which were put into a treatment plan that I was responsible for implementing. I also knew that case managers are usually social workers – not typically social workers with an MSW (master's in social work).

I wondered if I was helping these people. I knew I was helping their families, but I wasn't getting direct feedback from the clients I was serving.

The relationship with Lynn was growing, I was beginning graduate school and working several jobs.

In late 1994, Lynn and I moved into a nice neighborhood in northern Wilmington, and one of the clients with whom I was assigned to work lived in that neighborhood. I worked with him through the Southeastern Center for Mental Health/Developmental Disabilities and Substance Abuse Services and with a company with whom they contracted.

This client's name was James.

I worked with James both in the community and at his home. James lived in a home that was staffed 24/7 – all the time every day. Unlike a "group home," he lived in a home where the rent was paid by the state as were the staff and other services that he received.

I had been "networking" with employees of the Southeastern Center for Mental Health/Developmental Disabilities/Substance Abuse Services as well as agencies with which they contracted for direct-care services to clients. I worked at group homes and in the community including at the Day treatment center as I described earlier in this chapter.

While James had his own residential placement, I was also working at other residential locations where individuals with a mental illness and/or developmental disability were staffed 24/7 365 days per year. A "shift" at these residential locations was 8 hours straight and you had to bring a meal with you or eat food that was available for staff because sometimes you were alone on duty.

James was unique and that's why he had to be placed by himself instead of with others at a "group" home. He had Cerebral Palsy, Intermittent Explosive Disorder, and an Intellectual Disability. I can't give his last name for confidentiality purposes.

"Intermittent explosive disorder" is just what it sounds like.

I had to learn how professionals in the field restrain a client who might get combative. In all my years of experience that only has been an issue in cases in which a person has a developmental disability like autism or some form of mental retardation and a mental illness.

Unfortunately, when you combine intellectual disabilities, problematic or limited social skills, and certain psychiatric conditions, there is a potential for aggression.

As an aside, it is possible to be hurt by someone with a mental illness without the mental illness causing a person to hurt you. Many years later I would learn that when things happened.

I started working with James shortly after Lynn and I moved into our home on Brucemont Dr. .

Getting back to working with James...

Our goals with James were to help him to fit into the community and to go places within the community. This could include the library, restaurants, the park, the beach, shopping, and maybe the movies among other things.

At least, I knew that these were goals that James desired. The challenge was to teach him socially appropriate behaviors, so we didn't get thrown out of places where we went.

Indeed, that was a challenge. He was the opposite of shy. He would approach anyone and everyone and start talking to them as well as a great deal of touching – potentially sexually inappropriate, hugging and putting his arm around people. Everyone. And he was loud. So, everywhere we went he knew people and he would hug them or otherwise touch them.

James loved to see Lynn when I took him by the house where we were living. As it turned out his residence was less than a quarter-mile from where we lived.

I didn't leave James alone with Lynn because he might get inappropriate. I am sure he saw me as more than just a staff person giving him directions about how to act appropriately in a particular setting. He saw me as someone who would protect Lynn from ANYTHING that bothered her.

I did get approval from Lynn and confirmation that she was comfortable with me bringing James there.

I didn't disabuse James of the notion that I would treat him the same way I would treat anyone who dared to do anything Lynn didn't want them to do. He would struggle to keep his urges in check... moving to touch Lynn on the shoulder and then start to invade her personal space. Lynn would put up her arms and say "James!"

I wasn't far away, obviously. Instantly, I looked up and James would look at me. Then James would say "uh, oh, he's mad now" with an uncomfortable, low rumbling laugh.

I'd say, "Okay, we are leaving now."

Lynn would say "he's okay, right James?"

"Well, we need to go anyway," would be my response because he had to learn. I was a bit uncomfortable whenever he did these things but not everyone was as forthcoming and understanding as Lynn.

Then Lynn would say "when will you be home, honey?" and Lynn would give me a kiss, unaware of what kind of reaction this was eliciting in James. I knew from his low rumbling laughter.

He wanted another hug or something. So, I would turn and guide him out the door before he or Lynn knew what was happening.