If you have a look at the picture above, I’m sure you’ll agree that I am an unlikely pool shark but some pool skills are a good tool for any psychiatrist who looks after adolescents. A game of pool is an excellent opportunity to have a conversation with a young person or a group of young people and it really helps if you play well enough that they’d like to have you on their team. It is also always an excellent topic of conversation for a patient to have with new people in a group when you cannot figure out how to break the ice: “Have you played pool with Dr. Beck? It’s a lot of fun.” It seems that it’s worth a laugh for everyone to see the look on the newbee’s face when you ask that question.
My patients are always interested to know how I learned to play. I have to confess that I would love to play well enough to be able to say, “I put myself through medical school playing pool.” I am very proud that I did learn to play from my patients and from one young woman in particular who explained to me that it was better if we were “doing something and not just staring at each other.”
It is from this statement that you learn the most basic interviewing skill when dealing with adolescents (maybe anybody). Don’t stare, keep your expression neutral and nonjudgmental and don’t say a word unless you have to. It’s better to know how much cannabis someone is using daily than it is to know, “Do you ever worry that that’s too much?” You want to understand what is really happening in someone’s family and they are more likely to speak about this when you’re shooting some pool than if you’re both sitting in stiff little chairs while one of you is asking “empathic” questions.
Another reason to do something enjoyable with a group of teens at times is to model that pleasant, healthy activities can improve one’s mood. Laughing at the psychiatrist who’s old enough to be your mother as she tries out a new technique is also good for everyone’s mood. First of all, laughing is just good for you and pool, like any game, is a great teacher. You learn how to be a good loser, a gracious winner and a kind teacher from a game.
Why am I thinking about pool today? I was going through my notes today, remembering how I learned to play pool originally. It was 10 years ago and a young girl joined the group who was very hardened, with a lot of bravado. She came to group after group without saying a word. She had come from a chaotic family situation and had lost her only positive contact, a sibling, to suicide. She was barely hanging on herself.
Those who know best insisted that she come to a group program and for months we could not figure out why this could possibly be a good idea since she said absolutely nothing. Adolescents are often kinder than we imagine – they offered this girl seats in the circle, snacks, conversation – even though she was surly and bitter.
One day, a pool table arrived – a gift from hospital volunteers – and we gathered around to try it out. I couldn’t play at all then and hit the 8 ball. “Oh, God,” she cried out and dumbfounded we watched as she broke and ran. (Broke and ran like in pool, not as in ran away.)
After all these years, when I consider my years of education, and continuing education, and ever increasing years of experience, my perspective on my fancy title and credentials remains realistic. The reason lies in the humbling realization that one of my best interventions is, “C’mon, it’s your break.”