Friday, December 23, 2011

Christmas Wishes

I just read a story about a naked man who bolted from the back of an ambulance and was run over on the freeway today. The news presented it as a bizarre tidbit, but I understood immediately what must have happened. I've been thinking a lot this week about compassionate care for people suffering from mental illness.

This Christmas, T is in relapse, and just went through what his doctor describes as an extended hypomanic cycle. We have to withhold the new cell phone we intended for Santa to deliver, along with any other present he might sell or misuse. Meanwhile, his brother, who was to spend Christmas with us, is locked up in juvenile hall. He's only 14, and he'll wait in juvenile hall indefinitely while his social worker figures out where to put him next. It will be his fourth placement in three months.

Both boys suffer from different types of mental illness and disability. T is extremely bright, and apparently high achieving, handsome and capable of great compassion. His demons are more hidden, and his impairment manifests in extreme mood swings, grandiosity tempered with insecurity, periods of excessive self-discipline alternating with bursts of wild abandon. When he learned about his brother today, he drew his lips tight over his teeth as if to contain all the feeling - the shock, the guilt, the shame, the fear that have all been with him since he was about six. Eleven years is a long time for a child to carry such a painful bubble of mixed emotion.

I can write about him with compassion, but in the day to day as a parent, I'm exceedingly aware of my limitations. I get angry with T's behavior, and with him. I try to discipline, negotiate, incentivize, and wheedle him into changing. I work daily to manage my tendency to enable him. I recognize that sometimes a parent is the last person likely to help a kid in distress - a counselor, nurse, doctor, a coach, but some days, not me. My maternal love for him is a blessing and a blind spot. I truly struggle with the boundary between holding him accountable for his behavior and recognizing that self-governance is, at times, beyond his capacity.

The literature about enabling, codependence, and compassionate discipline is helpful, to a degree, but I find that it has the unintended side effect of making it seem that there are answers. When we are in a rough period, as we are now, I've learned there truly are no answers. It's more like meditation - the best I can do if I really try is to remain objectively aware of what is really going on, and to cease trying to control it.

Even when T is at his worst, the one thing he responds to is honesty. This week he said softly, "You must be worried." I said, "Yeah, it's really hard when you love your kid so much, and they're on a path that harms them, and you know you can't convince them to get off that path. And you see all the things that make it so hard for them. And you try to support them. But you also have to make sure you don't do anything or give them anything that might contribute to your kid making those bad choices. It's hard to say no to your child, but you know you have to, because you love them, even when it makes them feel unloved. It's just really confusing." He just nodded, like a wise little owl. Disappointed, because he's smart and he knows this means he's probably not getting the cell phone he wants. But appreciative of the honesty.

I realize sometimes that he's scared too. He truly gets beyond himself sometimes, and he's wracked by guilt. After engaging in outrageous acts, he comes close, hovering near us for days, as if seeking comfort from the uncertainty he's created for himself. He's quiet and pensive and small, taking naps next to us on the couch and sitting silently in the kitchen while we cook, tracking us with his giant eyes. I truly admire him - I admire his strength and his humility as he grapples with his demons, and tries to get up and continue forward.

For Christmas this year, I'm aware of what this season of heightened expectations and requisite merriment is like for people who struggle to make sense of their world. I'm very grateful for the presence of a really good psychiatric nurse practitioner who entered our world recently, and a gifted counselor who has stuck by him through a year of phenomenal ups and downs: through bottoming out, successfully seeking treatment, relapsing, and reconsidering. I'm grateful to an old friend who helped us when we were falling apart, and a new friend who gave him a place to sleep when no other sane person would have taken him in. I wish a blessing for mothers and other mothers whose selfless mind-expanding love for a child makes them vulnerable and confused in the face of that child's illness. I wish for him and his brother peace and compassion in the coming year. I wish for all of us a world capable of evolving to a fuller understanding of human complexity that allows for the fact that not everything is a matter of discipline, and that not every dilemma has a solution.

Friday, December 16, 2011


Ah, sigh. We're in a down cycle. It was bound to happen.

At times like this, I'm often aware that I'd like to be a therapeutic parent, capable of endless patience and commitment, but I'm too human to achieve that. I get tired of the cycles. I find it hard to strike the right balance between warmth and compassion, on the one hand, and reasonable limit-setting on the other. I find an average of extremes more often than I find true balance; parenting him is like sailing, leaning into the wind of love and connection one minute, and then suddenly shifting to the other side and using your weight to provide discipline and structure. Just when I think we've hit a patch of calm water, a gust comes up and we're off again.

An acquaintance recently said to me in passing when I was describing some new challenge with T, "Oh, he's just a typical teenager." But he isn't. It might look that way to outsiders. We deal with many of the usual teen issues - sex, driving privileges, parties, curfews. The difference is that a typical teenager (hopefully) went through a period of loving attachment and parental limit-setting ten or fifteen years ago, and despite the gale force of hormones and teen brain development mitigating against sanity, they formed basic habits of self-governance. That just isn't true with a kid like T. He might seem like a regular teenager (often he even seems hyper-disciplined) to someone who sees him for a few hours, but at home, things are quite different. There's a lot of chaos and confusion and cycle-rinse-repeat that goes on at our house. As my mom always says, it's like parenting a three year-old who is six-foot-three and can drive a car and is simultaneously experiencing all the physical and psychological changes of adolescence.

There's a reason we humans first attach to our mothers, then go through our toddler years, and only later, go through adolescence. It's very turbulent to go through all of those stages at once. When other kids were learning to accept limits from a loving, attached parent, T learned that nobody is looking out for you. He learned to keep his instincts on high alert because misfortune could (and often did) befall him on a regular basis. He learned that a hint of anger or frustration in someone's voice might signal life-threatening violence in the immediate offing. He learned that nobody could ever understand his needs, nor would they want to meet them if they could. He learned that mistakes might bring extreme punishment or even abandonment. He learned that other people will use you and take from you and that if you want to survive, you need to be prepared to do the same.

There are days when, frankly, nothing works. It might take him until he's 30 to learn a new pattern. He might struggle with the same patterns for his whole life. I still want him to be safe and achieve a basic level of well-being. He works harder than most, and results are much, much harder to come by. What often happens despite our best intentions is that he makes a poor decision, and I get exasperated, and he can sense that. Then he feels shame, and that makes him disconnect, and then I feel guilty, and then we both feel bad. Eventually, we manage to pull ourselves out of that cycle and reconnect, and then we try all over again.

He makes me very, very aware of my own limitations and personality flaws, which is only fair, because I probably serve to make him feel his more keenly too. It's something to work on--and an aspect of motherhood that, in my opinion, is not often acknowledged in honest terms.
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