Category Archives: mental illness

Gun Control versus Mental Health: the Debate from a Parent’s Perspective

Shortly after the tragic massacre of children in Connecticut, I wrote the following Letter to the Editor to the Oregonian, Portland’s main newspaper:

normal-murderer“Tragic shootings always raise the question, “Why?”, and the response often jumps to guns. Yet guns are tangential to the problem. Those of us with a mentally ill person in our families can answer “why.” We’ve witnessed the behaviors leading to a mental health crisis. There are always signs, but many don’t interpret or take them seriously until it’s too late.

“If you have a loved one at risk of harming themselves or others, but aren’t sure if it’s serious or real, trust your gut. Look for behavior changes that are abrupt or steadily worsen over time. Listen for statements that seem out of character Pay attention to significant overreactions to events or ideas. Never be afraid to ask directly, “Are you OK?” Don’t hesitate to seek help from mental health advocacy or support groups. Whatever the cause, mental illness is treatable; there is hope, and people who can help.”

gun in knotsA couple of weeks later, a reporter from the Oregonian contacted me to help with a story on mental illness in children.  She said she wanted this important longstanding issue brought back into the national discussion.

Perhaps we have finally reached a turning point?

 

gun deaths per 100,000

Sandra Spencer, Executive Director for the National Federation of Families for Children’s Mental Health, met at the White House with Vice President Biden’s task force on gun control to ensure that the issue goes beyond just gun control.  The following is an excerpt:

“We must deal with the real issue that children do have mental health challenges and parents don’t have support or access to services without fear of losing their children to public scrutiny, bullying, discrimination and even institutionalization. …These children, youth, and families need to know where to go, which treatment is best, and how to access community support.

“The isolation parents feel because of their children’s behavior, due to mental illness, keeps them from reaching out or even knowing who to trust for help.  There should be national outrage at the number of young people who die each year by suicide and drug abuse, or the number of children with a mental health diagnosis that go untreated, and the lengths parents go to just trying to keep their children safe and out of trouble.  This has to change in our nation before we can adequately address the need for an improved children’s mental health care system”

brain-green backgroundThe issue of gun control is important to work through, but not at the expense of mental health and the millions who continue to struggle—the families and their loved ones.  Not again.

 

Your comments are strongly encouraged.  What do other parents think?

–Margaret


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“You’re under arrest”: Crime and troubled teens

You’ve tried everything. Now you watch helplessly as your troubled teenager starts down the path leading to jail, and you wait for that call from the police. But bad news can be good news. This may be the point when things start to turn around.

“Experts estimate that from 40 percent to 70 percent of youth in the juvenile justice system suffer from some form of mental health disorder or an illness – anything from ADHD to full-blown psychosis. About 15 percent to 25 percent have mental illnesses “severe enough to significantly impair their ability to function.”” (see “Mentally ill minors put in juvenile hall” at end of this post)

Juvenile crime is considered as serious as adult crime, and juvenile “detention” is full-blown jail, just like jail for adults. Yet there is one critical distinction between teenage and adult justice: teens are given a second chance for a clean record, as well as education and treatment for mental illness or addictions. An adult criminal record is forever a barrier and an embarrassment. It comes up when a former convict applies for a job, a loan, a college degree, military service, a rental, or even a volunteer opportunity.

The juvenile justice system is only partially punitive because society recognizes that the teenage brain is the problem that causes much criminality, whether or not they have a mental disorder or addiction.  Enlightened juvenile court judges want their rulings to be “rehabilitative” or “restorative” justice.  Enlightened agency directors understand the need for additional support services for learning disabilities, addiction, mental illness, and vocational training.

In the system, teen criminals (or adjudicated youth) are required to participate in consequences and treatment; it’s a “carrot and stick” approach.

  • The carrot:  The teens attend school and receive training for vocations such as car repair or catering.  They participate in positive character-building activities such as training dogs for adoption, building and maintaining hiking trails, or constructing homes for Habitat for Humanity.
  • The stick: Teens have a complete lack of freedom, whether in detention or out on probation, intensive monitoring (including random urinalyses), immediate consequences for behavior violations, and physical labor to pay back victims (community work programs).

When a police officer calls to say your son or daughter has been arrested, use this as an opportunity to help your kid. It’s a perfect teachable moment. Not only do you have their attention, you can hand the problem over to the Law to enforce their behavior and treat their disorders or addictions. Your son or daughter cannot refuse—when held or convicted on criminal charges, your child has no rights to anything except humane treatment and an appearance before a judge. You are off the hook. You can step back and relax… and be the Good Guy for once.

How to work with the juvenile justice system:

  • Be an active partner with the court. Cooperate fully with the judge, court counselor or therapist, and any attorney, case worker, or probation officer involved.
  • Show up for everything:  visitation, family therapy, court hearings, and parenting classes even if you don’t think you need them.
  • Stand shoulder-to-shoulder with staff.  If your teen has a probation officer, do what they tell you, even if it means tattling on your kid.
  • Be cooperative with staff, and they will work harder for you and your son or daughter. Support the programs required for your teen, and support your teen when they struggle. Your involvement will someday impress on your child that you’re on their side and care.
  • Change your ways.  If you’ve been too harsh with your teen in the past, go easy on them now and let him or her see your good side. If you’ve been too easy on them or too protective, demonstrate backbone. Show you know what’s best for them and that you will remain in charge once they are released.
  • Stick with your child.  If your teenager becomes a Frequent Flyer in the system, it doesn’t mean they are lost.  Remember, they have that uncontrollable teenaged brain and need more time and lessons for it to reach maturity.

Once they come home on probation you need to set strict limits on their activities, and work with the probation officer or social worker to enforce them. These are harsh at first, but should be negotiated later when behavior improves, with consultation with the juvenile justice staff.

Remove risks:

  • Don’t allow them to stay out late ever. Set an early curfew, and report them to their probation officer if they are late.  When they get angry about this, explain that you are bound by the law, and that they should discuss their concerns with the officer.
  • Ban drugs and alcohol, especially marijuana. Hide prescription drugs and alcohol if you use them.  (Marijuana causes brain damage in adolescents; this is not a myth.)  You have the right to search their room and private things.  If pertinent, hide weapons, matches, or other means of harm to themselves or others.
  • Stop or strictly limit contact with risky friends. This may mean taking away a cell phone and internet access.
  • Reduce their allowance if they get one, and reduce free time. Again, this should be negotiated later if behavior and compliance improves.
  • Build your own network of other concerned parents to track your kid… in other words, to spy on them.  Besides other parents, I even contacted businesses where my teen was known to hang out, such as a mall and cafe.  See  “Gang up on your kids: Parent networks for tracking at-risk children.”

Three house rules: 1) stay at home, 2) stay in school, 3) stay out of trouble. He or she must also continue mental health treatment; show respect even if they’re upset; and be encouraged to seek help from another trusted adult if they need to.

Build their esteem as you would for any troubled child. Guide them to their strengths. Give your teenager something to do that they good at, and allow them ample opportunity to shine. More at  The good things about bad kids.

Extreme measures. I know of three cases where parents took drastic steps to help their son or daughter stay out of trouble, and these worked!

True story – a single father was worried about his son’s gang involvement, especially since the son was still on probation, and additional charges would draw lengthy prison time. Dad sold the family home and bought another one in a neighborhood ‘run’ by an opposing gang. The son was terrified to leave the house except for school—a new school away from his gang brothers. This son graduated high school and left the area for college… with a clean record and new respect for his father.

True story – After a couple of years trying to keep their daughter out of trouble, parents started looking for work in a smaller town.  They wanted to find a safer place with fewer risks and more eyes. After she completed her mandated one year probation, the family moved.  She was upset to leave her friends, but they were the problem friends. Her crime sprees ended.

True story – a single mother was on the edge of sanity and financial ruin trying to manage the world her son created.  While visiting a juvenile justice counselor with her son, the counselor made an off-hand comment about handing him over to foster care so that she could get her job back and sleep at night.  With a heavy heart, she went forward and obtained a “voluntary placement” for him (temporary state custody), and he went to a foster home.  After two years, he was ready to come home and she was ready and empowered to support him.

A note of caution:  You may have seen ads for outdoor programs or “boot camps” for at-risk teens. Some of these programs are extremely inappropriate for troubled youth, even traumatizing. Or some may not allow teens with a criminal history. Get advice about therapeutic programs for your at-risk teenager from a counselor or social worker, not just from the program itself.  Your teen’s providers often know which ones are appropriate.

The people in the Juvenile Justice System

In my personal experience, 99% of employees in juvenile justice are there because they care about teens, they like teens and “get it” about them, and they believe in the power of what they do. My co-workers have many success stories among their cases. Some former delinquents come back to work for the juvenile justice system and use their hard-won experience to help the next generation.  Ironically, it’s the one job where a criminal record helps!

If you are concerned about what your child will experience in the juvenile justice system, just call and ask.  You may be surprised.

Challenges, risks, and potentially serious problems

  • A troubled young person in detention or incarceration is exposed to others with criminal behavior. They may bully or be bullied or both.  They may meet fellow inmates to sell drugs to when they get out, or learn who can supply them with drugs. Depression is common, and presents as anger or self-destructive behavior, such as getting in trouble on purpose.
  • Not all juvenile departments provide mental health treatment, or treatment is inadequate.  And sadly, there are still places where staff and citizens don’t believe in the mental health “excuse” for bad behavior.  You may need to be an assertive advocate for treatment.  Work with your child’s public defender, who is provided by the court, and give them evidence of mental health problems in  medical records.  Your child will need to sign a waiver for the attorney to have the records.
  • Some states have Mandatory Minimums–pray it’s not yours. Certain crimes lead to long prison sentences regardless of the circumstances of the crime or the mental illness of your child. My state of Oregon will incarcerate anyone over age 15 for seven years if they commit one of these crimes. This made sense to the voters who put it into law, but the reality is a worst-case scenario for how NOT to rehabilitate youth.  No one I’ve ever met in our state, from judges to prosecuting attorneys to sheriffs to probation officers, thinks it’s a good idea–the outcomes have been horrible for reasons too lengthy to go into here.
  • Each county and state has a different culture and attitude towards juvenile delinquents. Some are exceptionally harsh, or they neglect the kids’ legitimate needs; some are reluctant to treat kids like individuals with different needs and strengths; some get that right balance of punishment and rehabilitation. It depends on the judges, the county, and the state. Each is different.

Is your child at risk from criminal involvement or charged in a crime?  Please comment so other parents who read it can learn from your experience.  Thank you.

How am I doing?  Please rate this article above, thank you.

–Margaret


Mentally ill minors put in juvenile hall (excerpt)
Daily Bulletin, Mediha Fejzagic DiMartino, June 12, 2010

“Juvenile halls have become catch-all basins for severely mentally ill youth.  Designed as secure holding facilities for minors who are going through the court system, juvenile detention centers now double as a default placement option for youth diagnosed with schizophrenia, bipolar disorder or major depression.   “There is no place for them in [our system],” said a county juvenile court judge in California.  “We can’t just arrest our way out of the problem. Juvenile hall is not a place to house mentally ill.”


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Why teens run, and what you can do about it

It’s an emotional shock when a child or teen runs. The feelings you may have are complex:  anger at his or her rebelliousness; fear for his or her safety; shame that you may be called a “bad” parent, or shame that your behavior caused your child to run.  The reasons teens run are also complex, and may or may not be the parents’ fault.

Why they run

Basic teenage development All teens go through a stage where they define themselves as unique, and start demanding two things: 1. freedom; 2. a say in their life.  These are necessary and important for maturity—some do it gracefully and some don’t.  Even teens with a mental illness will go through this phase.

Rebellion Most rebellious teens do not run away because they usually have better survival instincts.  If a teen is emotionally behind their peers, using drugs or alcohol, and part of a risky crowd that encourages them and undermines their parents’ authority, it’s likely they’ll run.

Mental disorders Mental health problems magnify any or all negative aspects of rebellion and immaturity.  They also disrupt a teen’s thought patterns and cause irrational ideas and fantasies.  They have a high likelihood of running.

Family stress This is the biggest reason: “65% of youth reported running away because of family conflict.”* Think about what’s going on at home that a teenager can’t handle (they are not as strong as they act).  Is there non-stop fighting between members?  Are they being nagged or constantly criticized, and not shown support or love?  Like all children, teens still deserve support and love.  Are they being bullied, or physically or sexually abused?  *National Runaway Switchboard at 1-800-RUNAWAY

What you might observe that foretells running

  • Changes in behaviors or normal patterns mean something is wrong.
  • Teens who suddenly stop eating or begin to overeat, sleep all day or never sleep, spend all their time with friends, or never want to leave their room.  Sudden mood swings mean teens are unsettled and restless, and they’re not coping well with stress.
  • Outward rebellious behavior is often the start of trouble, but not always.  Inward rebellion is also a problem, such as depression and isolating from their family.
  • Falling grades, truancy, school behavior, and breaking house rules are all symptoms that your child is having problems.
  • Substance use, mostly alcohol and marijuana.  Both cause paranoia and depression and aggravate anger.  I discovered many parents believe there’s no problem with marijuana, but scientific research shows marijuana is especially damaging to adolescents!  See Marijuana and psychosis in teens.
  • Disclosure of intentions to run away.  Some teens will hint that they want to run away and some will outright threaten their family with running.
  • Expressing fantasies that it’s easy to get ‘divorced’ from one’s family.  Teens often believe they can be legally emancipated before age 18, get a GED* and a job, and be free.  A juvenile court judge told me otherwise!  The legal test for emancipation is very restrictive.  *Pass a General Educational Development exam, a less valuable substitute for a high school diploma.
  • Accumulation of money and possessions. To survive, runaway teens need resources. Some prepare for their run by saving any money they receive.  They might keep a bag or backpack of clothes and food in the closet to make a quick escape.
  • Risky friends have a very powerful influence on the decision to run away.  Relationships like these almost always include substance abuse.  The risky associates include adults who undermine the parents, and who coach teens how to get away from home. They provide them with cigarettes and drugs, and possibly take advantage of them.
  • Full time access to unmonitored and unrestricted communication, and easy access to transportation, especially a car or an at-risk acquaintance with a car.

What to do if you suspect your teen might run away

“Clearly and calmly let your teen know you are concerned about them, and that their behavior makes you afraid they might run away from home. Invite them to talk with you or someone else about what is troubling them and be supportive of finding positive ways of dealing with their stress.”

Let them know you don’t want them to run away and you’re committed to helping the family work things out, and let them know you are concerned about their safety.

If your teen is intent on running away, give them the phone number of the National Runaway Switchboard* so that they can find safe options while out on their own.”  This does not mean you approve.  A good analogy is informing your kids about contraceptives even though you don’t want them to have sex.  *1-800-RUNAWAY

Give them some facts: Your teen should know the laws, and they should know about youth shelters.  This may help them recognize that you are concerned for their safety… just like you told them.

- – - – - – - – - -

Are you thinking about running away?

Are you worried about staying with a friend and getting your friend or their parents into trouble? Does it matter if you’re reported as a runaway or not? Deciding on whether or not to run away and where to go can be difficult. Here’s what you should know:

  • In most states it is not illegal to run away.
  • If you leave home without permission or stay away longer than you’re supposed to, and you are under the age of 18, your parents can file you as a runaway with the police.
  • If the police find you, you will be taken home or to police headquarters, and your parents will be called to pick you up.
  • If you are staying at a friend’s house or somewhere your parents didn’t give you permission to be, they can face possibly legal consequences.
  • If you are filed as a runaway, your parents can press charges against those allowing you stay with them or abiding you.
  • If you go to a youth shelter, generally they have to contact your parents within a certain amount of time to obtain consent for your stay.  Often, you are allowed to stay only 72 hours (3 days) before you must return home.  This gives you and your parents time to cool off.
  • If you are staying with a friend, in most cases the police are only allowed to do a courtesy check; which means they are not allowed to search your friend’s home without a warrant.
  • It is always best to check with your local non-emergency police hotline or legal aid when it comes to specifics because the law varies.

Hopefully the information listed here answered some of the questions you may have had. If not, you can give us a call and we can help.  1-800-RUNAWAY

(Parent: list the names and addresses of local youth shelters here—not adult shelters)

 - – - – - – - – - -

Get to know their friends and their friends’ parents.  If anyone who knows them is concerned about your child’s safety, they may help you if there’s a problem.  Other parents can keep an eye out for your child as well as their own.

Statistics indicate that most children stay in the same general area that they live in. Some go only as far as a friend or relative.  You must know where and be able to communicate with the responsible adults.

Get to know the at-risk teens and adults that your teen associates with. “At-risk kids hang out together, they know each other’s stories (true or not), protect each other, and keep parents out of the loop.  What if parents got together too, shared stories, and supported each other?  Everyone has the same goal of protecting their child.  Kids’ unsafe plans and activities are no match for the many eyes and ears (and cleverness and wisdom) of all their parents combined.”  Gang up on your kids: Parent networks for tracking at-risk children

If your teen is staying at a friends’, this may be helpful.  You might negotiate with the parent for a friendly arrangement for ‘shelter’ until things calm down.  If you cannot communicate with this parent, they may be guilty of custodial interference.  This is illegal and should be reported to the police.  More often than known, some parents actively encourage other parents’ children to leave home, as well as provide them with alcohol and drugs.

What to do if they run

Notify the police and file a missing persons report.  If your teen has a mental disorder, bring this up on the call and be specific (he needs to take medications, she has a history of assaulting others, he has threatened suicide, she might be out of control and unable to respond if you shout at her…).

Are you worried that your police report will go on your child’s record?  Don’t.  Even if your child is charged and convicted as a juvenile, his or her record can be expunged (erased) at age 18 with good behavior.

Call the National Runaway Switchboard at 1-800-RUNAWAY. NRS operates a 24-hour confidential hotline for teens and their families. Leave a message with the NRS for your child, www.nrscrisisline.org. NRS also provides bus tickets to get kids back home to their families

Spread the word among friends and your child’s friends that you reported your child, and ask them to ask your child to call or give a message to you if they see them.  Also spread the word that protecting a runaway is a crime.

Track.  “Friend” your child on Facebook, or find someone who can and will report to you.  Set your computer up to track and store web search history and email.  Search their room.  Get their cell phone contacts if possible, track their GPS location by cell phone, and get every address and phone number of every friend.  All of this is legal.

Investigate.  This is not a situation where you respect your teen’s privacy.  Besides tracking their activities above, drive around and look for them.  Be sure they and their friends see you because then the risky friends will avoid your child.

Check in with your child’s teachers or counselor for any information that might be useful.

Take care of yourself and your other children. This is a difficult time and you don’t have to deal with it alone. Turn to people you know and trust for support. The NRS is available 24 hours every day and offers information and support for parents too.

Ask yourself the hard questions:  Is life at home that bad?  Is there abuse (emotional or physical)?  What changes am I willing to make to reduce my child’s stress at home or at school.

Good news from statistics

  • 85% parents reported that the issues that led the youth to run away were somewhat, mostly, or completely resolved within a month.
  • Most parents reported that their youth used alcohol or other substances less once they returned (68%).
  • Most reported they engaged in physical fights less (64%).
  • Most reported they broke the law less (66%).
  • Of those who ran once, 75% did not leave home again.

Creative things other parents did that worked

True story.  A father made business cards to give to everyone who was ever in contact with his 15-year-old daughter.  It had her photo, contact information, and the message that he and her mother loved (name) and wanted to ensure her safety and appropriate behavior.  He made a point of personally visiting with her friend parents where daughter went.  She hated her dad for this, but never ran again, and every time she visited a friend, the parents always reminded her to call her own parents and report her whereabouts

True story.  Two 13-year-old girlfriends decided it would be fun to run away and party.  During the week they went missing, their frantic mothers collaborated on a ‘full court press’ to notify others and get their daughters back safe and sound.  They printed flyers with photos of their daughters, their phone numbers, and offered a $25 reward, no questions asked.  These were given to the police, posted at school, at youth shelters downtown, and at business hangouts the girls were known to frequent (a mall, a fast food place, a big box retailer).  Both girls were eventually returned safe and sound, and they were really angry.  Apparently, street kids and risky adults spurned the girls because of the flyers, for fear of attracting the attention of law enforcement.

How am I doing?  Please rate this article at the top–5 stars will be greatly appreciated!

–Margaret


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The good things about bad kids

Take an average car.  If a salesman calls the car a “cherry”, it means it’s in perfect condition. But if a salesman calls the same car a “lemon”, it means it has expensive mechanical problems.  The name means everything to a buyer, true or not.

See strengths

If you apply the same concept to your child, it will change the way you think about and treat him or her. You’ve been enduring  disturbed or stressful behavior–this is glaringly obvious–but notice the “cherry” behaviors when you are getting relief from the “lemons.”   What’s great about him or her?  Even problematic behaviors are strengths in some circumstances.  For example: resistance and wilfulness are good survival traits for the future:

  1. Your child will need to resist being taken advantage of.
  2. He or she will need to resist ‘friends’ who pressure them to use drugs.
  3. Your child will need to stick with schoolwork or a job without the distractions of parties or alcohol or other time bandits.

Mom carries this in her purse, always.

Make a list of ‘awesome-ness’

What is your child or teen good at?  When is he or she at their best?  What character “flaw” is actually a good thing?  What shows intelligence, nimble thinking, a sense of right and wrong, athletic prowess, social maturity, artistic depth, or compassion for those who are vulnerable?

It’s not important to know why they have problems.   It’s important to know why they will overcome them.

An overwhelmed mom once asked for help with her adult son and daughter. They were still not ready for adulthood, in fact, they were both falling apart.  They needed her more than she could handle emotionally.  After she shared all her concerns, I asked her to list what was great about them.  It took her off guard at first, but she scribbled out a few things and kept the list, and many months later pulled it out to show me that she still referred to it. She said it totally changed her mindset.

Instead of concentrating on your child’s weaknesses, help your child master existing strengths.

Allow your child ample time to do the positive things he or she is already good at, the things that bring out self-esteem and confidence.  Proactively provide the materials and time to attend a class or camp, join a team, write poetry, make art or music, train the dog, style a friend’s hair… anything he or she can be proud of that has value for their future.  Your child’s behavior will improve, and your mutual interactions will improve.

Use the positive power of self-fulfilling prophecy

In her list , my friend wrote that her daughter had compassion for people and wanted to make the world a better place.  What would you suggest this mother do to support her 24-year-old daughter’s interests and strengths?  One idea:  tell her daughter she believed she would be “a natural” at this.  Another idea:  encourage her daughter to get involved in a charity organization.  And the daughter did.

Lets take another situation where your troubled son plays online video games to the exclusion of all else.  What do you see?  Rapid mental processing, hand-eye coordination, focus, a passion for technology.  If you feel you must limit the video-gaming, what can you replace it with?  There are robot kits for kids; he could build a robot and program its behavior.  A remote control helicopter could be given an obstacle course to go through.  Perhaps the obstacles are altered to make them harder to get through.  Perhaps there’s a reward for getting through a really difficult course.  Use your imagination, and ask your son to do the same.  Collaborate.  It’s a much better form of interaction and it plays to his natural gifts and interests.

It’s a disability, that’s why they can’t be good at everything

Make a point of noticing the good side. They ALL HAVE A GOOD SIDE.

Let’s be realistic, some children with serious mental health problems may never be well-rounded or competent in the many subjects and skills they need for adulthood.  (It is the tragedy of their disability.)  If this is your child, they’ll probably do better in the long run if not pressured to overcome their weaknesses with extra classwork, homework, or incessant behavioral modifications.  Your son or daughter can catch up later, or if they can’t, they at least have something to carry with them into adulthood.

Now about YOU

What are YOUR strengths as a person and as a parent?

  1. You care enough to go online and learn how to be a better parent.
  2. You admit that you need help, and you know how to find it.
  3. (now add your own… and be generous with yourself)
  4.         “
  5.         “
  6.         “

How am I doing?  Please rate this article above, thanks. Five stars would be really nice.

–Margaret


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Your troubled child from birth to 18, what to expect and do

Parents face daily challenges with a troubled child or teen, and easily overlook the future.  I know I did.  What’s going to happen as they grow and change?  What does one plan for?  It helped me to hear from parents who had already traveled this path.  Based on their experiences, these are some things you can expect–and do–before your child  reaches the pivotal age of 18.

Your child may not be ready for adulthood by age 18, but be OK with this.  Collective experience indicates your son or daughter  will continue to need your support and health care management into their mid-20′s.

If he or she reaches young adulthood with the capacity to maintain well-being on their own, you’ve done a good job.

From birth to age ~5

YouConsider yourself lucky if he or she has an identifiable behavior problem early!  You have ample time to understand your parenting needs and prepare, and use the many “special needs” services for young children.  Start a file and keep absolutely every medical and school record and contacts for people and services.  You are about to become a case manager.

Your family

  • Talk with siblings frankly.  Explain that sister or brother has a different brain and will be treated differently.  Inform them you will be distracted by their sibling’s need for appointments and other issues, and that it may feel unfair.  Ask for their patience.  Reassure them you love them very much.
  • Talk with your partner or spouse about revising expectations for your child, and accepting that your life may be harder than you planned .  Discuss how you will work together and share responsibilities, and work through disagreements about parenting the child in the future.

Everyone – Keep friends, activities, and plans the same.  Keep hobbies and interests alive.  Be as inclusive as possible of your special needs child but don’t sacrifice your family’s needs.  It’s a tricky balance.

Ages ~6-11  – young children

If your child’s behavior problems started at this age, read the above.  It still applies, except you may find fewer services, and sadly, more blame.  Seek professional help now.  Early intervention is the key to future mental health.

What to teach your family:

    • Our lives will be different from other families, but this is normal for families like ours.
    • We will support your sister or brother, but we will take care of ourselves and each other, we will have each other’s back.

What you should do:

  1. Make safety a high priority in your home, emotional safety as well as physical safety.
  2. Focus on schedules and planned time for activities every day.  Maintain this structure consistently, including weekends and holidays.
  3. Teach your child skills for managing behavior–they may not be able to stop it completely.
  4. Modify your home to reduce stress: Less noise or over-stimulation.  Better diet. A separate time-out  space.  Lock up valuables or dangerous items.  Consider a therapy pet.  Create a  tradition of whole-family activities:  Wii, playing cards, board games, exercise games, art or crafts, movie night…
  5. Take frequent “mental health breaks.”  Be generous with yourself without guilt.  Let other family members have breaks too.

 Managing resistance: tips and advice

Practical ways to calm yourself, your child, your family

From ~12-18 – ‘tweens and teens

If your child started having problems at this age, most information above still applies, but this may be the most difficult period!

Two things happen in the teen years:

  1. They enter a normal phase of development where they seek their own identity, and want freedom and a social life separate from the family.  But they take more risks, and expose themselves to more risks.
  2. Some mental disorders start at this phase, or get much worse and become quite serious:  major depression, bipolar disorder, schizophrenia and schizoaffective disorder, anorexia, borderline personality disorder… Risks include school failure, criminal activity, substance abuse, suicide, and assault.

Priorities

Safety – You may need to take unusually strong measures to ensure physical and emotional safety. Many need to lock up all knives, or allow siblings to lock themselves in their own room for protection, or search their teen’s room, or take away the cell phone and internet access.

Your well-being and that of other family members - Assertively seek outside support for your family, such as a support network of friends and family, or a religious community or support group, or mental health treatment for yourself, or all of the above.

Education – This is critical, even if it’s only for one or two classes per day.  If your teen cannot complete high school in time with their peers, it’s not a disaster. They may not graduate now, but they can finish their education eventually.  It’s never too late.

Positive peers and adult mentors - Keep your son or daughter from risky youth or adults.  Encourage activities with anyone they like and trust whom you approve of.

Ongoing mental health treatment –  your child may not believe (or accept) they have a mental health problem but they can at least comply with treatment.

By age 18

At a minimum, this is what your child needs–fundamental criteria for a functional adult life:

  • A steady job and income, or a meaningful activity (volunteering, school)
  • Healthy, stable relationships
  • Maintenance of health and hygiene
  • Decent housing, maintenance of housing and belongings
  • Maintenance of financial stability

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Faith can help, and harm, a family’s mental health

When faith helps

Most of the time, people can heal and find peace and self-acceptance through faith. All the world’s great faiths, those that have lasted centuries, are kept alive for this reason. All have common themes of healing and service to others. When things go poorly, meditation and prayer, with others or in private, lead to connection and wholeness. Faith reveals that things are better, and will be better, than they seem.

When families are in crisis because of their troubled child, parents tell me they depend on faith, even parents who don’t profess a faith practice. They say it’s their only source of strength. Most families with a child who is sick, disabled, or mentally ill will go through dark times, when a parent’s world is simply too overwhelming. Most often, no answers are forthcoming, nor any rescue. The only choice is to hand over their burden to a “higher power,” God, the Buddha, Allah, the Great Spirit… This act of “handing over” is a foundation of healing in Alcoholics Anonymous, Narcotics Anonymous, and dialectical behavioral therapy (DBT).

Few things help a family more than a supportive community of believers.  There will be one person who listens to a frightened parent on the phone, and another person who takes a traumatized sibling on an outing, and another person who provides hugs and cookies. If a mentally ill child continues to decline, a good faith-based support network will stay on. The child may not thrive, but the family does, and has the strength and forbearance to handle the years’ long task of supporting their mentally ill loved one.

Science shows that faith results in better lifetime outcomes for a child

This writer typically trusts science, but in the depths of my family’s despair, only faith and the prayers of others kept me from falling apart.

There are scientists among the faithful who have asked the question: does faith really help the mentally ill? In another blog post, Spirituality and mental health, some research are summaries of research going back 36 years.  (Follow this link for the research citations.)  The answer?  Yes, faith makes a real and measurable difference in improving mental health.

More recent scientific research shows clear evidence from brain scans that meditation and prayer change brain electrical activity, from anxious or agitated to serene and grounded.  The person actually feels and behaves better.  This article has more information on this, Yoga – Safe and effective for depression and anxiety.

Like prayer, “talk therapy” or psychotherapy also shows improvement on brain scans. Imagine, just talking with someone improves the physical brain. According to the article appended below, “When God Is Part of Therapy,” many prefer therapists who respect and encourage their faith. It just makes sense.

When faith harms

This section is a personal appeal to faith communities who have unconscionably failed families and their children with mental disorders.

Faith communities depend on people, and people have biases and foibles.  Many of ‘the faithful’ hold negative beliefs about others, right or wrong.  Children who suffer, and their families, are identified as possessed, of evil character, disbelievers, victims of abuse, or cruelest:  those who are paying for their sins. Families are repeatedly told these very things today.

“Sometimes, people hide from the Bible. That is, they use the Christian holy book as an authority and excuse for biases that have nothing to do with God.”
–Leonard Pitts Jr., Miami Herald

Stigmatization from a faith community is a cruel betrayal.

A child’s inappropriate behavior is not a choice, it is a verifiable medical illness, one with a higher mortality rate than cancer:  Mental illness more deadly than cancer for teens, young adults.  (A graph comparing mortality rates of cancers and mental disorders is at this link.). Families with sick children need support. From my personal experience, and from parents in my support groups over the past 13 years, our sense of loss is devastating.

Testimonials

Mother with five children, one with bipolar disorder:

“We were members of our church since we were first married, all our daughters grew up here, but when my youngest spiraled down, I was told the sins of the father are visited on the sons. Or we weren’t praying enough. I knew they thought (Dad) had done something bad to her. We left and went church shopping until we found a pastor who understood and supported us.”

Mother of two children, one with acute pervasive development disorder:

“I wish we had a “special needs” church. We’re so afraid our kid is going to say something and we’re not going to be accepted. We haven’t gone to church for years because of this. They just turned their backs on us, it happened to another family with a deaf child. They avoid parents in pain. Deep down in my heart I believe in the Lord, but there are days when I wonder “where is God?” People call out to pray for a job, or a kid’s grades, but we wouldn’t dare ask for us, no one would get it, we’d be told we were bad parents or didn’t punish him enough.”

Mother of two children, one with schizoaffective disorder:

“When I went up to the front to light a candle and ask for a prayer for my daughter, I expected people would come up afterward and give a hug or something, just like with other families with cancer and such. But it didn’t happen. No one even looked at me. I left alone and decided never to go back.”

Some good news

FaithNet

The National Alliance on Mental Illness (NAMI) has recognized the need for the mentally ill to be part of faith communities, and the negative experiences most face when they attempt to participate in a religious community. NAMI started FaithNet to encourage and equip NAMI members to engage with and share their story and NAMI resources with local faith groups, and appeal for their acceptance.

Key Ministry

Key Ministry: Welcoming Youth and Their Families at Church
Stephen Grcevich, M.D., president, Key Ministry and child & adolescent psychiatry in private practice, Chagrin Falls, Ohio

“Key Ministry believes it is not okay for youth living with mental illness and their families to face barriers to participation in worship services, educational programming and service opportunities available through local churches.”

Churches in American culture lack understanding of the causes and the needs of families impacted by mental illness, which poses a significant barrier to full inclusion.

“A study published recently by investigators at Baylor University examined the relationship between mental illness and family stressors, strengths and faith practices among nearly 5,900 adults in 24 churches representing four Protestant denominations. The presence of mental illness in a family member has a significant negative impact on both church attendance and the frequency of engagement in spiritual practices.” When asked what help the church could offer these families, they ranked “support for mental illness” 2nd out of 47 possibilities. Among unaffected families, support for mental illness ranked 42nd.

________________________________________

When God Is Part of Therapy
Tara Parker Pope, March 2011, New York Times

Faith-based therapy is growing in popularity, reports Psychology Today, as more patients look for counselors who can discuss their problems and goals from a religious frame of reference.

Studies show that people prefer counselors who share their religious beliefs and support, rather than challenge, their faith. Religious people often complain that secular therapists see their faith as a problem or a symptom, rather than as a conviction to be respected and incorporated into the therapeutic dialogue, a concern that is especially pronounced among the elderly and twenty-somethings. According to a nationwide survey by the American Association of Pastoral Counselors (AAPC), 83 percent of Americans believe their spiritual faith and religious beliefs are closely tied to their state of mental and emotional health. Three-fourths say it’s important for them to see a professional counselor who integrates their values and beliefs into the counseling process.

The problem for many patients in therapy is that many patients are far more religious than their therapists.

Nearly three-fourths of Americans say their whole approach to life is based on religion. But only 32 percent of psychiatrists, 33 percent of clinical psychologists and 46 percent of clinical social workers feel the same. The majority of traditional counselor training programs have no courses dealing with spiritual matters.

When children are hospitalized with other ailments, the family draws sympathy and support from others.  But because of mental health stigma, most families like ours don’t when our child is hospitalized.  If not blame, we are second-guessed, or as bad, met with silence or a change of subject.


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Five-minute wisdom for parenting difficult children and teens

From many years of  counseling parents with difficult children, I’ve found the following wisdom helps clarify one’s priorities, improve understanding, and help take the next steps.

You are not alone. All families experience the same fears no matter what the child’s challenges: guilt, anger, frustration, failure, and mental and physical exhaustion.

There is a way. The steps to finding peace in the home are the same for all families.

You can start now. You can improve behavior without having a diagnosis, and the techniques work for the majority of difficult children.

There is reason for HOPE. They have the capacity to do better. With support and treatment, difficult children improve.

Have realistic expectations: They may not be ready for adulthood, and may need extra support into their 20’s… but that’s OK. There’s time to catch up with their peers.

Plan ahead for a crisis, brainstorm options for an effective response and create a checklist. We can’t think clearly in a tension-filled moment.

GOOD Things to do for Your CHILD or TEEN

Pay attention to STRENGTHS not weaknesses. Always find something great about them.

Guide them to their gifts. Give them ample opportunity to do what they are already good at.

GOOD Things to do for YOU

o Be your own cheerleader. Silently think, “I can handle this;” “I’m the one in control.

o Regularly talk through your feelings with others who understand and won’t judge.

o Get a life, maintain personal interests, and set thoughts of the child aside without guilt.

o Commit to doing the best you can, and own that this enough – plan to let go someday.

You’ve done a good job when they are able to take responsibility for their own care. This is a monumental personal achievement!

KEYS to CALM

In a neutral patient voice, give directions or requests . You will need to repeat yourself, calmly, several times. Your voice should not communicate strong emotions. Tone of voice, not words or volume, is what creates a bad response.

Don’t rush calm. Give the child plenty of time to unwind and settle. Calm is more important than quick.

Ensure there’s a calm place to go – a time-out space, even for you.

Get an appropriate therapy animal – a calm and durable creature unlikely to be harmed.

Reduce chaos in your home: noise, disorder, family emotional upheavals, the intrusive stimulation of an always-on TV, etc.

Ideas for MANAGING resistance

You want your child to be resistant to the negative things they’ll face in life. It represents willpower, and is a strength to cultivate.

o Be quiet and LISTEN. If you respond, address how they feel, not what they say.

o Use reverse psychology-ask them to do something you don’t want them to do, so they can defy you and do the opposite.

o Choose your battles. Let them think they’ve won on occasion.

o For an ODD child, give multiple instructions at once, including things they do and don’t want to do. It becomes too much work to sort out what to defy.

o Actively ignore – Stay in the vicinity but don’t respond, look away, act like you can’t hear. They eventually give up. Works best for ages 2 – 12.

o Mix it up – Be unpredictable. Give a reward sometimes but not all the time. Try new ways to use incentives or set boundaries and structure.

Nine COMMON Parenting MISTAKES

1. Treat your home like a democracy, let your child have an equal say in decisions.

2. Find fault with them and tell them about it repeatedly. If they do something positive, it’s not good enough.

3. Pretend your child has no reason for their behavior. Ignore his or her needs or challenges. Are they being bullied? Are they having a hard time sleeping? Is your home too chaotic?

4. Make rules and only enforce them once in a while, or have consequence come much later.

5. Don’t treat your child appropriately for his or her age. Make long explanations to a 3-year-old about your reasoning. Assume a teen wants to be just like you.

6. Expect common sense from children who are too young (5), or from young adults with a long track record of not showing common sense.

7. Keep trying the same things that still don’t work. Repeat yourself, scream, show how frustrated you are with them.

8. Jump to conclusions that demonize the child. “You are manipulative and deceitful,” “You don’t listen to me on purpose,” “I’m tired of your selfishness…”

9. Make your child responsible for your feelings. If you lose your cool, insist they apologize.

Problem SYMPTOMS, not problem children

- Does not show common sense and is not influenced by reason and logic;

- Has no instincts for self-preservation, and poor personal boundaries;

- Has no well-adjusted friends; has friends who are risky or troublesome;

- Doesn’t respond to rewards and consequences;

- Has limited character strengths: honesty, tolerance, respect for others, self-control;

- Does not make plans they can realistically achieve, hangs on to fantasies;

- Acts younger than their peers. Will not be ready for adulthood by 18;

- Lives in the here and now; doesn’t think about the past or future;

- Does not notice their effect on others.

Your PRIORITIES in Order

1. You and your primary relationship(s)

2. Basic needs and responsibilities: housing, clothing, food, income, health

3. Your challenged child or teen.


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Good messages for siblings (and parents) of a troubled child or teen

Your other children already know something is terribly wrong, and they deserve to hear the truth from you.

Most are old enough. They see other children in school and discover other families are nicer, so they don’t talk about their own. They are afraid to bring friends over to visit because of how their troubled brother or sister behaves–pestering them, upsetting them–then those friends talk about it with fellow students and their own parents. Word gets out about your family and people form opinions, especially teachers.

Siblings also feel unsafe and insecure. They never know what’s going to happen! Tell them the truth and trust them to understand and appreciate your candor.

  • You cannot cure a mental disorder for a sibling.
  • No one is to blame for the illness.
  • No one knows the future; your sibling’s symptoms may get worse or they may improve, regardless of your efforts.
  • If you feel extreme resentment, you are giving too much.
  • It is as hard for the ill sibling to accept the disorder as it is for you.
  • Separate the person from the disorder.
  • It is not OK for you to be neglected. You have emotional needs and wants, too. The needs of the ill person do not always come first.
  • The illness of a family member is nothing to be ashamed of.
  • You may have to revise your expectations of your sibling. They may never be ‘normal’ but it’s OK.
  • Acknowledge the remarkable courage your sibling may show when dealing with a mental disorder. Have compassion, they suffer and face a difficult life.
  • Strange or upsetting behavior is a symptom of the disorder. Don’t take it personally.
  • Don’t be afraid to ask your sibling if he or she is thinking about hurting him or herself. Suicide is real.
  • If you can’t care for yourself, you can’t care for another.
  • It is important to have boundaries and to set clear limits. You should expect your sibling to show respect for others.
  • It is natural to experience many and confusing emotions such as grief, guilt, fear, anger, sadness, hurt, confusion, and more. You, not the ill person, are responsible for your own feelings.
  • You are not alone. Sharing your thoughts and feelings in a support group has been helpful and enlightening for many.
  • Eventually you may see the silver lining in the storm clouds: your own increased awareness, sensitivity, receptivity, compassion, and maturity. You may become less judgmental and self-centered, a better person.

Excerpted from “Coping Tips for Siblings and Adult Children of Persons with Mental Illness,” from the National Alliance on Mental Illness (NAMI), 2001, www.nami.org.


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Therapy types explained: DBT, CBT, CPS, and others

The fantastic news about the brain is that it can heal itself by talking with someone! And there is ample evidence to back this up.

The therapist or psychologist who works with your child or teen will use a type of therapy or “modality” based on their symptoms or diagnosis, because some work better for mood disorders, some work better for defiant children, some work better for borderlines, and so forth. (In thought disorders like autism and schizophrenia, talk therapy has limits. Those on the autism spectrum need specialized interactions due to their processing issues. Those on the schizophreniform spectrum need medication to think logically before starting

Therapy models. Each type of therapy follows a model, and five are covered in this article. Your child’s therapist must be trained and practiced in any model they use. Why? It’s a matter of quality control. A therapist who has fidelity to a model (adheres to protocol) will help the most people most of the time, because that model has data to prove that the majority will benefit–the ones in the center section of the Bell Curve. (Therapists include psychiatrists, psychologists, and psychotherapists with MSW (Masters in Social Work), LCSW (Licensed Clinical Social Worker) and other licensure.)

Therapy models

CBT – cognitive behavioral therapy
CBT works when the child can examine their own feelings and make sense of them—the “cognitive” part. They learn to understand what affects them and why. The therapist will guide your child to create a list of options for themselves for when they face the next stressful situation that pops up in their lives. CBT helps a person think their way out of the confusion and have plans in place for appropriate actions. It works for mood disorders and anxiety, and some thought disorders if person has ‘insight’ (able to notice when they are behaving or thinking irrationally). CBT is one of the most widely used therapeutic models because it works for people who are relatively stable but enduring a difficult life situation (divorce, medical illness, job loss, and other big stressors).

DBT – dialectical behavioral therapy
DBT is unusual in that it can help anyone for any reason! The term “dialectical” describes how a patient learns to hold two opposing truths in their mind and respond effectively to the discomfort and emotions this causes. DBT is the one therapy model that can work for people with borderline personality disorder, who are considered the hardest to treat. It also helps those with mood dysregulation, those who’ve thought about or attempted suicide, or those with uncontrollable and negative responses to the world, such as oppositional defiant disorder. DBT relies less on personal self-examination and analysis, and instead concentrates on self calming, tolerating stress without overreacting, accurately perceiving the nature of a conflict, and communicating with others appropriately. Anyone can benefit from DBT. Notice how commonly people hear bad news and immediately expect the worst, then act to address the worst possible outcome? Does your child do this, only to extremes?

EMDR – eye movement desensitization and reprocessing
The goal of EMDR therapy is to help a person process extremely distressing memories of trauma and mitigate their torturous subconscious influence so children and adults can adapt and cope when memories are triggered in the future. EMDR is used for people with PTSD (physical, sexual, or emotional abuse) and other traumas such as from war, accidents, and major disasters. The therapy process uses rhythmic stimuli as a distraction during the precise moments when the person relives the traumatic memory—eye movement back and forth (by following a swinging object or a therapist’s hand), clapping, or listening to tones switching from ear to ear through headphones. The person does not have to talk about the horrible memory, so EMDR is less stressful—so important for a trauma survivor! EMDR works but there are no acceptable explanations. It is based on a belief that the memory and associated stimuli of the event must be processed to remove it from “an isolated memory network” where it creates havoc.

Parents as therapists

There are two proven models of therapy that are taught to parents to practice with their children in the home. Like the other models, they don’t work for every child, but they work for most children with a certain range of behaviors, rages, resistance, and physical violence, which can be caused by ODD, ADHD, and depression/bipolar disorders.

CPS – collaborative problem solving
CPS can be learned by anyone to manage an intensely frustrated child who goes into uncontrollable fits or tantrums, and the parent can do nothing to calm them down. The fits may last hours, and must run out of steam on their own. Afterwards, the child is often remorseful. Why? Their brain is “chronically inflexible” and has difficulty with the unexpected, switching from one situation to another or one plan to another. Using CPS, a parent doesn’t enforce rules per se, but negotiates with child so that they together come up with a win-win solution. This is very counterintuitive! The parent does not give away their authority, but offers the child an acceptable choice. For example, if a child can’t get a red jacket because there aren’t any in their size, and they must have red (!), the parent asks the child if they want to order one and wait 2 weeks, or if they will accept another color. This seems fair to the child because they have a say, and much easier on the parent because the child accepts the outcome they’ve chosen.

PMT – parent management training
PMT refers to a proven intensive educational program for parents to teach them skills for managing extremely difficult children, especially those with ODD. PMT helps parents assert consistency and predictability at home and in school, and promote positive social behavior in their child. The parents are also trained to change their own behavior towards their child, and taught how to analyze different home/school situations, “then apply moment-to-moment positive reinforcement or punishment” (called interventions) based on what is happening. The punishments are humane, such as taking time outs. It is hard on the parents, but works for children with serious behavior problems in addition to ODD: Conduct disorder, ADHD, and autism spectrum disorders.

What makes a good therapist? Because multiple models are out there, a really skilled therapist will figure out which model your child needs once they get to know them, and they will apply parts of different models depending on your child’s individual challenges. That same skilled therapist will also be a cheerleader for your child, helping them feel good about themselves (and you), helping them discover their talents, and helping them to stay committed to their need for self-care. This is the very definition of a good therapist! Therapy is hard to take for anyone, but your child will trust a good therapist if they feel they have their best interests. Chemistry is important. If your child doesn’t like the therapist or make progress, it’s worth spending the time to find someone else who’s a better match. If the therapist has professional ethics; they will recognize they are not a fit and recommend someone else.

I know of a 10-year old child whose therapist dragged out appointments for a year with zero progress or results. From the start, the child didn’t like her and simply refused to talk with her. And this child, now 11, refuses any therapy because “it’s boring and a waste of time.” What an unfortunate consequence!

How you know you have a good therapist. A good therapist will be able to discover something valuable that brings light on your child’s situation after the very first session. They should ask you for background information about your child, and listen to you when you talk about recent problematic situations. They cannot talk to you about your child’s therapy, but they can encourage you to partner with them, and should recognize your need (your family’s need) for your child to function as normally as possible. You can ask to have therapy together with your child if its appropriate. If the therapist can’t connect meaningfully with your child after a few weeks, ask them about this. If you have any doubts about the therapist, share them, and expect to have a thoughtful, respectful explanation.

Which therapy is best for your child?

Seek a therapy provider with knowledge of all of them, and with experience treating children and teens. Ask about a specialty when you make the initial contact, and ask about a model you think fits your child’s behaviors (based on their descriptions). You can get a one-time assessment from a therapist for an opinion on which model to use. The best way to find a good therapist is through personal referrals: your child’s doctor or psychiatrist, support groups, school counselors, and other parents.


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The blessings and curses of schizophrenia – A father’s view

This guest article is by Don Moore.

Some families are presented with the dual dilemmas of dealing with a child that is both gifted and troubled.  Such is the case with my daughter who in spite of her schizophrenia nearly ended up on the popular television show American Idol.

Most fathers would be quite pleased if children came with owner’s manuals.  Mind you, the great majority would not read the manual, but prefer to use their own experiences and logic to determine appropriate actions in parenting.  Owner’s guides would be a fine reference resource to look up how things were to be done after trying their own thoroughly contemplated actions before resorting to some sort of predetermined remedial action.

Particularly in American society, a Man’s perspective is to reason out and come up with solutions to problems they encounter or to follow a set of requirements at their employment to retain their job.  Sure, there are exceptions, especially for those who pursue artistic endeavors, but even these can often be reduced to techniques, learned, practiced and then applied.  (More about men’s approaches to parenting is here:  For men who raise troubled kids) 

Like many other parents and especially fathers, my work revolves around the repair of things and when I first encountered my daughter’s difficulties with life, I followed an approach of analyze, find a solution and apply a remedial fix to my interactions with her.

Much of Western medicine follows this thought process as well; study the problem, recommend a treatment and magically the problem will be gone.  The real problem is that this simplified view does not reflect the nature of the underlying problem with many mental health issues.  An especially difficult disorder to use this approach with is schizophrenia.  Because we define this illness as a set of behaviors and characteristics and each person can have or not have many of the characteristics, the approaches that I followed in dealing with my daughter’s situation were woefully inadequate as well as misguided.

In fact, most of my approach to dealing with my daughter would have been ineffective with just about any teenager, much less one suffering from hearing voices and disjointed thinking.

If the point of reference that you are using to deal with a child with schizophrenia is that the child is somehow concerned with what effect their behavior will have upon you, you are sadly mistaken.  This is precisely what I thought when I would painfully explain why some task had to be done, like load a dishwasher.  If she could not complete the task, it was obviously because she was trying to agitate me and I responded by becoming agitated and angry at either her lack of compliance with my instructions or the poor quality of her efforts.  As the behavioral difficulties became more serious my frustrations escalated accordingly.  The escalations were equally ineffective.

All of the difficulties came to a crisis point when my daughter left to attend a performing arts college in Minneapolis.  There her difficulties took on another level of seriousness and she returned home.  Under the care of a psychiatrist, some progress was made and my wife and I elected to take a class in dialectic behavioral therapy (DBT) for parents.  The class, in conjunction with some wise advice from her psychiatrist finally got me to see that her difficulties were from within her own mind and the best approach was to understand her behavior reflected her struggles to deal with her view of the world and were not based upon a master plan to disappoint or offend me personally.  DBT techniques allow you to understand the effect of delusions on the child’s behavior and instruct you to deal with the feelings that those delusions have on the child’s behavior. There is not an acceptance of the truth of the delusion, but there is an acceptance of how the person feels about the thoughts they have.  Having someone verify their feeling about the delusion (It must be frightening to believe the government is using thought control on everyone) without accepting the truth of the idea helps the person modify their response to the delusional thought.

Once there is an understanding of the thought issues facing the person with schizophrenia, there is hope that the narrative that their brain has created for their existence in the world can be refocused to include new ways of viewing the world and how they are to interact with those around them.  Proposing alternatives to how they see the world is a method of getting them to rethink the ideas that they hold and readjust to a new way of behaving.  It is by no means as simple as an owner’s guide, but progress is possible.

Tracy and Emmy winner Joey Pantolino

In my case, the treatments my daughter received helped considerably at first and she was able to make a journey to American Idol tryouts, meet the famous judges in person and come one audition from actually being on the television show.  You can see her story in the February 2006 SZ Digest magazine http://www.schizophreniadigest.com/e107_plugins/szproducts/images/articles/2006_spring_story1.pdf  or at my website, www.matersofthemind.info .

Another aspect of mental illness that seems to be misunderstood is the wide range of seriousness and variation with symptoms.  My family has been both fortunate and unfortunate.  My daughter has been blessed with a set of skills in singing that brought her national recognition for her efforts with American Idol, but did not ultimately reward her with employable skills or remediate her disease.  There are others with schizophrenia with truly exceptional talents who find jobs and recovery.  There are also those who struggle with more serious symptoms.  Whatever the course of your loved one’s illness, there is some measure of comfort in seeking and finding skills that will help in dealing with the issues that are confronting them.  Not the least of these skills are understanding the emotional turmoil that the person feels in dealing with their view of the world and helping them deal with the issues surrounding that view.

Tracy and Senator Gordon Smith (wrote and passed mental health legislation)

During her American Idol experience, my daughter wrote and recorded a song entitled “I am Not Alone.”   There is no reason that any family or person should be alone in their efforts to deal with their condition.  While it may sometimes feel lonely, seeking out resources and learning about the experiences of other people with similar challenges will help in your efforts to create not an owners’ manual but a guide to help you understand alternatives while you seek a better path to follow.  You may not cure the disease, but you can respond better to the challenges you face in your own journey.

–Don Moore

I offer deep gratitude to both Don and Tracy for sharing their remarkable experiences

Margaret, blog owner


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