That Kind of Breaking

The guidance counselor was kind and calm. Anyone who can maintain those two qualities while in the confines of a public middle school all day has my immediate respect. I sat and listened as he began to speak.

“Your daughter tells me things have been rough at home, that your family has had some pretty big challenges.”

“Yes. That’s true. We certainly have.”

It had been about two years since my husband’s traumatic and failed fight for his life, and though he was a stepfather to my children they loved and missed him deeply. I had returned to the workforce, my son had moved to his dad’s and his sisters didn’t often see him, we had made the transition from homeschooling to public school, and my older daughter had recently been released from a five-day stay at the psych ward.

Yup, I’d say those were some pretty big challenges.

“Well, she’s been having a tough time dealing with it all, as you can imagine.”

Teenage Problems, Social Issues and Bullying

This was the coming-to-life of some of my deepest held fears at the time. In all fairness, I had quite a few fears, pretty much all of which included my kids. I knew that my older daughter’s struggles and rages were traumatizing our family. I knew that her continuing self harm and relentless thoughts of suicide were more than taking their toll.

I knew that I tried so hard to protect my younger daughter from her sister’s struggles, even as I didn’t know how to define or predict what those struggles might be. I knew how frightened I was, and I could only imagine how terrifying it must feel to a 13-year-old girl whose world had been shattered long before her sister’s mental balance had.

I knew that my youngest was getting lost in the shuffle of psychiatric appointments. I knew she felt invisible and dispensable as so much of my time was spent talking her sister ‘off the ledge’, cleaning and bandaging her self-inflicted wounds, walking on eggshells, trying to find an answer, a balance, a cure.

I knew that the older often goaded the younger, then immediately wanted her sympathy and compassion. She showed us all macabre, dark drawings she’d made, somehow expecting us to praise the depictions of death and blood she produced.

I could make no sense of it as an adult. I certainly could never expect my youngest teen to have the ability to process and make peace with all that was going on. And yet I felt powerless to guide her. How can you teach someone to do what you are unable to do yourself?

And so here we were, in the school guidance counselor’s office. I was waiting for what I didn’t want to hear, but what I needed to know.

 Worried

My daughter had ended up there after having had a particularly rough day, and she’d thankfully confided in her counselor about the unfathomable mess that was our family. She’s always been one to think she can tough her way out of anything (I have vivid memories of a three-year-old determined to swim in the deep end of the pool, working hard to hide the panic on her face) and I was so glad to see that she’d taken the chance to share her confusion and pain with a trusted adult.

The counselor continued, gently breaking the news to me that my daughter – the one here with me, not the one (hopefully) waiting in the car – had been cutting herself as a way to deal with her distress and pain.

My stomach dropped then just as quickly threatened to jump up out of my throat. I was facing my daughter, whose eyes were filled with many things, including fear. I knew she’d seen me deal with her sister and that she’d seen me be both gentle and brusque in trying to stop the ongoing and escalating self harm. Of course she had to be nervous about what my reaction to this news would be.

Outwardly I pretty much held it together, meaning I didn’t curl up in the corner in a fetal position. I fought the sudden nausea I felt.

But inwardly I was breaking, as if there was a  tire screeching, metal crushing, glass shattering  75 car pileup, the kind where you know things are so out of control you are clueless as to where or how to start administering any kind of aid. The kind where you are the lone witness and all you have are Band-Aids and the phone lines are down so try as you might you can’t call for the 50-plus ambulances that you need.

That kind of breaking.

 Car pileup

Tears sprang to my eyes.

“Oh, sweetie.”

It was all I could say.

© Monica Simpson and Help To Hope, 2014
https://www.facebook.com/HelpToHope
https://twitter.com/HelpToHope

Advertisements

A Tough Task

“Yes. I’m her mother. Can I help you?”

I got the call while I was sitting in the car outside my younger daughter’s middle school. I’d left work, picked my older daughter up at her high school, and driven to the middle school to park and wait for the day’s final bell. The interaction with my daughter sitting next to me was stilted and unnatural, as it so often was at the time.

 girl in car

Source

Her behavior after release from her first hospitalization for a mental health hold had been shaky. We’d had high hopes and bundles of nerves, and we were trying hard to make right something that we weren’t even able to completely identify.

In addition to obvious depression and unmanageable rages, she’d become involved with a boy at school who shared some of her struggles. He was a nice enough kid, but the dysfunctions they shared caused them worrisome co-dependence, especially when it came to their self harm behaviors.

teen couple

 Source

And while being together could be uncomfortable for both of us, I had serious concerns about leaving her unattended. She had alluded to running away on a number of occasions,  even trying to run off on that weekend before I’d had to call the ambulance. I knew that her thought processes were off-kilter enough that she could make some dangerous decisions.

My youngest daughter’s guidance counselor had called while we waited. “I have her here in the office with me. Is there any way you can meet with us before the school day is over?”

“I’m actually parked right outside. I can be right there,” I replied. The evasive, non-committal tone of the conversation made it clear to me that no good news was waiting inside.

I did the quick mental gymnastics: If I leave her here in the car while I go inside, will she be safe? Will she run? Will she be here when I get back? Should I make her go inside with me, feeding her insistence that I never trust or understand her?

I swallowed hard as I told her that I needed to go inside and speak with someone, and that I’d see her when I was done. She sat with her earphones on, black eyeliner encircling her downcast eyes, too cool and too annoyed to acknowledge much of anything. I put my car keys in my purse and walked to the school entrance.

Photo: D Sharon Pruitt

I signed in and was directed to the counselor’s office where my younger daughter peered up at me nervously from her seat. She was dressed like a typical middle-schooler, sporting a bulging backpack, carefully styled hair, colorful braces, and inches of plastic bracelets halfway to her elbows.

I tried to smile, to remain calm, to not read into the situation anything that wasn’t specifically presented. After all we’d been through as a family in the past years, that was a tough task to handle.

© Monica Simpson and Help To Hope, 2014
https://www.facebook.com/HelpToHope
https://twitter.com/HelpToHope

On Thin Ice

The weeks following my daughter’s release from her first mental health hold were a tenuous mix of hope and dread. I was hopeful the change of medication would help stabilize her, and at the same time I was terrified that the change of medication would not help stabilize her. Worse yet, I was afraid the change of medication would aggravate her already fragile demeanor.

It felt as if we were walking on thin ice, fearing a web of cracks with each step.

Walking_On_Thin_Ice_by_X_ample

(Photo Source)

My daughter returned to school, and it’s hard to say whose nerves were more frayed. Returning to classes and trying to explain to her peer group all that had happened could not have been easy for her.

I still had daily worries about her younger sister and the volatility within which we were all living. It was clear that, although the five days in the psych ward had helped to temporarily steady the crisis we were facing, our predicament was by no means resolved.

Soon enough the unpredictable and explosive episodes returned. The fragile and subdued girl who left the behavioral center after a psych eval was gone. In her place once again was a struggling teen unable to manage the emotional eruptions that plagued her.

There were necessary boundaries I was continuing to implement for her safety and my sanity, but I tried to allow my daughter time for friends. Though the dynamics of those friendships were not what I would have chosen (for any of them), I wanted to honor her need for her own identity and self-discovery. It seemed to be an integral part of the solution for her, but only if done in a healthy way.

I offered to drive them to the local ice skating rink or make our home available for their gatherings. All offers were declined, sometimes with a dismissive or angry attitude, sometimes with what seemed like abject hopelessness.

I tried to arrange my work schedule so that I could pick her up at school not too long after classes ended for the day. Getting in enough work hours could be difficult, and there were days she would call me filled with rage, demanding I pick her up right away.

on the phone

(Photo Source)

I wasn’t often able to leave early, though if I felt she was not emotionally safe, I would try to head out as soon as possible for the half hour drive. Memories and thoughts of her self inflicted wounds were never far from my mind.

It could be tough to know the right thing to do: Was she trying to manipulate me with her anger, expecting me to respond to her every whim? Or was she truly incapable of regulating her emotions, succumbing to the darkness that enveloped her like a cloud?

The answer to both questions was a resounding yes.

I was often confused by the seesaw of emotions I witnessed. She would insist that she wanted to stay after school to be with her friends, dramatically declaring that they were the only reason she went to school or kept herself alive. But her insistence about the importance of being with her peers was equally matched by her absolute loathing of them at times.

Life remained utterly unpredictable.

One thing that was relatively unsurprising was my daughter’s therapy sessions. As per the discharge paperwork from her hospitalization, she started seeing a new counselor. Unlike the previous therapist, this one was not located near our home. In all fairness, it wasn’t too terribly far; it just felt that way. The drives there and back were filled with heavy silence or forced, uncomfortable conversation.

What was not a surprise was the refusal from my daughter to fully engage in the help that was available to her. While she would talk on a superficial level with her counselor, she had in truth done nothing but reinforce the brick wall that surrounded her, the wall that she mistakenly felt would protect her from pain and struggle. At times she would even agree with insights her therapist offered, but by her own admission, she simply didn’t care.

Sometimes near the end of her sessions, I was brought into the office and the conversation. It was not unusual for me to watch my daughter sit in stony silence, her arms crossed tightly, her breathing heavy with anger. Her eyes would be filled with rage while she stared at a distant point, as if to will her bodily out of this universe and into one of her own making, one that would soothe her despair and anguish.

Sadly, she was unable to see that she was surrounded by people who truly wanted to help her reach a place of calm and peace. Her depression had convinced her that this was not a possibility for her.

Our lives continued to be lived in the shadow of her illness.

© Monica Simpson and Help To Hope, 2013
https://www.facebook.com/HelpToHope
https://twitter.com/HelpToHope

Work

My daughter’s stay in the psych ward (her first stay, at least) was five days. Yet it seemed interminable and exhausting to me. I can only imagine how it must have felt to her.

While my daughter was hospitalized, I worked. I worked to find the new therapist she needed. I worked to prepare my younger daughter for her sister’s return. I worked to prepare myself for her return as well. I worked at calming my nerves in anticipation of the unknown that lay ahead for us.

I worked at contacting personnel in my daughter’s high school to let them know why she’d missed school and was failing her core classes. I worked to advocate to her teachers on her behalf as depression, anxiety, and panic had interrupted class tests, make-up tests, and all manner of school work and homework in the preceding weeks.

I worked to make it clear to her teachers that I was not trying to excuse any behavior; I simply wanted my daughter to know she could walk into a classroom, take a test, and not let anxiety continue to drag her into a dark abyss leading to self harm and despair.

I worked to prepare the way to help my daughter find even a tiny but necessary victory.

I worked to release the frustration of not hearing back from several of her teachers. I worked to let go of the fear that they would judge me as “that mom”, the one who let her kid get away with anything, then made excuses.

mean-teacher

Source

 

I worked to remember that my goal was not to get my adolescent daughter to pass English, sing in choir, or even pass her freshman year. I worked to stay focused on helping her reach a place of mental wellness, health, and personal safety.

I worked, literally, to keep my daughter alive, to help her want to stay alive.

I worked to respond to the teachers who had kindly and compassionately replied after I contacted them to inform them of my daughter’s deep struggles. I worked to contain my tears, to thank these good people for seeing the inherent value in my 15-year-old, even though she could not see it in herself.

I worked to remind myself that they were bearing witness to the good in my daughter, and helping me hold onto hope, whether they realized it or not.

I worked at letting go of the frustration that I was the one having to do everything, with no help from my children’s father. I worked to not allow wasteful bitterness about that overtake me.

I worked to arrange my schedule so I could be where I had to be when I had to be there, whether taking my youngest to cheer practice, or visiting my older daughter in the psych ward.

I worked at pushing aside the grief I felt as a widow, the utter sorrow I felt at not having my husband to talk with at the end of an exhausting day. I worked at trying to think of the encouraging words I knew he would say to me.

I worked to recall the feel of his arms around me, the safest place I’d ever known. I worked to remember that, no matter how distant it now seemed, I hadn’t imagined him in the first place.

I worked at staying awake and focused despite little sleep. I worked at the dailies of life: carpool, laundry, dishes. And, of course, I worked at work.

I was tired.

 

(One of my favorite bands/songs/videos. Best when played at a loud volume.)

 

Saturday finally arrived. Though two days earlier my daughter had angrily demanded I pick her up “Saturday morning at 6!” I kept my word and arrived around 9:30 a.m. The requisite paperwork took a little while. And there were new friends she’d made to whom she wanted to say goodbye.

We left with a prescription and a plan, and I was hopeful they would work at the same time I was terrified they would fail.

One of the perks of a psych ward stay (who knew there was such a thing?) was that my daughter was able to continue as the patient of the psychiatrist who saw her during her days there.

While that may not seem like such a big deal, the truth is that finding a qualified psychiatrist can take more time than one might imagine. And after finally tracking someone down, it’s not unusual to have to wait up to two months (yes, TWO MONTHS – or more) for an available appointment.

This one not-so-small detail had now been taken care of. It’s not like the appointments would be close to home, but just to HAVE appointments for someone who could manage medication was a major hurdle crossed. I was very grateful.

sunny day

 (Source: Google Images) 

 

My daughter and I stepped out into a bright, sunny February morning in Colorado. She hadn’t had the freedom to be outside for several days. She seemed small and fragile, a combination of embarrassment, nervousness, and relief. I felt much the same as she.

I didn’t know the rules for what a parent is supposed to do when they pick their kid up from the psych ward. So we went to Jamba Juice. It seemed like a good idea. And it was.

© Monica Simpson and Help To Hope, 2013
https://www.facebook.com/HelpToHope
https://twitter.com/HelpToHope

Waiting For The Unknown

We waited at the Emergency Room. That’s what Emergency Rooms are for, it seems.

We waited for a mental health evaluation for my middle child who a short while earlier had threatened suicide to anyone who would listen. We waited with knotted stomachs and interminably slow clocks.

And I personally waited with the audacity to hope that things could change, that she could ‘get better’ and stop skipping school, stop wearing torn black clothes, stop wearing her hair covering three quarters of her face, stop believing that she was a doomed failure, stop reading and writing and drawing about nothing but blood and death, and stop carving her body to help relieve the anguish she was feeling.

My daughter was understandably distraught and confused. And of course, how else might a teenage girl initially feel when armed police officers walk into her bedroom and announce that she will be going in for an emergency psychiatric evaluation? She alternated between tears of remorse and bursts of frustration, then her anger began to flare as the realities of the situation became apparent.

girl on bed

(Photo Source: Google Images)

Her cell phone had been taken upon arrival, along with her clothes and shoes. She wore oversized maroon-colored scrubs as she endured the aggravation of not being able to communicate with her friends beyond the few messages she had frantically texted before the phone confiscation.

I had known that her peers were firmly intertwined in her self-destructive and dysfunctional behaviors, and her inability to communicate with them during this crisis annoyed her greatly. (Okay, that’s a major understatement.) When her younger sister came to the ER after a while, she secretly asked her to contact certain people for her, to give them specific messages.

After several hours of waiting and evaluation, of tears and apologies mixed with empty promises and accusatory adolescent eyes, I was only partly taken aback at the announced possibility that my daughter might simply be released from the ER and sent home. She’d said that she no longer wanted to be alive and wasn’t at all averse to ending her own life. But she had not formulated a specific plan.

In an emergency room that’s apparently a pretty big distinction.

I wanted my daughter be admitted on a mental health hold. I had watched her descend into darkness over the previous months. I had been the recipient of so many of her rages. I had cleaned and bandaged her self-inflicted wounds. I had seen the black emptiness in her eyes as she spoke of the hopelessness she could not crawl out of, the blackness she’d seemed to learn to surrender to and eventually embrace.

I knew that if she went home nothing would be different. She would still carve through her skin, she would still rage and make threats that included suicide, she would still be failing school, living in the dark despair that had become her reality. Our home would still be held hostage in turmoil, and I would still fear for her life. Every single day.

I could not help her to stabilize. We needed someone else to facilitate that. So at my insistence, the decision was made to admit her. I believed without a doubt that, as backwards as it might have seemed or felt, it was the only chance for her overall long-term safety and wellbeing.

medical chart

(Photo Source: Google Images)

There was no room available in the mental health section of the hospital we were at, so calls were made to “find a bed” for her. A freestanding behavioral center with available space was located halfway across town, and we began another wait for her second ambulance ride of the day.

It was nearing midnight when my daughter was once more loaded into an ambulance. By this time my car had been brought to the hospital, so I got directions to the facility where I was to connect with them after transport and sign the consent for a 72-hour mental health hold.

My ex-husband had left and I traveled a couple of interstates alone to a multi-story building I’d seen many times off the highway. I parked my car and hurried to meet the ambulance as my daughter was once more offloaded and taken inside.

This facility was secure, meaning that no one could get in or out the glass front door without the lock being ‘buzzed’. I learned that no bags or purses were allowed inside, so I returned mine to my car. Again, the emergency personnel were sympathetic and considerate. They conversed easily with my daughter and offered their best wishes as they departed.

We were led to some elevators and up to another floor. We approached an area with yet another set of secure doors. These were large, locked, wooden doors. No going in or out without an electronic passkey, which only the employees were permitted.

locked hospital doors

(Photo Source: http://keyeslifesafety.com/)

And this was it. This was the unknown that I had both feared and longed for, the place where I trusted my daughter would not be able to self-harm or act on her suicidal thoughts. This was the place I hoped she could start to find safety and stability.

This was the psych ward.

 

© Monica Simpson and Help To Hope, 2013

A Friday in February

+++ SELF HARM TRIGGER WARNING+++

*****

“Can you step in to my office, please?” It wasn’t unusual for my daughter’s therapist to ask me back for the final part of the session, so I followed her. My daughter sat sadly in a leather chair, and I took my place next to her.

“She has something she needs to show you.” I was puzzled as my daughter stood part way and started to unzip her jeans. Still hunched over, she pulled down one leg of her jeans further than the other. I winced as my eyes began to water.

There, etched in large, crude letters covering most of her thigh, carved not with a pin but with the thick blunt end of large household scissors: FUCK

My hand instinctively went to my mouth in deep grief. My heart raced and my stomach began to churn with anxiety as my daughter quickly zipped her jeans and sat down.

She had not shown me this damage she had done to herself, and she had purposefully not cleaned the cuts.

I kept thinking how badly it must sting, to have tight denim on the open scrapes she had self-inflicted only the night before. She’d worn those jeans all day; I imagined how every time she’d moved or adjusted her pants, the wounds would have ruptured anew from the bond they’d made to the fabric.

girl in jeans

(Photo Source: Google Images)

Her self harm and self hatred had become unmanageable.

I wanted to scoop my daughter up, to take her home, to clean her wounds and make her pain disappear. But weeks’ worth of trying had made it abundantly clear that such a thing was beyond my capability. And on top of that, my daughter deeply and openly resented going to any type of mental health counseling.

Her stock was placed firmly in the peer group she had chosen, and any efforts to intercede for her safety were complained against. She went to therapy because I made her go, but her emotional loyalties were to those who had taught her about self harm and with whom she was dangerously emotionally enmeshed.

I believe that a small part of her was hoping desperately for help and rescue, though the larger and more visible part of her was resentful and angry at the intrusion of counseling appointments twice or more each week. But what choice does a parent have? It was soberingly clear this was not a phase she would outgrow.

“We’ve been talking,” said her counselor, “and while I think she is right on the cusp of needing to be hospitalized, we have come to a compromise.”

To the best of my understanding, while my daughter was saying she wanted to die, she did not have a specific plan to carry out that desire. And that’s how we ended up in the therapist’s office on a Friday afternoon in February, planning a long holiday weekend of what was basically house arrest.

jailcell door

(Photo Source: Google Images)

“She has to be with someone 24 hours a day. She must sleep, eat, and be in the same room with you all the time. She cannot be alone except for short bathroom breaks.”

My mind raced to take in all the information, envisioning how we would put the plan into action. I’m nothing if not a planner, but even I was overwhelmed by this. “We’ve agreed that if she will stick to this plan, she won’t have to go straight to the hospital when you leave here today.”

I nodded as I looked at my daughter’s therapist, trying to take in the details and instructions, but inside of me there was a thunderous voice of fear and uncertainty: “WHAT??? Are you nuts?!? I think she should be hospitalized! NOW! How can I do this? This is impossible! I cannot keep her safe!!!”

I looked over at my daughter, who had disappeared inside herself. She was definitely angry, but she was more frightened by the thought of actually having to go to the hospital on a mental health hold.

sad_girl_by_majed_ahmad-d33oeft

(Photo Source: majed-ahmad, http://fav.me/d33oeft)

Despite my own fear, I chose to believe the part of her that was the frightened child, the part that felt trapped and afraid and just wanted to go home. So we went home with plans to return in four days.

 

© Monica Simpson and Help To Hope, 2013

Uncertain

+++ SELF HARM TRIGGER WARNING +++

*****

“She needs to have her medication changed.” These were the words of the therapist who had been seeing my daughter for a few weeks. “And I’d like to arrange for some testing, too.”

There were mornings when, in a panic, my daughter had had to leave school. Thankfully, on some of those days, I was able to miss work and take my daughter to an emergency therapy appointment. Her dad had even left work a time or two to pick her up and take her when I was unable. Oftentimes she calmed down and was able to return for part of the school day.

crowded high school hallway

(Photo Source: Google Images)

The steepness of her downward spiral was becoming painfully clear. Still, I worried that she was being rescued in an unhealthy way, unsure of what was in her control and what was not. I felt uncertain as to whether she was just manipulating me, or if the bulk of her actions were really symptomatic of things beyond her control.

Was she just trying to get out of classes she didn’t like? She was skipping so many of them anyway that maybe she was just using panic as an excuse. I looked forward to psychological testing, hoping it would provide some answers. I didn’t realize that it would not happen until months down the road.

The anxiety was believed to be caused by medication, thus the therapist’s advice to switch to something else.  The change was made from one SSRI antidepressant to another. The side effects were no different. Panic and anxiety grew. Physical ills plagued my daughter. Depression deepened to a place far beyond blackness. And I began to see more clearly that what she was experiencing was very, very real.

I felt that despite all my best efforts to provide stability after her dad had left years earlier, after my attempts to address and allow for grief following her stepdad’s death less than two years prior, I had failed. Miserably. I only knew that I was at my wit’s end. I had no more ideas, only a deepening panic. My heart broke for her struggle, but I felt powerless.

Anger and rage poured from my mild-mannered, fair-skinned, introverted middle child. Although she was at her dad’s at least pretty much every other weekend and then some, she saved her raging for me. She has come to tell me in the ensuing years that it was a safety issue to her, that she felt I was a safe place for her to unload her fury and frenzy.  At the time, I was simply bewildered and deeply hurt.

angry teen girl (google)

(Photo Source: Google Images)

She self harmed daily with much more than just a single cut. There were times when, after she cut, I would calmly clean and bandage her wounds. I would offer her my tears as a cleansing balm, hoping she would see the love I had for her, and that it would somehow fill the chasm of her need. Other times, I would remain detached and aloof, thinking that if I approached this matter-of-factly, the emotional dysfunction she was seeking to feed would instead be starved out.

Although she often cut while alone in her bed at night, I reminded her that she needed to be sure to clean her wounds to avoid a dangerous infection. (These types of conversations are not covered in parenting books, by the way.) After all, my late husband had succumbed to sepsis, his body unable to fight and overcome a serious infection, which had ultimately taken his life.

While she would at least sometimes attempt to sanitize a cutting instrument with a lighter, the concept of death by infection seemed to somehow intrigue her as she began to allude to her own demise. In fact, at least once she said she welcomed the idea of such a manner of death.

Her bed sheets and pillowcases became bloodstained. She left bloody tissues or clothing lying on the floor, evidence of the previous night’s anguish. I hated to go to bed every night, truly fearful that on any given morning I would find my daughter dead from one cut that had accidently gone too deep.

I remember wondering for a while if she was cutting on purpose, to manipulate me, to see how she could get me to react or what kind of sympathy she could garner. So sometimes I simply didn’t engage with her after she had self harmed. I told her to find the bandages and soap and take care of it herself.

And then there was the time I had just had enough. I was so fed up, so terrified, so OVER it. I was furious with panic and confusion. And I told her so. And that’s the time she remembers. Of course.

I can’t undo it, but it still feels shameful to me. I didn’t know then what I know now, and I try hard to see it as one incident in the scope of the whole journey. But I’m still embarrassed and deeply saddened by my behavior that evening.

(Source)

One memorable night she came downstairs to my room and showed me her arm. The fresh carvings were somewhat erratic and still bloody, so it took me a few seconds to decipher what I saw.

U  R  SHIT

There it was, on her arm, under my nose. Still wrestling with my own culpability in her struggles, and because she had presented herself to me for inspection, I asked her slowly and as gently as I could, “Um, who are you saying that to? Are you trying to say that to me?” Because if so, I would have much preferred she just declare it to me, not carve it into her body as a permanent reminder.

I remember the tears in her eyes.

“No, mom. It’s to me.”

And so we wept together as I silently begged for some kind of help to save my daughter from herself.

© Monica Simpson and Help To Hope, 2013

Do you have a teen who is self harming? Please see Responding to Your Teen’s Self Harm. Information regarding self-injury (cutting, burning, biting, bruising, etc.) can be found at  S.A.F.E. Alternatives, Self Injury Foundation and Self Injury Outreach and Support.

Searching For Help

I started January of that year searching for a therapist for my daughter. The family doctor had listened as she and I had talked openly of her pervasive sadness and increasing self injury. He prescribed an antidepressant for her, and made it clear that mental health counseling was essential.

Besides the constraints imposed by insurance, I wanted desperately to find a mental health professional close to home. I was, after all, still a widowed single mom with two daughters. I had intense and constant worry about my younger daughter, not only about her exposure to her sister’s maladaptive coping skills, but also about her  getting lost in the shuffle now that my older daughter’s issues were taking virtually all of my time and energy.

I had to fit in my daily work schedule as well as transporting both girls to and from two different schools at different times. Their dad, who had left more than ten years earlier, had given some lip service to helping transport them, but claimed that he really couldn’t help on a regular basis because of his work schedule.

This left most of it to me, except for those rare occasions when I could find someone willing to carpool on our schedule.  So for better or worse, proximity to home became a factor for hiring a therapist.

I finally located a counselor whose office was close to us. She was kind, professional, knowledgeable, and not a very good fit for my 15-year-old daughter. Still, I pressed my daughter to give her a try. “She’s not here to be your best friend. She’s here to offer her knowledge and help work some things out.”

angry girl in therapy (google)

(Photo Source: Google Images)

And this is where I must say, that is a terrible attitude to take into therapy. Imagine telling your deepest pains and fears to someone you just don’t click with, to someone who may be very nice but with whom you really feel no personal connection. I wouldn’t do it.

But I mistakenly expected my daughter to. I was wrong. I wanted her to do it because I was scared and exhausted and weary to the core, but I was still wrong. I didn’t know how to be two places at once, or how to keep my younger daughter from feeling forgotten and lost, but I was still wrong.

I have since referred other people to this therapist. I meant it when I said she was kind, professional, and knowledgeable. But I also meant it when I said she was not a good fit for my daughter at that particular time. Still, for a few weeks, we made regular trips to see her.

During those weeks, my daughter began to feel the effects of the antidepressant she had begun. She was exhausted, felt physically ill, experienced increased anxiety, and ironically fell deeper into depression. Many days I would take her to school, only to have her call me in a panic, unable to stay beyond even part of the morning. By this time, her self injury was increasing in both frequency and intensity, as was my fear.

Both carefully crosshatched as well as untamed cuts often covered her forearms, etched with safety pins, push pins, or blades taken from disposable razors. Her anger would spew out in screaming rages, in torrents of sobs neither she nor I could help her to control. What had happened to the loving, affectionate, self-assured girl who had been my daughter?

One moment she would curse me to the four winds, and the next she would fall into my arms for comfort and reassurance. Her terror was matched by my own, but I did not have the luxury of letting mine be known.

Her moods and tirades ruled our home, and I grasped desperately for ways to quell the unpredictable storms. I tried reason. I tried consequences. I tried being emotionally neutral or removed. I tried tough love. I tried empathy and understanding. Always I tried to convey my unconditional love for her.

In truth, the deeper she fell, the deeper my heart broke. The more she pushed me away, the more I longed for her to know the love and safety that were ready and waiting for her. It’s not that I could have loved her more than I already did. It was that I ached more deeply for her to know the love that was already hers.

TEEN-BEING-HELPED-BY-MOM-copy1

(Photo Source: Google Images)

There were many times when my daughter vented her anger that I simply laid down on the floor during our conversations so that she would not have any reason to feel threatened. I didn’t realize what I was doing until afterwards. I did it instinctively, recognizing that she felt susceptible to some deep, unnamed danger. What I failed to understand was that her biggest threat came from within.

 

© Monica Simpson and Help To Hope, 2013

Darkness Descending

After my husband’s death, I took over the off-site property management of an apartment complex he’d managed for years. I did my best to learn the job without the benefit of a teacher, and even managed to figure out some of the many details he’d kept brilliantly within his own mind, thus taking them to the grave. (I had plenty of one-sided conversations with him about this, believe me!)

But a year and a half after he died, the apartments were sold and the new owners brought in all new staff. Not only did I have to lay off some dear and hardworking people, I lost my own job as well.

I found more work relatively quickly, but the stressors of a sharp learning curve and constant change, both personally and professionally, were wearing me down. I missed the calming reassurance of my husband’s presence the most in the quiet, solitary hours of nighttime, so my sleep schedule was often erratic at best.  I was weary and worn, pulled on every side, knowing there wasn’t enough of me to cover all the bases that needed to be manned.

I felt that I was leading my little family into a new school year in about as unsettled a manner as I could imagine.

schoolbooks

(Photo Source: Google Images)

The previous fall, less than 6 months after my husband died, we were of course all still reeling with the loss. I had homeschooled both of my girls up to that point. They had always been involved in enrichment programs, youth groups, parks and rec activities, and/or homeschool co-op, as well as having friendships with neighborhood kids.  In the interest of allowing them to honor their own grief and needs, I let them each choose whether or not they would stay home for school.

My younger daughter had chosen to no longer homeschool. But my older daughter chose to remain at home for one more year, her final year before high school. She was an introvert to be sure, but had always made friends easily and was fierce and loyal in her friendships. She was compassionate and empathetic, with a heart quick to love, give, and forgive.

A year later, in preparation for high school, she had gone to freshman orientation. Later, we had walked the empty halls to find her classrooms so as to ease her in to her daily schedule.

As I dropped her off that first day of school, she was anxious and tense. “Mom, I just want to throw up.” I did my best to lovingly but firmly send her on her way, confident that she would make friends and find her place. After all, aren’t the majority of high school freshmen nauseous with worry on the first day of school? Don’t we all have to learn to make our way, to take a big, scary leap into the world at some point, and learn that we will indeed survive?

I watched with curiosity and concern while she went about making her way. I came to learn later that because of her quiet nature and unique style, other students made erroneous and unkind assumptions about her. Like all of us who were not in the popular crowd in high school (which by definition is most of us), she was misunderstood and unfairly mislabeled by adolescents whose opinions I wish hadn’t mattered to her. In response, she latched on to the first crowd that welcomed her.

They wore, for the most part, black clothes, black hair, black makeup, and hair in their faces to obscure wounded and mistrusting eyes. I observed relational dysfunction, adolescent angst, and the deep longing we all have to find a place where we feel loved and worthy.

They talked of things dark and macabre, and from them she learned of self harm and the relief they claimed it offered. While some of them had blonde hair and wore neon colored clothing and toothy smiles, they all shared a brokenness that drew them together. And I could fault none of them for the wounds that had been visited upon them.

I was sad for their pain, heartbroken and even angry for what my daughter was exposed to through them, but I understood that they were really just a group of wounded souls, holding on to one another for dear life. They were brokenness begetting brokenness. Still, when your child is in the quicksand, you don’t just feel sad that she has fallen in. You fight through hell and high water to get her out.

quick sand

(Photo Source: Google Images)

As we neared the end of December, my anxiety increased as I realized my daughter’s depression, confusion, and self harm were increasing. She had written a lengthy and scathing diatribe of a suicide note to her sister shortly before Christmas. And while many siblings may go through times of severe dislike and perhaps even loathing of one another, this note was particularly troubling. It was rambling, coherent, precise, and inconsistent all at the same time.

My younger daughter had the sad and scary task of first reading it, and then bringing it to my attention. I will always be proud of her for summoning the courage to do that.

Chaos, despair, and self injury were enveloping my daughter’s first four months of high school. The road ahead looked more desperate and steep to me than any I’d ever seen, darker even than the realization less than two years earlier that my husband would soon die.

In an effort to bring order to the chaos, my daughter and I went to see the family doctor who’d treated her for most of her life. He prescribed an antidepressant and made it clear that mental health counseling was not optional.

 

© Monica Simpson and Help To Hope, 2013

In The Beginning

It began about sixteen months after my husband died.

He’d battled a rare liver disease for a few years, his diagnosis coming less than two years after we were wed. His final two months were spent in the hospital, save for a Valentine’s Day discharge home that lasted less than 72 hours. About five weeks later, we gathered around him, saying our final goodbyes as he lay unconscious. The nurses, by this time very dear to me, were kind enough to turn off the alarms that began sounding after life support measures were removed.

Hospital Monitor

(Photo Source: Google Images)

We had cried, we had prayed, we had sung, we had told him the things we felt were most important to say, many of us at the same time. It was a cacophony of loving sentiments and earnest anguish expressed in the most grievous of times. He breathed his last. We lingered a while.  And then we all went home.

My adult step-kids and their cousins left to return to their families. (I sure love all those “kids”.) My in-laws drove back home after the death of their firstborn. (I love them even now.) My dear mother, herself widowed a few short years earlier, left with what I imagine were difficult thoughts at best.

My son (age 16) was living with his dad, so while he departed to a separate destination, my two daughters and I walked into our darkened and forever-changed home. And while I rarely allowed them to sleep the night in my bed when they were little, we all piled under my comforter together in the cold March darkness. It didn’t matter that they were 12 and 13 years old. No one was going to sleep much anyway.

Life changed, of course. In drastic ways that could not be undone. Grief is an odd phenomenon for so many reasons, not the least of which is that everyone experiences it differently. But we could say the same about life, couldn’t we? Everyone experiences it differently. The triumphs and losses a family experiences together are processed and assimilated uniquely by each individual.

As I did my best to adjust to being a widow, an unexpectedly single mom for the second time, my kids did their best to adjust to life without the step-dad that they had known and loved for more than half their lives. The wound was deep.

My older daughter, a few months shy of her 14th birthday when my husband died, began to grapple with adolescence in more marked ways when she turned 15. It was subtle at first, not nearly as obvious or aggressive as it became in time. She had always been quiet and observant, even as a baby. Though introverted, she was affectionate, with a natural talent for words, music, and bold creativity. But as she prepared to enter high school, any sense of worth or identity she had possessed seemed to disappear into thin air.

When the kids were quite young (ages 7, 4, and 2½), their dad had made the choice to leave our family. Having been the child of divorced parents from years ago (before the divorce statistics were so high, when – unlike today – I didn’t know anyone else whose parents had split) I knew the potential for damage to my impressionable children. I took them to a counselor, and the most useful long-term piece of advice I received was that, as young children of divorced parents, they would most likely struggle more than normal during milestone transitions as they grew up.

This had absolutely seemed to be the case up to that point, so when my daughter started to act out with impatience, eye rolling, frustration, and withdrawal, I chalked it up to the cumulative losses we’d all been through, plus the hellishness that adolescence in general can be. And I reminded myself that the ride would likely get bumpier than most, but we’d get through it.

I saw her as I saw her brother and sister: capable, full of life, with so much to experience and to offer the world. I hoped that as she entered high school she would be able to try a myriad of new things, to find her niche. I expected the confidence in her many talents and abilities would only strengthen. I was wrong.

I am not so old that I don’t remember high school and what it takes to try to find your way socially. In fact, I went to three different high schools in three different states all within the final year and a half of high school. I remember well. But as I said, we all experience life differently, and my daughter’s experience was nothing any of us expected. Her sense of identity and worth were shaken to the core. The beautiful and talented girl I saw was nowhere in her view. While I tried to reassure us both that she would return to herself, she was spiraling into an abyss of confusion and despair.

It’s worth noting that I don’t think there is one particular reason we can point to for this. I believe it was the culmination of so many things, both genetic and environmental, that landed my daughter where she ended up, with peers who tended towards emotional dysfunction and physical self harm. Her black hair, black fingernail polish, and thick black eye liner didn’t concern me near as much as the darkening shadow in her heart. She was trying. She was trying so hard. But she was at a loss, and I was simply not fully aware of all she was wrestling with.

Goth makeup

(Photo Source: Google Images)

At first she tried to make excuses about the cuts I saw on her arms and wrists. At first I tried to believe her. In retrospect, I can see that she was initially reticent and even somewhat delicate with her self injury. But as time went on, as her darkness descended, the increasingly aggressive scratches, cuts, and gashes began to mirror the turmoil she felt inside.

 

© Monica Simpson and Help To Hope, 2013