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
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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.

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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
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His Sweatshirt

“Bring me his sweatshirt, mom. Please.”

“Of course, sweetie. Of course I will.”

My daughter was limited in the personal items she was allowed to have during her mental health hold. Hoodies – the staple of teen fashion – were okay, but drawstrings had to be removed. Favorite (imitation) Converse shoes? Fine, but no shoestrings allowed. The safety pins my daughter loved to use as fashion statements were absolutely forbidden.  I was forced to look at clothing, and much of life, in a whole new way.

But the thing my daughter wanted most was “his sweatshirt”, and there was no reason to deny her request.

When my husband had died almost two years earlier, I’d invited all three of his adult kids to go through his clothes, to pick out some favorite items they might want to keep for themselves or their own children.

I tried to also give them each special items, perhaps tokens of affection they or their children had given their dad that would now make their way back to the original gift givers. Or maybe an item that they had seen growing up in their childhood home that held special memories for them. It seemed only fitting to do this.

(Admittedly, there were a few things it took me time to be able to part with. Thankfully, my step kids are gracious and patient.)

I had also asked my own three adolescent children what they would like to have of their stepdad’s as special mementos. My older daughter had chosen an old sweatshirt that my husband used to wear often. He was great at coming home from a day of work and changing into comfy clothes, a signal that work was left behind and he was now present and available at home.

But this particular sweatshirt was one he often threw on early on a Saturday morning as he brewed coffee, read the paper, and prepared his favorite bagel for breakfast. It was a treasure on many levels and had become something of a security blanket to my daughter

 red sweatshirt

(Photo Source: Google Images)

In both the best and worst of times she slept nightly with the worn shirt close by. So often she had cried to me after his death about missing him and wanting him back. I understood at a deep level how she felt (and then some), and was not at all surprised that she wanted “his sweatshirt” now that she had been placed on a psychiatric hold for suicidal ideations.

It made perfect sense to me. To a frightened and unstable fifteen-year-old it was portable comfort, raveled and worn, in a place where comfort was difficult to find. I was happy to grant her request.

Visiting hours included Tuesdays, so I was returning less than 24 hours after I’d followed the ambulance across town and had her admitted. I took some approved clothes, the needed sweatshirt, my younger daughter, and an anxious heart, and drove us all through afternoon traffic for our first visit.

To call it uncomfortable would be an understatement. And incomplete. How else might I describe it? It was bewildering, sad, strange, surreal, terrifying, and with a few tendrils of hope that I tried to believe weren’t just taunting me.

There was one room where all visits took place simultaneously. All of the adolescents hospitalized there and all of the visitors who had come to see them were confined to this one very plain not-terribly-large space. Each group had their little gathering of chairs as segregated as possible from the others, with some people having to share their seat with another.

visiting room

(Photo Source: Google Images)

Some groups sat close together, speaking in hushed tones. Some seemed less eager to sit closely, or to even talk with one another. Some were loud and frustrated, others subdued and resigned.

I tried to (or not to?) catch glimpses of the others in the room while simultaneously trying to figure out how our family had ended up here, how my daughter was faring in the psych ward, and just exactly what the next step might be.

Add “disconcerting” to the list of adjectives.

© Monica Simpson and Help To Hope, 2013
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At The E.R.

The ambulance driver and I made small talk as he transported us to the Emergency Room. Lights and sirens were not used on our drive, and I was thankful. He told me that, in his experience, drivers did strange things when they saw an ambulance on the road.

Most notably, he said, when a situation is emergent (using lights and sirens) people tend to not see him or just don’t move out of the way as the law dictates. Ironically, he noted that when there are no loud sirens or flashing lights, other drivers tend to give him a wide berth.

I tried hard to stay engaged in the conversation. It helped to fight the rising nausea in my stomach, the indistinguishable thoughts in my head, and the constant threat that my heart kept making: that all of this was simply and ridiculously too much, and it would soon just give up and shut down.

My daughter was a few feet behind me in the ambulance, separated by the cab wall, but strapped safely to a gurney and attended to by competent emergency personnel. I could only imagine what she was experiencing, how scared she must be, if she – like me – was wondering just how all of this had happened and where things went from here. Did she too feel a sharp mixture of fear, dread, relief, and hope?

I wanted to be with her, to reassure her that she was not alone among strangers, to promise that I would not leave her to fend for herself. After all this time, I still wanted desperately to know that I could hold her and make everything okay again. I couldn’t. I couldn’t hold her, and I couldn’t make everything okay. But I so wanted to.

ER Ambulance Bay

(Photo Source: Google Images)

We reached the bay doors of the ER and I watched my daughter, on her gurney, come out of the back of the ambulance. She was wheeled in through the automatic doors and I followed closely behind, gratefully noting the kind interactions and well-wishes of the EMTs as they spoke with her and shared their goodbyes.

She was taken back to an evaluation area set up for situations just like ours. There were a few patient rooms with large windows for easy observation. Mini-blinds were sandwiched inaccessibly between two panes of  (presumably unbreakable) glass and doors were double hinged to prevent tampering and escape.

The rooms were Spartan in their appearance, leaving nothing to chance when it came to patients who were making physical threats or experiencing suicidal ideations or other mental health crises.

There was a small central area which the rooms surrounded, a place where nurses and guards could keep a watchful eye on those who were unstable, who were a very possible threat to themselves or others.

It was sobering to realize this was a necessity at our local Children’s Hospital.

I remember walking out to a large, public waiting room to call my daughter’s therapist. I needed to let her know what was happening, and to cancel the next afternoon’s appointment.

Hospital Waiting Room

(Photo Source: Google Images)

I dared to wish for understanding and empathy from another adult who grasped the intensity, depth, and true severity of my daughter’s plight.

How grateful I was when she offered words of sympathy and encouragement. I was comforted by the fact that she wasn’t surprised by our current turn of events.

It helped me understand that I had not failed, that I was not incompetent and thus unable to keep my daughter safe at home. I was reassured to know that the professional who knew my daughter best agreed with my assessment and decision to call 911 and take her to the Emergency Room for a mental health evaluation.

My ex-husband had arrived and we began a long wait. I think we likely both felt a natural though unrealistic hope that now that we were here in the ER, now that she knew this wasn’t a joke and when you threaten suicide, adults take it seriously … now she would just come to her senses and stop with the crazy talk already. Unrealistic indeed.

 

© Monica Simpson and Help To Hope, 2013

Semantics

I directed my ex-husband up the stairs to our daughter’s bedroom. “Turn right at the top of the stairs and go straight back.”  When he went in to talk with her, my step-daughter came downstairs to allow them privacy.

It seemed like hours, but it wasn’t. I went up after a bit to see if he’d been able to calm her down as he’d seemed sure he could. Admittedly, I was frustrated that he’d mistrusted my assessment of the situation, that he’d inferred I was overreacting, that he’d assumed he could step in and fix it all.

And I was angry with myself, that I’d basically allowed him to talk me out of trusting my gut, to think that I’d been misreading the darkening situation of the past few months. I hadn’t. I knew my daughter’s threat of suicide was very real.

I also knew that there was no space in this situation for annoyances between ex-spouses. Thankfully, the urgency I felt helped focus my attention on my daughter and getting her the help she needed. There was no room for growing irritation, only for ensuring her safety.

After a while of leaving them time together and checking in two or three times, there was no improvement in my daughter’s demeanor. I picked up the phone to call 911. My ex-husband still didn’t like the idea, but I announced my intention and felt there was no need for further conversation. By this time he simply said, “Okay.”

911 2

(Photo Source: Google Images)

“Do you need lights and sirens?” The 911 dispatcher’s question took me by surprise.

“What? No. She’s traumatized enough; there is absolutely no need for lights or sirens screaming through the neighborhood. Please don’t use them.”

“Well, is she safe? Like, can she pull out a weapon quickly and hurt herself?”

“She hasn’t been allowed to be alone for four days. There is someone with her all the time, right next to her, and there will be until you get here. So no, she hasn’t hidden a weapon she can pull out to kill herself. But we need some help here. Fast.”

I hung up the phone as the first police car arrived. I willed my mind and body to be calm, though I don’t know how well they cooperated. It all becomes rather relative when armed police officers begin filing through your front door.

I was first explaining the situation to the police, next directing them up the stairs, then busy answering their questions alongside my ex-husband. I still don’t know why  they needed to have my work address that day, but I’m sure they had their reasons. And I’m sure I almost got the address right. Almost.

“There were seven of them, Mom.” My younger daughter told me this later, well after the fact. “There were?” “Yes. Seven really big cops. With guns. Walking up our stairs to her room. I counted.”

I don’t doubt this.

My heart breaks even now as I recall my younger daughter that awful afternoon. She was, in my mind anyway, somewhat glued to my step-daughter’s side. I was thankful she had that place of safety. I knew my step-daughter was a wise and compassionate woman who would care well for her younger step-sister while the rest of us worked to intervene on behalf the older.

If I close my eyes now I can still see my younger daughter back then, somehow smaller than her real self, trembling and weeping as she wondered what would happen next. She, too, had witnessed her sister’s decline, at least in part. I had tried hard to shield her from what I could, and I had succeeded in part. But only in part.

At that moment, the trauma was overwhelming and far too real for a young girl who had turned fourteen only a few weeks earlier. She was keenly aware of much that her sister was experiencing. And while their relationship had been justifiably unstable in the prior months, her awareness of the gravity of the situation still saddens me to this day.

It’s hard enough to be a young teen with no memory of your parents’ marriage, only the weekly trade-off of time between two homes; to have a strong memory of watching your step-father die and seeing the world as you know it come to a screeching halt. It’s hard going to new schools, making new friends, trying to figure out who you are and what life is all about in the often confusing teenage years.

Add to that the fact that your sister, often mistaken for your twin, has mental health issues that are literally driving her to destruction and in many ways holding your family hostage. What’s left to do except count the number of really big cops marching up the stairs to haul away your suicidal sibling?

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(Photo Source: Google Images)

In all fairness, the police officers were of average size. They just looked terrifyingly large. And they were not there to haul anyone away. They were there to intervene and save a life. But in the midst of such overwhelming dread, those things are just semantics, details that grow exponentially in a mind filled with fear.

I know this because in my mind’s eye, those seven men may as well have been giants.

 

© Monica Simpson and Help To Hope, 2013

Point of No Return

I don’t know that anything in particular set her off . It’s just that, in general, she wanted to die.

That President’s Day is a blur in a lot of ways, but in others it’s marked indelibly on my mind. Parenting books simply don’t prepare you for calling 911 on your suicidal child.

We drove home from church that Monday afternoon after my two daughters and I had had a family picture taken for the church directory. And while I’d wanted to do nothing for four days except throw up from the anxiety of keeping a suicide watch on my 15-year-old daughter, what I was feeling surely couldn’t compare to her struggles.

My step-daughter had so kindly agreed to stay a third and final night with us. Her young family was waiting patiently for her to get back home, while we were just trying to get through another afternoon alive. Literally.

My older daughter was still not allowed to be alone. She was under strict orders to be with someone 24/7. It was the compromise she and her therapist had come to the Friday before, a last-ditch option to keep her from being hospitalized on a “3 day”, a 72-hour mental health hold.

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(Photo Source: Google Images)

I had chosen to ignore the blaring voice in my head that had told me she should in fact go to the psych ward instead. I had chosen to take her home on Friday, even though I was more uncertain than certain that I could keep her safe.

For months I had watched depression, rage, and anxiety take the life from her eyes and replace it with a deep black void that defied definition. I had listened with fear and confusion as she told me that she hated to hear people tell her they loved her or supported her. She insisted this only made her feel more alone, more judged, more like a hate-filled failure who wanted to die.

I had bandaged her bloody arms, washed her blood-stained clothing, and tried to find any support or help from anyone I could.

It wasn’t working. I was afraid of her state of mind, afraid of what she would do.

I went up to her room late Monday afternoon, where her step-sister sat with her, and posed the questions I’d learned to ask on a semi-regular basis: Do you feel safe? Do you want to hurt yourself? Do you want to kill yourself?

“If you people would just leave me alone at all I would kill myself!” she screamed.

I’m sure there were a few other choice words thrown in, but the fact remained. Despite any and all interventions up to that point, despite a small respite of silly laughter only a couple of hours earlier, despite the availability of resources and people who loved and wanted to assist her, my daughter insisted that she wanted to die. And she was furious that we would not let her.

girl with noose

(Photo Source: Google Images)

She shrieked obscenities and hate in my direction that day, but more heartbreaking to me were the hate-filled accusations she hurled at her step-sister, who had known her for more than half her fifteen years. My step-daughter had loved and supported my children since meeting them, and she’d held them even more dearly since her father’s death less than two years earlier.

This fury was a sure sign that although my daughter was standing right in front of me, she was nowhere to be found.

The rage and darkness were palpable. Her threats and accusations hung in the air as the bottom dropped out of my world. This was the point of no return. At that moment, the tiniest shred of hope of keeping her safe within the walls of our home disappeared. I knew I had to call 911.

I decided that I would make a quick to call her dad first, as a courtesy. If the roles were reversed, I’d certainly want him to call me and let me know he was going to have an ambulance come for our daughter. It seemed the right thing to do.

“No, don’t do that. She’ll be okay. Just give her a chance to calm down,” he said. No matter how I’d tried, I had not seemed to be able to make him comprehend how she had been deteriorating the past months. She’d held herself together when she was with him, apparently, so to try to describe her increasing rages and despair to him had been a futile effort.

“She is not calming down. She’s getting worse as the day goes on. She has said outright that she wants us to leave her alone so that she can kill herself,” I insisted.

“Well, then I’ll come over and talk to her,” he replied, seemingly confident that I was mistaken in my assessment of the situation.

Not really knowing what to think, do, or feel anymore, frightened and too worn down on every side to say anything else, I responded with a resigned sigh. “Okay. Hurry.”

 

© Monica Simpson and Help To Hope, 2013

House Arrest

As we drove home from the therapist, my mind raced frantically. I was supposed to take both of my daughters to a weekend conference for teen girls, and the first session was to start in a matter of hours. Not only had my older daughter been placed on a 72-hour hold in her own home, I had been too.

This left my younger daughter lost in the shuffle once again. I ached so deeply for her, for all that she was losing and missing while I fought to keep her older sister alive. There was no way she could or should have to understand everything that was happening. But I also felt she should not have to have her life put on hold in deference to her sister’s struggles.

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(Photo Source: Google Images)

I made some calls so that my youngest would still be able to attend the weekend’s events. It was hard to ask for favors from friends who didn’t know our situation, and I didn’t want to dishonor my daughter by airing her dirty laundry for her, so to speak.

Additionally, I did not want to put my younger daughter in a position of having to explain or defend or even vilify her sister. (This brings up the subject of the stigma of shame surrounding mental health issues, which is another post for another time.)

Finally, I reached my step-son’s gracious and generous wife, who agreed to accompany my youngest to the event we’d all looked forward to. What a remarkable and kind woman she was and is, to willingly change her weekend plans so she could step in and help us in our deep need.

They did miss parts of the weekend, and it was difficult and sad for my younger daughter knowing what was going on back at home. Even so, how could a sibling not resent, at least in part, another whose life problems were growing to take over the whole family, leaving everyone and everything else in virtual and unpredictable ruin?

I learned quickly that when you have to keep watch on someone 24/7, you don’t get to shower. You don’t get to relax, much less get any decent sleep. And you have to take really fast bathroom breaks.

You don’t get a chance to let down and grieve the fact that the person you are keeping guard over would really rather be dead. You just keep going. You have no other choice.

By Saturday, the day after her therapist had set up the 24/7 arrangement to avoid a mental health hospitalization, my daughter was already tired of me and her anger had returned full force. She wanted to leave home to go see her father.

She had already tried to run away. We had gone outside at her request, just to get out of the house. As we stood on the driveway, she inched her way closer to the street, eyeing me defiantly as I asked her to please come back up the driveway closer to the house.

Finally she did a quick double take and began to sprint. I caught her quickly, and in full view of the neighbor across the street. I grabbed her around the waist, wrestling her back towards and part way up the driveway, as she railed and kicked, ending with a scream of, “I hate you, Mom!”

She then went limp as a rag doll, landing on the ground with my arms still around her. “Oh, honey, right now I hate you, too” was the only resigned response I could mutter, trying to hold back the tears. I hate so much that I said that.

Our bewildered neighbor, meanwhile, was in his garage, staring, power tools in hand, wondering what was going on with that house full of females across the street.

confused man

(Photo Source: Google Images)

I hauled my teenager up off the pavement where she had collapsed and took her back into the house. And I agreed wholeheartedly that it was a fine idea for her to spend a little time with her dad.

“I’ll have her back soon,” he said to me as he picked her up. “Oh, please,” I responded. “Take a little extra time. I would really love to just take a shower today.”  We had a preplanned family birthday dinner to attend that evening, and I was in need of a good scrubbing by then.

Clearly he had never been the lone officer on duty during a house arrest.

 

© 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.

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(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.

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(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.

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(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