Photo by Jed Wells
Aspiro – a wilderness adventure therapy program for boys and girls – came to visit last week. I was impressed and pleased with their approach to their students. They made this comment during their presentation: “Because we take our students into more ‘public’ ares such as Arches National Park, we have been accused of only being able to treat ‘softer’ kids – kids who won’t run away.”
I was struck with how similar our approaches are, and how similar the criticisms levied against us were during our first five years in business. New Haven has been around for 15 years this month. In our first five years, much like Aspiro, we were refining a more relationship-based model of residential treatment for girls. (We were tired of working in places that just applied a boot-camp or behavioral model to the treatment of teen girls.) We were questioned repeatedly about being able to treat “harder” girls – but what our critics really were wondering is if we would be able to “contain” girls who didn’t want to be in treatment.
How ironic that, 15 years later, our model is the most copied by new startups in the world of private teen treatment for girls! “Relationship-based”, “family therapy”, and “values” – all terms which were never spoken together in 1995 – are now tired old buzzwords in our industry. Even though it means competition for us, I’m glad. Girls deserve better treatment.
Why is Aspiro able to take its students into public places? Why is New Haven able to operate on 31 acres without magnetized steel doors? It’s because our students realize quickly that we love them and want the best for them. What’s more, we won’t constrain, abuse, or coerce them into doing what is best for them.
The beauty of a relationship-based model is that “tough” kids CAN be treated. No, Aspiro and New Haven don’t take highly violent kids. But we do take the very ill family systems, the kids who have internalized their problems to the point of suicidality, and the kids who have failed treatment time and again.
All good therapy begins and ends with a strong therapeutic relationship.
Photo by Jaypeg21
We were huddled around a bonfire during a heat wave in July. Julie’s mother was holding an empty bottle of painkillers in her hand. She raised the bottle and held it over the flames. I had led scores of burning ceremonies for students over the years, but I’d never had a parent spontaneously participate before. Her eyes shone with tears but her voice was strong and clear. “I’m burning this because I finally have confidence that Julie will never attempt suicide again,” she said.
Julie wore only black clothing. She lied constantly about sexual abuse and cut on her forearms weekly. She had attempted suicide by overdosing on painkillers. That had been the final straw for her parents. They’d sent her to a wilderness program and then to New Haven. Julie was diagnosed with budding borderline personality disorder traits.
Psychologists do not agree upon what causes borderline traits in teens. I prefer a systemic view – both for its description of how personality disorder traits form and for the effective interventions it offers.
In therapy, Julie revealed that her father had been unfaithful to her mother and distant from the rest of the family during Julie’s formative years. Her father and mother had separated for a year when Julie was nine years old. Julie’s mother had contracted cancer during that same year. As a doctor, Dad was away from home for long periods of time. Yet even when he was home, he was emotionally distant and critical. Dealing with the fear of death caused by her cancer diagnosis, Mom would draw close to her children; bouts of depression, however, would make her emotionally unavailable. This family system was extremely difficult to navigate for an already overly sensitive, dramatic child like Julie.
One of the hallmarks of borderline personality traits is a fear of real or imagined abandonment. The result of living with this constant fear is a feeling of perpetual emptiness and what I call the “borderline drowning reflex”. Julie thrashed about emotionally, as if anchorless in a sea of abandonment. A string of poor relationships with boyfriends as she grew into adolescence further confirmed what she feared: everyone she loved would leave her eventually. She was unlovable and destined to be lonely her entire life. If that was the case, she reasoned, why not be done with it and end life now? If she left them before they left her, maybe it wouldn’t hurt so badly.
When Julie attempted suicide, she swallowed a large quantity of painkillers. Her mother found her and called the paramedics. When Julie’s father arrived, Julie was fighting with the paramedics who were attempting to strap her to a gurney so that they could remove the poison from her body. In an attempt to save his child, Julie’s dad removed the belt from his waist, looped it around one of her arms and tied her to the gurney. He would later tell me that the look in her eyes as he strapped her down with his own belt haunted him for months.
Throughout treatment, I attempted to create experiences for Julie and her family which would foster emotional communication and bond them to each other. It is very difficult for a young woman struggling with the fear of abandonment to feel connected. But when she participates in an emotionally powerful event – a shared experience with those most important to her – it is very difficult for her to deny that connection in the future. An experience is something that cannot easily be taken away or forgotten.
As an example, after months of treatment Julie, her parents, and I had gathered on a hot summer day in July to participate in a special ceremony designed to symbolize the cleansing of the past and to celebrate the beginning of a hopeful future. We lit a bonfire in the cherry orchard at the back of New Haven’s property and watched as Julie burned her black clothing, short skirts, CDs of depressing music, and the straight-edge razors with which she’d cut her skin. The symbols of her abandonment were consumed by the flames of the fire.
When Julie was finished, Julie’s mother unexpectedly held up an empty bottle of painkillers – the painkillers on which Julie had overdosed – and said she was burning it because she trusted that Julie would never again attempt to take her life.
When his wife had finished, Julie’s dad slowly removed the belt from around his waist, wound it around his fist then thrust it over the fire. He said that he was burning the “horror” of being forced to strap his oldest daughter to a gurney with his own belt. “I’m moving on,” he said, looking at Julie, “and I invite you to do the same.” Then he threw his belt into the burning cherry logs. Julie ran to embrace her father.
This was a hallmark event for Julie and her family. It was a powerful, positive bonding experience which could never be taken away from them because they had lived it – together. The burning ceremony and other therapeutic experiences like it addressed the issue of abandonment at the core of Julie’s borderline traits, and she completed her healing.
At a four year follow-up, Julie’s parents are happily married and Julie is successfully completing a bachelors degree.
