What residential treatment needs is a clear vision. The old ways of doing things are fading, but not fast enough. I’m referring to the behavior modification programs of yesteryear. Those well-intentioned but power-hungry programs and people who felt that they could impose their will on teens and call it “treatment”. There are still too many of them around
I’m calling for crystal-clear leadership! We need therapists, nurses, teachers and all levels of staff to embrace the truth: no one makes permanent positive change simply because we tell them to, incent them to do so, or punish them if they don’t. People change for other people.
Read that last sentence again.
We need treatment that respects the suffering individual. Who among us would berate or otherwise abuse, incent or punish a cancer patient? Why then do we tolerate those treatment centers who believe that bars belong on bedroom windows and contact with one’s family is a “privilege”?
It is time to be done with our excuses.
Let’s have the courage to build relationships with those we serve. Healthy, life-affirming relationships.
Today I spoke with a young woman who – not four months ago – harbored an extreme death wish. She and I were outside on the swings, side-by-side, swinging and talking in the crisp fall weather. We spoke for a long time about how far she’d come, about her new vigor for life and about her future plans. I pointed to the relationship we’d developed. A mutual friendship, full of life and joy and peace. Nothing weird, nothing sexual. Just the friendship of two people who have almost finished a difficult journey together. The healing she’d experienced, I told her, was in the process of building that relationship. “What is it about relationships,” I asked her, “that is so powerfully healing for you?” She thought for a minute then said, “When someone wants to be near me and works to build a relationship with me, well, that feels pretty good.”
Let’s start being honest with ourselves. Let’s simply answer this question:
How would I treat my own daughter/sister/friend?
After all, unless you’re a sadist, the answer to that question is sufficient to guide you toward more compassionate ways of dealing with those clients with whom we are privileged to work.
Photo by beaniebg17
I heard about TWLOHA last year. I was alerted to it by a student of mine who struggles with self-harm.
On Facebook there are over 315,000 people who have committed to being a part of TWLOHA Day, which takes place tomorrow, Feb. 12.
Tomorrow, let’s all help raise awareness of those who choose to deal with intense emotional pain by harming themselves. Let’s all help raise awareness of the reality of depression.
I spoke with a young woman yesterday who is beginning to find hope in the trusting, loving relationships she is building in her life. For the first time in three years, she sees the possibility of living a life without thoughts of suicide.
Another young woman slipped a notecard into my box at work a few weeks ago. Inside the card read, “Dustin, I haven’t cut for six months now. Thank you for talking to me and encouraging me to do hard things.”
Tomorrow, let’s go out of our way to reach out to those who are suffering silently. Healthy relationships are the best ways to begin healing self-loathing and depression.
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.
