Saturday, May 31, 2008


Thought I would share some more specific stories. For the sake of confidentiality, some of the below information can be considered a composite of more than one patient. How's that for a disclaimer?

Let's talk about "John." John was born to a mom/dad (although it's usually only the parent who is raising them who does this) who had some serious mental illness issues of her/his own. Mom/Dad continuously told him they wished he had never been born. Nothing he did was ever good enough. This changed when he hit puberty. Then the parent realized that he could be valuable to them. They would sexually abuse him in front of their friends (entertainment value?) and then let the friends do the same. The only time they ever praised him was during this abuse. He grew up thinking the only value he was to them (or anyone?) was sex based. He feels soiled and ashamed. Who can he tell? Everything hurts so much, he begins to drink and use whatever drugs he can find. Sometime during this period, he also begins to hear voices. Guess what? The voices are degrading too. Hello Schizoaffective Disorder/Schizophrenia/Schizotypal Personality Disorder (take your pick). More illegal drugs to drown out the voices. A life of crime (centered around getting more drugs) ensues.

Don't get me wrong here -- I never say that people can excuse their illegal drug use or criminal activities just because they had a bad childhood. That one doesn't work with me. But we have to admit, it doesn't make things any easier to do the right thing.

So the guy's in prison and not for the first time. The psychotropic drugs help with the voices/depression/visual hallucinations/hell that is mental illness, but they certainly don't make him normal. And through it all, he continues to ask himself, why didn't my mom/dad love me? What did I do wrong?

So even in prison, he self-mutilates. Releases the pressure of all the questions. He puts up with other prisoners asking questions about his self-inflicted scars. Make fun of him when they hear him talking back to the voices. Give him a hard time when he tries to get out of his cell to take his psyc meds. This in addition to the guards who point him out as a psyc patient and may deliberately prevent him from going to his psyc appt or getting the meds he needs to be close to normal -- just because they can.

Sometimes it seems like these folks never had a fighting chance. You just want to go back in time and help the child. Trying to heal the broken adult is an up-hill battle. Still, because they keep trying to heal, we keep trying to help them.

Friday, May 23, 2008

Perspective revisited

There are times when I feel that life is passing me by. And definitely times when I'm okay with that. But I see my patients whose lives really are in a holding pattern while they're incarcerated. Some have been in prison for 20 or even 30 years. They've never used a cordless or cell phone, never used a personal computer, or driven cars with all the fancy gadgets they now come with. Never had the fast food so many of us take for granted. Commercials on TV are the only link they have to the outside world - what's called the "free world" in prison. Some havenot held their loved ones in years, have missed their parents' last days on this planet (and their funerals), missed an opportunity for a career, and missed saving for retirement. They've not seen their children grow up or grandchildren be born. When they finally leave prison, the ones who WILL leave, of course, they'll start over from scratch. They'll be labeled an ex-con. With felonies, they'll never vote again, never be able to rent an apartment, may have great difficulties getting jobs or buying cars, and may find their entire families have died or moved away.

It's challenging for me to be their therapist. I can't really wrap my mind around how challenging it is to be in their shoes.

When all is said and done, no matter how hard I've worked, how many people I've made time to see or listen to or counsel, no matter how many lunches I've missed or stairs I've climbed - I go home every day. Home to my own car, my own apartment. I wear clothes I've chosen. I hold my baby. I shop for, cook, and eat food that I've chosen. I watch the TV channels I want to watch. I sleep in my own soft bed. I know I'm safe while I sleep.

I think that having led the life I have, I've always been grateful for my many blessings. These days, I feel my gratitude run so much deeper.