I recall working with a young man who had undergone sexual trauma at the age of 4. He lived in a chaotic family with an aggressive, addicted father. There was little positives spoken to this young man. He had an extensive history of psychiatric hospitalizations. What I began to note was that within the hospital setting he was able to ‘conform’ and was discharged in only a few weeks, but problems would erupt again once sent home leading to further hospitalizations. In one instance, this young man stayed in the home of those outside his family. Though there remained some challenges, he appeared calmer and more able to communicate.
I recall a similar instance with another child. The step-father was abusive both verbally and physically. The mother often because of her own fear would ‘cover’ for the step-father’s actions. The child in one on one settings never created any disturbance.
However, his behaviors in the home were often ‘disturbing’. I was pleased that during my work with him he was not hospitalized at any point nor on psychiatric drugs. However, I was aware that he had a prior history of this many times over. In both of these situations, I saw the family dynamics as oppressive and detrimental and tried my best to help the children navigate through the challenges with the system doing little to collaborate in meeting these children’s needs.
In light of these two situations, and hearing of others from colleagues, I determined that it was the home, the family dynamics that was the catalyst for making these children ‘mad’. When apart from these dynamics, they were able to conform to the rules of the institutions because they were forced to do so. But really what were the psychiatrists accomplishing for them? They merely subdued them with drugs, forced their compliance, and returned them to the same oppressive environment which led to their being hospitalized in the first place. It became evident that the psychiatric establishment could really care less, for each admission added to their coffers. The family was pleased to create a scapegoat rather than addressing the core problem and to have a place to send the ‘disturbed child’ to so that they could continue in their own self-interest.
I recall two other clients that I collaborated with in therapy. One was an adolescent boy who I will refer to as Alan. Alan was seen by most as an obstinate young man who had completely departed from any sense of reality. His hallucinations had earned him the diagnosis of a psychotic disorder not to mention he frequently displayed
aggressive behavior. Reading the charts from before, it painted a monstrosity, but gave little detail to what Alan’s experience might have been. When I first encountered Alan, I did not demand that he speak to me or that he not speak to me. I made no demands. I solely informed him that I was a supportive person who wanted to know him for who he is. This opened the door to intense dialogues. Together we explored questions about life that we both may have never thought much on before. The topics would drift to purpose, impermanence, suffering, the human condition. He related to me the pain of years of abuse, how he felt dehumanized and humiliated by the various people he thought would help him. He told me of his feelings of being alone, of being nothing. This feeling of nothing for him was an end at the time, but really it was the beginning. It was the door for him to question life, to question what he had been taught, to become. He related to me about his hallucinations, and his imaginary friends became mine as well. I asked about their habits, and their words. I noticed that these beings he saw were him at various points in time. As I met each of these beings, I learned something a bit more about the experience of Alan. Gradually as his emotional needs were met and he began to see himself once again as a singular person in the present moment of time and space, these beings began to depart. I saw in Alan the resilient human spirit and I will not forget him.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.