Book Text: Part I General Issues: Parenting the Mentally Ill Adolescent Wendla A. Schwartz, MD

 Part I
General Issues: Parenting the Mentally Ill Adolescent 

(cont'd from May 9th)

Wendla A. Schwartz, MD

2. Borrowed Creatures

Lisa and her daughter Courtney had been coming my office for many years. Lisa came to me for

therapy and medications and I had, over the years, seen her daughter intermittently for ADHD

treatment. Unfortunately Courtney rarely complied with treatment and at 18 was now finishing

high school and looking toward college. Sort of. One particular day, Lisa came in very distraught

because her daughter was "not applying" herself in any way. She was doing essentially nothing

in terms of worrying about improving her grades. She was minimally concerned with studying

for SAT's and had no particular interest in working with the expensive college counselor her

parents had chosen for her. Courtney had never been terribly interested in school. Generally a C

student, she preferred shopping and socializing and, for reasons that were a mystery to Lisa,

seemed unmotivated to work hard at school. Lisa was "mortified" and "ashamed" that her

daughter would not be attending a prestigious University (or maybe not to a four year college at

all) as would most of the other kids at her high school. Courtney did not really care. Lisa worried

about Courtney’s future. The teenager did not worry. Lisa felt she had failed as a mother because

of her daughters' lack of motivation in this area.

Lisa had become lost in the greatest delusion of parenthood. It is the DELUSION OF

CONTROL. Jennifer believed she could "DO" something that would control the outcome in this

situation. Not change the outcome, but really control the outcome to force it be what she

thought would be best for her daughter. Specifically, Lisa saw it as her duty to DO something

that would MAKE a specific outcome occur. She asked me "How can I make her more

motivated?” The answer, of course, is that one cannot make another person more motivated. One

cannot insert an agenda into another person. The idea that we have ultimate control over our children (or any other human being that is not us) should be abolished from our minds. We do

not. We do not have control once they are adults. Many parents can accept this. The reality is, we

never had it. Not when they were teens, not as grade schoolers, not even when they were babies.

Think, for example about the preposterous notion of deciding when an infant will urinate. Or

when they will eat. Really when they will eat. Not when you will feed them. That you can

decide. Whether they will eat is ultimately up to them. Similarly, with a teen, a parent can

provide tools, education, love, support, guidance. Whether that teen takes a particular action

(verbal or physical) is ALWAYS up to the teenager and NEVER up to the parent. We will revisit

the delusion of control later. It is a particularly appealing delusion for parents of mentally ill and

addicted teenagers because it offers the seductive notion that one can fix a desperate situation if

one just tries hard enough or thinks carefully enough or runs fast enough or some such nonsense.

For now, suffice it to say, the DELUSION OF CONTROL is just that: a delusion.

Why there exists such a DELUSION OF CONTROL has to do with the fact that we have

forgotten exactly what children are. Children are not possessions, like toys. They are not

purchases. We did not go to a store and buy them to take home and fiddle with until we are tired

of them. They are also not objects we created with our hands out of materials found or bought at

the store. Objects to be dressed up and manipulated and admired. No matter what we think about

where kids come from, we did not create them. We couldn't even begin to figure out how to do

that. We did not create them and we are not responsible for everything that has happened, is

happening or will happen in their lives. We are just not that powerful. Children are a mysterious

gift from somewhere or something else. During my residency, I delivered or assisted on the

delivery of dozens of babies. I also had three of my own. Still, I have no idea where they come

from. To me they remain a mysterious gift and not really a gift at that. They are more like a loan.

We are entrusted with the care of this precious creature for an extraordinarily brief time and then

we must let the creature go. If we are lucky we are given the privilege of continuing to care for

and love that creature for the rest of our lives but really it is only on loan to us. We do not own

the creature. The creature belongs to the Earth, the Universe, to whatever it is you believe in and

understand, but certainly not to us.

For many parents, discussing the idea of "Borrowed Creatures" is, at first, terrifying. How can I

let go of my child like that? If I am really only the short-term caretaker of this child then how is

what I do of any use? Why read this silly book? How can I not do everything in my power to

control the outcome for my child? Isn't that being irresponsible?

Fully accepting the idea that our children are borrowed and that we delude ourselves into

thinking we have any control takes time. It certainly does not mean we throw up our hands and

do nothing. On the contrary. It frees us to focus our energies on the types of actions over

which we really do have power. Although we do not have power or control over OTHER

people, places and things, we certainly do have power over ourselves. We can avoid

enabling negative and unhealthy behaviors in our kids, we can reward and support positive

behaviors, we can provide treatments, tools, education, guidance, and of course love.

However, in the end, we do not know what will happen. We cannot choose how or what our

child will do with the actions we take.

The key is not in not doing anything, it is in accepting the outcome of what we choose to do.

The Rules for Borrowed Creatures are:

1. If we did not create or cause it we cannot control it. And we did not create our kids (even if we think we did.)

2. The fact that we cannot ultimately control our children does not mean that we are relieved of responsibility related to them.

3. Our responsibility extends only to that which we have power over: ourselves. 

This text will be published in sections over the next several months on this blog in the hopes that it will provide ongoing support and information for families in need.

Wendla A. Schwartz, MD Board Certified Psychiatrist Child and Adolescent Psychiatrist and Psychopharmacologist