MENTAL ILLNESS AND ITS CONSEQUENCES FOR A FAMILY

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
MENTAL ILLNESS AND ITS CONSEQUENCES FOR A FAMILY
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

Q. Four years ago my son had a nervous breakdown. He has since been diagnosed with bipolar disorder. His wife divorced him because he became physically abusive during an argument. They have a 5-year-old son, who has not been allowed to see his dad for the last three years, due to a restraining order by the mother, which included my grandson (although he has never been abused). My former daughter-in-law is financially stable and has a good lawyer, while my son is still barely able to support himself and cannot afford a lawyer.

My grandson is restless, angry and is already having problems in kindergarten. He can’t sit still and pay attention. He yells at his mother and does exactly what he wants to do, like going to bed at 9:30 on a school night. She loves him very much and wants him to have everything he wants in life. I feel her behavior is causing him to be insecure, and his actions are a call for help.

I tried to continue to be involved in his life, but have not seen him as much as I did (my husband as well) because his mother always makes it difficult by making excuses not to schedule visits — not enough notice, he’s going to a friend’s party, etc. I have told her how important it is to keep our relationship. She always says she understands and wants him to have a relationship with us, but does nothing to help us.

We have told her that we feel it’s vital to our grandson’s mental health that he see his father, and have offered to supervise any and all visits so our grandson would feel safe and be in a familiar setting. Nothing we say or do is working. We are sick about this and honestly feel the stress and heartache is wearing us down to the point that maybe we would all be better off if we gave in to her and stopped seeing him and stopped trying to reunite him and his father.

She says she doesn’t feel her son is safe with us (although when they were married he was with us at least once a week) and she says our son is too unstable and hasn’t changed enough that she wants him to see their son. I have told her he can’t change — this is a mental health problem that’s not going away (although he is getting help). I have told her all we want is for their son to have the best life possible, to be included as part of our family and to have a relationship with his father. She can’t see that her son is suffering silently and now overtly. What more can we do?

A. You are all suffering, and you’d all like it to stop. So you try to understand what is causing the pain and the problems. Inevitably, you end up blaming yourselves, and each other. But finding fault just leads to bitterness, misunderstanding and more pain. Deep down you all know that if anything is to blame, it is your son’s serious mental illness. That, of course, is no one’s fault.

If you could all forgive yourselves and each other, you might have a better chance of developing the kind of communication and teamwork that you know you all need. (When there are tough decisions to make that threaten to pit you against each other, a neutral third party such as a court appointed guardian ad litem for the child who would independently represent the child’s best interest might also help settle down the understandable tensions.)

Of course it would be best for your grandson for family ties to be preserved and strengthened, even while squarely facing whatever limits there must be to your son’s interactions with his son when he is unstable. Repairing your relationship with your ex-daughter-in-law will have to come first, before any hope of influencing your grandson’s life more directly.

You have been so strong and brave to face the realities of your son’s illness. No wonder you may need your own time to heal before you can understand his ex-wife’s reactions. Until then, see if you can hold off on attributing the child’s “bad” behavior to her parenting. She’s unlikely to feel that he’ll be safe with you as long as she has to worry that you are judging her critically, which may subtly undermine the authority she needs as a parent.

Of course the boy needs limits, and he may need more limits than he is getting. But the sadness and fear that sets in when a marriage ends often drains parents’ ability to tune into their children’s needs until they’ve had a chance to heal. Can you help her to heal as a critical first step to helping your grandson? She might feel that you could understand her side better if you could consider the possibility that her boy might be hard to handle for a number of reasons beyond late bedtimes and lack of limits.

How could he not be thrown off by his father’s violent behavior (even if it was never directed at him), the divorce and all of the family’s stormy feelings that have resulted? Or he might be showing early signs of threats to his own mental health, especially since these are sometimes transmitted genetically.

You sound big-hearted and generous, as if you can acknowledge his mother’s challenges. Can you take it a step further to let her know you can see and appreciate what she is doing right by her boy? She’s been violated and traumatized. So have you — by your son’s terrible illness. She’s lost her love, marriage and dreams for her future with her life’s partner.

You may feel that you’ve lost your son — at least temporarily — to the delusions and distortions of acute manic episodes. Are your feelings about this something you can share with her? Only once she believes that you understand what she’s been through, that you know she has the child’s best interests at heart, that you will support her as a parent rather than blame her, will she begin to feel safe enough with you herself to entrust your grandson to you.

We understand how close you feel to giving up, but we hope you won’t. We hope you have others in your family you can turn to so that you won’t have to turn away, and so that this little boy can have all the family he needs too. You sound like you have been such a critical support for your son — facing adversity together is the true test of family.


This article is not intended as a substitute for medical or psychiatric evaluation, diagnosis and treatment. Because of the rapid pace of research and new clinical findings, the information it contains is subject to change. If you are concerned about your child, consult your pediatrician, who can refer you to a mental health professional.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.

WHEN PARENTS DIVORCE

NEW YORK TIMES COLUMN:  FAMILIES TODAY:
WHEN PARENTS DIVORCE
By: T. Berry Brazelton, M.D., and Joshua Sparrow, M.D.

From TOUCHPOINTS: BIRTH TO THREE: YOUR CHILD’S EMOTIONAL AND BEHAVIORAL DEVELOPMENT, by T. Berry Brazelton, M.D., and Joshua D. Sparrow, M.D., published by Da Capo Press, a member of The Perseus Books Group.

Parents whose marriages seem to be failing have a major obligation to protect their children as much as they can, whether this means trying to work things out or deciding to divorce. This is a lot to ask of parents who are already overwhelmed with their own feelings.

In the aftermath of divorce, it is very hard for parents who may not only be angry, but also frightened, anxious and grieving the loss of their relationship, to focus on the needs of their children.

But there is no other choice. In the first years after a divorce, a child blames himself for his parents’ breakup and dreams of having his two parents to himself again, even though the original family may have been stressed and stressful. While everyone in the family suffers during a divorce, and during the first year or so that follows, the long-term effects of divorce vary depending on a wide range of protective and risk factors, including how parents handle the divorce and how well they recover from its immediate effects to become effective parents again. Over time, it turns out, many other individual characteristics of the child and parents, as well as life events, play a bigger role than a past divorce in a child’s well-being and healthy development.

As a result, there is no need to label the children of divorce with a self-fulfilling prophecy or to burden their parents with more guilt and anxiety than they may already feel.

The most serious harm to children is done by placing them in the middle of parents’ animosity – using them as a football. Angry parents all too readily take out their feelings on each other by using the child. That is sure to hurt the child. Her capacity to make solid relationships with other adults in the future is likely to be impaired by this insensitivity on the part of divorcing parents.

At first, children may continue to wish for the “old family.” They will feel deserted by the nonresident parent and will fear desertion by the resident parent, reasoning, “If one can leave me, why won’t the other?” Short-term separations become magnified in the child’s mind. Every time a parent leaves, the child must wonder, “Will she be gone for good? Will she remember to come back? Who will take care of me?” Or she may wonder, “Why does he leave me? Am I bad, and no one will want me?

Before every separation, parents must prepare a child as carefully as possible. After they return, they must say, “I missed you. Did you miss me? Remember I told you I’d be back at (such and such a time), and here I am. You worry, don’t you?” Then, the parent needs to be ready for the child’s feelings about being deserted. Every time the child has a chance to air them, the adult has a chance to demonstrate that desertion is not in the nature of all relationships.

The nonresident parent has a parallel responsibility. Visitation should be clear, dependable and on time. Even a 15-minute wait is an eternity for a small child. Visits from the absent parent offer reassurance about what he fears most – desertion.

A child takes everything personally. No matter how often she is told that a separation or a divorce is not her fault, she will continue to blame herself.

A child will fear that the reason the absent parent has gone is because he or she doesn’t love her, because she’s been “bad.” Later, children dare to put their fears into words: “I knew if I’d been a better kid, they’d never have split up.

Small children are less able to express it, but they also feel responsible for the split. Both parents must be ready to reiterate over and over and over: “We love you and we never wanted to leave you. We grown-ups couldn’t live together, but we both want to be with you. Nothing you do could ever change that for us.

A divorced parent must remember that demonstrating any animosity to the ex-spouse in the child’s presence will frighten her. She will take it personally. “If Dad and Mom can fight with each other, they can hate me, too. I must be a perfect child, or I’ll be in for it.”

Parents can help reassure a child that she needn’t try to be perfect. She may need constant reassurance about this, for she is likely to regress with the trauma of the divorce.

Most children regress in the area of the last achievement. If she has just become dry at night, she may begin to wet all over again. If she has been talking well before, she may begin to stutter. Her behavior may be either too good or too provocative. A sensitive parent will accept this and discuss it with the child so that she, too, understands it as normal and expectable. The usual limits should apply, however, and are more important than ever. Limits reassure the child that someone is still in control.

The presence of a sibling can lessen the fear of separation. Sibling relationships can become closer than they were before. Although rivalry will still surface, taking it too seriously can make relationships in the split-up family seem more fragile than they really are.

Grandparents, aunts, uncles and cousins can become important supports for children during and after a divorce. Not only can they give the child help in understanding the split-up, but they also fill her need for reliable, caring people who remain constant in her life.

Resident parents need to reconcile their own feelings about their in-laws in order to respect the child’s need for family. During a divorce, grandparents are likely to “spoil” the children in the family. They may let down all discipline. The resident parent may feel threatened by the lack of rules at Grandma’s. The child will use this: “Grandma gives me what I want. You’re mean and you don’t realize what I’m going through.

Since you are feeling pretty raw and deprived yourself, this criticism hits below the belt. You bristle. If these are your in-laws, you will feel even angrier at this undermining of your household rules.

If you can, discuss this with your in-laws. Ask them to back you up in your effort to support the child with firm rules and discipline. If relations are too tense for such discussions, simply tell the child, “Grandma does things her way at her house, we do them our way here.” Respectful discipline becomes a source of security.

Try not to overprotect the child. Let her make her own adjustment, and from time to time, point out how well she is doing. When a child can master the stress and change, she can take pride in this demonstration of her competence. Your continued love, respect and discipline can be shown without hovering.

AFTER THE DIVORCE, IF YOU BEGIN DATING

  • If you begin dating, be careful about introducing new people of the opposite sex to your children. Wait until you are pretty sure the child can rely on the relationship. A child of divorce will make new relationships with adults of the same gender as the missing parent all too easily, and she will be deeply disappointed if it doesn’t work.
  • When you do form a lasting relationship, point out that “friends” and stepparents are different from parents, but having two of each can be great.
  • Talk about the child’s fears of your desertion of her. Tell her that you aren’t going to leave her under any circumstance.
  • Find BOOKS about divorced families, or introduce your child to other children whose parents have gone through a divorce. These days, children of divorce are not a small minority, but it still helps a child going through one to know other children who are adjusting to divorce.

Responses to questions are not intended to constitute or to take the place of medical or psychiatric evaluation, diagnosis or treatment. If you have a question about your child’s health or well-being, consult your child’s health-care provider.

Dr. Brazelton, prior to his passing, was the founder and head of the Brazelton Touchpoints Center, which promotes and supports community initiatives that are collaborative, strength-based, prevention-focused sources of support for families raising children in our increasingly stressful world. Dr. Sparrow, a child psychiatrist, is currently the Director of the Brazelton Touchpoints Center. Learn more about the Center at www.touchpoints.org.

Reprinted with permission from the authors.